Current Medical Mycology最新文献

{"title":"A rare case of a nasal cavity fungus ball due to <i>Aspergillus niger</i>.","authors":"Emine Nur Kahraman,&nbsp;Şehrazat Evirgen,&nbsp;Ahmed Badri Abed,&nbsp;Safiye Elif Korcan,&nbsp;Cansu Gül Efeoğlu Koca","doi":"10.18502/cmm.8.3.11213","DOIUrl":"https://doi.org/10.18502/cmm.8.3.11213","url":null,"abstract":"<p><strong>Background and purpose: </strong>Fungus Ball (FB) is a non-invasive fungal infection caused mainly by <i>Aspergillus</i> species. It can occur after root canal treatments are applied to the teeth adjacent to the maxillary sinus. These balls are commonly seen in the paranasal sinuses and rarely observed in the nasal cavity. This report attempted in to highlight such a rare case of fungal infection which requires accurate observation. Moreover, it highlights the importance of careful microbiological and histopathological examinations that were combined with imaging and can lead to a definitive diagnosis.</p><p><strong>Case report: </strong>Herein, we report a rare case of a FB found in the vicinity of the nasal cavity of a 73-year-old male patient. Microbiological examination supported by radiographic and histopathological results indicated that the FB is due to <i>Aspergillus niger</i>. Excised surgery was done to the FB area, and the patient was referred to the post-operation room with the proper recommendations. After the wound healed, the total denture was performed as requested by the patient, and his overall oral health was improved.</p><p><strong>Conclusion: </strong>In this article, we report the first case of a rare FB in the vicinity of the nasal cavity of a 73-year-old male patient. The appropriate investigation is an essential step in the diagnostic process for these infections and requires effective communication and collaboration.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"8 3","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9297847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Candida auris</i> and COVID-19: A health threatening combination.","authors":"Shaghayegh Khojasteh,&nbsp;Jalal Jafarzdeh,&nbsp;Seyed Abdollah Hosseini,&nbsp;Iman Haghani,&nbsp;Habibollah Turki,&nbsp;Sanaz Aghaei Gharehbolagh,&nbsp;Mahdi Abastabar,&nbsp;Shahram Mahmoudi","doi":"10.18502/cmm.8.3.11211","DOIUrl":"https://doi.org/10.18502/cmm.8.3.11211","url":null,"abstract":"<p><p>Since its first emergence in December 2019, due to its fast distribution throughout the world, SARS-COV-2 become a global concern. With the extremely increased number of hospitalized patients, this situation provided a potential basis for the transmission of nosocomial infections. <i>Candida auris</i> is a multidrug-resistant pathogen with improved transmission dynamics and resistance traits. During the worldwide spread of COVID-19, cases or outbreaks of <i>C. auris</i> colonization or infection have been reported. Resistance to antifungal drugs has been observed in the causative agents of the majority of such cases. The focus in this review is on COVID-19-associated <i>C. auris</i> infections (case studies/outbreaks) and the pandemic's potential effect on antifungal drug resistance.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"8 3","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9297854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral <i>Candida</i> colonization and anti-fungal susceptibility pattern in patients with hematological malignancy.","authors":"Maryam Talebshoushtari Zadeh,&nbsp;Ensieh Lotfali,&nbsp;Mahsa Fattahi,&nbsp;Sara Abolgasemi","doi":"10.18502/cmm.8.3.11210","DOIUrl":"https://doi.org/10.18502/cmm.8.3.11210","url":null,"abstract":"<p><strong>Background and purpose: </strong>Candidiasis is regarded as one of the most important fungal infections and a cause of disease and mortality in patients with hematological malignancy. Accordingly, antifungal prophylaxis is of significant importance in this regard. This study aimed to identify the epidemiology of <i>Candida</i> colonization and evaluate its antifungal susceptibility pattern in patients with hematological malignancy.</p><p><strong>Materials and methods: </strong>In this study, the samples were collected from the oral cavity of 100 patients, and <i>Candida</i> colonization was confirmed by fungal culture. <i>Candida</i> strains were also identified by ITS-PCR. <i>In vitro</i> antifungal susceptibility tests against fluconazole, amphotericin B, and caspofungin were performed according to CLSI M60.