Mycoses最新文献

{"title":"Diode Laser and Red-Laser Photodynamic Therapy Versus Ciclopirox 8% HPCH Nail Lacquer for the Treatment of Onychomycosis: A Randomised Controlled Trial.","authors":"Sara García-Oreja, Francisco Javier Álvaro-Afonso, David Navarro-Pérez, Diego León-Herce, Aroa Tardáguila-García, José Luis Lázaro-Martínez","doi":"10.1111/myc.70121","DOIUrl":"10.1111/myc.70121","url":null,"abstract":"<p><strong>Background: </strong>Antifungals are the standard treatment for onychomycosis. However, oral antifungals present contraindications and potential drug-drug interactions, while topical antifungals suffer from limited efficacy and penetration. Recently, researchers have explored physical therapies, including laser and photodynamic therapy.</p><p><strong>Objective: </strong>To evaluate the clinical efficacy of combining diode laser therapy with photodynamic therapy and ciclopirox 8% hydroxypropyl chitosan (HPCH) nail lacquer in treating onychomycosis.</p><p><strong>Methods: </strong>We conducted a randomised controlled clinical trial involving patients with onychomycosis. A total of 26 patients were enrolled and followed for 12 months. Participants received either eight sessions of laser treatment combined with three sessions of photodynamic therapy, or daily treatment with ciclopirox 8% HPCH.</p><p><strong>Results: </strong>The clinical cure rate was 94.1% in the group treated with laser and photodynamic therapy, compared to 53.3% in the group treated with ciclopirox 8% HPCH (p = 0.008). All patients who achieved clinical cure with either treatment also reached mycologic and complete cure, with a rate of 100%. The average time to healing was significantly shorter for the group receiving laser and photodynamic therapy (3.6 ± 1.2 months) than for those treated with ciclopirox 8% HPCH nail lacquer (9.2 ± 1.6 months) (p < 0.001). In the laser and photodynamic therapy group, adverse events, specifically subungual hematoma and blisters, occurred in 11.4% of patients, with a recurrence rate of 33.3%. No adverse events or recurrence were observed in patients treated with ciclopirox 8% HPCH.</p><p><strong>Conclusions: </strong>Treatment of onychomycosis using diode laser and photodynamic therapy results in higher clinical cure rates and shorter healing times compared to the reference treatment with 8% ciclopirox HPCH.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05809297.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 10","pages":"e70121"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192101","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":"Evaluating the Prognostic Value of the EQUAL Candida Score and a Nomogram-Based Approach for Candidaemia-Related Mortality.","authors":"Elif Mukime Saricaoglu, Melike Inan Hekimoglu, Ezgi Gulten, Irem Akdemir, Gule Cinar, Afife Zeynep Yilmaz, Duygu Ocal, Irem Kar, Kemal Osman Memikoglu, Fugen Yoruk","doi":"10.1111/myc.70119","DOIUrl":"10.1111/myc.70119","url":null,"abstract":"<p><strong>Introduction: </strong>Candidaemia is a life-threatening infection with a persistently high mortality rate, despite significant advances in antifungal therapy and supportive care. The European Confederation of Medical Mycology developed the EQUAL Candida Score as a standardised tool to evaluate adherence to guideline-based management; however, its prognostic value has not been consistently demonstrated in different patient populations. This study aimed to evaluate the clinical impact of adhering to guidelines and determine the predictive value of the EQUAL Candida Score for mortality risk in candidaemia patients.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients with candidaemia who were treated at a tertiary care hospital. Patients were classified as survivors or nonsurvivors based on 90-day candidaemia-related mortality. We identified independent predictors of mortality using multivariable Cox regression analysis and subsequently developed a prognostic nomogram based on the final model.