Mycoses最新文献

{"title":"Coccidioidomycosis in Oklahoma: A retrospective case series.","authors":"Brian Scott, Joseph Sassine, Olivia Gordon, Nelson Iván Agudelo Higuita","doi":"10.1111/myc.13749","DOIUrl":"https://doi.org/10.1111/myc.13749","url":null,"abstract":"<p><strong>Background: </strong>Coccidioidomycosis is a systemic fungal disease endemic to arid regions of the Western Hemisphere. In the south-western US, Coccidioides spp. may account for up to 20%-25% of all cases of community acquired pneumonia. Clinical manifestations vary widely, from asymptomatic infection to life-threatening disease, especially in immunocompromised hosts.</p><p><strong>Objectives: </strong>The primary objective of the study was to characterise cases of coccidioidomycosis in an area of the United States not considered traditionally endemic for the disease.</p><p><strong>Methods: </strong>We performed a single-centre retrospective study of all cases of coccidioidomycosis from 1 January 2000 to 31 December 2020, in the University of Oklahoma Health Sciences Medical Center.</p><p><strong>Results: </strong>A total of 26 patients were included for analysis. The central nervous system (CNS) and the lungs were the sites most frequently involved. Twenty (77%) had travelled to a coccidioidomycosis endemic region. Most were male (81%) with a median age of 42 years (range: 3-78 years). The majority (46%) were Caucasians, 19% were African American, 19% Hispanic, and 12% Native American. The most common comorbidities were diabetes mellitus and acquired immunodeficiency syndrome, identified in 27% and 23% of patients, respectively. Patients on immunosuppressive therapy accounted for 12% of all cases.</p><p><strong>Conclusion: </strong>Our study is one of the largest single-centre case series of coccidioidomycosis from a non-endemic area. Diabetes mellitus was the most frequent comorbidity. Compared to other case series of coccidioidomycosis, our patient population had higher rates of immunosuppression and had both a higher rate of disseminated disease and overall mortality.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"67 5","pages":"e13749"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087863","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":"Epidemiological patterns of candidaemia: A comprehensive analysis over a decade","authors":"Gordon Ferngren, David Yu, Tugce Unalan‐Altintop, Patrik Dinnétz, Volkan Özenci","doi":"10.1111/myc.13729","DOIUrl":"https://doi.org/10.1111/myc.13729","url":null,"abstract":"BackgroundThe prevalence of fungal bloodstream infections (BSI), especially candidaemia, has been increasing globally during the last decades. Fungal diagnosis is still challenging due to the slow growth of fungal microorganisms and need for special expertise. Fungal polymicrobial infections further complicate the diagnosis and extend the time required. Epidemiological data are vital to generate effective empirical treatment strategies.ObjectivesThe overall aim of this project is to describe the epidemiology of monomicrobial candidaemia and polymicrobial BSI, both with mixed fungaemia and with mixed <jats:italic>Candida</jats:italic>/bacterial BSIs.MethodsWe conducted a single‐centre retrospective epidemiological study that encompasses 950,161 blood cultures during the years 2010 to 2020. The epidemiology of monomicrobial and polymicrobial candidaemia episodes were investigated from the electronic records.ResultsWe found that 1334 candidaemia episodes were identified belonging to 1144 individual patients during 2010 to 2020. <jats:italic>Candida albicans</jats:italic> was the most prevalent species detected in candidaemia patients, representing 57.7% of these episodes. <jats:italic>Nakaseomyces</jats:italic> (<jats:italic>Candida</jats:italic>) <jats:italic>glabrata</jats:italic> and <jats:italic>Candida parapsilosis complex</jats:italic> showed an increasing trend compared to previous studies, whereas <jats:italic>Candida albicans</jats:italic> demonstrated a decrease. 