Medical mycology最新文献_第3页

Drug-resistance genes and antifungal susceptibility of Trichophyton verrucosum variants isolated from bovine skin lesions and farm environments.

IF 2.7 3区医学

Medical mycology Pub Date : 2025-01-25 DOI: 10.1093/mmy/myae124

Han Gyu Lee, Young-Hun Jung, Ara Cho, Yoon Jung Do, Eun-Young Bok, Jae Ku Oem, Tai-Young Hur

{"title":"Drug-resistance genes and antifungal susceptibility of Trichophyton verrucosum variants isolated from bovine skin lesions and farm environments.","authors":"Han Gyu Lee, Young-Hun Jung, Ara Cho, Yoon Jung Do, Eun-Young Bok, Jae Ku Oem, Tai-Young Hur","doi":"10.1093/mmy/myae124","DOIUrl":"10.1093/mmy/myae124","url":null,"abstract":"Trichophyton verrucosum causes a highly contagious disease in bovines and is occasionally transmitted to humans. Azoles are widely used as antifungal drugs in bovines, and act by targeting the ergosterol biosynthesis pathway. However, cases of treatment failure and recurrence of dermatophyte infections have been associated with mutations at the drug target site. Currently, information on T. verrucosum variants is lacking. This study aimed to classify T. verrucosum variants isolated from animals exhibiting clinical symptoms and cattle environments in the Republic of Korea based on their antifungal susceptibility and the presence or absence of ergosterol biosynthesis (ERG) and subtilisin genes. Of 139 clinical and 39 environmental samples, 86 and 21 were found to be infected, respectively. The positivity rate of calves aged 1-6 months was 73.1%, which was significantly higher than that of calves aged >6 months (55.2%). Twenty-seven T. verrucosum strains were identified as T. album (n = 9), T. ochraceum (n = 6), and T. discoides (n = 12). Antifungal susceptibility testing showed that enilconazole had the lowest geometric mean antifungal activity of 1.08, 1, and 0.94 µg/ml against T. album, T. ochraceum, and T. discoides, respectively. The detection ratios of ERG3 and ERG6 differed significantly among the three variants. In conclusion, our study suggests conducting sample cultures and antifungal susceptibility tests on isolates before administering antifungal drugs. Moreover, the expression profile of ERG appears to have a potential link to drug susceptibility. This information may contribute to the prevention and management of dermatophytosis in cattle.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123370","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

Genomic investigation of an antifungal-resistant Aspergillus fumigatus outbreak in a French hospital.

IF 2.7 3区医学

Medical mycology Pub Date : 2025-01-25 DOI: 10.1093/mmy/myaf012

Valentin Joste, Maëlys Delouis, Abdelmounaim Mouhajir, Stuti Gera Denis-Petit, Pierre Moënne-Locoz, Solen Kernéis, Sandrine Houzé, Christine Bonnal, Romain Coppée

{"title":"Genomic investigation of an antifungal-resistant Aspergillus fumigatus outbreak in a French hospital.","authors":"Valentin Joste, Maëlys Delouis, Abdelmounaim Mouhajir, Stuti Gera Denis-Petit, Pierre Moënne-Locoz, Solen Kernéis, Sandrine Houzé, Christine Bonnal, Romain Coppée","doi":"10.1093/mmy/myaf012","DOIUrl":"10.1093/mmy/myaf012","url":null,"abstract":"Aspergillus fumigatus is associated with various invasive, chronic, and allergic fungal diseases. The emergence of environmental azole-resistant strains complicates the treatment of these infections. The use of whole-genome sequencing (WGS), which is widely used to study bacterial and viral outbreaks, could be beneficial for characterizing azole-resistant A. fumigatus outbreaks. Here, nine azole-resistant cyp51A TR34/L98H A. fumigatus strains isolated during an outbreak in a French hospital between November 2021 and October 2022 were studied. The genetic relatedness of these strains was assessed using microsatellites, high-quality single-nucleotide polymorphisms (SNPs) from WGS data, phylogenetic reconstruction, and principal component analysis. Multiple sequenced but independently cultured A. fumigatus strains were used as identical strain controls. Among the nine unrelated patients infected by TR34/L98H A. fumigatus, five had previously isolated A. fumigatus strains without the cyp51A TR34/L98H mutation. Both microsatellites and WGS confirmed that the initial cyp51A wild-type strains for these five patients were genetically different from the new mutant strains. Eight of the nine TR34/L98H strains were genetically close, with a number of SNPs similar to the controls. These resistant strains were not related to four environmental strains isolated in the hospital. Altogether, the results suggest that at least eight patients were exposed to a common source, although its exact origin could not be determined. The presence of antifungal-resistant strains in healthcare settings underscores the need for active research into resistant strains and that both microsatellites and WGS techniques have their place in the management of A. fumigatus epidemics.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382882","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