</p><p><strong>Results: </strong>A total of 189 patients with candidaemia were included in the study, of whom 88 (46.6%) died within 90 days. The median EQUAL Candida Score was significantly lower among nonsurvivors compared with survivors (8 vs. 13, p < 0.001). This prognostic association remained consistent in subgroup analyses, both in patients with (10 vs. 13, p < 0.001) and without (10 vs. 13, p = 0.022) central venous catheters. An optimal cut-off score of 12 was identified across all groups, yielding a sensitivity of 70%-80% and a specificity of 79%. Kaplan-Meier survival analysis further confirmed that patients with an EQUAL Score ≥ 12 had significantly higher survival rates in all subgroups. In multivariable Cox regression, immunosuppressive treatment (HR 1.728), septic shock (HR 2.035), lack of source control (HR 2.013) and an EQUAL Score < 12 (HR 3.503) were identified as independent predictors of candidaemia-related mortality. Based on these variables, a nomogram was developed to estimate individualised survival probabilities at 1, 3 and 6 months. External validation in an independent cohort (n = 64) confirmed the model's prognostic performance, with a Harrell's C-index of 0.704 (95% CI: 0.587-0.821), despite the limited sample size.</p><p><strong>Conclusion: </strong>The EQUAL Candida Score serves as a reliable prognostic marker for candidaemia. When combined with clinical parameters, it enhances the accuracy of mortality risk estimation. Our novel nomogram provides a practical framework for early risk stratification and may optimise management strategies for high-risk patients.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70119"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131358","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":"The Effect of Topical Ketoconazole and Topical Miconazole Nitrate in Modulating the Skin Microbiome and Mycobiome of Patients With Tinea Pedis.","authors":"Yen Tan, Yakun Shao, Tingting Li, Xunyi Hu, Xiaowen Wang, Zhe Wan, Fuyou Yin, Ruoyu Li, Ruojun Wang","doi":"10.1111/myc.70116","DOIUrl":"10.1111/myc.70116","url":null,"abstract":"<p><strong>Background: </strong>Tinea pedis is a type of dermatophytosis that affects the superficial layers of the skin on feet. Limited data are available on the skin microbiome composition in affected patients and its changes following topical antifungal therapy.</p><p><strong>Objectives: </strong>To evaluate the clinical and microbiological effects of topical ketoconazole 2% cream (KTZ) and miconazole nitrate 2% cream (MCZ) using standardised clinical scoring and amplicon sequencing.</p><p><strong>Methods: </strong>A total of 42 patients with tinea pedis and 28 healthy controls were enrolled. Skin swabs were collected from lesional sites (interdigital or heel) at baseline, after 4 weeks of treatment, and 2 weeks post-treatment. DNA was extracted from the samples, and the bacterial 16S rRNA (V3-V4 region) and fungal ITS1-5F regions were sequenced to analyse microbial community composition.</p><p><strong>Results: </strong>Both KTZ and MCZ led to comparable clinical improvement. However, the KTZ group showed faster symptom resolution and a higher sustained improvement rate during follow-up. Treatment with either antifungal effectively reduced the abundance of pathogenic Trichophyton species to levels similar to those in healthy controls, thereby contributing to partial recovery of the overall fungal community structure. In parallel, the bacterial profile became more dispersed, with notable shifts observed in bacterial genera such as Staphylococcus and Corynebacterium following treatment.</p><p><strong>Conclusion: </strong>Topical antifungal therapy with KTZ or MCZ effectively improved the symptoms of tinea pedis, diminished the pathogenic fungal load and altered both fungal and bacterial community compositions. However, only partial restoration of the mycobiome was achieved, and the bacterial profile, especially in the interdigital region, showed a lack of bacterial normalisation. These findings highlight the need for further studies to assess long-term outcomes and to explore microbiome-targeted strategies addressing both bacterial and fungal components.