19.8% of these episodes were polymicrobial and 17% presented with mixed <jats:italic>Candida</jats:italic>/bacterial BSIs while 2.8% were mixed fungaemia. <jats:italic>C. albicans</jats:italic> and <jats:italic>N. glabrata</jats:italic> were the most common combination (51.4%) in mixed fungaemia episodes. <jats:italic>Enterococcus</jats:italic> and <jats:italic>Lactobacillus</jats:italic> spp. were the most common bacteria isolated in mixed <jats:italic>Candida</jats:italic>/bacterial BSIs.ConclusionsPolymicrobial growth with candidaemia is common, mostly being mixed <jats:italic>Candida</jats:italic>/bacterial BSIs. <jats:italic>C. albicans</jats:italic> was detected in more than half of all the candidaemia patients however showed a decreasing trend in time, whereas an increase is noteworthy in <jats:italic>C. parapsilosis</jats:italic> complex and <jats:italic>N. glabrata</jats:italic>.","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"30 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140838036","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":"Systematic review on efficacy and safety of empirical versus pre‐emptive antifungal therapy among children with febrile neutropenia reveals paucity of data","authors":"Meenakshi Sachdeva, Meenakshi Malik, Pranita Pradhan, Kulbir Kaur, Sarita Dogra, Joseph L. Mathew","doi":"10.1111/myc.13722","DOIUrl":"https://doi.org/10.1111/myc.13722","url":null,"abstract":"BackgroundTwo approaches are used to manage invasive fungal disease (IFD) in febrile neutropenic patients viz. empirical therapy (without attempting to confirm the diagnosis), or pre‐emptive therapy (after screening tests for IFD).ObjectiveThis systematic review was undertaken to compare these approaches in children.MethodsWe searched PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, CINAHL, Clinical Trial Registries and grey literature, for randomized controlled trials (RCT) comparing empirical versus pre‐emptive antifungal therapy in children with FN suspected to have IFD. We used the Cochrane Risk of bias 2 tool for quality assessment, and evaluated the certainty of evidence using the GRADE approach.ResultsWe identified 7989 citations. Stepwise screening identified only one relevant RCT that administered empirical (<jats:italic>n</jats:italic> = 73) or pre‐emptive (<jats:italic>n</jats:italic> = 76) antifungal therapy. There were no significant differences in all‐cause mortality (RR 1.56, 95% CI: 0.46, 5.31), IFD mortality (RR 1.04, 95% CI:0.15, 7.20) and other clinically important outcomes such as duration of fever, duration of hospitalization and proportion requiring ICU admission. There were no safety data reported. The number of days of antifungal therapy was significantly lower in the pre‐emptive therapy arm. The certainty of evidence for all outcomes was ‘moderate’.ConclusionsThis systematic review highlighted the paucity of data, comparing empirical versus pre‐emptive antifungal therapy in children with febrile neutropenia having suspected invasive fungal disease. Data from a single included trial suggests that both approaches may be comparable in research settings. Robust trials are warranted to address the gap in existing knowledge about the optimal approach in clinical practice.","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"41 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140582205","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":"Global prevalence of onychomycosis in general and special populations: An updated perspective","authors":"Aditya K. Gupta, Tong Wang, Shruthi Polla Ravi, Avantika Mann, Mary A. Bamimore","doi":"10.1111/myc.13725","DOIUrl":"https://doi.org/10.1111/myc.13725","url":null,"abstract":"BackgroundOnychomycosis is a chronic nail disorder commonly seen by healthcare providers; toenail involvement in particular presents a treatment challenge.ObjectiveTo provide an updated estimate on the prevalence of toenail onychomycosis.MethodsWe conducted a literature search using PubMed, Embase and Web of Science. Studies reporting mycology‐confirmed diagnoses were included and stratified into (a) <jats:italic>populations‐based</jats:italic> studies, and studies that included (b) <jats:italic>clinically un‐suspected</jats:italic> and (c) <jats:italic>clinically suspected</jats:italic> patients.ResultsA total of 108 studies were included. Based on studies that examined <jats:italic>clinically un‐suspected</jats:italic> patients (i.e., with or without clinical features suggestive of onychomycosis), the pooled prevalence rate of toenail onychomycosis caused by dermatophytes was 4% (95% CI: 3–5) among the general population; special populations with a heightened risk include knee osteoarthritis patients (RR: 14.6 [95% CI: 13.0–16.5]), chronic venous disease patients (RR: 5.6 [95% CI: 3.7–8.1]), renal transplant patients (RR: 4.7 [95% CI: 3.3–6.5]), geriatric patients (RR: 4.7 [95% CI: 4.4–4.9]), HIV‐positive patients (RR: 3.7 [95% CI: 2.9–4.7]), lupus erythematosus patients (RR: 3.1 [95% CI: 1.2–6.3]), diabetic patients (RR: 2.8 [95% CI: 2.4–3.3]) and hemodialysis patients (RR: 2.8 [95% CI: 1.9–4.0]). The prevalence of onychomycosis in <jats:italic>clinically suspected</jats:italic> patients was significantly higher likely due to sampling bias. A high degree of variability was found in a limited number of <jats:italic>population‐based</jats:italic> studies indicating that certain pockets of the population may be more predisposed to onychomycosis. The diagnosis of non‐dermatophyte mould onychomycosis requires repeat sampling to rule out contaminants or commensal organisms; a significant difference was found between studies that performed single sampling versus repeat sampling. The advent of PCR diagnosis results in improved detection rates for dermatophytes compared to culture.ConclusionOnychomycosis is an underrecognized healthcare burden. Further <jats:italic>population‐based</jats:italic> studies using standardized PCR methods are warranted.","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"45 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140586087","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":"Low toxicity contributes to Sporothrix globosa invade the skin of patients in low‐epidemic areas of China","authors":"Yuying Qu, Yahui Feng, Shaodong Bian, Yang Yang, Dongmei Li, Weida Liu, Dongmei Shi","doi":"10.1111/myc.13724","DOIUrl":"https://doi.org/10.1111/myc.13724","url":null,"abstract":"ObjectiveThis study aims to assess the clinical characteristics of sporotrichosis in low‐endemic areas of China, including the prevalence geography, genotypic traits of patients, clinical manifestations, and strain virulence and drug sensitivities. The objective is to improve the currently used clinical management strategies for sporotrichosis.MethodsRetrospective data were collected from patients diagnosed with sporotrichosis through fungal culture identification. The isolates from purified cultures underwent identification using CAL (<jats:italic>Calmodulin</jats:italic>) gene sequencing. Virulence of each strain was assessed using a <jats:italic>Galleria mellonella</jats:italic> (<jats:italic>G. mellonella</jats:italic>) larvae infection model. In vitro susceptibility testing against commonly used clinical antifungal agents for sporotrichosis was conducted following CLSI criteria.ResultsIn our low‐endemic region for sporotrichosis, the majority of cases (23) were observed in middle‐aged and elderly women with a history of trauma, with a higher incidence during winter and spring. All clinical isolates were identified as <jats:italic>Sporothrix globosa</jats:italic> (<jats:italic>S. globosa</jats:italic>). The <jats:italic>G. mellonella</jats:italic> larvae infection model indicated independent and dose‐dependent virulence among strains, with varying toxicity levels demonstrated by the degree of melanization of the <jats:italic>G. mellonella</jats:italic>. Surprisingly, lymphocutaneous types caused by <jats:italic>S. globosa</jats:italic> exhibited lower in vitro virulence but were more common in affected skin. In addition, all <jats:italic>S.globosa</jats:italic> strains displayed high resistances to fluconazole, while remaining highly susceptible to terbinafine, itraconazole and amphotericin B.ConclusionGiven the predominance of elderly women engaged in agricultural labour in our region, which is a low‐epidemic areas, they should be considered as crucial targets for sporotrichosis monitoring. <jats:italic>S. globosa</jats:italic> appears to be the sole causative agent locally. However, varying degrees of melanization in larvae were observed among these isolates, indicating a divergence in their virulence. Itraconazole, terbinafine and amphotericin B remain viable first‐line antifungal options for treating <jats:italic>S.globosa</jats:italic> infection.","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"55 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140585532","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":"Comparison of dermoscopic characteristics on toenail onychomycosis in psoriatic and non‐psoriatic patients: A prospective study","authors":"Shiqi Wang, Wei Chen, Fang Liu, Ruoyu Li","doi":"10.1111/myc.13721","DOIUrl":"https://doi.org/10.1111/myc.13721","url":null,"abstract":"BackgroundPsoriatic patients may experience the coexistence of onychomycosis (OM). However, the evaluation of OM in psoriatics has been hindered by potential clinical differences from OM in non‐psoriatics.ObjectiveTo assess and compare dermoscopic features between toenail OM in psoriatic and in non‐psoriatic patients.Patients and MethodsBetween September 2020 and September 