Medical mycology最新文献

Genetic confirmation of terbinafine resistance in Trichophyton rubrum mediated by the squalene epoxidase Leu393Phe mutation via targeted gene replacement. 角鲨烯环氧化酶Leu393Phe突变介导的红毛癣菌特比萘芬抗性的基因置换证实

IF 2.3 3区医学

Medical mycology Pub Date : 2026-05-07 DOI: 10.1093/mmy/myag044

Shusaku Suzuki, Masaki Ishii, Shinya Ohata, Yoko Mano, Nobuhiko Furuya

{"title":"Genetic confirmation of terbinafine resistance in Trichophyton rubrum mediated by the squalene epoxidase Leu393Phe mutation via targeted gene replacement.","authors":"Shusaku Suzuki, Masaki Ishii, Shinya Ohata, Yoko Mano, Nobuhiko Furuya","doi":"10.1093/mmy/myag044","DOIUrl":"https://doi.org/10.1093/mmy/myag044","url":null,"abstract":"Terbinafine (TBF) is a first-line allylamine antifungal used to treat dermatophytosis caused by Trichophyton species, targeting squalene epoxidase (SQLE). The recent emergence of TBF-resistant Trichophyton rubrum (T. rubrum) strains represents a significant global clinical challenge. Although the SQLE Leu393Phe substitution is a commonly reported resistance mechanism in Japan, direct genetic evidence demonstrating its effect when introduced into a T. rubrum recipient strain has been lacking. In this study, we established the causal relationship between the SQLE Leu393Phe substitution and TBF resistance via targeted gene replacement in T. rubrum. A homologous recombination plasmid containing SQLE from the TBF-resistant T. rubrum strain BGUTR13, which harbours the 1177TTA→TTC mutation encoding Leu393Phe, together with the neomycin phosphotransferase II (nptII) selection marker, was constructed and introduced into the TBF-susceptible strain T. rubrum CBS118892 Δku80. The resulting mutant transformants exhibited a >8,000-fold increase in TBF minimum inhibitory concentration compared with the parental strain, whereas control transformants carrying nptII but lacking the SQLE Leu393Phe substitution remained susceptible. Structural modelling indicated that the Leu393Phe substitution causes substantial steric hindrance within the SQLE binding pocket, displacing TBF's aliphatic chain and disrupting key hydrophobic interactions. Molecular docking simulations predicted reduced TBF binding affinity (ΔG changed from -6.3 to -0.8 kcal/mol) following the mutation. These findings provide the first robust genetic evidence that the single SQLE Leu393Phe substitution is sufficient to confer high-level TBF resistance in T. rubrum. These findings highlight the importance of monitoring SQLE mutations in clinical isolates and provide a foundation for developing strategies to address antifungal resistance in dermatophytes.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Detection and molecular characterization of Enterocytozoon bieneusi, Microsporidia, in wild small mammals from Portugal. 葡萄牙野生小型哺乳动物中bieneusenterocytozoi， Microsporidia的检测和分子特征。

IF 2.3 3区医学

Medical mycology Pub Date : 2026-05-01 DOI: 10.1093/mmy/myag035

Andreia V S Cruz, Hélia M Vale-Gonçalves, Joana Paupério, Ricardo Pita, Sérgio Santos-Silva, Laura Lux, Rainer G Ulrich, Paulo Célio Alves, Juan José Luque-Larena, João Queirós, João R Mesquita

{"title":"Detection and molecular characterization of Enterocytozoon bieneusi, Microsporidia, in wild small mammals from Portugal.","authors":"Andreia V S Cruz, Hélia M Vale-Gonçalves, Joana Paupério, Ricardo Pita, Sérgio Santos-Silva, Laura Lux, Rainer G Ulrich, Paulo Célio Alves, Juan José Luque-Larena, João Queirós, João R Mesquita","doi":"10.1093/mmy/myag035","DOIUrl":"10.1093/mmy/myag035","url":null,"abstract":"Enterocytozoon bieneusi is a widespread endoparasite, commonly found in the gastrointestinal tract of humans and various vertebrate and invertebrate animals. It is the most common cause of microsporidiosis in humans, particularly among immunosuppressed individuals. Given the limited epidemiological data in Portugal, this study aimed to estimate the occurrence of E. bieneusi, perform genetic characterization, and explore its circulation dynamics in small mammal populations of Trás-os-Montes region. A total of 294 faecal samples from rodents and shrews non-invasively collected were analysed using a nested polymerase chain reaction (PCR) assay targeting the internal transcribed spacer region and flanking ribosomal RNA coding sequences of E. bieneusi. The parasite DNA was detected in two rodent samples: wood mouse (Apodemus sylvaticus) and Lusitanian pine vole (Microtus lusitanicus), corresponding to an overall occurrence of 0.68%. Our findings represent the first report of E. bieneusi in Lusitanian pine vole and the first detection of this parasite in small mammals from Portugal. Both samples belonged to the zoonotic Group 1, with one identified as genotype C. These findings provide baseline data on the distribution and host range of E. bieneusi in Portuguese wildlife and may guide future surveillance efforts within a One Health framework.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gaps in fungal disease diagnostics and availability of antifungals: A nationwide survey of hospital laboratories in Peru. 真菌疾病诊断和抗真菌药物供应方面的差距：秘鲁全国医院实验室调查。

