Diagnostic microbiology and infectious disease最新文献

{"title":"Mass spectrometry over biochemistry: MALDI-TOF MS identifies roseomonas mucosa as the cause of cervical osteomyelitis—A case report","authors":"Moath Fateh ,&nbsp;Ahmad Abdulraheem ,&nbsp;Glenn W. Wortmann ,&nbsp;Nelson Martinez Balarezo ,&nbsp;Christian woods","doi":"10.1016/j.diagmicrobio.2025.117016","DOIUrl":"10.1016/j.diagmicrobio.2025.117016","url":null,"abstract":"<div><div>The microbial world encompasses a vast array of organisms, many of which remain poorly understood, yet possess the capacity to cause significant disease in humans. <em>Roseomonas</em> species, originally described in 1993 by Rihs et al., are amongst the less frequently encountered bacteria that can be pathogenic to humans. They are slow-growing, Gram-negative coccobacilli that predominantly cause disease in immunocompromised individuals. We report a rare case of vertebral osteomyelitis and cervical epidural abscess due to <em>Roseomonas mucosa</em> infection in a 50-year-old woman, who initially presented with neck pain and weakness. Treatment generally requires surgical drainage, followed by a prolonged course of targeted antibiotics. Since the discovery of this bacterium, only two cases of vertebral osteomyelitis secondary to <em>Roseomonas mucosa</em> have been reported in the literature. To our knowledge, this is the first reported case of cervical osteomyelitis due to <em>Roseomonas mucosa.</em></div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117016"},"PeriodicalIF":2.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delafloxacin and levofloxacin activities on Helicobacter pylori in Bulgaria over four years","authors":"Lyudmila Boyanova ,&nbsp;Victor Kamburov ,&nbsp;Nayden Kandilarov ,&nbsp;Nikolay Katsarov ,&nbsp;Petyo Hadzhiyski ,&nbsp;Liliya Yordanova Boyanova ,&nbsp;José Medeiros ,&nbsp;Raina Gergova ,&nbsp;Galina Gergova ,&nbsp;Rumyana Markovska","doi":"10.1016/j.diagmicrobio.2025.117012","DOIUrl":"10.1016/j.diagmicrobio.2025.117012","url":null,"abstract":"<div><div>Delafloxacin is a potent 4th-generation fluoroquinolone with enhanced activity in acidic environments. However, recently, delafloxacin resistance in facultative anaerobic species has been reported. Thus, we examined levofloxacin and delafloxacin susceptibility of 98 <em>Helicobacter pylori</em> strains in 2020-2023. Minimum inhibitory concentrations (MICs) were detected with E tests. Levofloxacin resistance was 33.7%, while delafloxacin resistance was 2.0% at 1 mg/l (the levofloxacin resistance breakpoint for <em>H. pylori</em>), and 9.2% at 0.125 mg/l (the recently suggested delafloxacin ECOFF for the species). Overall proportion of the strains exhibiting &gt;0.125 mg/l delafloxacin MICs was similar to that in the previous study in 2018-2019 (8.5%). None of the 65 levofloxacin susceptible strains had delafloxacin MICs of &gt;0.125 mg/l. Among levofloxacin resistant strains, delafloxacin MICs &gt;1 mg/l (6.1%, 2/33 strains) were detected only in 2022 and 2023. Briefly, the results showed the much higher activity of delafloxacin over levofloxacin. The high delafloxacin activity in acidic environments is an additional advantage of the newer fluoroquinolone for treating <em>H. pylori</em> infection. Given that fluoroquinolone-based eradication regimens can be used as a second- or third-line therapy for <em>H. pylori</em>, testing the susceptibility of levofloxacin-resistant strains to delafloxacin could provide a useful option for eradication of the frequent and potentially carcinogenic bacteria. New regimens, such as the combination of vonoprazan with delafloxacin and another antibiotic deserve investigation.