</p><p><strong>Results: </strong>Demographic characteristics, comorbidities, distribution of <i>Candida</i> species (spp.), and antifungal susceptibility were analyzed in this study. The study participants included 100 patients with a mean age of 15.48%±48.74 years (age range: 17-84 years). Regarding gender distribution, the majority (64%) of the patients were male. In terms of the distribution of underlying hematologic malignancy, 27% of the cases had lymphoma. The most commonly isolated species among patients were <i>C. albicans</i> complex (49%; n=49), <i>C. glabrata</i> (39%; n=39), and co-colonization of <i>C. albicans</i> complex and <i>C.</i> with <i>C. glabrata</i> (10%; n=10). The overall resistance of <i>C. albicans</i> complex was 5% to fluconazole (n=5) and 2% to amphotericin B (n=2). Furthermore, <i>C. glabrata</i> showed 11% (n=11) resistance to fluconazole and was susceptible to amphotericin B. All <i>Candida</i> spp. isolated from patients who were susceptible to caspofungin.</p><p><strong>Conclusion: </strong>The high rate of colonization of <i>Candida</i> spp., especially the significant increase in the frequency of <i>C. glabrata</i> in patients with blood malignancies and the gradual increase in resistance to fluconazole, necessitate a change in the use of antifungal drugs for the prevention and experimental treatment of hematological malignancy.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"8 3","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9297852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of molecular resistance to azole and echinocandin in <i>Candida</i> species in patients with vulvovaginal candidiasis.","authors":"Ensieh Lotfali,&nbsp;Mahzad Erami,&nbsp;Mahsa Fattahi,&nbsp;Houshang Nemati,&nbsp;Zeinab Ghasemi,&nbsp;Elham Mahdavi","doi":"10.18502/cmm.8.2.10326","DOIUrl":"https://doi.org/10.18502/cmm.8.2.10326","url":null,"abstract":"<p><strong>Background and purpose: </strong>Vulvovaginal candidiasis (VVC) is considered the most common mucosal infection caused by <i>Candida</i> species. Azoles were considered the first-line treatment for VVC or recurrent vulvovaginal candidiasis (RVVC) in both healthy and immunocompromised populations. Recently, azole-resistant isolates, especially among non-<i>albicans</i> <i>Candida</i> samples have been encountered. This study aimed to evaluate the antifungal susceptibility profile of <i>Candida</i> spp. isolated from VVC or RVVC patients and assess the molecular resistance mechanism of <i>Candida</i> spp. to azole and echinocandin.</p><p><strong>Materials and methods: </strong>Point mutation analysis was performed on the <i>ERG11</i> and <i>FKS</i> candidate genes of azole- and caspofungin-resistant <i>Candida albicans</i> and <i>Candida glabrata</i> isolates. Real-time polymerase chain reaction was performed to gain insight into the differential expression of <i>ERG11</i> mRNA.</p><p><strong>Results: </strong>Variations in the amino acid D116E were observed in fluconazole- and itraconazole-resistant <i>C. albicans</i> strains, and changes in amino acid E517Q were observed only in fluconazole-resistant <i>C. albicans</i> strains. No polymorphisms were observed in the complete sequence alignment of the <i>ERG11</i> gene in one azole-resistant <i>C. glabrata</i> isolate. The mutation triggered the changes in the amino acid serine in the reference gene <i>FKS1</i> by the leucine at position 642 (S642L) of the isolates.</p><p><strong>Conclusion: </strong>In patients with persistent or recurrent infection, the choice of an antifungal agent is often challenging and requires monitoring of the antifungal susceptibility of the colonizing strain. <i>C. albicans</i> and <i>C. glabrata</i> isolates can be resistant to azole and caspofungin antifungal agents without mutations in the <i>ERG 11</i> and <i>HS1</i> regions of the <i>FKS1</i> gene.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"8 2","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10604167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study on the production of extracellular hydrolytic enzymes of <i>C. albicans</i> and non-<i>albicans Candida</i> species isolated from HIV⁺/AIDS patients and healthy individuals.","authors":"Fatemeh Fathi,&nbsp;Ali Zarei Mahmoudabadi,&nbsp;Mahnaz Fatahinia","doi":"10.18502/cmm.8.2.10330","DOIUrl":"https://doi.org/10.18502/cmm.8.2.10330","url":null,"abstract":"<p><strong>Background and purpose: </strong>Oropharyngeal candidiasis is the most prevalent opportunistic fungal infection in patients with human immunodeficiency virus (HIV) as well as other immunodeficiency disorders, which is caused by various <i>Candida</i> species, mostly <i>Candida albicans</i>. Studies have shown that <i>Candida</i> isolates differ in their pathogenicity. These variations are attributed to virulence factors, host characteristics, and the target tissue. This study aimed to determine and compare the secretion of hydrolytic enzymes in <i>C. albicans</i> and non-<i>albicans Candida</i> species isolated from HIV⁺/AIDS patients and healthy individuals.