Mycoses最新文献

{"title":"New Asthma Diagnosis Codes or Short-Acting β₂ Agonist Prescriptions After Histoplasmosis Among Patients With Commercial Health Insurance, United States, 2018-2023.","authors":"Ian Hennessee, Kaitlin Benedict, Dallas J Smith, Nicolas Barros","doi":"10.1111/myc.70109","DOIUrl":"https://doi.org/10.1111/myc.70109","url":null,"abstract":"<p><strong>Background: </strong>Although several fungal infections have been linked to asthma development, the relationship between histoplasmosis and asthma development has not been fully described.</p><p><strong>Objectives: </strong>To assess the incidence of new asthma diagnosis codes or short-acting β₂ agonist (SABA) prescription in the year following histoplasmosis diagnosis and identify potentially related factors.</p><p><strong>Methods: </strong>We used a large health insurance claims database to identify patients with histoplasmosis with and without an asthma diagnosis code or a short-acting β₂ agonist prescription in the year after diagnosis.</p><p><strong>Results: </strong>Among 1819 patients diagnosed with histoplasmosis, 252 (13.9%) received a new asthma diagnosis or SABA prescription in the subsequent year, more than double the proportion in the general population (5.8%). Pulmonary histoplasmosis and symptoms such as dyspnea and wheezing were associated with asthma diagnosis or SABA receipt.</p><p><strong>Conclusion: </strong>These findings suggest that histoplasmosis may predispose certain patients to airway hyperreactivity, particularly those with acute pulmonary symptoms. Further research is needed to elucidate potential mechanisms underlying these findings, which could inform strategies to mitigate post-infectious airway disease in affected patients.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70109"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993131","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":"CT Findings for Differentiating Pulmonary Mucormycosis From Invasive Pulmonary Aspergillosis, Prior to Invasive Procedure Such as a Biopsy or Surgery: A 22-Year Single-Center Experience.","authors":"Hyeon Mu Jang, Mi Young Kim, So Yun Lim, Eui-Jin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Ho Choi, Sang-Oh Lee, Yang Soo Kim, Sung-Han Kim","doi":"10.1111/myc.70115","DOIUrl":"10.1111/myc.70115","url":null,"abstract":"<p><strong>Objectives: </strong>Computed tomography (CT) plays a critical role in the early detection and diagnosis of pulmonary invasive mould infection. This study aimed to compare the CT findings of proven invasive pulmonary aspergillosis (IPA) and proven pulmonary mucormycosis (PM) and develop a clinical scoring system based on CT features to differentiate PM from IPA.</p><p><strong>Methods: </strong>The medical records of the pathology database among adult patients (aged ≥ 18 years) diagnosed with proven IPA or PM between January 2003 and June 2024 were retrospectively reviewed, according to the 2020 European Organisation for Research and Treatment of Cancer criteria. CT scans were reviewed by an experienced radiologist. The primary outcome was CT findings in PM and IPA. We investigated and compared the thoracic CT findings between PM and IPA to identify the predictors of PM compared to IPA prior to invasive diagnostic procedures.</p><p><strong>Results: </strong>A total of 94 patients were included (60 with IPA and 34 with PM). The most common underlying conditions were malignancy (53.2%) and transplantation (47.9%). In univariable analysis, CT features significantly associated with PM, compared to IPA (p < 0.05), included representative lesion size ≥ 4 cm (odds ratio [OR] 3.61, 95% CI 1.48-8.79), consolidation (OR 5.56, 95% CI 1.52-20.38), halo sign (OR 3.33, 95% CI 1.39-8.02), reverse halo sign (RHS) (OR 6.73, 95% CI 2.39-18.98) and airway-invasive lesion (OR 0.32, 95% CI 0.13-0.78). In multivariate analysis, representative lesion size ≥ 4 cm, RHS, and airway-invasive lesion were identified as independent predictors of PM, compared to IPA. These three factors were incorporated into a point-based scoring system (representative lesion size ≥ 4 cm = 11 points; RHS = score 17 points; airway-invasive lesion = -12 points). A total score of > 8 differentiated PM from IPA with 70.6% sensitivity and 78.3% specificity.</p><p><strong>Conclusions: </strong>CT findings of large consolidative lesions, the presence of a reverse halo sign, and the absence of airway invasion may aid in the early differentiation of PM from IPA.