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117012"},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polymorphisms of the CYP2D6 gene and its relationship with Plasmodium vivax relapses after chloroquine-primaquine treatment in Turbo, Colombia","authors":"Veronica Sierra-Cifuentes ,&nbsp;Lina Zuluaga-Idárraga ,&nbsp;Daniel Aguirre-Acevedo ,&nbsp;Maria Carolina Silva de Barros Puça ,&nbsp;Tais Nobrega de Sousa ,&nbsp;Tatiana M. Lopera-Mesa","doi":"10.1016/j.diagmicrobio.2025.117013","DOIUrl":"10.1016/j.diagmicrobio.2025.117013","url":null,"abstract":"<div><h3>Background</h3><div><em>Plasmodium vivax</em> relapse due to hypnozoites represents a significant mechanism for parasite persistence in the population. Primaquine (PQ), the drug of choice for eliminating hypnozoites, requires metabolic activation by Cytochrome P450-2D6 (CYP2D6). Genetic variations in <em>CYP2D6</em> can alter PQ metabolism, potentially increasing the risk of relapses. This study aimed to determine <em>CYP2D6</em> polymorphisms in subjects with <em>Plasmodium vivax</em> under supervised chloroquine-primaquine treatment and explore their association with relapses and PQ plasma levels.</div></div><div><h3>Methods</h3><div><em>CYP2D6</em> phenotypes and genotypes were successfully determined for 71 out of 78 patients included in the study. Nine polymorphisms (SNPs and indels) and gene copy number variation were analyzed. The association between the <em>CYP2D6</em> phenotype, <em>P. vivax</em> relapse over six months follow-up, and PQ plasma levels were explored.</div></div><div><h3>Results</h3><div>Most diplotypes (81.7 %) were associated with normal (gNM-F) and ultrarapid (gUM) CYP2D6 metabolizers, while 18.3 % were associated with poor (gPM) and intermediate (gIM and gNM-S) metabolizers. The median plasma PQ concentration on day 2 was higher in impaired CYP2D6 activity group (poor/intermediate) compared normal metabolizers (normal/ultrarapid) (660.4 ng/ml vs 313.5 ng/ml; effect size r -0.51, 95 % CI -0.82 to 0.03). No significant difference was found in the hazard ratio (HR) of relapse between impaired and normal CYP2D6 activity (adjusted HR: 1.45; 95 % CI: 0.39–5.39).</div></div><div><h3>Conclusion</h3><div>Impaired <em>CYP2D6</em> activity phenotypes were frequent in individuals infected with <em>P. vivax</em> from an endemic region of Colombia. Further research is essential to elucidate the relationship between these phenotypes and <em>P. vivax</em> relapses, as suggested by this exploratory study.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117013"},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital transmission of Chagas disease: current status and control strategies","authors":"Christian Tague","doi":"10.1016/j.diagmicrobio.2025.117015","DOIUrl":"10.1016/j.diagmicrobio.2025.117015","url":null,"abstract":"","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117015"},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of thermostabilized “ready-to-use” multiplex PCR assay for the rapid detection and distinction between Mycobacterium tuberculosis complex members and non-tuberculous mycobacteria","authors":"Abdah Karimah Che Md Nor ,&nbsp;Marimuthu Citartan ,&nbsp;Lee Li Pin ,&nbsp;Ravichandran Manickam ,&nbsp;Zainul F. Zainuddin ,&nbsp;Thean-Hock Tang","doi":"10.1016/j.diagmicrobio.2025.117010","DOIUrl":"10.1016/j.diagmicrobio.2025.117010","url":null,"abstract":"<div><div>Tuberculosis (TB) is a worldwide health problem with significant morbidity and mortality. Current diagnosis of mycobacterial infections is largely based on clinical features, microscopy and culture. However, these methods can be time consuming, lack sensitivity and specificity. Therefore, rapid detection of both <em>M. tuberculosis</em> and NTM are highly desirable. Multiplex PCR assay, which is able to