</p><p><strong>Materials and methods: </strong>Samples were taken from 201 patients with HIV and 118 healthy individuals. The samples were identified by macroscopic, phenotypic, and molecular methods, and virulence factors were subsequently measured. Statistical differences in enzymatic activity of various <i>Candida</i> isolates were calculated (<i>P</i><0.0001).</p><p><strong>Results: </strong>In total, 95 samples (47.20%) from patients and 46 samples (38.90%) from healthy individuals were positive for the growth of different Candida species. There were 39 (41.10%) and 36 (78.30%) <i>C. albicans</i> in patients and healthy individuals, respectively, as well as 56 (58.90%) and 10 (21.70%) non-<i>albicans</i> species in patients and healthy subjects, respectively. All the enzymes produced by <i>Candida</i> species enzymes were at low, medium, and high levels. Hemolysin activity in <i>Candida</i> species isolated from patients was significantly higher, compared to healthy individuals. Moreover, the activity of all <i>C. albicans</i> enzymes in patients was significantly higher than other <i>Candida</i> species.</p><p><strong>Conclusion: </strong>The <i>C. albicans</i> isolated from HIV-positive individuals secreted higher amounts of exoenzymes, and can cause oropharyngeal candidiasis and become a source of candidiasis for the host.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"8 2","pages":"32-39"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9114843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High frequency of <i>Candida krusei</i> colonization in critically ill pediatrics: A cross-sectional study in children's medical center, Tehran, Iran.","authors":"Amirhossein Davari,&nbsp;Jalal Jafarzadeh,&nbsp;Mohammad Taghi Hedayati,&nbsp;Tahereh Shokohi,&nbsp;Mahdi Abastabar,&nbsp;Bahram Nikmanesh,&nbsp;Maryam Moazeni","doi":"10.18502/cmm.8.2.10329","DOIUrl":"https://doi.org/10.18502/cmm.8.2.10329","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study aimed to evaluate the species distribution and susceptibility pattern of the strains isolated from Candida colonization in pediatric patients staying at pediatric intensive care unit (ICU) and infant ICU of Children's Medical Center in Tehran, Iran.</p><p><strong>Materials and methods: </strong>This study was conducted in the Children's Medical Center in Tehran, Iran. In total, 440 samples from 56 patients with oral cavity, skin surrounded catheters, and ear, throat, nasal, and urine cultures were collected. All patients were evaluated in terms of <i>Candida</i> colonization on the admission day as well as the days 7, 14, and 28 according to the previous studies. CHROMagar <i>Candida</i> medium was applied for primary/multiple species identification and the isolates were identified by using polymerase chain reaction-based methods to the species-specific complex level. The antifungal susceptibility test was performed according to the Clinical and Laboratory Standards protocol published as M27-A3 and M60 documents.</p><p><strong>Results: </strong>In total, 136 yeast samples from 26 individuals (30.9%) out of 440 samples were considered colonization. The most prevalent species in IICU was <i>C. albicans</i> (27%, n=20) followed by <i>C. krusei</i> (24 %, n=18) and <i>C. parapsilosis</i> (16%, n=12). In PICU, the predominant species was <i>C. krusei</i> (40%, n=24) followed by <i>C. parapsilosis</i> (18%, n=11) and <i>C. dubliniensis</i> (16%, n=10). Among the 40 tested isolates from both units, fluconazole-resistant isolates (n=11, 8.15%) were determined according to the new breakpoints. In the case of echinocandins, 2 isolates, including C. albicans (n=1) and C. krusei (n=1) were resistant against both caspofungin and anidulafungin (totally 1.48%).</p><p><strong>Conclusion: </strong>In the present study, since <i>C. krusei</i> is intrinsically-resistance against fluconazole, emphasizing the importance of species-level identification of <i>Candida</i> isolates is outstanding. However, according to the antifungal susceptibility testing results, only 7.2% of the strains were resistant to fluconazole. It would be beneficial to monitor the ICU patients who are at high risk of invasive <i>Candida</i> infection.