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70116"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081076","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":"Characterisation of Antifungal Resistance to Azoles in Colombian Isolates of Malassezia spp.","authors":"Juan Camilo Galvis-Marín, Adriana Marcela Celis-Ramírez, Fredy Alexander Tabares-Villa, Augusto Zuluaga-Vélez, Juan Carlos Sepúlveda-Arias","doi":"10.1111/myc.70112","DOIUrl":"10.1111/myc.70112","url":null,"abstract":"<p><strong>Background: </strong>Malassezia genus includes lipodependent commensal yeasts of humans and animals' skin and mucous membranes. It can cause dermatological pathologies, and azoles are mainly used for treatment. However, in vitro susceptibility testing has shown decreased sensitivity to these antifungals. Some publications have suggested that resistance mechanisms to azoles include biofilm formation and efflux pump expression, which are proteins encoded by the ATM1 gene, among others.</p><p><strong>Objective: </strong>This work aimed to characterise Colombian isolates of Malassezia spp. resistant to azoles.</p><p><strong>Methods: </strong>Twenty-six Malassezia spp. isolates were identified via PCR, ribosomal gene sequencing and phylogenetic analyses. Susceptibility tests were performed on planktonic and sessile cells by microdilution against azoles and by adding efflux pump inhibitors. The relative expression levels of the ATM1 gene in fluconazole-resistant isolates were evaluated via RT-qPCR.</p><p><strong>Results: </strong>It was observed that 42% of the isolates in their planktonic form were resistant to voriconazole, 31% to fluconazole, 23% to itraconazole and 15% to ketoconazole. The minimum inhibitory concentration (MIC) was higher in sessile cells than planktonic cells, especially for fluconazole. The MICs of itraconazole, ketoconazole and voriconazole decreased in the presence of haloperidol, promethazine and tacrolimus, while this effect did not occur with fluconazole. The expression of the ATM1 gene was markedly greater in Malassezia spp. isolates resistant to fluconazole than in those susceptible (p < 0.05), both in those exposed and not exposed to the antifungal agent.</p><p><strong>Conclusions: </strong>We observed resistance of Colombian Malassezia spp. isolates to azoles, mainly fluconazole, through the expression of efflux pumps and biofilm formation.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70112"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033623","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":"T Cell Exhaustion and Function State Correlated With Outcomes in Patients With Intra-Abdominal Candidiasis.","authors":"Yawen Xie, Jiahui Zhang, Guoyu Zhao, Xianli Lei, Hao Wang, Huaiwu He, Na Cui","doi":"10.1111/myc.70113","DOIUrl":"10.1111/myc.70113","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-abdominal candidiasis (IAC) still has a high mortality rate despite prompt antifungal therapy due to immunosuppression. T cell exhaustion is an important manifestation of immunosuppression. This study aimed to explore the expression pattern of exhaustion-related molecules in patients with IAC and determine the possible association between dynamic trends and prognosis.</p><p><strong>Methods: </strong>Patients with IAC were enrolled, and non-IAC critically ill patients were included as controls. Peripheral blood mononuclear cells (PBMCs) were analysed by flow cytometry to determine the expression levels of T cell exhaustion-related markers. T cells isolated from PBMCs were stimulated by IL-2 in α-CD3/α-CD28 medium to compare intracellular cytokine production and proliferative capacity.</p><p><strong>Results: </strong>A total of 34 patients with IAC and 35 controls were enrolled in this study. Patients with IAC had a significant decrease in lymphocytes. CD4+ and CD8+ T cells from patients with IAC had a significantly higher level of immune checkpoint molecules, such as programmed cell death protein 1 (PD-1), cytotoxic T-lymphocyte antigen 4 (CTLA4), and B and T lymphocyte attenuator (BTLA), and exhibited a consistently impaired cytokine-secreting function. Increased exhaustion-associated molecules and deteriorating dysfunction were detected in non-survivors, while survivors demonstrated the opposite tendency. Patients with impaired granzyme B (GZMB) production function who died from IAC over the course of the disease had higher levels of PD-1 expression in CD8+ T cells.