Mycoses最新文献

{"title":"Surgical Outcomes and Exploratory Preoperative Risk Stratification for Invasive Pulmonary Fungal Infections in Paediatric Patients: A Single-Center Retrospective Study.","authors":"Gang Yang, Chang Xu, Taozhen He, Xiao-Xi Lu, Xia Guo, Miao Yuan, Yanan Li","doi":"10.1111/myc.70201","DOIUrl":"10.1111/myc.70201","url":null,"abstract":"<p><strong>Background: </strong>Invasive pulmonary fungal infections (IPFIs) in immunocompromised children carry high morbidity and may interrupt life-saving chemotherapy or haematopoietic stem cell transplantation (HSCT). Evidence on perioperative risk stratification for surgical management is limited.</p><p><strong>Patients and methods: </strong>We conducted a single-center retrospective cohort study of patients < 16 years with proven/probable IPFI who underwent lung resection from 2017 to 2025, with fungal infection confirmed by pathology. Preoperative clinical variables, laboratory tests and CT features were collected. Outcomes included intraoperative blood transfusion, severe postoperative complications, 90-day mortality and time to resumption of chemotherapy/HSCT. An exploratory preoperative weighted risk score was derived and evaluated.</p><p><strong>Results: </strong>Thirty-three patients were included (median age 9 years; 75.8% male). Aspergillus was the most common pathogen (72.7%); 57.6% had centrally located lesions and 12.1% had multilobe involvement. Procedures were mainly lobectomy (66.7%) or wedge resection (30.3%), with VATS in 45.5%. Peripheral lesion location was associated with less intraoperative transfusion, while hemoptysis and central lesion predicted delayed resumption of chemotherapy/HSCT; preoperative platelet count < 100 × 10⁹/L, multilobe involvement and central location were significantly associated with severe complications. Integrating these independent findings, a 0-8 point composite risk score was constructed (optimism-adjusted C-index: 0.948). The model effectively stratified outcomes: severe complications occurred in 0% (low), 26.7% (moderate) and 75% (high) (p = 0.004). Among survivors, median time to resume chemotherapy/HSCT was 18 days (low) versus 35 days (moderate) versus 78 days (high) (p < 0.001). All 90-day deaths occurred in the high-risk group (p < 0.001).</p><p><strong>Conclusions: </strong>Surgery can support source control and timely oncologic treatment in selected paediatric IPFI. A simple, statistically validated preoperative score may help anticipate surgical risk and recovery time and identify a high-risk subgroup with poor short-term outcomes.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 6","pages":"e70201"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272340","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":"Correction to 'Seroprevalence Screening of Chronic Aspergillus Infection in a Post-Tuberculosis Cohort in Senegal: A Cross-Sectional Study Comparing ELISA and Rapid Diagnostic Tests'.","authors":"","doi":"10.1111/myc.70202","DOIUrl":"10.1111/myc.70202","url":null,"abstract":"","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 6","pages":"e70202"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302509","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":"Video-Based Training on Physicians' Proficiency in Invasive Fungal Disease: A Multicentre, Cluster Randomised Controlled Trial.","authors":"Yijian Chen, Xiaojun Huang, Haibo Qiu, Linling Cheng, Yunsong Yu, Xiaochun Ma, Sizhou Feng, Qi Li, Depei Wu, Wenxiang Huang, Dechang Chen, Xiaoju Lv, Jianda Hu, Jingbo Wang, Jiabin Li, Wenjie Yang, Qingyuan Zhan, Bing Sun, Minggui Wang","doi":"10.1111/myc.70198","DOIUrl":"10.1111/myc.70198","url":null,"abstract":"<p><strong>Background: </strong>Previous research indicated that physicians possess limited knowledge of the diagnosis and treatment of invasive fungal disease (IFD).</p><p><strong>Objective: </strong>This study aimed to assess the efficacy of training via video or PDF formats in increasing physicians' knowledge of IFD.</p><p><strong>Methods: </strong>This was a multicentre, cluster-randomised controlled trial involving 18 tertiary hospitals in China. Physicians specialising in IFD clinical diagnosis and treatment from four departments were randomised 1:1 into a video training group or PDF training group, and questionnaires were completed before and after training. The primary outcome was the change in total questionnaire score before and after training.