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70115"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138296","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":"Utility of MALDI-ToF MS for Recognition and Antifungal Susceptibility of Nannizzia, an Underestimated Group of Dermatophytes.","authors":"Chao Tang, Xue Kong, Jasmijn Jansen, Katharina Vossgroene, Thi-Lam-An Vu, Boris Oberheitmann, Marlou Tehupeiory-Kooreman, Shaoqin Zhou, Xin Zhou, Clement Kin-Ming Tsui, Weida Liu, Yingqian Kang, Sarah A Ahmed, Sybren de Hoog","doi":"10.1111/myc.70117","DOIUrl":"10.1111/myc.70117","url":null,"abstract":"<p><strong>Background: </strong>Geophilic Nannizzia dermatophytes are increasingly implicated in stubborn skin, hair, and nail infections, yet MALDI-TOF MS evaluations and antifungal-susceptibility data have focused almost exclusively on N. gypsea. Biochemical profiles and MICs cut-offs are limited.</p><p><strong>Objectives: </strong>To benchmark two commercial MALDI-TOF MS libraries and to determine in vitro activity of eight antifungals against a genus-wide panel of Nannizzia species.</p><p><strong>Methods: </strong>One-hundred-and-three ITS-confirmed isolates representing 12 species were grown on potato-dextrose agar (PDA) for 7-14 days. Spectra were acquired with (i) the MSI-2 Dermatophyte Library after 4-14 days' PDA incubation (100 cultures) and (ii) the Bruker MALDI Biotyper Filamentous-Fungi Library 6.0/2023 after ≤ 3 days' growth in Sabouraud-dextrose broth (SDB) (73 cultures). BCCM/IHEM strains could not be evaluated on the Biotyper because of licence restrictions, leaving 73 non-duplicate isolates for direct MSI-2 vs MBT comparison. EUCAST E.Def 11.0 micro-broth dilution determined MICs for eight agents.</p><p><strong>Results: </strong>MSI-2 achieved its highest accuracy with PDA day-7 cultures (45/73, 62%), whereas the liquid Biotyper protocol yielded 49/73 correct identifications (67%) within four days. Accepting low-confidence scores (≥ 1.7) from either library increased overall accuracy to 73%. MSI-2 remained superior for N. gypsea (73%) and uniquely detected N. nana (50%), which is absent from the current Biotyper release. Conversely, the Biotyper outperformed MSI-2 for N. incurvata, N. fulva, and N. praecox. Six very rare species (N. lorica, N. aenigmatica, N. corniculata, N. duboisii, N. perplicata, N. polymorpha) were not recognised by either database. Terbinafine displayed the lowest geometric mean MIC (0.009 mg/L); fluconazole and griseofulvin showed the highest values, and one US N. fulva isolate exhibited elevated itraconazole/voriconazole MICs (1 mg/L).</p><p><strong>Conclusions: </strong>Diagnostic coverage of Nannizzia remains incomplete. Expanding commercial MALDI-ToF MS libraries with spectra from rare species and performing routine susceptibility testing are essential to optimise patient management.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 9","pages":"e70117"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081078","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":"Drug-Related Candidiasis Risk Profiling: A Real-World Pharmacovigilance Study Leveraging the FDA Adverse Event Reporting System (FAERS).","authors":"Xiaoli Yang, Tinghua Liu, Jiaying Lei, Wangjing Cai, Yougang Mai, Xikang Tang","doi":"10.1111/myc.70106","DOIUrl":"https://doi.org/10.1111/myc.70106","url":null,"abstract":"<p><strong>Background: </strong>Although several drugs have been linked to candidiasis, the risk profiles of this condition remain unclear for most therapeutic agents.</p><p><strong>Objectives: </strong>Aiming to provide critical references for developing clinically actionable risk stratification frameworks, this study investigated risk factors associated with the occurrence and mortality of drug-related candidiasis using real-world data.</p><p><strong>Methods: </strong>Reporting odds ratios (ROR) were calculated to evaluate the signal strength of candidiasis across drugs reported in the FDA Adverse Event Reporting System (FAERS; Q1 2004 to Q3 2024). Multidimensional regression analyses were conducted to identify key risk factors for drug-related candidiasis.</p><p><strong>Results: </strong>This pharmacovigilance study identified 259 drugs associated with candidiasis through disproportionality analysis. After exclusion through univariate regression and LASSO regression, the final multivariable logistic regression analysis included 1526 candidiasis cases and 200,173 non-cases (control), revealing that female gender, older age (≥ 65 years) and 32 specific drugs were independent risk factors for drug-related candidiasis. These drugs primarily included monoclonal antibodies (6/32), antibiotics (4/32), glucocorticoids (4/32) and chemotherapy agents (4/32). Affected patients exhibited distinct clinical outcomes, with mortality-related regression analysis further revealing a significant association for these drug classes. Notably, five drugs, cytarabine, etoposide, prednisone, prednisolone and dexamethasone, exhibited dual associations as both independent susceptibility factors and mortality risk factors in drug-candidiasis progression. Our temporal analysis suggested enhanced clinical vigilance during the first month following the administration of these drugs to facilitate early infection detection.