Medical mycology最新文献

{"title":"Occupational risk of Histoplasma capsulatum exposure among field biologists in Ecuador: Evidence from skin testing and serology.","authors":"Primavera Alvarado, Mónica Salomé Guerrero-Freire, Julio Rivas, Fernanda Hernández-Alomía, Pablo Sánchez, Jacobus H de Waard, Carlos Bastidas-Caldes","doi":"10.1093/mmy/myag101","DOIUrl":"10.1093/mmy/myag101","url":null,"abstract":"<p><p>Histoplasma capsulatum, a dimorphic fungus, is the causative agent of histoplasmosis, a respiratory disease with a wide clinical spectrum ranging from asymptomatic infection to severe pulmonary or disseminated disease. Although Ecuador is recognized as an endemic country, histoplasmosis remains underreportesd. This study presents the first investigation in Ecuador assessing occupational exposure to H. capsulatum among field biologists and environmental scientists, a group presumed to be at increased risk due to frequent contact with wildlife, caves, and rural environments. A total of 46 workers underwent histoplasmin intradermal skin testing to assess prior exposure. Positive reactions were defined as induration ≥ 5 mm at 48 h. Histoplasmin positivity was detected in 21 participants (45%), with induration sizes ranging from 5 to 32 mm (mean 15 mm). Among histoplasmin-positive individuals, reported risk factors included cave visitation (83%), contact with dead animals or feces (55%), and contact with live wildlife such as bats, rodents, and birds (50%). Serological testing identified evidence of recent infection in three participants, none of whom presented clinical symptoms at the time of evaluation. Our findings demonstrate substantial occupational exposure to H. capsulatum among Ecuadorian field biologists and highlight the need for improved surveillance, diagnostic capacity, and clinical awareness of histoplasmosis in endemic, resource-limited settings.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990366","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}

{"title":"Molecular characterization and antifungal susceptibility of Aspergillus spp. isolated from critically ill COVID-19 patients: Implications for suspected COVID-19-associated pulmonary aspergillosis (CAPA) in a Brazilian tertiary referral hospital.","authors":"Tiago Alexandre Cocio, Vivian Caso Coelho, Ludmilla Tonani, Ingrid Gonçalves Costa-Leite, Marcia Regina von Zeska Kress, Gilda Maria Barbaro Del Negro, Marcia de Souza Carvalho Melhem, Célia Soares, Nelson Lima, Tânia Sueli de Andrade, Marcello Mihailenko Chaves Magri, Gil Benard, Roberto Martinez, Valdes Roberto Bollela","doi":"10.1093/mmy/myag092","DOIUrl":"10.1093/mmy/myag092","url":null,"abstract":"<p><p>COVID-19-associated pulmonary aspergillosis (CAPA) is a severe complication in critically ill patients, but species identification and antifungal resistance data from middle-income countries remain limited. We analyzed 17 Aspergillus isolates from respiratory specimens of 15 critically ill patients with COVID-19 in São Paulo State, Brazil, during 2020-2021. Patients were retrospectively classified according to ECMM/ISHAM criteria as probable CAPA (n = 5), possible CAPA (n = 7), or non-CAPA (n = 3). Complementary reassessment using the 2024 FUNDICU definitions classified patients as probable invasive pulmonary aspergillosis (IPA; n = 3), probable tracheobronchial aspergillosis (TBA; n = 1), or as not meeting these definitions (n = 9); two were ineligible due to classical EORTC/MSGERC host factors (n = 2). Species identification was performed by benA sequencing and MALDI-TOF MS. Susceptibility to amphotericin B (AMB), itraconazole (ITZ), voriconazole, and posaconazole (PCZ) was determined according to CLSI M38-A2, and cyp51A and its promoter were analyzed in A. fumigatus. The predominant species were A. fumigatus (n = 7) and A. flavus (n = 5), followed by A. tamarii (n = 2), A. parasiticus, A. terreus, and A. welwitschiae (n = 1 each). All A. fumigatus isolates exhibited non-wild-type phenotypes (NWT) against PCZ, with some also showing reduced susceptibility to ITZ and AMB. Silent cyp51A mutations occurred in three A. fumigatus isolates, while several section Flavi isolates displayed multiazole NWT. These findings highlight diagnostic limitations and emerging azole resistance, supporting susceptibility testing and surveillance.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919970","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}