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"8 2","pages":"25-31"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10604164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-antifungal effect of the combination of anidulafungin with amphotericin B and fluconazole against fluconazole-susceptible and -resistant <i>Candida albicans</i>.","authors":"Narges Vaseghi,&nbsp;Majid Piramoon,&nbsp;Shaghayegh Khojasteh,&nbsp;Kiana Abbasi,&nbsp;Sahar Mohseni,&nbsp;Javad Javidnia,&nbsp;Behrooz Naghili,&nbsp;Narges Aslani","doi":"10.18502/cmm.8.2.10327","DOIUrl":"https://doi.org/10.18502/cmm.8.2.10327","url":null,"abstract":"<p><strong>Background and purpose: </strong>Invasive candidiasis is a life-threatening condition that kills a large number of immunocompromised patients each year worldwide. We used post-antifungal effect studies to analyze the activities of anidulafungin (AFG), as a clinically crucial antifungal drug, amphotericin B (AMB), and fluconazole (alone and in combinations) against FLC-susceptible and -resistant <i>Candida albicans</i> (<i>C. albicans</i>) isolates obtained from the cancer patients.</p><p><strong>Materials and methods: </strong>We tested the phenomenon of post antifungal effects of FLC, AMB, AFG, and combinations of FLC+AFG, AFG+AMB, and FLC+AMB against 17 <i>C. albicans</i> isolates obtained from the oral cavity of cancer patients. Isolates that had not been exposed to antifungals, served as a control group. Colony counts were performed at 0, 2, 4, 6, and 24 h after a brief (1 h) exposure to antifungal.</p><p><strong>Results: </strong>The FLC had no detectable post-antifungal effect independent of antifungal concentration and resembled drug-free FLC (control). Significant variations in the post-antifungal effect were observed when all AMB and AFG were compared to FLC. The combination of AFG and AMB with FLC resulted in effective activity compared to FLC alone. Combination regimens were rated as indifferent in general. Interestingly, low dosages of the AFG displayed increasing fungistatic action as it approached a fungistatic endpoint against <i>C. albicans</i> isolates (n=17).</p><p><strong>Conclusion: </strong>Our findings suggested that brief exposure to AFG, in combination with FLC and AMB, at low concentrations of the medicines utilized, could be effective in the evaluation and optimization of new dosage regimens to manage candidiasis. However, future studies will determine the clinical utility of our findings.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"8 2","pages":"8-15"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10604166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous cryptococcal infection: Initial manifestation of acquired T-cell immunodeficiency due to malignant thymoma.","authors":"Timothy McCann,&nbsp;Anar S Patel,&nbsp;Neha Patel D,&nbsp;Deepali B Sharath,&nbsp;Borna Mansouri,&nbsp;Cynthia Contreras","doi":"10.18502/CMM.8.2.10334","DOIUrl":"https://doi.org/10.18502/CMM.8.2.10334","url":null,"abstract":"<p><strong>Background and purpose: </strong>Cryptococcosis is a known opportunistic infection. Thymomas are known to cause immune dysregulation. We describe an atypical case of cutaneous cryptococcosis in a patient with acquired T cell immunodeficiency that has been found to be secondary to a type B3 thymoma with progression to carcinoma.</p><p><strong>Case report: </strong>A 63-year-old male presented with a chronic skin lesion confirmed as <i>Cryptococcus neoformans</i> on biopsy and an incidental mediastinal mass found during infectious work-up for the notable cluster of differentiation 4 (CD4)+ lymphopenia. This led to the diagnosis of a type B3 thymoma requiring resection. The cryptococcal lesion was treated successfully with azole therapy.</p><p><strong>Conclusion: </strong><i>C. neoformans</i> is an opportunistic infection rarely associated with isolated T cell immunodeficiency due to thymomas. A multidisciplinary approach and understanding of the pathogenicity of <i>cryptococcus</i> and the immunological effect of thymic dysfunction are paramount to diagnosis and treatment.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"8 2","pages":"55-58"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9100297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary tuberculosis and rhinosinus mucormycosis co-infection in a diabetic patient.","authors":"Shiva Shabani,&nbsp;Payam Tabarsi,&nbsp;Golnaz Afzal","doi":"10.18502/cmm.8.2.10332","DOIUrl":"https://doi.org/10.18502/cmm.8.2.10332","url":null,"abstract":"<p><strong>Background and purpose: </strong>Diabetes and immunosuppressive diseases have been reported as increased risk factors for developing invasive pulmonary tuberculosis and mucormycosis.