</p><p><strong>Results: </strong>Of the 294 participants, 146 were assigned to the video group and 148 to the PDF group. Engagement with the training materials was observed among 127 participants from the video group and 135 from the PDF group. In the per-protocol set (PPS), post-training score improvements for total scores (p = 0.008), invasive candidiasis scores (p < 0.001), and invasive aspergillosis scores (p = 0.044) in the video group were significantly greater than those in the PDF group. Overall, 161 (61.5%) physicians in the PPS exhibited enhanced total scores post-training, with the video group outperforming the PDF group (70.9% vs. 52.6%, p = 0.002). The findings in the FAS were largely consistent with those observed in the PPS.</p><p><strong>Conclusion: </strong>Both video and PDF training modules are appealing to physicians. Further, the video training module displayed superior efficacy in improving physicians' knowledge of IFD.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 6","pages":"e70198"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278054","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":"Comparison of DermaGenius and In-House qPCR Methods for Detection of Recalcitrant Dermatophyte Infections: A Practical Approach for Dermatologists and Mycologists.","authors":"Murat Durdu, Engin Kaplan, Oğuzhan Bingöl, Nevzat Ünal, Mehmet Emin Demircili, Bram Spruijtenburg, Carolina Melchior do Prado, Eelco F J Meijer, Macit Ilkit","doi":"10.1111/myc.70199","DOIUrl":"10.1111/myc.70199","url":null,"abstract":"<p><strong>Background: </strong>Chronic and recalcitrant dermatophytosis has become increasingly problematic in dermatology practice, largely due to emerging antifungal resistance, affecting not only terbinafine but also azoles. Among the causative agents, Trichophyton indotineae has emerged as a key pathogen associated with treatment failure, extensive disease, and frequent relapse, even in immunocompetent patients.</p><p><strong>Objective: </strong>This study aimed to evaluate and compare two rapid molecular diagnostic approaches: A commercial multiplex qPCR assay (DermaGenius Resistance Multiplex PCR, DermaGenius RMP) and a T. indotineae-specific in-house qPCR assay, focusing on their practical value for early detection of recalcitrant dermatophyte infections and terbinafine resistance in routine dermatology practice.</p><p><strong>Methods: </strong>Sixty-four dermatophyte isolates obtained from patients with chronic or treatment-resistant dermatophytosis in Türkiye wereanalysed. Species identification and detection of squalene epoxidase (SQLE) gene mutations associated with terbinafine resistance were performed using DermaGenius RMP and the in-house T. indotineae-specific qPCR assay, with confirmatory ITS/SQLE sequencing and CLSI microbroth dilution antifungal susceptibility testing.</p><p><strong>Results: </strong>Overall concordance between the two qPCR methods was 93.8% (κ = 0.74, z = 5.99, p < 0.001) for T. indotineae identification. Most recalcitrant cases were caused by T. indotineae, and SQLE mutations were detected in > 90% of these isolates, consistent with the observed clinical resistance. DermaGenius RMP enabled rapid, standardised detection of terbinafine resistance-associated mutations suitable for routine diagnostics, whereas the in-house qPCR provided highly specific identification of T. indotineae. Notably, 10 T. indotineae isolates harboured the SQLE F397L substitution despite terbinafine susceptibility.</p><p><strong>Conclusions: </strong>Rapid molecular diagnostics, particularly qPCR-based assays, provide actionable information early in the course of infection. In this study, both assays showed comparable performance for T. indotineae detection. Prompt identification of T. indotineae and associated resistance mutations may help avoid ineffective antifungal therapy, reduce chronicity, and support rational treatment decisions in routine clinical practice.