Aspergillus spp., aspergillosis and azole usage in animal species in Europe: Results from a multisectoral survey and review of recent literature.

IF 2.7 3区医学

Medical mycology Pub Date : 2025-01-25 DOI: 10.1093/mmy/myaf009

Judith E de Jong, Annet E Heuvelink, Lucía Dieste Pérez, Manon M C Holstege

{"title":"Aspergillus spp., aspergillosis and azole usage in animal species in Europe: Results from a multisectoral survey and review of recent literature.","authors":"Judith E de Jong, Annet E Heuvelink, Lucía Dieste Pérez, Manon M C Holstege","doi":"10.1093/mmy/myaf009","DOIUrl":"10.1093/mmy/myaf009","url":null,"abstract":"Aspergillosis in humans and animals is caused by certain Aspergillus spp. and can be treated with fungicide azoles. Treatment in animals is often long and complicated by the lack of registered products, species-specific pharmacodynamics, side effects, and withdrawal periods for animal products. The emergence of azole resistance in Aspergillus spp. isolates from human, environmental, and avian samples is alarming, requiring multisectoral attention and a One Health approach. Recent information on the prevalence and impact of aspergillosis in animals, and the use of fungicide azoles in their treatment is however lacking. In this study, we collected and analysed data on the occurrence of aspergillosis and/or presence of Aspergillus spp., and the use of fungicide azoles in animal categories in Europe over the last decade, by means of an international survey and literature review. Thirty-three survey responses were included, from respondents with various professional backgrounds. Fifty-eight articles were included for literature review, of which 90% contained information on the presence of Aspergillus spp. in diseased or healthy animals and 38% on the veterinary use of azoles. Results were consistent: the presence of Aspergillus spp. and related disease, and the use of fungicide azoles were most frequently reported in 'companion animals' and 'zoo animals and wildlife'. Considering the limitations in interpreting the obtained results and the lack of available data, more consistent data collection is necessary to accurately estimate the importance of Aspergillus spp. and related diseases, the use of azoles in veterinary medicine, and its relevance in public health.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075162","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

The profound effect of diabetes mellitus control on outcomes of coccidioidomycosis. 糖尿病控制对球孢子菌病预后的深远影响。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-01-25 DOI: 10.1093/mmy/myaf004

Rawan El Kurdi, Alyssa McGary, Matthew R Buras, Patricia M Verona, Curtiss B Cook, Janis E Blair