</p><p><strong>Conclusion: </strong>The findings offer critical references for developing risk stratification frameworks in clinical practice, and establish priority targets for future research into the pathogenesis and mortality mechanisms of this infection.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 8","pages":"e70106"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144961771","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":"Rapid Increase in the Incidence of Human Invasive Fungal Diseases Based on One Health Perspective.","authors":"Junyan Qu, Mei Liang, Yanan Luo","doi":"10.1111/myc.70098","DOIUrl":"https://doi.org/10.1111/myc.70098","url":null,"abstract":"<p><p>The incidence of invasive fungal diseases has witnessed a significant increase in recent years, presenting a major threat to global public health. Nevertheless, research on fungi lags behind that on bacteria, and the understanding of how fungi cause infections in humans remains limited. Fungi are highly diverse and play a crucial role in natural ecosystems. In this review, we analysed the causes of the increase in human invasive fungal diseases from the perspectives of environmental changes, plant factors, animal factors, soil alterations, human activities and fungal resistance from the viewpoint of One Health, aiming to better understand fungi, adapt to nature and collaborate in multiple fields to reduce human invasive fungal diseases.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 8","pages":"e70098"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804374","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":"Appearance of Environment-Linked Azole Resistance in the Aspergillus fumigatus Complex in New Zealand.","authors":"Arthur J Morris, Wendy P McKinney, Sally A Roberts, Sasiharan Sithamparanathan, Zain Chaudhry, Matthew C Fisher","doi":"10.1111/myc.70104","DOIUrl":"https://doi.org/10.1111/myc.70104","url":null,"abstract":"<p><strong>Background: </strong>Until 2020, azole resistance in Aspergillus fumigatus complex isolates in New Zealand was due to cyp51A hot spot mutations. This report details the appearance of environment-linked tandem repeat (TR)-related azole resistance genotypes since 2021.</p><p><strong>Methods: </strong>Isolates were tested by broth micro-dilution. Clinical Laboratory Standards Institute criteria were used to define wild type (WT) and non-wild type (non-WT) isolates, which were identified by ß-tubulin gene sequencing and had their cyp51A genotype for azole resistance determined. Whole genome sequencing (WGS) was applied to two patient pairs of sequential WT and non-WT isolates.</p><p><strong>Results: </strong>From January 2021 to June 2024, 15 of 147 (10.2%) A. fumigatus complex isolates were resistant or non-WT for one or more azole agents. Genotyping detected hot spot mutations in four and TR-associated resistance in nine. No mutations were detected in two isolates. Four of the five TR₄₆ mutations were TR₄₆/Y121F/T289A. Three of the four TR₃₄ mutations were different. WGS of the paired isolates showed that the non-WT isolates were distinct. Azole-containing fungicides are available for home use from garden centres. Patients with TR-associated resistance did not have any obvious exposure to azole-containing fungicides. There was no evidence for healthcare-acquired transmission.</p><p><strong>Conclusions: </strong>A. fumigatus sensu stricto isolates with TR-mutations linked to environmental resistance are now present in New Zealand. Those at risk of invasive A. fumigatus infection should receive advice to avoid high-risk exposures. Reintroducing monitoring of azole-containing fungicides is recommended.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 8","pages":"e70104"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144961796","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":"Global Emergence of Antifungal-Resistant Dermatophytosis Caused by Trichophyton indotineae (Formerly T. mentagrophytes ITS Genotype VIII): A Genomic Investigation Involving 14 Countries.","authors":"Amanda Ribeiro Dos Santos, Silke Uhrlaß, Pietro Nenoff, Jeremy A W Gold, Mohammed Saiful Islam Bhuiyan, Srikumar Goturu, Lalitha Gade, Ujwal R Bagal, Joyce G Peterson, Nathan P Wiederhold, Shawn R Lockhart, Helle Järv, Ammar F Hameed, Jacek Szepietowski, Resham Vasani, Archana Singal, Lindsay Parnell, Brian Schwem, Tom Chiller, Anastasia P Litvintseva, Nancy A Chow, Shyam B Verma","doi":"10.1111/myc.70101","DOIUrl":"10.1111/myc.70101","url":null,"abstract":"<p><strong>Background and objective: </strong>Trichophyton indotineae is a globally emerging, frequently antifungal-resistant fungus causing severe dermatophytosis. To inform prevention efforts, we analysed the genomic epidemiology and resistance to terbinafine (first-line oral antifungal) from a collection of multinational T. indotineae isolates collected from patients with clinically suspected dermatophytosis during 2016-2023.