Medical mycology最新文献_第2页

Role of Phenotypic Switching in the Adaptive Response of Candida tropicalis to Hyperosmotic Stress. 表型转换在热带假丝酵母对高渗胁迫的适应性反应中的作用。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf035

Hugo Felix Perini, Cássia Milena de Souza, Eloiza Aparecida Paulo, Fernanda Tomiotto-Pellissier, Wander Rogério Pavanelli, Luciana Furlaneto-Maia, Marcia Cristina Furlaneto

引用次数: 0

Mucormycosis coinfection in patients with proven aspergillosis. 已证实患有曲霉菌病的患者合并感染粘孢子菌病。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf027

Hyeon Mu Jang, Ji Yeun Kim, Joon Seon Song, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Ho Choi, Sang-Oh Lee, Yang Soo Kim, Sung-Han Kim

{"title":"Mucormycosis coinfection in patients with proven aspergillosis.","authors":"Hyeon Mu Jang, Ji Yeun Kim, Joon Seon Song, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Ho Choi, Sang-Oh Lee, Yang Soo Kim, Sung-Han Kim","doi":"10.1093/mmy/myaf027","DOIUrl":"10.1093/mmy/myaf027","url":null,"abstract":"Data on the coinfection of molds are limited. Therefore, we systematically investigated mucormycosis coinfection in patients with morphologically proven aspergillosis. The medical records of adult patients with proven aspergillosis and available formalin-fixed paraffin-embedded (FFPE) tissue sections were retrospectively reviewed at a tertiary hospital between January 2019 and July 2024. The fungal culture results were reviewed and polymerase chain reaction (PCR) was performed to detect Aspergillus- and Mucorales-specific DNA using FFPE tissues. A positive Mucorales PCR test was confirmed when positive results were obtained for both the 18S and 28S targets. A total of 49 patients with proven aspergillosis were analyzed. The sterile specimen was not found to contain Mucorales. However, fungal cultures from a non-sterile site (endotracheal aspirate) revealed the presence of Aspergillus niger and Cunninghamella spp. in 1 (2%) of 49 patients (Patient A). A positive Mucorales-specific PCR result was obtained for one patient (2%) while positive Aspergillus- and Mucorales-specific PCR results were obtained for five patients, including Patient A (10%). Overall, 6 (12%) of the 49 patients with proven aspergillosis were found to be coinfected with mucormycosis. Coinfection with mucormycosis was significantly more associated with rhino-paranasal sinuses (33% vs. 2%, P = .03). In-hospital mortality was not found to significantly differ between patients with mucormycosis coinfection and those with aspergillosis alone (33% [2/6] vs. 14% [6/43], P = .24). Approximately one-tenth of patients with proven aspergillosis had molecular or microbiologic evidence of mucormycosis coinfection. Further studies are needed to highlight the clinical implications of the molecular evidence of mucormycosis coinfection in patients with proven aspergillosis.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674306","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

Keratomycosis: An insight into epidemiology, etiology, and antifungal susceptibility testing of causative agents at a tertiary care centre. 角孢病：深入了解流行病学，病因学，和抗真菌药敏试验的病原体在三级保健中心。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf038