{"title":"The profound effect of diabetes mellitus control on outcomes of coccidioidomycosis.","authors":"Rawan El Kurdi, Alyssa McGary, Matthew R Buras, Patricia M Verona, Curtiss B Cook, Janis E Blair","doi":"10.1093/mmy/myaf004","DOIUrl":"10.1093/mmy/myaf004","url":null,"abstract":"Coccidioidomycosis is an endemic fungal infection caused by the soil-dwelling Coccidioides. One prior study showed that persons with diabetes mellitus (DM) with elevated glucose at the time of coccidioidomycosis had poorer coccidioidal outcomes compared to persons without DM. We aimed to assess the association between hemoglobin A1C (A1C) and outcomes among persons with coccidioidomycosis and coexisting DM. We conducted a retrospective case-control study of patients with DM (cases) and without DM (controls) with coccidioidomycosis to assess the effect of glycemic control on outcomes in patients with DM. From January 1, 2017, to October 13, 2022, we identified 138 DM patients with coccidioidomycosis and compared them with 283 non-DM control patients with coccidioidomycosis. Compared with controls, cases were more likely to require hospitalization (OR 1.20, P < .001), have a lung cavity (OR 1.36, P < .001) and cavitary complications (OR 1.09, P = .001), require surgical management (OR 1.07, P = .016), and experience relapsed infection (OR 1.09, P = .041). Among the cases, when baseline A1C was assessed as a continuous variable, each 1-unit increase of A1C had a significant effect on coccidioidomycosis-related hospitalizations (A1C OR 1.59, P = .005) and the presence of cavities (OR 1.42, P = .01). Controlling for Charlson Comorbidity Index did not change the significance of A1C influence on outcomes of hospitalization and lung cavities. DM patients with A1C levels ≤8.0 at presentation did not have increased adverse coccidioidomycosis outcomes. In summary, glycemic control profoundly impacts the outcomes of diabetic patients with coccidioidomycosis.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052865","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 an institutional antifungal stewardship program on antifungal usage and outcomes in patients with invasive fungal infections.

IF 2.7 3区医学

Medical mycology Pub Date : 2025-01-25 DOI: 10.1093/mmy/myaf003

Janya Sachdev, Sudesh Gourav, Immaculata Xess, Manish Soneja, Sryla Punjadath, Vijaydeep Siddharth, Mragnayani Pandey, Sonakshi Gupta, Aish Manhas, Bhaskar Rana, Kavi Priya Appasami, Gagandeep Singh

{"title":"Impact of an institutional antifungal stewardship program on antifungal usage and outcomes in patients with invasive fungal infections.","authors":"Janya Sachdev, Sudesh Gourav, Immaculata Xess, Manish Soneja, Sryla Punjadath, Vijaydeep Siddharth, Mragnayani Pandey, Sonakshi Gupta, Aish Manhas, Bhaskar Rana, Kavi Priya Appasami, Gagandeep Singh","doi":"10.1093/mmy/myaf003","DOIUrl":"10.1093/mmy/myaf003","url":null,"abstract":"Therapeutic and prophylactic use of antifungals is rising continuously. However, inadequate awareness of diagnostic and treatment guidelines and limited laboratory modalities lead to inappropriate use. This study assessed the impact of an institutional antifungal stewardship program on antifungal use practices and patient outcomes. In the pre-intervention phase, data was collected regarding antifungal therapy among patients with invasive fungal infections. Appropriateness of antifungal prescription was assessed. In the intervention phase, simple algorithms for diagnosis and management of fungal infections were prepared from international guidelines and incorporated into a booklet for distribution. Monthly training sessions were conducted. New serological and molecular tests and therapeutic drug monitoring were introduced. In the post-intervention phase, an antifungal stewardship team was constituted for clinical advisory on demand and ongoing training. Data regarding antifungal therapy was collected and compared with pre-intervention data. Untreated patients decreased from 25% to 18.9% post-intervention (P = .28). Appropriate antifungal use increased from 72.6% to 77.9% (P = .4) among patients with a single fungal infection, and from 57.1% to 88.5% (P = .04) for at least one infection among those with dual fungal infections. 49 incidents of inappropriate use in various categories were seen among 75 patients receiving antifungals pre-intervention, decreasing to 42 incidents among 94 patients post-intervention (P = .06), particularly evident among patients with dual infections (P = .002). Mortality increased from 51% to 75.86% post-intervention (P = .0001). Overall, the small improvement noticed in antifungal usage pattern can still be considered significant, given the limited study period.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029167","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 MIC Test Strip and reference broth microdilution method for amphotericin B and azoles susceptibility testing on wild-type and non-wild-type Aspergillus species. 在对野生型和非野生型曲霉菌种进行两性霉素 B 和唑类药物药敏试验时，比较 MIC 测试条和参考肉汤微量稀释法。