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 6","pages":"e70199"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265378","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 Global Antifungal Susceptibility Epidemiology of Trichophyton indotineae Indicating Voriconazole as an Alternative Therapy for Recalcitrant Dermatophytosis.","authors":"Ge Song, Wenting Xie, Xiaodong She, Weida Liu, Xiaofang Li, Guanzhao Liang","doi":"10.1111/myc.70195","DOIUrl":"10.1111/myc.70195","url":null,"abstract":"<p><strong>Background: </strong>The emergence of Trichophyton indotineae as a multidrug-resistant dermatophyte has challenged conventional therapeutic approaches for dermatophytosis, leading to a significant therapeutic dilemma. The absence of formal epidemiological cutoff values (ECVs) under the Clinical and Laboratory Standards Institute (CLSI) framework has led to inconsistent interpretation of antifungal susceptibility testing (AFST) data, highlighting the urgent need for standardised susceptibility interpretation criteria and effective therapeutic strategies.</p><p><strong>Objectives: </strong>This study aimed to (1) establish CLSI-based estimated tentative ECVs (ET-ECVs) to facilitate reliable minimum inhibitory concentration (MIC) interpretation; (2) analyse resistance rates of T. indotineae to terbinafine, itraconazole and voriconazole using a large-scale global dataset and (3) explore and identify effective therapeutic options following first-line treatment failure.</p><p><strong>Methods: </strong>This systematic review compiled global susceptibility data for T. indotineae through comprehensive literature searches, including only studies that performed CLSI- or European Committee on Antimicrobial Susceptibility Testing (EUCAST)-standardised AFST. Furthermore, the clinical efficacy of voriconazole was specifically evaluated by summarising and analysing reported treatment cases.</p><p><strong>Results: </strong>A total of 67 studies from 14 countries, comprising 981 isolates, were included. The proposed CLSI ET-ECVs for terbinafine, itraconazole and voriconazole were 0.125, 0.25 and 1 mg/L, respectively, showing full alignment with EUCAST tentative epidemiological cutoff values (TECOFFs). Integrated resistance rates were 77.6% for terbinafine, 17.0% for itraconazole and 1.4% for voriconazole. Cross-resistance analysis revealed that terbinafine resistance predominated, with 14.3% of isolates co-resistant to itraconazole. In vitro susceptibility data demonstrated high activity of voriconazole and clinical case summaries further confirmed its favourable therapeutic efficacy, with complete remission reported in all evaluated cases.</p><p><strong>Conclusion: </strong>This study defined the CLSI ET-ECVs for interpreting T. indotineae MICs, highlighted the resistance burden to first-line agents and provided in vitro evidence supporting further evaluation of voriconazole as a potential effective alternative therapy. These findings may provide critical warnings regarding the high-resistance landscape and help guide antifungal susceptibility interpretation for this emerging multidrug-resistant pathogen.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 6","pages":"e70195"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163761","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 Evaluation of Luliconazole-Loaded Nanostructured Lipid Carriers in Treatment-Resistant Dermatophytosis: A Randomized Clinical Trial.","authors":"Robab Ebrahimi Barogh, Seyed Ali Jeddi, Ghasem Rahmatpour Rokni, Hossein Mohammad Taghi Fam, Abbas Raeisabadi, Zahra Yahyazadeh, Seyyed Mobin Rahimnia, Pedram Ebrahimnejad, Eisa Nazar, Nasim Gholizadeh, Iman Haghani, Mohsen Nosratabadi, Armaghan Kazeminejad, Javad Javidnia, Mohammad Taghi Hedayati, Jacques F Meis, Ahmed Al-Harrasi, Mahdi Abastabar, Abdullah M S Al-Hatmi","doi":"10.1111/myc.70196","DOIUrl":"10.1111/myc.70196","url":null,"abstract":"<p><strong>Background: </strong>Dermatophytosis is a common superficial fungal infection that is increasingly complicated by terbinafine (TRB)-resistant strains, especially Trichophyton indotineae. Conventional antifungals often show limited efficacy against resistant isolates, highlighting the need for novel treatments. This study evaluated the efficacy and safety of nanostructured lipid carrier-loaded luliconazole (NLC-LCZ) gel in TRB-resistant dermatophytosis.</p><p><strong>Materials and methods: </strong>In a randomized, clinical trial conducted at Touba Specialty Clinic, Sari, Iran, forty-eight adults with confirmed TRB-resistant dermatophytosis were assigned to oral itraconazole (ITZ), topical luliconazole, NLC-LCZ gel, or ITZ + NLC-LCZ gel for 4 weeks (n = 12 each). The primary endpoint was complete recovery (clinical and mycological), while secondary endpoints included lesion size, itch, inflammation, Dermatology Life Quality Index (DLQI), and safety.