Swati Sharma, Nidhi Singla, Sudesh Kumar Arya, Neelam Gulati, Jagdish Chander

{"title":"Keratomycosis: An insight into epidemiology, etiology, and antifungal susceptibility testing of causative agents at a tertiary care centre.","authors":"Swati Sharma, Nidhi Singla, Sudesh Kumar Arya, Neelam Gulati, Jagdish Chander","doi":"10.1093/mmy/myaf038","DOIUrl":"https://doi.org/10.1093/mmy/myaf038","url":null,"abstract":"In India, mycotic keratitis accounts for 7%-63% of infectious keratitis. Ocular trauma being the primary predisposing factor for mycotic keratitis. The present prospective, observational study was conducted on the corneal scrapings from clinically suspected patients of keratomycosis. Samples were processed as per the standard mycological techniques. Antifungal susceptibility testing was performed as per CLSI guidelines M38A2 and M27A3 for mycelial fungi and yeast, respectively. Out of a total of 254 patients suspected to be suffering from mycotic keratitis based on clinical presentation, 68 (26.77%) were positive for fungal aetiology. Male preponderance was observed with male-to-female ratio of 2.78:1. Patients in age group 51-60 years were maximally affected. The majority of the isolates of patients having fungal keratitis were that of Aspergillus sp. (31, 45.6%), followed by Fusarium sp. (12, 17.6%), Curvularia lunata (5, 7.4%), Candida sp. (4, 5.9%), Alternaria sp. (2, 2.9%), Rhodotorula sp. (1, 1.5%), and Acremonium sp. (1, 1.5%). Some rare isolates were Colletotrichum sp. (1), Botryosphaeria dothidea (2), Lasiodiplodia pseudotheobromae (1), and Acrophialophora fusispora (1). Overall, MIC values for natamycin and amphotericin B were high in Aspergillus sp., while Fusarium sp. had high MIC for voriconazole and itraconazole. Candida sp. Curvularia and Alternaria sp. had high MIC values for fluconazole. As mycotic keratitis is an infective condition involving healthy eyes, leading to morbid eye conditions and even blindness, strong clinical suspicion of fungal keratitis followed by timely diagnosis and antifungal susceptibility testing-based treatment may help the clinicians in better management and improvement of the outcome of patients.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":"63 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001899","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

Clustered cases of Candida auris colonization: Roles of the infection prevention and control department and the mycology laboratory in controlling transmission. 聚集性耳念珠菌定植：感染防控部门和真菌学实验室在控制传播中的作用。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf033

Claire Cottrel, Marie Regad, Charlotte Arnal, Sandrine Henard, Marie Desnos-Olivier, Alain Lozniewski, Alexandre Alanio, Anne-Claire Bursztejn, Julie Lizon, Anne Debourgogne

引用次数: 0

MNN45 is involved in Zcf31-mediated cell surface integrity and chitosan susceptibility in Candida albicans. MNN45 参与了 Zcf31 介导的白色念珠菌细胞表面完整性和壳聚糖敏感性。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf025

Hao-Sen Chiang, Ji-Hong Chen, Yu-Ting Liao, Yu-Chun Peng, Chih-Chieh Hsu, Cai-Ling Ke, Chi-Ting Chung, Yu-Chiao Yeh, Hsiao-Yen Tsai, Ching-Hsuan Lin

{"title":"MNN45 is involved in Zcf31-mediated cell surface integrity and chitosan susceptibility in Candida albicans.","authors":"Hao-Sen Chiang, Ji-Hong Chen, Yu-Ting Liao, Yu-Chun Peng, Chih-Chieh Hsu, Cai-Ling Ke, Chi-Ting Chung, Yu-Chiao Yeh, Hsiao-Yen Tsai, Ching-Hsuan Lin","doi":"10.1093/mmy/myaf025","DOIUrl":"10.1093/mmy/myaf025","url":null,"abstract":"Candida albicans is a major human fungal pathogen; however, limited antifungal agents, undesirable drug side effects, and ineffective prevention of drug-resistant strains have become serious problems. Chitosan is a nontoxic, biodegradable, and biocompatible linear polysaccharide made from the deacetylation of chitin. In this study, a ZCF31 putative transcription factor gene was selected from a previous mutant library screen, as zcf31Δ strains exhibited defective cell growth in response to chitosan. Furthermore, chitosan caused notable damage to zcf31Δ cells; however, ZCF31 expression was not significantly changed by chitosan, suggesting that zcf31Δ is sensitive to chitosan could be due to changes in the physical properties of C. albicans. Indeed, zcf31Δ cells displayed significant increases in cell wall thickness. Consistent with the previous study, zcf31Δ strains were resistant to calcofluor white but highly susceptible to SDS (sodium dodecyl sulfate). These results implied that chitosan mainly influences membrane function, as zcf31Δ strengthens the stress resistance of the fungal cell wall but lessens cell membrane function. Interestingly, this effect on the cell surface mechanics of the C. albicans zcf31Δ strains was not responsible for the virulence-associated function. RNA-seq analysis further revealed that six mannosyltransferase-related genes were upregulated in zcf31Δ. Although five mannosyltransferase-related mutant strains in the zcf31Δ background partially reduced the cell wall thickness, only zcf31Δ/mnn45Δ showed the recovery of chitosan resistance. Our findings suggest that Zcf31 mediates a delicate and complicated dynamic balance between the cell membrane and cell wall architectures through the mannosyltransferase genes in C. albicans, leading to altered chitosan susceptibility.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674297","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