IF 2.7 3区医学

Medical mycology Pub Date : 2025-01-25 DOI: 10.1093/mmy/myaf006

Katherine Hermida-Alava, Santiago Pola, Guillermo García-Effrón, María L Cuestas

{"title":"Comparison of MIC Test Strip and reference broth microdilution method for amphotericin B and azoles susceptibility testing on wild-type and non-wild-type Aspergillus species.","authors":"Katherine Hermida-Alava, Santiago Pola, Guillermo García-Effrón, María L Cuestas","doi":"10.1093/mmy/myaf006","DOIUrl":"10.1093/mmy/myaf006","url":null,"abstract":"This study aimed to evaluate whether the MIC Test Strip (MTS) quantitative assay for determining the minimum inhibitory concentration (MIC) correlated with the CLSI reference broth microdilution (BMD) method for antifungal susceptibility testing of wild-type and non-wild-type Aspergillus species against antifungal agents known to be usually effective against Aspergillus spp. This study was performed to assist in the decision-making process for possible deployment of the MTS assay for antimicrobial susceptibility testing of Aspergillus species into regional public health laboratories of Mycology due to difficulties in equipping the reference BMD methods in a laboratory routine. For this purpose, a set of 40 phenotypically diverse isolates (27 wild-type, 9 non-wild-type, and 4 species with reduced susceptibility to azoles and amphotericin B [AMB]) collected from clinical samples were tested. MICs were performed by both MTS and reference BMD for AMB and azoles. MTS results for posaconazole correlated well with reference BMD, rendering an almost perfect agreement (kappa value = 1.000) by category interpretation (CI)/category distribution of MICs (CDM) (100%), while voriconazole MTS results yielded a substantial correlation with BMD (kappa value = 0.788) by CI/CDM (97.5%). In contrast, itraconazole and AMB yielded the poorest correlation with BMD, rendering moderate agreement (kappa values of 0.554 and 0.437, respectively) by CI/CDM (87.5% and 85%, respectively). In conclusion, the MTS method represents a valid option for antimicrobial susceptibility testing of Aspergillus species against posaconazole and voriconazole. Itraconazole and AMB MTS results showed some concerning lack of correlation with the corresponding reference BMD results.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052775","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

Positive sputum fungal culture, fungal sensitisation, and airway microbial diversity in asthmatic children.

IF 2.7 3区医学

Medical mycology Pub Date : 2025-01-25 DOI: 10.1093/mmy/myaf005

Paul J Seear, Kathryn G Welsh, Jack Satchwell, Deepa Patel, Catherine H Pashley, Andrew J Wardlaw, Erol A Gaillard

{"title":"Positive sputum fungal culture, fungal sensitisation, and airway microbial diversity in asthmatic children.","authors":"Paul J Seear, Kathryn G Welsh, Jack Satchwell, Deepa Patel, Catherine H Pashley, Andrew J Wardlaw, Erol A Gaillard","doi":"10.1093/mmy/myaf005","DOIUrl":"10.1093/mmy/myaf005","url":null,"abstract":"Sensitisation to thermotolerant fungi such as Aspergillus fumigatus and Candida albicans, which can colonise the airways, is associated with poor lung function in children with asthma. Dysbiosis of bacteria and fungi in the airway microbiome has been reported between health and asthma but has yet to be characterised for fungal-sensitised asthmatic children. We investigated if microbial diversity of the airways is altered in fungal-sensitised school-age asthmatic children. Sputum samples from children with asthma who were fungal sensitised (n = 22) and non-fungal sensitised (n = 17) along with children without asthma (n = 15), aged 5-16 years were profiled by traditional microbiological culture, modified fungal culture, bacterial 16S, and fungal ITS2 next-generation sequencing. Microbiota were compared between groups using alpha/beta diversity and differential abundance analysis. Bacterial alpha diversity was significantly lower in asthma compared to disease controls and in stable compared to acute asthma. Fungal alpha and beta diversity did not change between asthma states and disease controls, but alpha diversity was significantly lower in asthma samples from patients with positive A. fumigatus culture. Children sensitised to fungi had similar microbial diversity compared to non-sensitised children. However, in children not sensitised to fungi, those with a positive airway fungal culture had significantly lower fungal alpha diversity and bacterial beta differences compared to children with negative fungal culture. Fungal sensitisation did not alter bacterial or fungal microbiota in the airways of asthmatic children. However, positive airway fungal culture was associated with significant changes in microbial diversity, particularly in non-fungal sensitised children with asthma.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039991","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

A practical approach to investigating nosocomial acquisition of Aspergillus.

