Medical mycology最新文献

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A longitudinal study assessing Aspergillus polymerase chain reaction (PCR) performance through participation in external quality assessment schemes from 2019 to 2022. 一项通过参与2019 - 2022年外部质量评估方案评估曲霉聚合酶链反应(PCR)性能的纵向研究。
IF 2.7 3区 医学
Medical mycology Pub Date : 2025-04-30 DOI: 10.1093/mmy/myaf036
Alastair Ricketts, Dorothy Montgomery, Juergen Loeffler, Rosemary Barnes, Mario Cruciani, J Peter Donnelly, P Lewis White
{"title":"A longitudinal study assessing Aspergillus polymerase chain reaction (PCR) performance through participation in external quality assessment schemes from 2019 to 2022.","authors":"Alastair Ricketts, Dorothy Montgomery, Juergen Loeffler, Rosemary Barnes, Mario Cruciani, J Peter Donnelly, P Lewis White","doi":"10.1093/mmy/myaf036","DOIUrl":"https://doi.org/10.1093/mmy/myaf036","url":null,"abstract":"<p><p>Aspergillus polymerase chain reaction (PCR) now employs standardised methodology and commercial options, with clinical performance validated through meta-analyses. The long-term availability of external quality assessment schemes drives performance and provides a currently untapped source of technical data. The Fungal PCR initiative and the Quality Control for Molecular Diagnostics (QCMD) combined forces to evaluate data from the Aspergillus PCR QCMD schemes between 2019 and 2022. Analysis showed inferior detection of non-fumigatus Aspergillus species (i.e.,Aspergillus niger) compared with A. fumigatus. Longitudinal evaluation showed the use of 'in-house' PCR methods by new participants when testing plasma generated lower positivity rates compared to commercial assays.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":"63 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007804","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
Trichosporon species bloodstream infections in a tertiary care hospital in the western region of Saudi Arabia: A 7-year retrospective chart review from 2016 to 2022. 沙特阿拉伯西部地区一家三级医院的毛丝虫病种血流感染:2016 - 2022年7年回顾性图表回顾
IF 2.7 3区 医学
Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf029
Hassan Almarhabi, Aisha Alharbi, Raghad Alfagi, Abdulfattah Al-Amri
{"title":"Trichosporon species bloodstream infections in a tertiary care hospital in the western region of Saudi Arabia: A 7-year retrospective chart review from 2016 to 2022.","authors":"Hassan Almarhabi, Aisha Alharbi, Raghad Alfagi, Abdulfattah Al-Amri","doi":"10.1093/mmy/myaf029","DOIUrl":"https://doi.org/10.1093/mmy/myaf029","url":null,"abstract":"<p><p>Despite advances in medical mycology, invasive Trichosporon spp. infections continue to be associated with high mortality rates. Limited data exist on the risk factors and outcomes of Trichosporon fungemia, particularly in our region. Therefore, this study aims to describe the risk factors, patient characteristics, antifungal susceptibility, and outcome of Trichosporon bloodstream infections at a tertiary care hospital in Saudi Arabia. This was a single-center retrospective chart review that included adult patients ≥ 16 years with positive blood cultures for Trichosporon spp. from January 2016 to December 2022. Descriptive statistics are presented using the mean for continuous variables and the number (percentage) for categorical variables. Ten patients with Trichosporon spp. isolated from blood cultures were eligible for inclusion in this study. The mean age was 58.1 years (range 17-83), with 70% male patients. Additionally, 40% had diabetes mellitus, and 40% had underlying malignancy. Trichosporon asahii was the predominant species in 90% of isolates. All patients had recent broad-spectrum antibiotic use, 80% were exposed to corticosteroids, and all had central venous catheters. One kidney transplant had an early recurrence of Trichosporon spp. fungemia. Four patients were cured of the infection, two were treated with voriconazole monotherapy, and two were treated with a combination of liposomal amphotericin B plus Voriconazole. Thirty-day all-cause mortality was 60%, with three deaths occurring before identification of the isolates. In conclusion, our study reported a predominance of Trichosporon asahii and a mortality rate of 60% in patients with Trichosporon fungemia. Challenges include delayed diagnosis, high mortality, and antifungal resistance, underscoring the need for further research to enhance treatment strategies and patient outcomes.</p>","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/PMC12010956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970637","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
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
{"title":"Role of Phenotypic Switching in the Adaptive Response of Candida tropicalis to Hyperosmotic Stress.","authors":"Hugo Felix Perini, Cássia Milena de Souza, Eloiza Aparecida Paulo, Fernanda Tomiotto-Pellissier, Wander Rogério Pavanelli, Luciana Furlaneto-Maia, Marcia Cristina Furlaneto","doi":"10.1093/mmy/myaf035","DOIUrl":"https://doi.org/10.1093/mmy/myaf035","url":null,"abstract":"<p><p>Phenotypic switching in Candida tropicalis influences virulence and fitness attributes, aiding host colonization by yeast. This study assessed the role of phenotypic switching in hyperosmotic stress adaptation. Two C. tropicalis strains (49.07 and 100.10), each with five morphotypes, were exposed to 1 M NaCl for 10 and 60 min. Results showed that 62.5% of morphotypes were less sensitive to osmotic shock, and 50% had greater osmoadaptation. The crepe morphotype exhibited less cell damage. Changes in cell wall composition, porosity, and expression of EFG1, WOR1, and HOG1 were observed. Phenotypic switching enhances osmoadaptation, impacting treatment strategies and C. tropicalis epidemiology.</p>","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":"144035130","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