</p><p><strong>Results: </strong>Complete recovery occurred in 83.3% of ITZ + NLC-LCZ, 75% of NLC-LCZ, 58.3% of LCZ, and 0% of ITZ alone. LCZ and NLC-LCZ had lower MIC₅₀/ MIC₉₀ values (0.016 μg/mL) compared with ITZ (MIC₉₀: 8 μg/mL) and TRB (MIC₉₀: 4 μg/mL). DLQI improved most in NLC-LCZ (score: 2) and ITZ + NLC-LCZ (score: 3) groups (p < 0.001). Adverse events were mild and did not require discontinuation.</p><p><strong>Conclusions: </strong>These findings indicate that NLC-LCZ enhanced antifungal efficacy and quality of life in TRB-resistant dermatophytosis, and that combination therapy with ITZ + NLC-LCZ yielded the highest recovery, representing a promising strategy against resistant infections.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 6","pages":"e70196"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199430","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":"Integrated Genomic and Phenotypic Analyses Reveal Convergent Resistance Patterns in Clinical Candida tropicalis Isolates.","authors":"Christy Chedraoui, Nour Fattouh, Setrida El Hachem, Tsolaire Sourenian, Louna El Bitar, Lama El Moheb, Anna-Souraya Sleiman, Ibrahim Bitar, Rola Husni, Roy A Khalaf","doi":"10.1111/myc.70181","DOIUrl":"10.1111/myc.70181","url":null,"abstract":"<p><strong>Background: </strong>The incidence of Candida tropicalis isolation is increasing in hospital settings. High azole resistance and mortality rates make it a pathogen that requires further analysis.</p><p><strong>Methods: </strong>Fourteen azole resistant Candida glabrata clinical isolates were collected from a Lebanese hospital and analysed through whole genome sequencing for single nucleotide polymorphisms in key resistance and virulence genes, and for phylogenetic relatedness. Isolates were then characterised for pathogenicity related attributes.</p><p><strong>Results: </strong>All isolates had Lys314Glu mutation in ERG20 with multiple isolates displaying numerous shared mutations, such as Glu291Lys in CDR2 and Ala16Thr in CDR3. With the exception of two isolates that clustered together, most isolates were over 99.6% identical based on a genomic heatmap, implying high relatedness consistent with localised clonal expansion, although SNP differences appeared too high to support this. However, the isolates exhibited increased ergosterol and chitin content, as well as upregulation of drug efflux pumps resulting in drug resistance.</p><p><strong>Conclusion: </strong>Our hospital isolates showed convergent resistant pathways, with many isolates having both shared and unique mutations and a high degree of genomic similarities.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 5","pages":"e70181"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776599","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":"Histoplasma Urinary Antigen for the Diagnosis Histoplasmosis in Non-HIV Individuals.","authors":"João Nobrega de Almeida, Tamara Harb Roca, Denise Dos Anjos Laurentis de Souza Campos, Renée Zon Filippi, Cristóvão Luis P Mangueira, Marines Dalla Valle Martino","doi":"10.1111/myc.70183","DOIUrl":"10.1111/myc.70183","url":null,"abstract":"<p><strong>Background: </strong>Histoplasmosis is an endemic mycosis in the Americas. While urinary Histoplasma antigen enzyme immunoassay testing (HAET) has been validated mainly in HIV-infected patients with disseminated disease, its performance in HIV-negative populations with heterogeneous clinical presentations is unclear.</p><p><strong>Objectives: </strong>To describe the performance of urinary HAET for the diagnosis of histoplasmosis in a cohort of Brazilian HIV-negative patients.</p><p><strong>Material and methods: </strong>We conducted a retrospective study at Einstein Hospital Israelita (Brazil) including HIV-negative patients whose urine samples were analysed by Histoplasma antigen enzyme immunoassay test (HAET) from January 2022 to October 2025. Factors associated with positive urinary HAET were analysed using univariable and multivariable models. Among 346 patients, histoplasmosis was diagnosed in 43 (12%); 16 (37%) were immunocompromised and 14 (33%) had disseminated disease. Urinary HAET was positive in eight patients (19%), with antigen levels from 0.3 to > 15 ng/mL. Sensitivity and specificity were 19% and 100%, respectively; positive and negative predictive values were 100% and 90%. Sensitivity increased to 45% in immunocompromised patients with multiorgan involvement, and immunocompromised status independently predicted HAET positivity (p = 0.008). In HIV-negative patients, HAET demonstrates excellent specificity but low sensitivity, performing best in immunocompromised individuals with disseminated histoplasmosis.