Mycoses最新文献

{"title":"Central Nervous System Aspergillosis: Advances in Diagnosis, Therapeutics, and Multidisciplinary Management (2026 Update).","authors":"Moustafa A Mansour, Mohamed Wahid, Mohamed A S El Molla, Mohamed H Helmy, Taha Mohammed Adel, Hamdi Nabawi Mostafa","doi":"10.1111/myc.70214","DOIUrl":"10.1111/myc.70214","url":null,"abstract":"<p><strong>Background: </strong>Central nervous system (CNS) aspergillosis is a life-threatening infection with mortality rates exceeding 50%, especially in immunocompromised patients. Significant challenges persist due to limited antifungal drug penetration into the CNS, emerging resistance, and diagnostic delays, despite advancements in therapy and diagnostics.</p><p><strong>Objective: </strong>This comprehensive review aims to synthesize pivotal advances in the management of CNS aspergillosis from 2020 to 2026 and to provide a multidisciplinary framework for addressing these ongoing challenges.</p><p><strong>Methods: </strong>We conducted a comprehensive evaluation of the latest clinical data, pharmacokinetic studies, and expert recommendations from the specified period. The review critically appraises evidence on pharmacological therapies, diagnostic technologies, and adjunctive treatment strategies.</p><p><strong>Findings: </strong>Key findings include: Pharmacotherapy: Voriconazole remains the cornerstone of therapy due to its superior CNS penetration (CSF:Plasma ratio ~50%). The roles of alternatives like isavuconazole, salvage combination regimens, and novel agents (e.g., olorofim, fosmanogepix) are evolving.</p><p><strong>Diagnostics: </strong>Cutting-edge tools such as AI-assisted imaging, metagenomic next-generation sequencing (mNGS), and MR spectroscopy for trehalose detection show significant potential for enabling earlier and more accurate diagnosis. Adjunctive Strategies: Neurosurgical intervention, immunomodulation, and therapeutic drug monitoring (TDM) are critical for optimizing outcomes. Emerging strategies like nanoparticle-based drug delivery and host-directed therapies (e.g., PD-1/PD-L1 blockade) offer promising avenues to overcome the blood-brain barrier.</p><p><strong>Conclusion: </strong>This review integrates the latest evidence to provide a timely and actionable resource for clinicians. It bridges gaps in existing guidelines by offering a multidisciplinary approach that addresses the complex management of CNS aspergillosis, with particular relevance for high-risk populations such as COVID-19 and immunocompromised patients.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 9","pages":"e70214"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically Important Emerging and Uncommon Fungal Pathogens in Asia: Epidemiology, Antifungal Resistance and Challenges in Diagnosis and Management.","authors":"Narut Chancharussin, Anupop Jitmuang, Arunaloke Chakrabarti, Methee Chayakulkeeree","doi":"10.1111/myc.70222","DOIUrl":"10.1111/myc.70222","url":null,"abstract":"<p><p>Fungal infections in Asia are influenced by warm, humid climates, high population density and expanding healthcare systems, which together facilitate the emergence, transmission and detection of both common and rare pathogens. While Candida and Aspergillus species remain the leading causes of invasive fungal disease, increasing attention has focused on uncommon yeasts and rare moulds, many of which show intrinsic or acquired antifungal resistance. Advances in molecular diagnostics and susceptibility testing have improved identification of emerging pathogens, including uncommon Candida species and rare moulds such as Mucorales, filamentous Basidiomycetes, non-marneffei Talaromyces, Oomycetes and thermally dimorphic fungi like Emergomyces. These organisms primarily affect immunocompromised individuals and present significant diagnostic and therapeutic challenges due to identification difficulties, variable susceptibility patterns and limited clinical experience. Clinical presentations range from fungaemia and invasive pulmonary disease to cutaneous and disseminated infections. Treatment is guided by pathogen and susceptibility profiles, commonly involving echinocandins, amphotericin B and azoles. In some cases, particularly infections caused by Oomycetes and Mucorales, prompt surgical intervention is essential. This review provides a comprehensive overview of current epidemiological trends, risk factors, clinical features, antifungal susceptibility patterns and treatment outcomes associated with rare and emerging fungal pathogens in Asia. By highlighting these increasingly recognized infections, it aims to enhance awareness among clinicians and mycologists, promote evidence-based diagnostic and therapeutic approaches and inform future research addressing this evolving and clinically significant public health challenge.