IF 2.3 3区医学

Medical mycology Pub Date : 2026-05-01 DOI: 10.1093/mmy/myag032

Claudia Banda, Edgar Neyra, Romina Rios-Blanco, Patricia Espinoza-Lopez, Nicolas Antunez de Mayolo, Mariana Minei Ogata, Beatriz Bustamante

{"title":"Gaps in fungal disease diagnostics and availability of antifungals: A nationwide survey of hospital laboratories in Peru.","authors":"Claudia Banda, Edgar Neyra, Romina Rios-Blanco, Patricia Espinoza-Lopez, Nicolas Antunez de Mayolo, Mariana Minei Ogata, Beatriz Bustamante","doi":"10.1093/mmy/myag032","DOIUrl":"10.1093/mmy/myag032","url":null,"abstract":"Fungal infections remain an underrecognized public health threat in Peru. This study aimed to map the current laboratory diagnostic capacity for fungal diseases across Peru and identify potential barriers to timely and effective diagnosis. A cross-sectional electronic survey of 42 hospital laboratories was conducted from December 2021 to August 2022, evaluating infrastructure, personnel, diagnostic tests, sample volumes, quality assurance, and training. Descriptive and exploratory comparative analyses were performed by location (Lima vs. other regions) using Wilcoxon rank-sum, Fisher's exact tests, and Holm adjustments. Among surveyed laboratories, 28.6% were in Lima and 71.4% in other regions. Lima hospitals were more likely to be Level III-2 institutions (50% vs. 3.3%). Structural gaps were common: only 26% had dedicated mycology areas, and more than half reported ≤ 20 m² of workspace. Lima laboratories tended to have larger facilities, more automated equipment, and more staff. Only 36% participated in external quality assessments, and 17% reported mycology training activities. Microscopy was widely available, but advanced tools were scarce: Polymerase Chain Reaction (PCR) was used in 4.8% of laboratories, and serology in one. No laboratory performed DNA sequencing. Mold identification relied primarily on morphology. In-vitro antifungal susceptibility testing was available in 43%, mostly for yeast, and access to key antifungals was inconsistent, with better availability in Lima. Substantial gaps in infrastructure, diagnostic capacity, training, and drug access, particularly outside Lima, underscore the need for strengthened mycology services to improve fungal disease diagnosis and care in Peru.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

CAMEO-a cross-sectional survey study on candidemia management in Germany. CAMEO -德国念珠菌管理的横断面调查研究。

IF 2.3 3区医学

Medical mycology Pub Date : 2026-05-01 DOI: 10.1093/mmy/myag038

Ilana Reinhold, Jon Salmanton-García, Janina Leckler, Jannik Stemler, Albert Wahl, Oliver A Cornely, Danila Seidel, Rosanne Sprute