Availability and cost of antifungal therapy in Vietnam: A 5-year retrospective study. 越南抗真菌治疗的可得性和费用：一项5年回顾性研究。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf028

Yee Chin Kwang, Ha Thuy Nguyen, Jan-Willem Alffenaar, Justin Beardsley, Vu Quoc Dat

{"title":"Availability and cost of antifungal therapy in Vietnam: A 5-year retrospective study.","authors":"Yee Chin Kwang, Ha Thuy Nguyen, Jan-Willem Alffenaar, Justin Beardsley, Vu Quoc Dat","doi":"10.1093/mmy/myaf028","DOIUrl":"10.1093/mmy/myaf028","url":null,"abstract":"Access to antifungal agents for the treatment of invasive fungal infections (IFIs) varies significantly between countries. Limited access or high cost may contribute to the burden of IFIs. We aimed to investigate the availability and cost of antifungal treatment for IFIs in Vietnam. Procurement data from 2018 to 2022 was collected from the Drug Administration of Vietnam website. We calculated the cost per defined daily dose (DDD) and identified the manufacturing countries. We explored the pharmacotherapy cost of the four major IFIs if first-line agents were used in accordance with the Vietnam 2021 antifungal prescribing guideline. We also estimated the treatment expenditure in 2020 based on the estimated disease burden previously published and suggested cost-saving measures. At least 57.6 million USD was spent on 15.5 million DDD of antifungals in 5 years. Seven systemic antifungal agents were available in Vietnam. Caspofungin and micafungin were the least used but most expensive, whereas fluconazole and itraconazole were the most consumed but cheapest antifungals. Vietnam manufactured 70% of azole antifungals and relied on imports for the remaining antifungals consumed. We estimated the first-line pharmacological treatment for the estimated cases of four IFIs in 2020 to cost at least 209.1 million USD, which exceeded the actual spend in 2020. We discovered that antifungal agents for IFIs impose a substantial economic burden on Vietnam's healthcare system. We highlight the need for cost-effectiveness studies of expensive first-line medications. Efforts to mitigate this economic burden should include antifungal stewardship, prevention of IFIs, and sourcing from cost-effective manufacturers.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Allergic bronchopulmonary aspergillosis in cystic fibrosis: Case-control study from the French registry. 囊性纤维化患者的过敏性支气管肺曲霉病：来自法国注册中心的病例对照研究。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf030

Marine Tarizzo, Lydie Lemonnier, Soline Leblanc, Jeanne Bigot, Guillaume Thouvenin, Loïc Guillot, Harriet Corvol

{"title":"Allergic bronchopulmonary aspergillosis in cystic fibrosis: Case-control study from the French registry.","authors":"Marine Tarizzo, Lydie Lemonnier, Soline Leblanc, Jeanne Bigot, Guillaume Thouvenin, Loïc Guillot, Harriet Corvol","doi":"10.1093/mmy/myaf030","DOIUrl":"https://doi.org/10.1093/mmy/myaf030","url":null,"abstract":"Allergic bronchopulmonary aspergillosis (ABPA) is a significant complication in people with cystic fibrosis (pwCF), driven by hypersensitivity to Aspergillus fumigatus. This study aimed to identify factors associated with the development of ABPA in pwCF, using data from the French CF Registry (FCFR). We conducted a multicenter case-control study utilizing anonymized data from the FCFR, spanning the period from 2016 to 2021. A total of 312 ABPA cases were matched to 936 controls. Various clinical factors, including CFTR variants, nutritional status, glucose disorders, respiratory function, chronic bacterial colonization, and treatments such as antibiotics, corticosteroids, and antifungals, were analyzed. Multivariate analyses and logistic regression models were used to identify associations with ABPA. PwCF who received more frequent intravenous antibiotics (OR = 2.47, P = .013), long-term inhaled corticosteroids (OR = 1.82, P < .001), or antifungals (OR = 5.83, P < .0001) exhibited a higher likelihood of developing ABPA. Additionally, glucose disorders were significantly associated with ABPA (OR = 1.41, P = .03). In contrast, a higher body mass index (BMI >25 kg/m²) appeared to be a protective factor (OR = 0.47, P = .03). No significant associations were observed with lung function, CFTR variants, or chronic Pseudomonas aeruginosa colonization. These findings suggest that certain clinical factors and treatments, particularly glucose disorders, frequent antibiotic use, and corticosteroid therapy, are associated with the development of ABPA in pwCF. Notably, a higher BMI may have a protective effect. Further research is needed to explore the underlying mechanisms of these associations and optimize treatment strategies for ABPA in CF, especially as CF therapies continue to evolve.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":"63 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimization of cutoff values for (1→3)-β-d-glucan and galactomannan assays in cerebrospinal fluid for the diagnosis of non-cryptococcal fungal infections of the central nervous system. 脑脊液中（1→3）-β-d-葡聚糖和半乳甘露聚糖检测诊断中枢神经系统非隐球菌真菌感染的截止值优化