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 9","pages":"e70222"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antifungal Susceptibility Profile and Biocide Tolerance in Clinically Relevant Yeasts: Implications for Therapy and Hospital Infection Control.","authors":"Yasmim Passos Lima, Letícia Rebello Machado, Ricardo Villela Bastos, Victor Quinet de Andrade Bastos, Lucas Quinet de Andrade Bastos, André Netto Bastos, Claudio Galuppo Diniz, Vania Lúcia da Silva, Vanessa Cordeiro Dias","doi":"10.1111/myc.70216","DOIUrl":"10.1111/myc.70216","url":null,"abstract":"<p><strong>Background: </strong>Opportunistic yeasts account for a substantial proportion of invasive fungal infections and are important agents of healthcare-associated infections, especially in intensive care units (ICUs).</p><p><strong>Objectives: </strong>To describe the clinical and epidemiological characteristics of hospitalized patients with positive cultures for medically relevant yeasts and correlate these data with antifungal susceptibility, biocide tolerance and phenotypic efflux pump activity.</p><p><strong>Methods: </strong>Ninety-four clinical isolates were analysed: 31 Trichosporon asahii, 39 Candida albicans and 24 other yeasts. Antifungal susceptibility and biocide tolerance were assessed by disk diffusion, and phenotypic efflux pump activity was evaluated using ethidium bromide. Clinical and epidemiological data were retrieved from electronic health records.</p><p><strong>Results: </strong>Most isolates (73.4%) originated from ICUs. Urine (55.3%) was the most frequent clinical specimen. Overall mortality was 62.7%, reaching 71.8% among patients with C. albicans. Notably, 68.1% of patients did not receive antifungal therapy after diagnosis. All T. asahii isolates were susceptible to azoles and resistant to caspofungin. C. albicans showed high susceptibility to amphotericin B (100%) and caspofungin (93%). Phenotypic efflux pump activity was observed in all evaluated yeasts. Sodium hypochlorite showed greater antifungal activity, with inhibition zones of up to 18.0 mm, while hydrogen peroxide (4.25%) and benzalkonium chloride (5%) showed minimal zones (~6 mm) for all isolates.</p><p><strong>Conclusions: </strong>Opportunistic yeast infections continue to pose a major challenge in healthcare settings. Our findings highlight the critical importance of accurate laboratory identification, ongoing surveillance of antifungal susceptibility, and effective infection prevention and control strategies, including the rational selection of biocides, to improve patient outcomes.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 9","pages":"e70216"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidden Mould in the Air: A Practical Narrative Mini-Review of Invasive Mould Infection Prevention for High-Risk Patients and Clinicians.","authors":"Angelika Bauer, Cornelia Lass-Flörl, Stephan Steixner, Oliver Cornely, Ilana Reinhold, Laura Walti","doi":"10.1111/myc.70224","DOIUrl":"10.1111/myc.70224","url":null,"abstract":"<p><p>Airborne mould spores, including those of the Aspergillus species, are ubiquitous both indoors and outdoors. While they are generally harmless, inhaled spores can cause severe infections, particularly invasive pulmonary aspergillosis, in patients with impaired immune defences. Allergic manifestations such as asthma arise by different mechanisms and are not covered. This narrative mini-review summarises key evidence and guideline recommendations for healthcare teams and provides practical, patient-friendly advice by highlighting clinical and infection-prevention considerations. As there is no safe exposure threshold or minimum