differentiate <em>M. tuberculosis</em> and NTM in clinical samples was developed in this study. It is based on the detection of both genus (targeting genes encoding 65-kD heat shock protein and <em>dnaJ</em> protein which are highly conserved in mycobacteria species) and species (targeting IS<em>6110</em> and B<em>9</em> genes which are only present in <em>M. tuberculosis</em> complex). The sensitivity and specificity of the multiplex PCR assay were 97.7 % and 100 %, respectively. This multiplex PCR assay has the potential to be used as a rapid diagnostic tool to detect and differentiate <em>M. tuberculosis</em> and NTM.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117010"},"PeriodicalIF":2.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surveillance of multidrug resistant methicillin-resistant and Panton-Valentine leukocidin positive Staphylococcus aureus in healthy carriers in Lambaréné, Gabon","authors":"Christiane Sidonie Gouleu ,&nbsp;Tobias Grebe ,&nbsp;Guy Arnault Rogue Mfoumbi Ibinda ,&nbsp;Viktoria Rudolf ,&nbsp;Bayode Romeo Adegbite ,&nbsp;Jean Ulrich Muandze-Nzambe ,&nbsp;Marina H. Biteghe Nsole ,&nbsp;Augustin B. Boueya ,&nbsp;Bertrand Lell ,&nbsp;Matthew Benjamin Bransby McCall ,&nbsp;Peter Gottfried Kremsner ,&nbsp;Abraham Sunday Alabi ,&nbsp;Frieder Schaumburg ,&nbsp;Ayola Akim Adegnika","doi":"10.1016/j.diagmicrobio.2025.117009","DOIUrl":"10.1016/j.diagmicrobio.2025.117009","url":null,"abstract":"<div><div>We assessed the prevalence of methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) colonization in humans from both hospital and community settings in Gabon. The rate of MRSA was 18 % with no significant difference between healthcare and community members. We observed a remarkedly high prevalence of PVL (42 %) and MDR (83 %) among MRSA isolates.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117009"},"PeriodicalIF":2.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of imipenem-relebactam, meropenem-vaborbactam, aztreonam-avibactam and cefepime-zidebactam activities on a wide collection of French clinical Enterobacterales isolates","authors":"Camille Petillon ,&nbsp;Mauli Ululuipalelei ,&nbsp;Racha Beyrouthy ,&nbsp;Simon Proust ,&nbsp;Nejla Aissa ,&nbsp;Laurent Bret ,&nbsp;Nathalie Brieu ,&nbsp;Anne Carricajo ,&nbsp;Vincent Cattoir ,&nbsp;Olivier Dauwalder ,&nbsp;Nicolas Degand ,&nbsp;Laurent Dortet ,&nbsp;Florence Doucet-Populaire ,&nbsp;Véronique Dubois ,&nbsp;Antoine Grillon ,&nbsp;François Guérin ,&nbsp;Philippe Lanotte ,&nbsp;Nadine Lemaitre ,&nbsp;David Leyssene ,&nbsp;Catherine Neuwirth ,&nbsp;Frédéric Robin","doi":"10.1016/j.diagmicrobio.2025.117011","DOIUrl":"10.1016/j.diagmicrobio.2025.117011","url":null,"abstract":"<div><div>In recent years, novel β-lactam-inhibitor combinations (imipenem-relebactam (I/R), meropenem-vaborbactam (M/V), aztreonam-avibactam (A/A)) have been commercialized and some are not yet on the market (cefepime-zidebactam (C/Z)). The objective of this study was to evaluate the efficacy of these β-lactam-β-lactamase inhibitors (BL/BLIs) combinations against a wide collection of French clinical multiresistant <em>Enterobacterales</em> isolates and to assess the performance of the E-test MIC method for I/R and M/V.</div><div>BL/BLIs MICs were determined by broth microdilution on a collection of 200 ESBL-producing and 414 carbapenem-resistant clinical <em>Enterobacterales</em> (<em>K. pneumoniae</em> (271), <em>E. coli</em> (245), <em>E. cloacae complex</em> (48), other <em>species</em> (50)) including 292 carbapenemase-producing isolates. E-test method was evaluated for the determination of I/R and M/V MICs using 131 isolates from this collection.