{"title":"Molecular correlates of elevated terbinafine and fluconazole MICs in Trichophyton mentagrophytes complex isolates.","authors":"Sima Sadat Seyedjavadi, Hussein R Mahmood, Zahra Salehi, Mahdis Yousefi, Hadiseh Mirzaei, Mehdi Razzaghi-Abyaneh","doi":"10.1093/mmy/myag100","DOIUrl":"10.1093/mmy/myag100","url":null,"abstract":"<p><p>The Trichophyton mentagrophytes complex is a major etiological group in dermatophytosis, within which T. indotineae has emerged as an important cause of recalcitrant infection, with elevated minimum inhibitory concentrations (MICs) to first-line antifungal agents being reported with increasing frequency. However, the molecular features accompanying elevated MICs to terbinafine and azoles in clinical isolates remain incompletely resolved. Seventy-two clinical isolates of T. mentagrophytes complex were identified by the Internal Transcribed Spacer sequencing, and their susceptibility to eight antifungal agents was determined using the Clinical and Laboratory Standards Institute M38-Ed3 broth microdilution method. Isolates meeting predefined elevated-MIC criteria for terbinafine (≥ 0.5 µg/ml) and/or fluconazole (> 16 µg/ml) were subjected to partial sequencing of squalene epoxidase (SQLE) and multidrug resistance (MDR2) genes. Relative SQLE and MDR2 transcript abundance was quantified by qPCR. T. indotineae was the predominant species (86.2%) and exhibited higher geometric mean MIC values for eight antifungal agents than the other members of the complex. Among isolates with elevated terbinafine MICs, nonsynonymous SQLE substitutions were identified, most frequently F397L, L393S, Q408L, and the combined F397L/A448T profile; these isolates also exhibited increased SQLE transcript levels (approximately 8.6 ± 2.7-fold) relative to susceptible comparators comprising two reference strains and two susceptible clinical isolates. In isolates with elevated fluconazole MICs, the MDR2 V438I substitution was detected exclusively in T. indotineae and was absent from T. mentagrophytes and T. interdigitale, favoring its interpretation as a species-associated polymorphism rather than a resistance-associated mutation. Elevated fluconazole MICs were additionally associated with significantly increased baseline MDR2 transcript levels (16.32 ± 2.1-fold relative to susceptible strains). Isolates with elevated MICs to both terbinafine and fluconazole showed greater SQLE and MDR2 transcript abundance than isolates with an elevated MIC to only one agent. Collectively, elevated terbinafine MICs were associated with canonical SQLE substitutions and increased SQLE expression, whereas elevated fluconazole MICs were associated primarily with higher baseline MDR2 expression. The MDR2 V438I variant appears to be species associated and showed no evident relationship with reduced fluconazole susceptibility. These findings define molecular associations within this clinical collection but do not establish causality.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976773","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}