</p><p><strong>Conclusions: </strong>T cells from patients with IAC displayed an immunosuppressive phenotype of T cell exhaustion. Sustaining exhaustion status and deteriorated dysfunction were associated with poor prognosis. Persistently increased PD-1 expression and impaired GZMB secretion in CD8+ T cells were linked to worse outcomes. Immunoadjuvants reversing T cell exhaustion have promising prospects in treating IAC and improving prognosis.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70113"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075738","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":"Rezafungin Utilisation in Real Life-FungiScope Results From Europe and the United States.","authors":"Ilana Reinhold, Giovanni Mori, Massimiliano Lanzafame, Alessandro Limongelli, Antonio Vena, Julia Götz, Stilla Bauernfeind, Frank Hanses, Lukas Tometten, Michael Mayer, Ansgar Rieke, Ana Soriano-Martin, Maricela Valerio, Jose A Vazquez, Patrick Yue, Laman Rahimli, Nijat Azimli, Ertan Sal, Jon Salmanton-García, Natalia Vasenda, Rosanne Sprute, Jannik Stemler, Sebastian Wingen-Heimann, Oliver A Cornely, Danila Seidel","doi":"10.1111/myc.70114","DOIUrl":"10.1111/myc.70114","url":null,"abstract":"<p><strong>Background: </strong>Rezafungin, a novel echinocandin with once-weekly intravenous dosing, offers potential advantages for outpatient parenteral antifungal therapy (OPAT) in invasive candidiasis (IC). While clinical trial data support its efficacy and safety, real-world experience remains limited.</p><p><strong>Methods: </strong>A retrospective analysis of patients treated with rezafungin across Germany, Italy, Spain, and the United States between January 2024 and June 2025 was conducted. Data was collected via the FungiScope registry. Clinical characteristics, indications for rezafungin, outcomes, safety, and logistical aspects of administration were evaluated.</p><p><strong>Results: </strong>Fifteen patients were included, fourteen with IC; one with chronic pulmonary aspergillosis. Regarding patients with IC, the median age was 65.5 years; 43% were female. The most frequently identified pathogens were Candida glabrata (57%) and Candida parapsilosis (21%). Primary indications for rezafungin were intravascular (36%) and osteoarticular infections (36%). Rezafungin was mainly selected to enable OPAT (86%) or due to fluconazole resistance (36%) or drug-drug interactions (14%). The median treatment duration was 9 weeks (range: 1-38 weeks). One mild adverse event occurred (cutaneous photosensitivity), but rezafungin was otherwise well tolerated. Complete clinical or mycological response was observed in 36% at day 30, and partial response in 50% of patients. Access differed substantially across centres due to administrative and reimbursement hurdles, affecting treatment transition to rezafungin in 71% of patients with IC.</p><p><strong>Conclusions: </strong>Rezafungin was effective and well tolerated in this cohort, particularly in patients requiring long-term treatment. Administrative and logistical hurdles remain significant barriers to its widespread use. Facilitated access and enhanced awareness may improve patient outcomes by supporting early initiation and continuity of care.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70114"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075717","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":"Improving Diagnostic Sensitivity of Chronic Pulmonary Aspergillosis Using Species-Specific IgG.","authors":"Inderpaul Singh Sehgal, Ritesh Agarwal, Valliappan Muthu, Sahajal Dhooria, Kuruswamy Thurai Prasad, Shivaprakash M Rudramurthy, Ashutosh Nath Aggarwal, Mandeep Garg, Arunaloke Chakrabarti","doi":"10.1111/myc.70107","DOIUrl":"10.1111/myc.70107","url":null,"abstract":"<p><strong>Background: </strong>Chronic pulmonary aspergillosis (CPA) is most commonly caused by Aspergillus fumigatus (AF-CPA). Serum A. fumigatus-IgG, a pivotal investigation for diagnosing CPA, misses 10%-15% of CPA cases. We aimed to determine whether measuring serum IgG against non-fumigatus Aspergillus species enhances the serodiagnosis of CPA.