infectious dose for individual patients, prevention focuses on reducing avoidable exposure during high-risk periods. These high-risk periods typically refer to medical conditions such as prolonged neutropenia, the early post-transplant period, and high-dose corticosteroid therapy. Furthermore, prevention also focuses on optimising hospital environmental controls by implementing high-efficiency particulate air filter filtration, protective rooms and construction dust containment, alongside antifungal prophylaxis when indicated. The most impactful measures at home are preventing and rapidly remediating visible mould and dampness, avoiding high-spore activities such as composting, handling potting soil, and working with demolition or renovation dust, and maintaining simple hygiene practices that reduce dust reservoirs. This narrative mini-review also summarises what the literature can and cannot provide. Although Aspergillus species account for most of the available evidence, the same exposure-reduction principles apply to other environmentally acquired moulds, including Mucorales, Fusarium species and Scedosporium species.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 9","pages":"e70224"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multifactorial Azole Response in Clinically Relevant Fusarium Species Complexes.","authors":"Patrícia Helena Grizante Barião, Ludmilla Tonani, Adriana Rodrigues Alves, Otávio Guilherme Gonçalves de Almeida, Cledir Santos, Marcia Regina von Zeska Kress","doi":"10.1111/myc.70220","DOIUrl":"10.1111/myc.70220","url":null,"abstract":"<p><strong>Background: </strong>Fusarium spp. are clinically relevant filamentous fungi with intrinsically low susceptibility to multiple antifungal agents, particularly azoles, and are included in the World Health Organization fungal priority pathogens list.</p><p><strong>Objectives: </strong>To investigate azole resistance-related mechanisms in clinical isolates belonging to the Fusarium solani species complex (FSSC), Fusarium oxysporum species complex (FOSC) and Fusarium fujikuroi species complex (FFSC) recovered in São Paulo, Brazil.</p><p><strong>Methods: </strong>Twenty-six clinical isolates were identified by sequencing of the ITS region, TEF1 and RPB2. Antifungal susceptibility testing, CYP51A amplification and sequencing and expression analysis of CYP51A and ABC1 under voriconazole exposure were performed.</p><p><strong>Results: </strong>Antifungal susceptibility testing showed broadly elevated azole MICs, with the FSSC displaying the least favourable profile. Comparative CYP51A analysis revealed distinct amino acid signatures among the three species complexes, including residues at positions equivalent to canonical azole resistance hotspots in Aspergillus fumigatus. However, no simple relationship was observed between CYP51A amino acid profiles and azole MIC values. In contrast, voriconazole exposure induced marked CYP51A upregulation in all tested isolates, with substantially higher expression in the higher-MIC FSSC isolate. ABC1 was also upregulated in FSSC isolates, although at markedly lower levels than CYP51A.</p><p><strong>Conclusions: </strong>These findings support a multifactorial model of azole response in Fusarium species complex strains, involving conserved CYP51A sequence features, strong target-gene induction under antifungal stress, and a lower but detectable contribution of efflux-associated mechanisms.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 9","pages":"e70220"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotypes, Fluconazole Tolerance and Virulence Phenotypes of Candida albicans Bloodstream Isolates: A Multilocus Sequence Typing-Based Analysis.","authors":"Shang-Yi Lin, Yin-Tse Huang, Ho-Yin Huang, Wei-Chun Hung, Yi-Ting Tseng, Po-Liang Lu","doi":"10.1111/myc.70217","DOIUrl":"10.1111/myc.70217","url":null,"abstract":"<p><strong>Background: </strong>Fluconazole tolerance is an emerging phenotype in Candida albicans bloodstream infections, but its relationship to multilocus sequence typing (MLST) lineages and virulence traits is unclear.</p><p><strong>Objectives: </strong>To investigate the relationships among MLST genotypes, fluconazole tolerance, and virulence phenotypes in C. albicans bloodstream isolates.