{"title":"Microsporum canis complex infections in the United Arab Emirates: Clinical, molecular, and antifungal susceptibility profiles.","authors":"Febin Anes, Akela Ghazawi, Hari Pankaj Vanam, Dana Aljneibi, Mushtaq Khan, Fouzia Jabeen, Ahmed R Alsuwaidi, Jens Thomsen, Mohammad AlBataineh, Stefan Weber, Connie Gibas, Nathan P Wiederhold, Fatima Al Dhaheri","doi":"10.1093/mmy/myag091","DOIUrl":"10.1093/mmy/myag091","url":null,"abstract":"<p><p>Microsporum canis complex infections remain a major cause of pediatric dermatophytosis, yet molecular epidemiologic and antifungal susceptibility data from the Arabian Gulf are scarce, with no contemporary regional assessment since 1981-1988. We characterized the clinical, molecular, and antifungal susceptibility profiles of M. canis complex isolates in Abu Dhabi and assessed concordance between phenotypic and ITS-based identification. Fifty-two clinical dermatophyte isolates collected through passive surveillance at the UAEU Fungal Reference Laboratory (September 2024-December 2025) underwent phenotypic identification, ITS sequencing, and antifungal susceptibility testing (CLSI M38). Clinical data were available for 48 patients. ITS sequencing identified 47 isolates (90.4%) as M. canis and 5 (9.6%) as the M. audouinii clade, with phenotypic discordance in 9.6% of isolates (including one M. canis misidentified as Trichophyton rubrum). The cohort was predominantly pediatric (79.2% ≤12 years; 54.2% female). Tinea capitis predominated (60.4%), followed by tinea corporis (20.8%) and multifocal disease (16.7%). Cat exposure was reported in 50% and infected household contact in 27.1%. All isolates showed low minimum inhibitory concentrations (MICs ; terbinafine MIC₅₀/₉₀ 0.015/0.03; itraconazole ≤ 0.03/0.06; voriconazole ≤ 0.03/≤0.03; griseofulvin 0.125/0.25; fluconazole 4/8 µg/ml). Despite this, 81.2% (26/32) of patients with follow-up experienced treatment failure or recurrence, with no clear MIC-outcome association. This first molecular and antifungal characterization of M. canis complex infections in the UAE over three decades showed that ITS sequencing corrected phenotypic identification in nearly 10% of cases. High recurrence despite low MICs suggests limited predictive value of in vitro susceptibility, supporting species-directed management, molecular confirmation, species-directed management, and One Health strategies.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857527","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}

{"title":"Clinical characteristics, susceptibility profiles, and outcomes of infection with Alternaria species: A 14-year retrospective study.","authors":"Joya-Rita Hindy, Austin B Auyeung, Ryan W Stevens, Nischal Ranganath, Sharon M Deml, Nancy L Wengenack, Aditya S Shah","doi":"10.1093/mmy/myag093","DOIUrl":"10.1093/mmy/myag093","url":null,"abstract":"<p><p>Alternaria spp. are dematiaceous ascomycetes that can cause opportunistic infections in immunocompromised hosts. They are challenging to identify and treat. However, optimal antifungal therapy remains undefined. We retrospectively reviewed antifungal susceptibilities (AST) of all Alternaria spp. isolates from adults at a tertiary care center between 2011 and 2025. We evaluated culture sources, minimum inhibitory concentration (MIC) and minimal effective concentration (MEC) distributions, and MIC₅₀/MIC₉₀ and MEC50/MEC90 values. Clinical characteristics, treatment measures, and outcomes of patients with clinically significant Alternaria spp. infections were described. Forty-one patients had Alternaria spp. isolated, most commonly from skin (n = 13), bone/joint (n = 5), nail (n = 3), or cornea (n = 3). Posaconazole and itraconazole demonstrated low MICs (MIC₅₀/MIC₉₀: 0.06/0.5 and 0.25/0.5µg/ml, respectively). Voriconazole and isavuconazole showed higher MIC₅₀/MIC₉₀ (1/2 and 2/4µg/ml). Caspofungin (0.125/0.5µg/ml) and amphotericin B (0.25/1µg/ml) had low MICs and MECs. Alternaria spp. represented clinically significant infection in 27 cases (66%); 26% were solid organ transplant recipients and 15% had hematologic malignancies. Other risk factors included preceding trauma (22%) and autoimmune disease (15%). Posaconazole was the most frequently used empiric agent (6, 32%). Following AST results, 14 patients (52%) received oral antifungal therapy; posaconazole was used in all 14. In addition, seven patients (26%) received combination therapy with IV amphotericin B. Adjunctive surgery occurred in 14 cases (52%). Five patients (19%) died before completing therapy; Alternaria infections occurred predominantly in immunocompromised hosts and were frequently managed with posaconazole and surgery. Interpretive criteria for Alternaria spp. are needed to guide empiric and definitive therapy.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906690","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}