</p><p><strong>Case report: </strong>We presented here a case of a 55-year-old uncontrolled diabetic male with rhinosinus mucormycosis and pulmonary TB coinfection. Maxillary and ethmoid sinus involvement was observed in paranasal computed tomography. His chest computed tomography showed tree in the bud sign and cavitary lesions in the lungs. <i>Mycobacterium tuberculosis</i> was confirmed through molecular diagnosis using a real-time polymerase chain reaction assay. The nasal cavity biopsy revealed the fungal elements (aseptate hyphae) and confirmed mucormycosis infection. Amphotericin B liposomal, teicoplanin, and tazobactam were administered to treat the mucormycosis. The patient was successfully treated with a recommended four-drug regimen for TB without any adverse reaction.</p><p><strong>Conclusion: </strong>The clinicians must consider tuberculosis and mucormycosis tests when confronted with an uncontrolled diabetic patient with clinical symptoms of hemoptysis, fever, and cavitary lesions.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"8 2","pages":"45-48"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10604163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive pulmonary aspergillosis in critically ill patients with pneumonia due to COVID-19, influenza, and community-acquired pneumonia: A prospective observational study.","authors":"Syed Ahsan Ali,&nbsp;Kausar Jabeen,&nbsp;Joveria Farooqi,&nbsp;Hammad Niamatullah,&nbsp;Aisha Fareed Siddiqui,&nbsp;Safia Awan,&nbsp;Alishah Akbar,&nbsp;Muhammad Irfan","doi":"10.18502/cmm.8.2.10328","DOIUrl":"https://doi.org/10.18502/cmm.8.2.10328","url":null,"abstract":"<p><strong>Background and purpose: </strong>Influenza A and SARS-CoV-2 are risk factors for invasive pulmonary aspergillosis. Both influenza-associated pulmonary aspergillosis and COVID-19-associated pulmonary aspergillosis result in high mortality and poor clinical outcomes. No prospective study has so far compared the features, treatment, and outcomes of influenza-associated pulmonary aspergillosis and COVID-19-associated pulmonary aspergillosis within a similar time frame. Therefore, this study aimed to determine the frequency, risk factors, and outcomes of invasive pulmonary aspergillosis in critically ill patients with influenza, COVID-19, and community-acquired pneumonia.</p><p><strong>Materials and methods: </strong>This prospective study included adult patients with pneumonia and was conducted at The Aga Khan University Hospital in Karachi, Pakistan. Patients were divided into three groups, including community-acquired pneumonia, influenza pneumonia, and COVID-19 pneumonia. The data collected included information on demographic characteristics, comorbidities, clinical features, laboratory results, treatment, and outcomes.</p><p><strong>Results: </strong>A total of 140 patients were included in this study. These included 35 (25%), 70 (50%), and 35 (25%) patients with community-acquired pneumonia, influenza pneumonia, and COVID-19 pneumonia, respectively. In addition, 20 (14.2%) patients were found to have invasive aspergillosis, of whom 10/35 (28.5%), 9/70 (12.8%), and 1/35 (2.8%) patients were in the COVID-19, influenza, and community-acquired pneumonia groups, respectively. Moreover, nine (90%) COVID-19-associated pulmonary aspergillosis patients required vasopressors, compared to three (33%) patients with influenza-associated pulmonary aspergillosis (<i>P=0.020</i>). In total, seven (70%) COVID-19-associated pulmonary aspergillosis patients required invasive mechanical ventilation compared to four (44%) influenza-associated pulmonary aspergillosis patients (<i>P=0.37</i>). The mean±SD length of hospital stay was highest in the COVID-19-associated pulmonary aspergillosis patients (18.3±7.28 days) compared to influenza-associated pulmonary aspergillosis patients (11.7±5.34 days) (<i>P=0.036</i>). The number of deaths in influenza-associated pulmonary aspergillosis and COVID-19-associated pulmonary aspergillosis patients was three (33.3%) and five (50%), respectively (<i>P=0.526</i>).</p><p><strong>Conclusion: </strong>A higher proportion of patients with COVID-19 developed invasive aspergillosis compared to those with influenza. Although the mortality rate in COVID-19-associated pulmonary aspergillosis was comparable to that in influenza-associated pulmonary aspergillosis patients, COVID-19-associated pulmonary aspergillosis patients had a significantly longer stay in the hospital.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"8 2","pages":"16-24"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10604168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}