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf037

Arghadip Samaddar, Gregory R Kowald, Jenevi Margaret Mendonsa, Nagarathna S, Veena Kumari H B

{"title":"Optimization of cutoff values for (1→3)-β-d-glucan and galactomannan assays in cerebrospinal fluid for the diagnosis of non-cryptococcal fungal infections of the central nervous system.","authors":"Arghadip Samaddar, Gregory R Kowald, Jenevi Margaret Mendonsa, Nagarathna S, Veena Kumari H B","doi":"10.1093/mmy/myaf037","DOIUrl":"https://doi.org/10.1093/mmy/myaf037","url":null,"abstract":"Fungal infections of the central nervous system (FI-CNS) pose substantial diagnostic challenges, owing to their diverse clinical presentations and the limited sensitivity of conventional diagnostic tests. Although serum (1→3)-β-d-glucan (BDG) and galactomannan (GM) assays are FDA-approved for the diagnosis of invasive fungal infections (IFIs), their effectiveness in cerebrospinal fluid (CSF) remains underexplored, and optimal cutoff values in CSF are not well established. This study aimed to assess the utility of BDG and GM assays in CSF for diagnosing non-cryptococcal FI-CNS. We conducted a prospective observational study at the National Institute of Mental Health and Neuro Sciences in India from January 2022 to December 2023, including CSF samples from patients suspected of fungal meningitis. The cases were categorized as proven, probable, or possible FI-CNS based on the revised EORTC/MSGERC criteria. Among 61 suspected cases, 2 were proven, 48 were probable, and 11 were possible FI-CNS. The control group included 23 patients without FI-CNS suspicion. BDG and GM testing in CSF followed manufacturers' guidelines for serum. At the manufacturer's recommended cutoff of 80 pg/ml, sensitivity of BDG was 94% and specificity was 78.3%. For GM, using the manufacturer's recommended cutoff of 0.5 optical density index (ODI), sensitivity was 42% and specificity was 100%. Receiver operating characteristic curve analysis indicated optimal cutoffs of 72 pg/ml for BDG (sensitivity 96%, specificity 78.3%) and 0.47 ODI for GM (sensitivity 44%, specificity 100%). Combining both biomarkers increased sensitivity to 97.8%, suggesting that combined BDG and GM testing in CSF could significantly enhance the diagnostic accuracy and management of FI-CNS.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":"63 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018468","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

KL-6 as a predictor of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) and mortality in critically ill COVID-19 patients: A single-center retrospective cohort study. KL-6作为2019冠状病毒病（COVID-19）相关肺曲霉病（CAPA）和危重患者死亡率的预测因子：一项单中心回顾性队列研究