</p><p><strong>Methods: </strong>179 C. albicans bloodstream isolates collected from three hospitals in southern Taiwan (2013-2020) were evaluated. Fluconazole tolerance was quantified as the fraction of growth within the inhibition zone (FoG₂₀) using the diskImageR pipeline. Phenotypic profiling included quantification of biofilm biomass and extracellular hydrolytic enzymes. Genetic relatedness was determined via MLST.</p><p><strong>Results: </strong>The cohort exhibited significant fluconazole tolerance with a mean FoG₂₀ of 0.29 ± 0.19. FoG₂₀ weakly correlated with biofilm biomass (r = 0.218, p = 0.003). MLST identified 169 unique diploid sequence types with 14 clades and 25 clonal complexes (CCs). The high fluconazole tolerance phenotype was broadly distributed across genetically diverse lineages, although clade 16 showed higher mean FoG₂₀ (0.39) (p = 0.003) and biofilm biomass (0.83) (p = 0.039). In multivariable analysis, clade 16 (aOR 2.86; 95% CI 1.08-7.56; p = 0.034) and protease activity (aOR 2.65; 95% CI 1.24-5.64; p = 0.012), but not biofilm biomass (p = 0.142), were independently associated with high tolerance. High tolerance showed a borderline association with 14-day mortality (aOR 2.56; 95% CI 0.99-6.62; p = 0.052).</p><p><strong>Conclusions: </strong>Fluconazole tolerance in C. albicans was distributed across diverse lineages, suggesting convergent adaptation. Clade 16 and protease activity were independently associated with tolerance. Given the observed trend toward an association between high tolerance and 14-day mortality, future mechanistic studies and larger clinical outcome studies are warranted.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 9","pages":"e70217"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Dimensional Airway Reconstruction and Computational Spray Simulation to Guide Bronchoscopic Amphotericin B Delivery in Chronic Pulmonary Aspergillosis: An Exploratory Prospective Cohort Study With Historical Controls.","authors":"Yonghui Cheng, Hao Zhu, Guoshi Wan, Enguo Chen, Riqing Chen, Chenhui Su, Hong Xu, Xiongjun Fu, Wenwen Kong, Jisong Zhang","doi":"10.1111/myc.70219","DOIUrl":"10.1111/myc.70219","url":null,"abstract":"<p><strong>Objective: </strong>To initially evaluate the feasibility and potential clinical value of high-resolution computed tomography (HRCT)-based three-dimensional (3D) airway reconstruction combined with computational spray simulation for guiding bronchoscopic amphotericin B delivery in patients with chronic pulmonary aspergillosis (CPA).</p><p><strong>Methods: </strong>This multicenter, prospective cohort study with an expanded historical control was conducted. Patients in the prospective reconstruction cohort received HRCT-based 3D airway reconstruction combined with computational spray simulation to guide bronchoscopic amphotericin B delivery. Historical controls consisted of eligible CPA patients with complete clinical, imaging, treatment, adverse-event, and 6 month follow-up data who had received conventional bronchoscopic amphotericin B administration before implementation of the reconstruction-guided approach.</p><p><strong>Results: </strong>A total of 10 patients in the reconstruction cohort and 30 historical controls were included. Baseline characteristics were generally comparable between groups, although fatigue was more frequent in the historical control cohort. At 6 months after treatment, the reconstruction cohort showed lower total St. George's respiratory questionnaire (SGRQ) scores than the historical control cohort. And SGRQ scores decreased significantly after treatment in each group, with a decrease of well over four points from baseline. More favourable clinical and radiographic responses and fewer adverse events were observed in the reconstruction cohort.</p><p><strong>Conclusion: </strong>The integrated reconstruction-guided strategy may provide a feasible strategy for optimizing bronchoscopic amphotericin B delivery in CPA. Given the historical-control design, small intervention cohort and potential residual confounding, these preliminary findings should be interpreted as exploratory and require confirmation in larger prospective controlled studies.