{"title":"Oral wash PCR for the diagnosis of Pneumocystis jirovecii pneumonia in non-HIV immunocompromised hosts: a diagnostic accuracy study.","authors":"Isshak Bendjelloul, Hannah Kaminski, Nahéma Issa, Eliot Quintin, Olivier Guisset, Didier Neau, Fabrice Camou, Antoine Dewitte, Mathieu Larroquette, Edouard Forcade, Benjamin Repusseau, Louis Bébéar, Aurélie Lafargue, Laurence Delhaes, Frédéric Gabriel, Sébastien Imbert, Elodie Blanchard","doi":"10.1093/mmy/myag086","DOIUrl":"10.1093/mmy/myag086","url":null,"abstract":"<p><p>We assessed the Pneumocystis jirovecii PCR accuracy on non-invasive oropharyngeal wash (OW) specimens for the diagnosis of Pneumocystis jirovecii pneumonia (PJP) in non-HIV immunocompromised patients. In this retrospective study, 134 patients with suspected PJP undergoing both OW and deep respiratory sampling were included. PJP was defined by composite criteria. OW P. jirovecii PCR showed a sensitivity of 61.5% (95% confidence intervals [CI] 42.5-77.6) and a specificity of 97.2% (95% CI 92.2-99.1). Positive and negative predictive values were 84.2% and 91.3%, respectively. These results suggest OW P. jirovecii PCR may support non-invasive diagnosis, but cannot be used to exclude PJP.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723861","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}

{"title":"Dematiaceous fungal keratitis: prevalence, spectrum, clinical features, outcome, and antifungal susceptibility from a tertiary care centre in North India.","authors":"Ankita Saroya, Amit Gupta, Shivaprakash M Rudramurthy, Chintan Malhotra, Parul Chawla Gupta, Snigdha Reddy, Vrinda Sharma, Indu Dhiman, Harsimran Kaur, Anup K Ghosh","doi":"10.1093/mmy/myag099","DOIUrl":"10.1093/mmy/myag099","url":null,"abstract":"<p><p>Fungal keratitis (FK) is a sight-threatening corneal infection that leads to corneal blindness. Dematiaceous fungal keratitis (DFK) emerged as the predominant cause of FK, followed by Aspergillus spp. and Fusarium spp. This study aimed the prevalence, species distribution, associated clinical features, risk factors, and antifungal susceptibility for keratitis caused by dematiaceous fungi. A prospective study was conducted on suspected FK patients from June 2023 through November 2025 at PGIMER Chandigarh. The corneal samples were processed for routine mycological investigations, including direct microscopy potassium hydroxide (KOH mount) and culture on SDA (Sabouraud's Dextrose agar), further confirmed by DNA sequencing. Antifungal susceptibility testing (AFST) was performed as per the CLSI (Clinical Laboratory and Standards Institute) broth microdilution method (M38-A2) for a panel of nine drugs, including voriconazole, itraconazole, posaconazole, luliconazole, miconazole, ketoconazole, amphotericin-B, natamycin, and terbinafine. Among 1931 suspected FK patients, 452 were confirmed FK where 75 were DFK and prevalence of DFK was calculated 3.88%. Curvularia spp. was found to be most prevalent (n = 39,52%), followed by Alternaria spp. (n = 9, 12%), Colletotrichum spp. (n = 8,10.66%), and Exserohilum spp. (n = 6, 8%) along with eight other rare genera were isolated. Redness, watering, and a decrease in vision were significantly more common in DFK. Amongst the triazoles, voriconazole showed low minimum inhibitory concentration (MIC) range of 0.03-16 µg/ml. AFST also demonstrated low MICs to luliconazole and terbinafine. The present study showed a prevalence of 3.88% DFK in North India with Curvularia spp. as the predominant causative agent. In vitro susceptibility of voriconazole demonstrated better performance against DFK isolates.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990409","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}