</p><p><strong>Methods: </strong>We prospectively enrolled consecutive, treatment-naïve adults with CPA. The diagnosis of CPA was made using the ESCMID-ERS criteria. Serum IgG against Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger and Aspergillus terreus (cut-off, 27 mgA/L) was measured by fluorescent enzyme immunoassay. Non-fumigatus-CPA (NF-CPA) was defined when non-fumigatus species-specific IgG titres exceeded A. fumigatus-IgG by ≥ 25%. The primary objective was to evaluate the incremental diagnostic yield of non-fumigatus species-specific IgG for identifying CPA cases missed by A. fumigatus-IgG. The secondary outcome was to compare clinical features and treatment outcomes of AF-CPA and NF-CPA.</p><p><strong>Results: </strong>Among 279 patients (mean age 45.7 ± 14.8 years, 64% male), seropositivity was 95.3% for A. fumigatus, 70.6% for A. flavus, 56.6% for A. niger and 30.5% for A. terreus. The addition of non-fumigatus-IgG increased serologic yield by 61%. NF-CPA was diagnosed in 14% (39/279), with A. fumigatus-IgG alone missing 25.6% of these cases. Treatment outcomes at six (n = 228) and 12 (n = 222) months were similar between AF-CPA and NF-CPA groups, although the percentage reduction in serum A. fumigatus-IgG was significantly greater in AF-CPA.</p><p><strong>Conclusions: </strong>Incorporating non-fumigatus Aspergillus-IgG enhances the serodiagnosis of CPA. However, treatment outcomes are similar in patients with AF-CPA and NF-CPA.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70107"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144961782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspergillosis and Mucormycosis-Associated Hospitalizations, United States, 2016-2021.","authors":"Robert J Rhee, Johnathan A Edwards, Kaitlin Benedict, Jeremy A W Gold","doi":"10.1111/myc.70108","DOIUrl":"10.1111/myc.70108","url":null,"abstract":"<p><strong>Background: </strong>In the United States, aspergillosis and mucormycosis are associated with substantial healthcare costs and mortality. Recent nationally representative data about hospitalisations for these infections are limited, though several reports specifically describe increases in COVID-19-associated aspergillosis and mucormycosis, likely because of critical illness-related immune dysregulation and treatments involving systemic corticosteroids.</p><p><strong>Objectives: </strong>To update disease burden estimates, we describe trends in aspergillosis-related and mucormycosis-related hospitalisations (A-RH and M-RH).</p><p><strong>Methods: </strong>We used the 2016-2021 Healthcare Cost and Utilisation Project National Inpatient Sample and U.S. Census Bureau data to calculate A-RH and M-RH rates, examining annual trends, overall and stratified by demographic characteristics. We examined A-RHs and M-RHs during 2020-2021, comparing features and in-hospital mortality for those with vs. without COVID-19.</p><p><strong>Results: </strong>During 2016-2021, an estimated 86,570 A-RHs occurred, with rates (per 1,000,000 population) stable from 2016 to 2019 (range: 42.3-44.5) and increasing from 40.1 (2020) to 51.5 (2021). An estimated 8565 M-RHs occurred, with rates increasing from 3.8 to 5.8. During 2020-2021, 6025/24,285 (24.8%) of A-RHs and 420/2920 (14.4%) of M-RHs were COVID-19-associated. A-RHs and M-RHs involving COVID-19 had mortality rates exceeding 50%, which was ≈3 to 4-fold higher than those for A-RHs and M-RHs without COVID-19.</p><p><strong>Conclusion: </strong>Rates of A-RHs and M-RHs in the United States peaked in 2021, likely reflecting the increased burden of COVID-19 in 2021 compared with 2020. Ongoing monitoring of risk factors and clinician awareness is essential for managing and preventing these infections.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70108"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144961793","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":"Clinical Characteristics, Radiological, and Outcomes of Mucormycosis: A 14-Year Retrospective Study From Southern China.","authors":"Jinqing Liu, Lu Yu, Xingchao Ma, Qianbing Wang, Xuejing Jin, Shifang Peng, Lei Fu","doi":"10.1111/myc.70110","DOIUrl":"https://doi.org/10.1111/myc.70110","url":null,"abstract":"<p><strong>Background: </strong>Mucormycosis is a rare, rapidly progressive fungal infection with a high mortality rate. However, clinical data of mucormycosis patients, especially those related to adverse outcomes in China, remain limited.</p><p><strong>Objective: </strong>To enhance understanding of the clinical characteristics of different infection site mucormycosis and identify the factors associated with adverse outcomes.