</p><p><strong>Methods: </strong>We performed whole genome sequencing and phylogenetic tree analysis based on single-nucleotide polymorphisms (SNPs). T. indotineae phylogenetic results were correlated with patient demographic characteristics and isolate terbinafine susceptibility profiles that were determined by antifungal susceptibility testing and squalene epoxidase gene sequencing. Trichophyton mentagrophytes and Trichophyton interdigitale isolates from the USA, and Trichophyton rubrum isolates from three countries were added for contextual analysis.</p><p><strong>Results: </strong>Among 347 T. indotineae isolates, 227 (65%) were in vitro resistant to terbinafine. Countries represented were India (43%); Germany (21%); Bangladesh (8%); United States (8%); United Arab Emirates (7%); Iraq (5%); Finland (3%); Poland (2%); Austria, Canada, Cambodia, Estonia, Singapore, and Switzerland (each < 1%). Median SNP difference between isolates was 106 SNPs (range: 0-392). Clustering by age, sex, or country was not observed. One subcluster was composed of terbinafine-resistant isolates with a specific squalene epoxidase gene mutation (F397L) and was widely dispersed among 10 countries. Intra-species genomic diversity was greater among 19 T. rubrum isolates (260 SNPs [range: 73-1038]), or among 10 T. mentagrophytes/T. interdigitale isolates from the USA compared with the intra-species diversity of the T. indotineae isolates.</p><p><strong>Conclusions: </strong>Our findings corroborate T. indotineae's recent emergence and ongoing international transmission and suggest the rapid spread of a subset of terbinafine-resistant isolates. Continued efforts are necessary to mitigate this pathogen's spread.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 8","pages":"e70101"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847581","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":"Utility and Pitfalls of β-D-Glucan for Diagnosis and Response Monitoring of Chronic Disseminated Candidiasis in Paediatric Cancer Patients.","authors":"Katharina F Körholz, Marc T Hennies, Heidrun Herbrüggen, Katja Krämer, Martina Ahlmann, Birgit Fröhlich, Frieder Schaumburg, Thomas Wiesel, Peter M Rath, Andreas H Groll","doi":"10.1111/myc.70102","DOIUrl":"10.1111/myc.70102","url":null,"abstract":"<p><strong>Background: </strong>β-D-Glucan (BDG) is a useful but nonspecific biomarker in patients with suspected invasive fungal diseases including Pneumocystis pneumonia. Little is known, however, about its utility for response monitoring in chronic disseminated candidiasis (CDC).</p><p><strong>Patients and methods: </strong>We describe the utility and pitfalls of serum BDG in paediatric cancer patients with suspected CDC. BDG in serum was measured serially (i.e., 5 to 10 times of a time period of 200 to 400 days) by a commercially available assay (Fungitell; Associates of Cape Cod, MA, USA) and values were correlated to patient- and disease-related variables.</p><p><strong>Results: </strong>Five paediatric patients (4f/1 m; 4-18 years) with acute lymphoblastic leukaemia (n = 4) and Ewing sarcoma (n = 1) followed between 2013 and 2024 were included. CDC was located in the spleen (n = 5), liver (n = 4), lungs (n = 3), CNS (n = 2), kidney (n = 1), and skin (n = 1); and diagnosed based on imaging, a positive blood culture (n = 1), a positive BDG assay in serum (n = 5), and absence of other etiologies. Patients received IV liposomal amphotericin B and/or caspofungin, followed by fluconazole orally for 184 to > 365 days, respectively. BDG concentrations in serum (35 time points) stayed elevated for prolonged periods of time, were independent of clinical symptoms, and returned to normal with resolution of imaging findings in the four leukaemia patients. In the patient with Ewing sarcoma, liver biopsy performed 5 months after diagnosis due to lack of improvement revealed disseminated aspergillosis.</p><p><strong>Conclusions: </strong>BDG in serum is useful for microbiological diagnosis and monitoring of probable CDC; however, it remains a non-specific fungal biomarker whose results need to be scrutinised in patients who do not respond to treatment as expected.