</div><div>All the combinations were active against most ESBL-producing isolates (99-100 %), but C/Z and A/A MIC90 were lower than that of I/R and M/V (2mg/L and 2mg/L <em>versus</em> 8mg/L and 8mg/L). The M/V and I/R E-tests performances were close to those required by the FDA recommendations: Categorical agreement (CA) and Essential agreement (EA) ≥ 90 %, Major discrepancy (MD) and Very major discrepancy (VMD) &lt; 3 %): 96.9 % (CA), 92.4 % (EA), 1.2 % (MD), 6.1 % (VMD) for I/R and 94.7 % (CA), 96.9 % (EA), 4.1 % (MD), 8.8 % (VMD) for M/V.</div><div>This work confirmed the interest of C/Z and A/A combinations against carbapenem-resistant <em>Enterobacterales</em> isolates compared with M/V and I/R. Additionally, the findings indicate that the E-test method can be used for the determination of M/V and I/R MIC for <em>E. coli</em> and <em>K. pneumonia</em>e strains.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117011"},"PeriodicalIF":2.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum VEGF-A and sVEGFR-1 levels as predictors of disease severity in COVID-19 patients","authors":"Sevgi Baltacı ,&nbsp;Mehmet Bakır","doi":"10.1016/j.diagmicrobio.2025.117007","DOIUrl":"10.1016/j.diagmicrobio.2025.117007","url":null,"abstract":"<div><h3>Background</h3><div>The pathogenesis of COVID-19 highlights the pivotal role of endothelial dysfunction and dysregulated angiogenic signaling. Vascular endothelial growth factor A (VEGF-A) and its soluble receptor (sVEGFR-1) are critical regulators of vascular integrity. This study aimed to investigate the association between serum VEGF-A and sVEGFR-1 levels and disease severity in patients diagnosed with COVID-19.</div></div><div><h3>Methods</h3><div>In this single-center observational study, 92 COVID-19 patients, classified into mild, moderate, and severe categories, and 29 healthy controls were enrolled. Serum VEGF-A and sVEGFR-1 levels were quantified using enzyme-linked immunosorbent assay (ELISA). Clinical, demographic, and laboratory data were collected. Statistical analyses included ANOVA, Kruskal-Wallis, Spearman correlation, logistic regression, and ROC curve analysis.</div></div><div><h3>Results</h3><div>Both VEGF-A and sVEGFR-1 levels were significantly lower in severe COVID-19 patients compared to controls (<em>p</em> &lt; 0.001). Negative correlations were observed between VEGF-A levels and disease severity (<em>r</em> = -0.55, <em>p</em> &lt; 0.001), and between sVEGFR-1 levels and severity (<em>r</em> = -0.48, <em>p</em> &lt; 0.001). Logistic regression analysis identified VEGF-A as an independent predictor of severe COVID-19 (OR = 0.964, <em>p</em> = 0.021). No significant differences in VEGF-A or sVEGFR-1 levels were found between survivors and non-survivors among the severe group.</div></div><div><h3>Conclusion</h3><div>Serum VEGF-A and sVEGFR-1 levels are inversely associated with COVID-19 disease severity, suggesting their potential role as early prognostic biomarkers. These findings underscore the importance of endothelial dysfunction in COVID-19 progression and encourage further research on angiogenic markers in viral infections.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117007"},"PeriodicalIF":2.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the BioFire® BCID2 panel on antimicrobial treatment and mortality in pediatric gram-negative bloodstream infections","authors":"Ilker Devrim ,&nbsp;Arife Ozer ,&nbsp;Deniz Ergun ,&nbsp;Hincal Ozbakir ,&nbsp;Berna Kahraman Cetin ,&nbsp;Ozlem Yilman ,&nbsp;Arzu Bayram ,&nbsp;Fahri Yüce Ayhan ,&nbsp;Tuba Hilkay Karaman ,&nbsp;Hasan Agin ,&nbsp;Nuri Bayram","doi":"10.1016/j.diagmicrobio.2025.117003","DOIUrl":"10.1016/j.diagmicrobio.2025.117003","url":null,"abstract":"<div><h3>Purpose</h3><div>Rapid molecular diagnostics, such as the BioFire® BCID2 Panel, may improve clinical outcomes by facilitating earlier pathogen identification and antimicrobial stewardship. This study evaluates the impact of BCID2 implementation on antimicrobial treatment and mortality in pediatric Gram-negative Bloodstream infections (BSI).