{"title":"CAMEO-a cross-sectional survey study on candidemia management in Germany.","authors":"Ilana Reinhold, Jon Salmanton-García, Janina Leckler, Jannik Stemler, Albert Wahl, Oliver A Cornely, Danila Seidel, Rosanne Sprute","doi":"10.1093/mmy/myag038","DOIUrl":"10.1093/mmy/myag038","url":null,"abstract":"Candida species cause life-threatening bloodstream infections, particularly in critically ill and immunocompromised patients. Although guideline adherence has been shown to improve outcomes, real-world implementation is often constrained. This cross-sectional, web-based survey evaluated current clinical practices and barriers in candidemia management across German healthcare institutions. A structured questionnaire based on the EQUAL Candida score was disseminated online from 10/2023 to 07/2025. Physicians involved in candidemia management reported institutional characteristics, diagnostic practices, antifungal treatment strategies, central line management, and follow-up practices. Data were analyzed using descriptive statistics and chi-square testing. A total of 217 physicians from 147 institutions participated, with 74.5% of participants affiliated with large care facilities. Caspofungin was the predominant first-line therapy (81.4%), whereas fluconazole was used by 5.3% of participants. First-line choice did not differ by years of clinical experience (P = 0.194). Echocardiography was routinely performed by 57% of participants; selective use showed no association with years of clinical experience (P = 0.845) or annual number of candidemia cases (P = 0.089). Ophthalmoscopy was performed routinely by 37% of participants and showed no association with experience (P = 0.907), but was significantly associated with lower annual caseload (P = 0.02) and infectious disease speciality (P = 0.003). Central line removal or replacement within 24 h was reported by 82.5%. Follow-up blood cultures were obtained daily by 31.4%, while 54.8% repeated cultures every 48 h. While core candidemia management practices are generally well implemented in German healthcare institutions, certain recommended diagnostic steps remain underutilized. Targeted educational and structural interventions are needed to strengthen guideline adherence and optimize patient outcomes across diverse settings.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Profiling medical mycologists: Results from a global survey of the ESCMID Fungal Infection Study Group (EFISG). 分析医学真菌学家：来自ESCMID真菌感染研究组（EFISG）的全球调查结果。

IF 2.3 3区医学

Medical mycology Pub Date : 2026-05-01 DOI: 10.1093/mmy/myag037

Jon Salmanton-García, Katrien Lagrou, Fanny Lanternier, Malcolm Richardson, Robina Aerts, Antonio Vena

{"title":"Profiling medical mycologists: Results from a global survey of the ESCMID Fungal Infection Study Group (EFISG).","authors":"Jon Salmanton-García, Katrien Lagrou, Fanny Lanternier, Malcolm Richardson, Robina Aerts, Antonio Vena","doi":"10.1093/mmy/myag037","DOIUrl":"10.1093/mmy/myag037","url":null,"abstract":"Invasive fungal infections are a major cause of morbi-mortality, particularly in immunocompromised and critically ill patients. Increasing antifungal resistance, unequal access to diagnostics and therapies, and complex host-pathogen interactions highlight the need for coordinated research. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Fungal Infection Study Group (EFISG) addresses these challenges by promoting multidisciplinary collaboration and advancing research and education in medical mycology. This study aimed to characterize the global medical mycology workforce using EFISG as a representative international network. A cross-sectional survey was conducted among EFISG members between June and December 2025. The survey collected data on demographics, geographic distribution, professional background, career stage, research interests, language proficiency, and involvement in other scientific societies and ESCMID study groups. A total of 342 members from 72 countries responded, representing two-thirds of all countries with EFISG membership. Most participants were based in Europe (60%). Sex distribution was balanced, and all career stages were included, with 22.8% early-career professionals and 14.6% trainees. Key research interests included epidemiology of fungal infections (68.4%), mycoses in immunocompromised hosts (67.5%), development of diagnostic methods (54.4%), and rare and emerging fungal diseases (54.1%). Infectious disease specialists (52.3%) and microbiologists (42.4%) comprised the majority of respondents, and most reported active participation in other ESCMID study groups and scientific societies. These findings provide the first structured overview of the medical mycology workforce, identifying gaps in representation, training, and emerging research areas, with implications for global capacity building, collaboration, and strategic planning beyond EFISG.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of three culture media for testing susceptibility of Malassezia pachydermatis to four antifungal agents by a microdilution method and gradient diffusion strips. 微稀释法和梯度扩散条法检测厚皮马拉色菌对4种抗真菌药物敏感性的培养基比较。

IF 2.3 3区医学

Medical mycology Pub Date : 2026-05-01 DOI: 10.1093/mmy/myag036

Maria Dolores Sánchez, Nathalie Clément, Agathe Cailleau, Céline David, Nadine Brisseau, Anne Lehébel, Faraj Fajloun, Jacques Guillot, Antoine Rostang