</p><p><strong>Methods: </strong>A 14-year retrospective study was conducted at a tertiary care hospital in China. Patients were categorised based on the site of infection and clinical outcomes.</p><p><strong>Results: </strong>From 2010 to 2024, 32 cases of mucormycosis were identified. Among these, pulmonary mucormycosis (PM) was the most common infection site, followed by disseminated mucormycosis. All patients had underlying comorbidities, predominantly chronic lung disease (37.5%) and diabetes mellitus (34.3%). All received pharmacological treatment, most commonly amphotericin B; 15.6% of patients additionally underwent surgical intervention. Chest CT findings in PM cases most frequently revealed bilateral involvement (68.8%) and cavitation (43.8%). Diagnosis was primarily based on metagenomic next-generation sequencing (mNGS, n = 14) and histopathological examination (n = 11). Adverse outcomes were observed in 46.9% of patients and were significantly associated with corticosteroid or immunosuppressant use, COVID-19 co-infection, disseminated disease, thrombocytopenia, hypoalbuminemia, elevated aspartate aminotransferase (AST), increased incidence of complications, and ICU admission (all p < 0.05).</p><p><strong>Conclusion: </strong>Pulmonary mucormycosis was the predominant subtype in this cohort and was frequently associated with chronic lung disease and diabetes. The high incidence of adverse outcomes highlights the necessity for early diagnosis, prompt antifungal therapy, and aggressive management of complications to improve patient survival.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70110"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-Hospital Spread of Fluconazole-Resistant C. parapsilosis in Northern Italy: Insights Into Clonal Distribution, Resistance Mechanisms and Biofilm Production.","authors":"Giorgia Palladini, Valentina Lepera, Serena Trubini, Gabriella Tocci, Andrea Zappavigna, Elizabeth Iskandar, Guglielmo Ferrari, Anna Prigitano, Nicola Ferraro, Roberta Schiavo, Fausto Baldanti, Caterina Cavanna, Giuliana Lo Cascio","doi":"10.1111/myc.70111","DOIUrl":"10.1111/myc.70111","url":null,"abstract":"<p><strong>Background: </strong>Starting from 2018 onwards, several outbreaks of fluconazole-resistant C. parapsilosis have been reported in many countries worldwide.</p><p><strong>Objectives: </strong>Here we report a retrospective study on C. parapsilosis blood isolates collected over 7 years (2018-2024) in two hospitals in Northern Italy.</p><p><strong>Patients/methods: </strong>The study involved 169 C. parapsilosis isolates collected from individual hospitalised patients. We assessed the antifungal susceptibility of the isolates, evaluated the presence of mutations in the ERG11 gene and performed multilocus microsatellite typing to highlight the genetic relatedness of the strains. All isolates were also tested for their ability to produce biofilm.</p><p><strong>Results: </strong>Among the 169 clinical isolates, 124 (73.4%) were classified as fluconazole-resistant C. parapsilosis (FRCP) and 45 (26.6%) as fluconazole-susceptible (FSCP). ERG11 sequencing highlighted that the most frequent mutation in FRCP is the Y132F (118/124, 95.2%). None of the FSCP carried the Y132F. Microsatellite genotyping showed five major clusters and 13 sub-clusters, formed by isolates sharing identical genotypes. Sub-cluster R1 included 96 FRCP carrying the Y132F substitution, isolated from 2018 to 2024 in both hospitals. Interestingly, 99.1% of the FRCP carrying the Y132F mutation were categorised as low biofilm formers, while FRCP carrying other ERG11 mutations were categorised as medium or high biofilm formers.</p><p><strong>Conclusions: </strong>Our results confirmed that Y132F may be mainly responsible for azole resistance in C. parapsilosis and inter-hospital spread. As we found, recent clinical studies indicate that FRCP isolates responsible for severe outbreaks produce thin biofilms. Mutated and therefore resistant strains may exhibit reduced biofilm production as a protective mechanism.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70111"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054575","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}