</div></div><div><h3>Methods</h3><div>Pediatric patients with microbiologically confirmed Gram-negative BSI were divided into two groups: the pre-BCID2 group (diagnosed using conventional blood cultures) and the BCID2 group (diagnosed using the BCID2 Panel). Primary outcomes included time to pathogen identification and antimicrobial treatment modifications. Secondary outcomes included 7-day and 30-day mortality rates.</div></div><div><h3>Results</h3><div>A total of 97 Gram-negative BSI episodes were analyzed (pre-BCID2: 59, BCID2: 38). The BCID2 panel significantly reduced the time to appropriate antimicrobial therapy (median reduction: 55.1 h, <em>p</em> &lt; 0.01). Antimicrobial treatment was modified in 78.9 % of cases following BCID2 results, with 42.1 % requiring changes due to resistance gene detection. Glycopeptide use was discontinued in 28.9 %. The 7-day mortality rate was 10.5 % in the BCID2 group versus 8.5 % in the pre-BCID2 group (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>The BCID2 panel significantly accelerated pathogen and resistance gene identification, leading to improved appropriate antimicrobial usage in pediatric Gram-negative BSI.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117003"},"PeriodicalIF":2.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candida tropicalis in the diabetic urinary tract: Biofilm resistance, genomic plasticity, and public health implications","authors":"Rob E. Carpenter","doi":"10.1016/j.diagmicrobio.2025.117005","DOIUrl":"10.1016/j.diagmicrobio.2025.117005","url":null,"abstract":"<div><div>Fungal urinary tract infections (fUTIs) are emerging as a public health concern, notably in South Asia, where a convergence of ecological, genetic, and clinical factors underlies a rising burden of antifungal-resistant disease. This review synthesizes epidemiological, mechanistic, and genetic evidence implicating Candida tropicalis as a dominant uropathogen in South Asia’s diabetic and immunocompromised populations. We examine the shift from Candida albicans to non-albicans Candida (NAC) species, driven by selective antifungal pressure and nosocomial transmission. Emphasis is placed on the virulence and adaptability of C. tropicalis, which forms biofilms, adapts metabolically under glycosuric and hypoxic conditions, and expresses antifungal resistance genes such as ERG11, CDR1, MDR1, and FKS1. Concurrently, South Asian host populations exhibit genetic variants—e.g., in TLR4, CLEC7A, CYP2C19—that impair fungal recognition, immune clearance, and antifungal pharmacokinetics, creating a syndemic landscape. We detail biofilm-mediated resistance mechanisms, epigenetic regulation of virulence genes, and the role of environmental sensing pathways in adaptive pathogenesis. Furthermore, the review delineates clinical challenges posed by biofilm-associated infections, delayed diagnostics, and resistance underestimation. Finally, we propose a suite of public health and clinical recommendations—including biofilm-specific diagnostics, antifungal stewardship programs, pharmacogenomic screening, and national surveillance—to mitigate the escalating burden of drug-resistant candiduria. This integrative perspective bridges molecular pathogenesis and systems-level responses, offering a strategic roadmap for clinicians and policymakers to address C. tropicalis-driven fUTIs in South Asia and other high-risk regions.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117005"},"PeriodicalIF":2.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}