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 9","pages":"e70219"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Cryptococcosis in Apparently Immunocompetent Hosts: Host Susceptibility, Occult Immunodeficiency and Clinical Implications.","authors":"Ran Ma, Xinyan Yang","doi":"10.1111/myc.70210","DOIUrl":"10.1111/myc.70210","url":null,"abstract":"<p><p>Pulmonary cryptococcosis (PC) in apparently immunocompetent hosts-now the majority of non-HIV cases in Asia-cannot be explained by the traditional opportunistic infection paradigm. Three epidemiological observations point toward occult immune susceptibility: familial clustering documented in multiple case reports and small family studies despite shared environmental exposure, normal routine immunological screening, and species-specific infection patterns between Cryptococcus neoformans and Cryptococcus gattii. We propose a three-layer framework: upstream genetic variants in pattern recognition, Fcγ receptor, complement-lectin, and macrophage-regulatory loci (Layer 1) act in concert with intermediate immune phenotypes (Layer 2)-the genetically influenced IL-17/Th17 axis and IgG2 subclass deficiencies, and acquired anti-GM-CSF neutralising autoantibodies-that are proposed to converge on alveolar macrophage dysfunction and defective pulmonary fungal clearance (Layer 3). The three Layer 2 phenotypes differ substantially in evidence strength: anti-GM-CSF autoantibodies have reached clinical validation; IgG2 deficiency remains a mechanistic hypothesis; and IL-17/Th17 deficiency is supported by a single unreplicated study and should be treated as preliminary. This framework is hypothesis-generating, derived from candidate-gene studies, limited immunophenotyping data, and animal models; it has not been validated by genome-wide association studies or prospective functional research, and its clinical value requires confirmation by higher-quality evidence.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 8","pages":"e70210"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Candidaemia Score (CanDi-Score) in Decision of Early Empirical Antifungal Treatment for Patients in Intensive Care Unit: The International Prospective Observational ID-IRI Study.","authors":"Bircan Kayaaslan, Halime Araz, Hatice Yağmur Zengin, Rukiyye Bulut, Zeynep Oktay, Meltem Tasbakan, Sumeyra Istek, Elif Doyuk Kartal, Ozlem Bayrak, Ayse Kaya, Fatma Eser, Pınar Yuruk Atasoy, Hatice Esranur Kıratlı, Berfin Cirkin Doruk, Mustafa Uguz, Sema Sarı, Bahar Busra Sivrikaya, Yasemin Akkoyunlu, Lutfiye Nilsun Altunal, Ayse Albayrak, Handan Alay, Gulsen Iskender, Elkholy Amani, Taylan Onder, Dilek Ozcengiz, Mediha Turktan, Mihalj Mirko, Ilad Alavi Darazam, Mohammad Mehdi Shadravan, Reza Yahyavi Sahzabi, Ahmet Cem Yardımcı, Ruveyda Korkmazer, Gunes Senol, Tuba Kuruoglu, Fatih Temocin, Ozlem Alıcı, Meral Sonmezoglu, Aliye Esmaoglu, Zeynep Ture, Andrea Cortegiani, Ozay Akyıldız, Hatice Rahmet Guner, Hakan Erdem","doi":"10.1111/myc.70213","DOIUrl":"10.1111/myc.70213","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Candidaemia remains a common, life-threatening infection among intensive care unit (ICU) patients, with high mortality, particularly in patients with delayed diagnosis and treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This international, multicentre, prospective, observational study aimed to identify risk factors for candidaemia in ICU patients and to develop an easy-to-use predictive tool, the CanDi-Score, for early initiation of empirical antifungal treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients/methods: &lt;/strong&gt;All adults over 18 years hospitalised for more than 48 h in the ICUs were included in the study and followed for 30 days. Data on demographics, comorbidities, clinical severity scores including APACHE II and SOFA scores, Charlson comorbidity index (CCI), established risk factors for candidaemia and their time-dependent effects such as total parenteral nutrition (TPN), mechanical ventilation (MV), and central venous catheter (CVC) were collected. Univariate and multivariate logistic regression analyses were used to identify factors associated with candidaemia development, and fast backwards variable selection was used. To account for