{"title":"Comparison of three culture media for testing susceptibility of Malassezia pachydermatis to four antifungal agents by a microdilution method and gradient diffusion strips.","authors":"Maria Dolores Sánchez, Nathalie Clément, Agathe Cailleau, Céline David, Nadine Brisseau, Anne Lehébel, Faraj Fajloun, Jacques Guillot, Antoine Rostang","doi":"10.1093/mmy/myag036","DOIUrl":"10.1093/mmy/myag036","url":null,"abstract":"The yeast Malassezia pachydermatis frequently causes otitis externa and dermatitis in dogs and cats. This often requires prolonged antifungal therapy, raising concerns about reduced susceptibility. Antifungal susceptibility testing (AFST) for Malassezia spp. remains challenging because many protocols require complex lipid supplementation and are difficult to implement in routine veterinary settings. Here, we compared three culture media for AFST of M. pachydermatis: (i) a complex, lipid-enriched RPMI formulation (RPMI1); (ii) a simplified RPMI formulation supplemented with Tween 40 and Tween 80 (RPMI2); and (iii) a Sabouraud dextrose medium supplemented with Tween 80 (SD). Forty-nine canine clinical isolates were tested against ketoconazole, itraconazole, posaconazole and terbinafine using a colorimetric broth microdilution approach and a gradient diffusion method on solid media (EzyMIC®). RPMI1 broth was unstable after freezing, resulting in weak or ambiguous resazurin readings and frequent data exclusions, and the solid formulation of RPMI1 was unsuitable for reliable gradient diffusion interpretation. By contrast, RPMI2 medium provided consistent minimal inhibitory concentration (MIC) determinations for azoles in both solid and liquid media, with comparable MIC values. Conversely, terbinafine MICs were frequently elevated in RPMI-based liquid media, often exceeding the upper testing range, whereas lower and more readily interpretable MIC values were obtained on SD agar, suggesting medium-dependent effects on terbinafine assessment. The results obtained with SD media on azoles were more heterogeneous. Overall, RPMI2 offered a practical and reproducible option for azole susceptibility testing of M. pachydermatis, while terbinafine results may require cautious interpretation depending on the testing medium.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Candida (Candidozyma) auris strains exposed to azole fungicides become less susceptible to manogepix. 耳念珠菌（念珠菌）菌株暴露于唑类杀菌剂变得不那么敏感。

IF 2.3 3区医学

Medical mycology Pub Date : 2026-05-01 DOI: 10.1093/mmy/myag041

Audrey Boutillier, Adrien Baillod, Jérémy Moreau, Jérôme Labanowski, Sandrine Marchand, Jonathan Clarhaut, Kévin Brunet

{"title":"Candida (Candidozyma) auris strains exposed to azole fungicides become less susceptible to manogepix.","authors":"Audrey Boutillier, Adrien Baillod, Jérémy Moreau, Jérôme Labanowski, Sandrine Marchand, Jonathan Clarhaut, Kévin Brunet","doi":"10.1093/mmy/myag041","DOIUrl":"https://doi.org/10.1093/mmy/myag041","url":null,"abstract":"Candida auris is a multidrug-resistant fungal pathogen responsible for invasive nosocomial infections with high mortality rates. Recent detection of C. auris in natural environments suggests the existence of an environmental reservoir, prompting investigation into the potential role of azole fungicides used for plant protection in the development of resistance to antifungals used in human medicine. Here, we assessed the impact of azole fungicides on in vitro resistance development in two C. auris strains (B11220 and B11221) through sequential exposure to epoxiconazole, propiconazole, or tebuconazole. Exposure resulted in a rapid and significant increase in fungicide MICs, accompanied by a reduced susceptibility to four azole antifungals (fluconazole, voriconazole, posaconazole, isavuconazole), and to a new antifungal agent, the manogepix. Several strains with elevated MICs exhibited stable phenotypes and were associated with a mutation in the TAC1B gene. One of these strains showed a significant overexpression of the efflux pump CDR1. These findings provide experimental evidence that azole fungicides can drive resistance to azole antifungals and reduce susceptibility to manogepix, underscoring the need for integrated One Health antifungal stewardship strategies to combat C. auris.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors of mortality in individuals with disseminated histoplasmosis and advanced HIV disease. 弥散性组织胞浆菌病和晚期艾滋病患者死亡率的预测因素

IF 2.3 3区医学

Medical mycology Pub Date : 2026-05-01 DOI: 10.1093/mmy/myag040

Jussemara Souza da Silva, Victor Garcia Nuñez, Victória Spínola D de Oliveira, Alessandro C Pasqualotto, José E Vidal