{"title":"Cross-species transmission risk of Enterocytozoon bieneusi in captive Tarim red deer from southern Xinjiang, China.","authors":"Duoduo Su, Qilin Wang, Aiyun Zhao, Fuchang Yu, Qiushuo Xiao, Zhenjie Zhang, Meng Qi","doi":"10.1093/mmy/myag081","DOIUrl":"10.1093/mmy/myag081","url":null,"abstract":"<p><p>Enterocytozoon bieneusi is a widespread intracellular fungal pathogen that infects a variety of hosts. To investigate its prevalence and genetic diversity in captive Tarim red deer in southern Xinjiang, we collected 630 fresh fecal samples from 10 farms between 2020 and 2021. PCR targeting the ITS gene revealed an overall infection rate of 23.5% (148/630), with 8 out of 10 farms testing positive. Infection rates varied significantly by farm (12.2%-83.9%, P < 0.01) and age group (P < 0.01), peaking at 53.9% in 12-24-month-old deer and dropping to 0.6% in 6-12-month-old individuals. Sequencing identified 22 genotypes: 7 known and 15 novel (XJRD1-XJRD15), with BEB6 (54.7%) and D (21.6%) being the most prevalent. Phylogenetic analysis categorized 16 genotypes into zoonotic Groups 1 and 6 into host-adapted Group 2, with novel genotypes forming distinct subclades. Tarim red deer serve as a crucial reservoir for E. bieneusi diversity and pose zoonotic risks, highlighting the need for targeted One Health interventions.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670096","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}

{"title":"Clinical spectrum, clinical associations, and treatment outcomes of scedosporiosis in South India: A retrospective cohort study.","authors":"Malavika Krishnakumar, Gayathri Mohan, Apeksha Singh, Annup Balan, Georg Gutjahr, Merlin Moni, Dipu Ts","doi":"10.1093/mmy/myag074","DOIUrl":"10.1093/mmy/myag074","url":null,"abstract":"<p><p>Scedosporium is an emerging opportunistic filamentous fungus widely distributed in soil and stagnant water. Mortality remains substantial and management is often challenging due to intrinsic antifungal resistance and delays in diagnosis. In this retrospective cohort study, we describe the clinical spectrum, microbiological characteristics, and outcomes of microbiologically culture-confirmed scedosporiosis at a tertiary care centre in South India between May 2016 and August 2024. A total of 18 patients were included, with a median age of 54 years and a predominance of male patients. Contrary to the patterns described in many Western and transplant-focused cohorts, the majority of infections in our series involved osteomyelitis and paranasal sinus disease. Disseminated infection was rare but was associated with poor outcomes. Voriconazole-based therapy was the most commonly used antifungal regimen, and surgical intervention was required in six cases. Our findings highlight a distinct clinical pattern of scedosporiosis in our setting, with osteomyelitis and sinusitis emerging as predominant presentations. These observations emphasize the importance of maintaining a high index of suspicion for Scedosporium infection in chronic bone and sinus disease, particularly when patients fail to respond to conventional antibacterial therapy.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697767","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}

{"title":"Candidemia during the COVID-19 pandemic in a Brazilian tertiary care hospital: Comparison of episodes with and without COVID-19.","authors":"Debora Otero Britto Passos Pinheiro, Anna Carla Castiñeiras, Luiz Felipe de Abreu Guimarães, Gloria Barreiros, Henrique Leandro Reis Rocha, Marcio Nucci, Simone A Nouér","doi":"10.1093/mmy/myag079","DOIUrl":"10.1093/mmy/myag079","url":null,"abstract":"<p><p>The epidemiology of candidemia changed during the COVID-19 pandemic, but direct comparisons of episodes with and without coronavirus disease 2019 (COVID-19) remain limited. We performed a retrospective cohort study of consecutive adult patients with candidemia diagnosed from February 2020 through February 2023 at a Brazilian tertiary-care teaching hospital. Demographic, clinical, microbiological, treatment, and outcome variables were compared according to COVID-19 status, and predictors of 30-day mortality were evaluated among treated patients. Among 106 episodes in 103 patients, 36 (34.0%) occurred in patients with COVID-19. The overall incidence was 4.41 episodes per 1000 admissions (95% confidence interval [CI], 3.61-5.33), and the incidence among COVID-19 admissions was 20.97 per 1000 (95% CI, 14.69-29.03). Episodes with COVID-19 were associated with intensive care, mechanical ventilation, corticosteroid exposure, higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, hypotension, and vasopressor use. Thirty-day survival was lower with COVID-19 (19.4% vs. 48.6%; P = .003). Among treated episodes, APACHE II score and vasopressor use were independently associated with 30-day mortality. Candidemia associated with COVID-19 occurred in a setting of substantially greater acute illness severity, and severity markers rather than COVID-19 itself appeared to drive excess mortality.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631036","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}