between-centre heterogeneity, sensitivity analyses were performed using mixed-effects logistic regression models including centre-specific random intercepts. A nomogram model was constructed using independent risk factors identified in multivariable analysis, and its predictive performance was evaluated with Area Under the Curve (AUC), sensitivity, and specificity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 2,704 ICU patients, including 204 with candidaemia, were enrolled. Patients with candidaemia had higher APACHE II (19 vs. 13) and CCI scores (6 vs. 5; both p &lt; 0.001), and more frequently had chronic renal failure, haemodialysis, malignancy, recent gastrointestinal surgery, and neutropenia (all p ≤ 0.05). Patients were randomly split into development (80%) and validation (20%) cohorts. Multivariate analysis identified higher CCI, concurrent infection, neutropenia, ICU stay &gt; 14 days, MV &gt; 3 days, CVC duration and TPN &gt; 14 days as independent risk factors. The risk associated with CVC increased substantially with prolonged use (OR: 0-7 days: 3.69; 8-21 days: 8.58; &gt; 21 days: 17.21). The model demonstrated good performance in both the development and validation cohorts, with sensitivity, specificity, and AUC values of 79.6%, 76.5%, and 0.86 (95% CI: 0.83-0.88) in the development cohort, respectively, and comparable predictive performance in the validation cohort. The score model was demonstrated by a nomogram.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Given the high mortality of candidaemia in ICU patients, the CanDi-Score may serve as a valuable tool for early prediction and timely empirical antifungal treatment. Key predictors include CCI, presence of concurrent infections, the duration of CVC use, and TPN administration. CanDi-Score provides clinicians with a practical approach to identify ","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 8","pages":"e70213"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermkielia cavawata sp. nov. gen. nov., Isolated From Plantar Eczema.","authors":"Jochen Brasch, Yvonne Gräser, Karen Voss, Stephan Weidinger, Andrey Yurkov","doi":"10.1111/myc.70218","DOIUrl":"10.1111/myc.70218","url":null,"abstract":"<p><strong>Background: </strong>Human skin is naturally exposed to diverse fungi. New taxa, including species with unknown pathogenic potential, continue to be isolated from human skin.</p><p><strong>Objective: </strong>To characterize a hitherto unknown hyphomycete isolated from human eczema and to assess its habitat and pathogenic abilities.</p><p><strong>Methods: </strong>A broad panel of culture conditions was used for morphological examination and physiological testing. Nucleotide ribosomal ITS and LSU sequences were analyzed separately by BLASTn to identify the closest relatives, and a combined ITS-LSU dataset was used for phylogenetic inference.</p><p><strong>Results: </strong>The isolate grew well on common mycological agars at 26°C and was not inhibited by 0.4 g/L cycloheximide. Colonies were flat, with a beige obverse and sparse aerial mycelium. Intercalary, round to subglobose spores developed within the hyphae, and submerged hyphae in cultures older than 4 weeks transformed into chains of spores consistent with chlamydospores. Neither microconidia, macroconidia, nor ascomata were observed. The isolate showed urease, keratinolytic, proteolytic, lipolytic and cellulolytic activity. It grew at 5°C and tolerated up to 6% NaCl; susceptibility to terbinafine was reduced. Phylogenetically, the isolate formed a distinct lineage branching basally to Pseudogeomyces, separated from related taxa by a distance comparable to that between Geomyces and Solomyces.</p><p><strong>Conclusions: </strong>Dermkielia gen. nov. (IF 905143) is introduced with Dermkielia cavawata sp. nov. (IF 905164) as the type species. Related ITS sequences in NCBI GenBank suggest that additional species of Dermkielia may be discovered. Dermkielia cavawata is presumably geophilic and possibly linked to forest ecosystems, but it possesses traits that may facilitate opportunistic colonization of human keratinized tissue.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 8","pages":"e70218"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}