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 8","pages":"e70102"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804375","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":"Efficacy and Safety of 40% Urea as an Adjuvant to Antifungals for Onychomycosis: A Systematic Review and Meta-Analysis.","authors":"Fitra Tri Kurniasari, Evy Ervianti, Damayanti, Citrawati Dyah Kencono Wungu, Dwi Murtiastutik, Diah Mira Indramaya, Sylvia Anggraeni, Fajar Avicenna","doi":"10.1111/myc.70097","DOIUrl":"10.1111/myc.70097","url":null,"abstract":"<p><strong>Introduction: </strong>Onychomycosis remains a challenging condition due to varying cure rates and the risk of recurrence. Topical 40% urea has been proposed as an adjuvant to antifungals to enhance efficacy. Many trials have been done, presenting mixed results.</p><p><strong>Methods: </strong>Four databases (PubMed, Web of Science, Scopus, and EBSCO), two registers (Cochrane), and grey literature sources were used to identify randomised controlled trials (RCTs) and non-randomised studies (NRSs) published until February 2025. Cure rates (clinical, mycological, and total) were analysed in the meta-analysis, analysing cure rates and comparing urea as an adjuvant to antifungal therapy with antifungals alone. We independently selected eligible articles and extracted relevant data before assessing the quality of the studies. A summary of the findings table was made with GRADEpro GDT using the results of the meta-analyses.</p><p><strong>Results: </strong>Based on six RCTs and six NRSs involving 424 participants treated with antifungals plus topical 40% urea-130 of which were compared to 129 participants who received antifungals without urea- we found that adding topical 40% urea as an adjuvant significantly improved the clinical cure rate compared to therapy using antifungals alone (OR: 2.05, 95% CI: 1.03-4.11, p < 0.05). However, there were no significant differences in mycological and total cure rates (OR: 1.71; 95% CI: 0.63-4.61; p > 0.25 and OR 1.23; 95% CI: 0.47-3.23; p > 0.5). The reported adverse effects were localised.</p><p><strong>Conclusions: </strong>Topical 40% urea can be used to improve the clinical efficacy of antifungals for onychomycosis. However, evidence for mycological and total efficacy is lacking. Thus, more rigorous trials are needed to confirm its efficacy and safety.</p><p><strong>Protocol registration: </strong>PROSPERO-CRD42025638277.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 8","pages":"e70097"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874192","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":"Pentraxin 3 as a Potential Biomarker of Invasive Fusariosis in Onco-Haematological Patients.","authors":"Larissa Simão Gandolpho, Elaine Cristina Francisco, Giovanni Luis Breda, Celso Arrais-Rodrigues, Arnaldo Lopes Colombo","doi":"10.1111/myc.70095","DOIUrl":"https://doi.org/10.1111/myc.70095","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the clinical use of pentraxin 3 serum level as a biomarker for screening episodes of invasive fusariosis among high-risk onco-haematological patients.</p><p><strong>Methods: </strong>We analysed 63 serum samples from patients with invasive mould diseases and controls, which had been collected between 2009 and 2021 and stored at the Special Mycology Laboratory of Universidade Federal de São Paulo, Brazil. Material included samples from eight patients with invasive fusariosis, nine with invasive aspergillosis, and control groups comprising 20 healthy individuals, eight neutropenic patients with acute myeloid leukaemia, and eight allogeneic haematopoietic stem cell transplant recipients without any concomitant infection, and 10 neutropenic individuals who developed a microbiologically documented gram-negative bacteremia. PTX3 levels were quantified using an enzyme-linked immunosorbent assay (ELISA), and statistical analyses were performed using SPSS Statistics v.28.0, California USA.</p><p><strong>Results: </strong>The optimal PTX3 detection threshold was established at 10 pg/mL, with the highest levels observed in patients with invasive aspergillosis (5532.8 pg/mL) and invasive fusariosis (3718.1 pg/mL). Healthy controls revealed PTX3 levels ranging from 109.9 to 385.7 pg/mL. Significant differences were noted among all groups (p < 0.001), with PTX3 levels exceeding 1000 pg/mL exclusively in patients with IMDs. Notably, high PTX3 serum levels were detected in four out of the eight samples that had been collected 1-5 days before the diagnosis of fusariosis by culture.</p><p><strong>Conclusions: </strong>Our results suggest that serum PTX3 quantification holds significant potential for screening patients with suspected invasive fusariosis among onco-haematological patients, similar to its role in invasive aspergillosis.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 8","pages":"e70095"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743155","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}