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf032

Hyun Kyu Cho, Si-Ho Kim, Cheon-Hoo Jeon, Jae Wan Jung, Yu Mi Wi

{"title":"KL-6 as a predictor of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) and mortality in critically ill COVID-19 patients: A single-center retrospective cohort study.","authors":"Hyun Kyu Cho, Si-Ho Kim, Cheon-Hoo Jeon, Jae Wan Jung, Yu Mi Wi","doi":"10.1093/mmy/myaf032","DOIUrl":"10.1093/mmy/myaf032","url":null,"abstract":"This study evaluated the predictive value of Krebs von den Lungen-6 (KL-6) for the development of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) and its association with mortality in critically ill COVID-19 patients. A retrospective single-center cohort study was conducted on critically ill COVID-19 patients who required high-flow oxygen or mechanical ventilation between January 2021 and June 2023. Serial serum KL-6 levels were measured at admission and weekly thereafter. The predictive performance of initial KL-6 was assessed using ROC curve analysis, and risk factors for CAPA and 30-day mortality were analyzed using multivariable models. Among 238 patients, 25 (10.5%) developed CAPA. Initial KL-6 demonstrated good discriminative ability for CAPA prediction (AUC 0.745; 95% CI: 0.685-0.799), with an optimal cutoff of 270.9 U/ml (sensitivity: 88.0%, specificity: 55.4%). KL-6 ≥ 270.9 U/ml remained independently associated with CAPA (aHR: 9.66; 95% CI: 2.28-40.89) after multivariable analysis. Serial measurements showed a trend toward a greater increase in KL-6 levels among CAPA patients than non-CAPA patients (median difference: 259.9 vs. 73.0 U/ml, P = .053). Additional independent predictors of CAPA included inotropic/vasopressor support, diabetes mellitus, and tocilizumab use. CAPA patients had higher all-cause 30-day mortality (60.8% vs. 45.2%; P = .020), which remained significant after adjustment (aHR: 2.19; 95% CI: 1.08-4.15). Furthermore, KL-6 was independently associated with 30-day mortality (aHR: 1.03 per 100 U/ml; 95% CI: 1.00-1.07). These findings suggest that KL-6 is a promising biomarker for predicting CAPA and mortality in critically ill COVID-19 patients.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803747","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

Impact of glycemic control on coccidioidomycosis outcomes in patients with underlying diabetes mellitus in central California. 血糖控制对加利福尼亚中部潜在糖尿病患者球孢子菌病预后的影响。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf039

Geetha Sivasubramanian, Kenneth Fox, Nam Huynh, John Woodley, Alec Chan-Golston, Seema Policepatil

{"title":"Impact of glycemic control on coccidioidomycosis outcomes in patients with underlying diabetes mellitus in central California.","authors":"Geetha Sivasubramanian, Kenneth Fox, Nam Huynh, John Woodley, Alec Chan-Golston, Seema Policepatil","doi":"10.1093/mmy/myaf039","DOIUrl":"https://doi.org/10.1093/mmy/myaf039","url":null,"abstract":"Diabetes mellitus (DM) is a known risk factor for severe coccidioidomycosis. Central California has some of the highest rates of DM in the USA, according to CDC data. This study examines the impact of glycemic control on the severity and outcomes of coccidioidomycosis in this high-DM-prevalent region. A retrospective analysis was conducted on patients with both coccidioidomycosis and DM from 2014 to 2022 at a large referral center in Fresno, California. Data collected included demographics, presentation, HbA1c levels, management, and outcomes. Fisher's exact test and the Wilcoxon-Rank sum test were used to analyze categorical and continuous measures, respectively. Logistic regression was applied for binary outcomes. We analyzed 131 patients with coccidioidomycosis and DM (62% male and 64% Hispanic). The median HbA1c at the diagnosis of coccidioidomycosis was 9%. A total of 64% developed complicated pulmonary disease, and 56% cavitary pulmonary disease. Higher HbA1c at diagnosis was associated with increased odds of complicated pulmonary disease (OR = 1.40; 95% CI: 1.05, 1.85), cavitary disease (OR = 1.43; 95% CI: 1.09, 1.88), and decreased odds of resolution (OR = 0.66; 95% CI: 0.48, 0.93). Central California, with one of the highest burdens of coccidioidomycosis, also has an increased prevalence of DM. Our study population had significantly uncontrolled DM. We also found that the level of glycemic control impacted the severity of pulmonary coccidioidomycosis and rates of resolution. Achieving reasonable glycemic control and addressing barriers to effective DM management may be just as crucial as effective antifungal therapy.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":"63 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0