{"title":"Predictors of mortality in individuals with disseminated histoplasmosis and advanced HIV disease.","authors":"Jussemara Souza da Silva, Victor Garcia Nuñez, Victória Spínola D de Oliveira, Alessandro C Pasqualotto, José E Vidal","doi":"10.1093/mmy/myag040","DOIUrl":"10.1093/mmy/myag040","url":null,"abstract":"Disseminated histoplasmosis remains a major cause of morbidity and mortality among people living with advanced HIV disease (AHD), particularly in Latin America, where delayed diagnosis and limited access to optimal antifungal therapy persist. Accurate tools to assess disease severity and predict mortality are essential to guide clinical decision-making, including hospitalization, intensive care unit admission, and treatment strategies. We conducted a retrospective observational cohort study of hospitalized adults with AHD (CD4 ≤ 200 cells/mm³) and a first episode of probable or proven disseminated histoplasmosis at a tertiary referral center in São Paulo, Brazil, between 2013 and 2023. Disease severity at admission was assessed using four tools: the World Health Organization (WHO) severity classification, the Histoplasmosis Fatality Score (HFS), the Sequential Organ Failure Assessment (SOFA), and the quick SOFA (qSOFA). The primary outcome was in-hospital mortality. Eighty-nine individuals were included; most were male (77.5%), with a median age of 39 years and profound immunosuppression (median CD4 count 24 cells/mm³). In-hospital mortality was 34.8%. Individuals who died had significantly higher HFS and SOFA scores. In multivariable analysis, HFS, SOFA score, and serum creatinine were independently associated with in-hospital mortality, whereas qSOFA was not. HFS showed the best discriminatory performance (AUC 0.798; 95% CI 0.707-0.889). The combination of HFS and elevated creatinine further improved discrimination (AUC 0.840; 95% CI 0.758-0.922), outperforming the WHO classification, SOFA, and qSOFA in predicting in-hospital mortality. These findings support the use of HFS as a practical and reliable tool for stratifying disease severity, optimizing resource allocation, and guiding clinical decision-making in high-burden settings.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fungal central nervous system infection caused by non-Candida yeasts and dimorphic fungi following neurosurgical procedures: Iatrogenic or not? 神经外科手术后非念珠菌和二形真菌引起的真菌性中枢神经系统感染：医源性还是非医源性？

IF 2.3 3区医学

Medical mycology Pub Date : 2026-05-01 DOI: 10.1093/mmy/myag034

Chia-Yu Chiu, Rachel S Hicklen, Dimitrios P Kontoyiannis

引用次数: 0

Lipid-based amphotericin B formulations (ABCD/L-AmB) were associated with better outcomes than deoxycholate (AmB-d) in non-HIV-associated cryptococcal meningitis: A retrospective cohort study. 基于脂质的两性霉素B制剂（ABCD/L-AmB）比脱氧胆酸盐（AmB-d）治疗非hiv相关隐球菌性脑膜炎的疗效更好：一项回顾性队列研究。

IF 2.3 3区医学

Medical mycology Pub Date : 2026-05-01 DOI: 10.1093/mmy/myag033

Junyu Liu, Jia Liu, Min Li, Ruiqi Dong, Dongcheng Li, Jiajie Chen, Wenhai Zeng, Zheqi Li, Xiaofeng Xu, Ying Jiang, Fuhua Peng

{"title":"Lipid-based amphotericin B formulations (ABCD/L-AmB) were associated with better outcomes than deoxycholate (AmB-d) in non-HIV-associated cryptococcal meningitis: A retrospective cohort study.","authors":"Junyu Liu, Jia Liu, Min Li, Ruiqi Dong, Dongcheng Li, Jiajie Chen, Wenhai Zeng, Zheqi Li, Xiaofeng Xu, Ying Jiang, Fuhua Peng","doi":"10.1093/mmy/myag033","DOIUrl":"10.1093/mmy/myag033","url":null,"abstract":"This retrospective cohort study compared the efficacy and safety of lipid-based amphotericin B formulations (amphotericin B colloidal dispersion [ABCD] and liposomal amphotericin B [L-AmB]) versus conventional amphotericin B deoxycholate (AmB-d) for the treatment of non-human immunodeficiency virus (HIV)-associated cryptococcal meningitis (CM). Data from 199 patients were analyzed, divided into three groups based on induction therapy: AmB-d (n = 110), ABCD (n = 44), and L-AmB (n = 45). At baseline, a higher proportion of patients in the lipid-based groups presented with altered mental status. After 2 weeks, the ABCD and L-AmB groups showed significantly better clinical improvement (as measured by British Medical Research Council Stage 1) compared to the AmB-d group (63.6% and 77.8% vs. 35.5%; P < .001), and experienced substantially lower rates of renal impairment (54.5% and 53.3% vs. 79.1%; P = .001). Early fungicidal activity was similar across all groups. Multivariate analysis at 10 weeks indicated that both lipid-based formulations were associated with a lower risk of unsuccessful outcomes compared to AmB-d. Furthermore, 1-year survival analysis for clinical cure demonstrated a significantly higher cumulative incidence in the lipid-based AmB groups (Log-rank test, P = .016). In conclusion, induction regimens based on ABCD or L-AmB were associated with better outcomes than AmB-d for non-HIV-associated CM, offering better long-term outcomes and a more favorable safety profile, particularly regarding kidney toxicity.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0