IF 2.7 3区医学

Medical mycology Pub Date : 2025-01-25 DOI: 10.1093/mmy/myaf007

Eelco F J Meijer, Aleksandra Marek, Gordon Ramage, Anuradha Chowdhary, Linda Bagrade, Andreas Voss, Abhijit M Bal

{"title":"A practical approach to investigating nosocomial acquisition of Aspergillus.","authors":"Eelco F J Meijer, Aleksandra Marek, Gordon Ramage, Anuradha Chowdhary, Linda Bagrade, Andreas Voss, Abhijit M Bal","doi":"10.1093/mmy/myaf007","DOIUrl":"10.1093/mmy/myaf007","url":null,"abstract":"Invasive mould disease (IMD) has a high mortality in immunosuppressed patients. Invasive aspergillosis (IA) is the most common IMD. A guideline for preventing IA has been published jointly by the Centers for Disease Control and Prevention, the Infectious Disease Society of America, and the American Society of Blood and Marrow Transplantation. Use of high-efficiency particulate air filters, adequate air exchange rates, sealing of patient rooms, and preventing exposure to moulds by nursing patients in areas away from construction sites are recommended by the guideline. However, there is limited information in relation to the actions to be undertaken by infection prevention and control teams in the event of one or more cases of nosocomial aspergillosis. In this review, we describe a systematic approach to aspergillosis by defining possible and probable nosocomial acquisition based on the number of days since hospital admission. We advocate an incremental response to the investigation of nosocomial aspergillosis in patients in protective isolation taking into account the number of cases and the likelihood of nosocomial origin. For single cases of nosocomial IA, we suggest that infection control investigations should focus on case surveillance and walk-through inspection escalating in a stepwise manner to enhanced case surveillance, verification of environmental controls, environmental monitoring, genotyping of clinical and environmental isolates, and review of antifungal prophylaxis for multiple cases and outbreaks. Where applicable, the construction site should be inspected with the aim to reduce the dispersal of conidia. Surveillance systems need to be strengthened to better understand the epidemiology of IA.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059785","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

Utility of Mucorales polymerase chain reaction to diagnose Rhizomucor infections in neutropenic patients.

IF 2.7 3区医学

Medical mycology Pub Date : 2025-01-25 DOI: 10.1093/mmy/myaf013

Elliot Pfister, Xavier Brousse, Elodie Blanchard, Nahema Issa, Frederic Gabriel, Charlotte Jubert, Hannah Kaminski, Edouard Forcade, Pierre-Yves Dumas, Laurence Delhaes, Maxime Lefranc, Sebastien Imbert