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 5","pages":"e70183"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13146122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840501","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":"Prevalence and Clinical Implications of Aspergillus fumigatus Sensitisation in Chronic Obstructive Pulmonary Disease.","authors":"Ying Luo, Yongchang Sun","doi":"10.1111/myc.70185","DOIUrl":"10.1111/myc.70185","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammatory disease characterised by airway obstruction. Aspergillus fumigatus sensitisation represents a distinct, clinically relevant endotype in COPD. In recent years, studies have shown that sensitised patients experience more frequent respiratory symptoms, exacerbations and a poorer prognosis, while the coexistence of allergic bronchopulmonary aspergillosis (ABPA) further increases morbidity and mortality. Recognising Aspergillus sensitisation (AS) as a potential treatable trait in COPD could provide new insights into disease heterogeneity and offer opportunities for personalised management. This review summarises the prevalence and clinical associations of AS among COPD patients.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 5","pages":"e70185"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005909","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":"Environmental Circulation of Aspergillus fumigatus With Reduced Susceptibility to Agricultural Triazole in Brazil: Clonal Dissemination of Potentially Resistant Genotypes.","authors":"Dality Keffelen de Barros Rodrigues, Manuel Leeuwerik, Balázs Brankovics, Wellington Santos Fava, James Venturini, Wieland Meyer, Teppei Arai, Hidetaka Majima, Akira Watanabe, Marcia de Souza Carvalho Melhem","doi":"10.1111/myc.70179","DOIUrl":"10.1111/myc.70179","url":null,"abstract":"<p><strong>Background: </strong>Aspergillus fumigatus resistance to triazole antifungals poses an increasing global health concern. Moreover, the cross-resistance between azole antifungal agents used in clinical settings and those applied in agriculture has become an important emerging issue.</p><p><strong>Objectives: </strong>In this study, we investigated the five environmental A. fumigatus strains showing reduced susceptibility to tebuconazole.</p><p><strong>Methods: </strong>Fungal strains were recovered from air samples collected around the homes of two patients with suspected aspergillosis caused by resistant isolates. Species identification was performed by sequencing the β-tubulin gene, and minimum inhibitory concentrations were determined by broth microdilution. The cyp51A gene was sequenced to detect mutations, and CRISPR-Cas9 genome editing was employed to investigate their influence on susceptibility patterns. Microsatellite genotyping was performed to assess genetic variability, followed by whole genome sequencing and single nucleotide polymorphism analysis.</p><p><strong>Results: </strong>The environmental strains presented the same cyp51A genotype characterised by the M172V substitution and silent mutations. Microsatellite genotyping and whole genome sequencing confirmed that the strains were clonal. Functional validation demonstrated that the M172V and silent mutations partially contribute to reduced susceptibility to tebuconazole but are not the main mechanism of resistance involved. Analysis of polymorphisms in genes other than cyp51A revealed no resistance-conferring mutations.</p><p><strong>Conclusions: </strong>The findings described herein suggest the possibility of local clonal dissemination of environmental strains under selective pressure from agricultural azoles in a major agribusiness region of the Midwest of Brazil. This study highlights the silent spread of potentially resistant genotypes in urban areas and reinforces the need for environmental surveillance and expanded genomic monitoring in South America.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"69 5","pages":"e70179"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776622","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}