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":"<p><p>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.</p>","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
Optimization and clinical evaluation of a 5.8S rRNA quantitative PCR assay for the diagnosis of talaromycosis. 5.8S rRNA定量PCR诊断塔氏菌病的优化及临床评价。
IF 2.3 3区 医学
Medical mycology Pub Date : 2025-04-02 DOI: 10.1093/mmy/myaf040
Dang Hoang Khanh, Lottie Brown, Phan Thi Ha My, Nguyen Thi Mai Thu, Emily Evans, Vo Trieu Ly, Nguyen Thanh Hiep, Ngo Thi Hoa, Thuy Le
{"title":"Optimization and clinical evaluation of a 5.8S rRNA quantitative PCR assay for the diagnosis of talaromycosis.","authors":"Dang Hoang Khanh, Lottie Brown, Phan Thi Ha My, Nguyen Thi Mai Thu, Emily Evans, Vo Trieu Ly, Nguyen Thanh Hiep, Ngo Thi Hoa, Thuy Le","doi":"10.1093/mmy/myaf040","DOIUrl":"10.1093/mmy/myaf040","url":null,"abstract":"<p><p>Talaromyces marneffei is a dimorphic fungus endemic in Southeast Asia that causes the invasive fungal disease talaromycosis in immunocompromised individuals. Detection of T. marneffei nucleic acid in blood by PCR has demonstrated potential as a diagnostic tool for talaromycosis, but previously developed assays have limited sensitivity. This study described the optimization of a quantitative PCR (qPCR) assay for the diagnosis of talaromycosis. Our assay performance was maximized by testing different primers, methods of cell lysis and DNA extraction, whole blood vs. plasma, and methods of specimen treatment, using mean quantification cycle (Cq) values to compare performance. Our qPCR assay achieved the highest analytical sensitivity of 1 yeast cell per mL of whole blood, using primers targeting the 5.8S ribosomal DNA, cell lysis by bead beating, and DNA extraction by the MasterPure Yeast Purification Kit. There was no cross-reactivity observed with six Penicillium species and nine clinically related fungal isolates. In a case-control, diagnostic validation study of 138 cases of talaromycosis and 30 controls with other invasive fungal diseases and opportunistic infections, our 5.8S qPCR assay detected T. marneffei in 99.0% (101/102, 95% CI: 94.6%-99.9%) of blood culture-positive and 55.6% (20/37, 95% CI: 38.1%-72%) of blood culture-negative patients. Overall, our 5.8S qPCR assay had significantly higher sensitivity compared to conventional BACTEC blood culture, 87.7% (95% CI: 80.7%-92.5%) vs. 73.9% (95% CI: 65.6%-80.8%, P < .001), and the specificity was 96.7% (95% CI: 80.9%-99.8%). Our 5.8S qPCR assay has potential as a non-invasive and rapid rule-in test for talaromycosis.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":"63 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022621","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
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
{"title":"Clustered cases of Candida auris colonization: Roles of the infection prevention and control department and the mycology laboratory in controlling transmission.","authors":"Claire Cottrel, Marie Regad, Charlotte Arnal, Sandrine Henard, Marie Desnos-Olivier, Alain Lozniewski, Alexandre Alanio, Anne-Claire Bursztejn, Julie Lizon, Anne Debourgogne","doi":"10.1093/mmy/myaf033","DOIUrl":"https://doi.org/10.1093/mmy/myaf033","url":null,"abstract":"<p><p>Candida auris is an emerging yeast that is responsible for outbreaks via nosocomial transmission. This study describes two cases of C. auris colonization, with confirmed interhospital transmission in the absence of travel history for the index case, although multiple risk factors were present. The role of the infection prevention and control department is essential in implementing barrier measures to limit yeast transmission, whereas the mycology laboratory plays a crucial role in the rapid and effective detection of potential contact cases, as well as environmental contamination.</p>","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":"144027697","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
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":"<p><p>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.</p>","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
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":"<p><p>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.</p>","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
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":"<p><p>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.</p>","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":"<p><p>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.</p>","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
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