{"title":"Utility of Mucorales polymerase chain reaction to diagnose Rhizomucor infections in neutropenic patients.","authors":"Elliot Pfister, Xavier Brousse, Elodie Blanchard, Nahema Issa, Frederic Gabriel, Charlotte Jubert, Hannah Kaminski, Edouard Forcade, Pierre-Yves Dumas, Laurence Delhaes, Maxime Lefranc, Sebastien Imbert","doi":"10.1093/mmy/myaf013","DOIUrl":"10.1093/mmy/myaf013","url":null,"abstract":"Mucormycoses are life-threatening infections related to fungi from the Mucorales order. Based on fungal culture, the most frequently involved genera are Rhizopus spp., Mucor spp., or Lichtheimia spp. However, since the introduction of Mucorales polymerase chain reaction (PCR), many diagnoses have been made without positive fungal culture, biasing mucormycosis epidemiology. We conducted a single-centre retrospective observational study on invasive mucormycosis cases diagnosed between April 2020 and December 2022. Cases were classified according to EORTC/MSGERC definitions, adding a 'PCR-only' category for patients with a positive Mucorales PCR as the only mycological evidence. Genus/species identification was obtained by sequencing the Mucorales 18S rDNA directly on Mucorales PCR-positive samples. We identified 35 cases of mucormycosis, including 6 proven, 7 probable, and 22 'PCR-only'. Genus/species identification was achievable in 34 cases and surprisingly revealed the genus Rhizomucor as the main aetiological agent (n = 14, 41.2%). Interestingly, all the Rhizomucor infections, except one, were classified as 'PCR-only', while fungal culture was positive in 11/20 (55%) for other Mucorales genera (P <.001). Moreover, in comparison with other genera, the genus Rhizomucor was significantly more associated with neutropenia (11/14 [78.6%] vs. 2/20 [10%], P < .0001) and pulmonary localizations (11/14 [78.6%] vs. 6/20 [30%], P = .01). Our study reveals the changing epidemiology of mucormycosis in our centre with the use of Mucorales PCR and underlines the importance of the genus Rhizomucor, especially in neutropenic patients. This highlights the benefits of using Mucorales PCR in clinical practice for mucormycosis diagnosis in high-risk patients and the need to include it in diagnostic criteria.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256240","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

Sensitivity of Coccidioides serologic tests among culture-proven coccidioidomycosis patients with hematological malignancy compared to a matched immunocompetent cohort.

IF 2.7 3区医学

Medical mycology Pub Date : 2025-01-25 DOI: 10.1093/mmy/myaf008

Mohanad M Al-Obaidi, Amith Rao, Tom Marco, Rishab Srivastava, Paulina Kuzmin, Saman Nematollahi, Tirdad T Zangeneh

{"title":"Sensitivity of Coccidioides serologic tests among culture-proven coccidioidomycosis patients with hematological malignancy compared to a matched immunocompetent cohort.","authors":"Mohanad M Al-Obaidi, Amith Rao, Tom Marco, Rishab Srivastava, Paulina Kuzmin, Saman Nematollahi, Tirdad T Zangeneh","doi":"10.1093/mmy/myaf008","DOIUrl":"10.1093/mmy/myaf008","url":null,"abstract":"Coccidioidomycosis is associated with an increased risk of mortality and morbidity among immunosuppressed patients. The sensitivity of current commercial Coccidioides serologic tests is not well evaluated in patients with hematological malignancy. We conducted a retrospective study, including patients with culture-proven coccidioidomycosis, from October 1, 2017, to December 12, 2023. Cases with hematological malignancy and hematopoietic stem cell transplant (HM) were matched with an immunocompetent cohort (1:2) to compare the sensitivity of serology (enzyme immunoassay IgG/IgM or complement fixation) tests-matched by age, gender, and race. We matched 43 HM patients with 86 controls. The median age of the HM/hematopoietic stem cell transplant cohort was 67 (Interquartile Range [IQR], 52-75), 65% male, and 86% White. Most HM had lymphoma (37%), followed by leukemia (35%). Most cases had pulmonary infection (74%) versus controls (84%), P-value = .2, and 12% had a prior history of coccidioidomycosis compared to controls (17%), P-value = .4. Positive Coccidioides serology test results among HM were statistically significantly lower than controls (37% versus 72%), P-value ≤ .001. Multivariate conditional logistic regression identified HM and a history of coccidioidomycosis as statistically significantly associated with positive serologic testing, with Odds Ratio (OR) 0.27 (95% Confidence Interval [CI] 0.12-0.62, P-value = .002) and OR 6.07 (95% CI 1.25-29.4, P-value = .025), respectively.Coccidioides serology tests in HM patients with culture-proven coccidioidomycosis had low sensitivity. Given the increased risk of complications in this group, future studies are needed to evaluate more sensitive diagnostic tests.","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075171","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