2023, dermoscopy was conducted on 183 affected toenails by OM in psoriatics and 232 affected toenails by OM in non‐psoriatics in two centres. The dermoscopic characteristics were compared using the Chi‐squared test.ResultsAmong toenail OM cases in psoriatic subjects, the most prevalent dermoscopic features included pitting (147/183, 80.33%) and subungual hyperkeratosis (118/183, 64.48%). Conversely, toenail OM in non‐psoriatics was characterized by subungual hyperkeratosis (175/232, 75.43%) and nail spikes (139/232, 59.91%). Comparative analysis revealed a significantly higher occurrence of pitting (80.33% vs. 15.96%, <jats:italic>p</jats:italic> &lt; .001), periungual telangiectasis (22.40% vs. 4.74%, <jats:italic>p</jats:italic> &lt; .001), oil patches (12.57% vs. 0.43%,<jats:italic>p</jats:italic> &lt; .001) and transverse grooves (43.72% vs. 28.45%,<jats:italic>p</jats:italic> &lt; .01) in toenail OM in psoriatics. Furthermore, toenail OM in psoriatics exhibited a significantly lower frequency of yellow structureless area (13.11% vs. 42.67%, <jats:italic>p</jats:italic> &lt; .001), nail spikes (43.17% vs. 59.91%, <jats:italic>p</jats:italic> &lt; .01), ruin appearance of sulphur nugget (8.20% vs. 31.03%, <jats:italic>p</jats:italic> &lt; .001), dotted/blocky haemorrhage (6.01% vs. 20.69%,<jats:italic>p</jats:italic> &lt; .001) and partial onycholysis (32.79% vs. 46.98%, <jats:italic>p</jats:italic> &lt; .01).ConclusionsDermoscopic features of toenail OM in psoriatic and non‐psoriatic patients exhibit notable differences. OM in psoriatics shows a higher frequency of pitting and periungual telangiectasis, while a lower frequency of yellow structureless areas and nail spikes under dermoscopy.","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"53 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140585529","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":"Distribution of Aspergillus species and prevalence of azole resistance in clinical and environmental samples from a Spanish hospital during a three-year study period.","authors":"Jose Lucio, Laura Alcazar-Fuoli, Horacio Gil, Samuel Cano-Pascual, Sara Hernandez-Egido, Maria Soledad Cuetara, Emilia Mellado","doi":"10.1111/myc.13719","DOIUrl":"10.1111/myc.13719","url":null,"abstract":"<p><strong>Background: </strong>Surveillance studies are crucial for updating trends in Aspergillus species and antifungal susceptibility information.</p><p><strong>Objectives: </strong>Determine the Aspergillus species distribution and azole resistance prevalence during this 3-year prospective surveillance study in a Spanish hospital.</p><p><strong>Materials and methods: </strong>Three hundred thirty-five Aspergillus spp. clinical and environmental isolates were collected during a 3-year study. All isolates were screened for azole resistance using an agar-based screening method and resistance was confirmed by EUCAST antifungal susceptibility testing. The azole resistance mechanism was confirmed by sequencing the cyp51A gene and its promoter. All Aspergillus fumigatus strains were genotyped using TRESPERG analysis.</p><p><strong>Results: </strong>Aspergillus fumigatus was the predominant species recovered with a total of 174 strains (51.94%). The rest of Aspergillus spp. were less frequent: Aspergillus niger (14.93%), Aspergillus terreus (9.55%), Aspergillus flavus (8.36%), Aspergillus nidulans (5.37%) and Aspergillus lentulus (3.28%), among other Aspergillus species (6.57%). TRESPERG analysis showed 99 different genotypes, with 72.73% of the strains being represented as a single genotype. Some genotypes were common among clinical and environmental A. fumigatus azole-susceptible strains, even when isolated months apart. We describe the occurrence of two azole-resistant A. fumigatus strains, one clinical and another environmental, that were genotypically different and did not share genotypes with any of the azole-susceptible strains.</p><p><strong>Conclusions: </strong>Aspergillus fumigatus strains showed a very diverse population although several genotypes were shared among clinical and environmental strains. The isolation of azole-resistant strains from both settings suggest that an efficient analysis of clinical and environmental sources must be done to detect azole resistance in A. fumigatus.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"67 4","pages":"e13719"},"PeriodicalIF":4.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318717","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":"Patients with recurrent vulvovaginal candidiasis exhibit a decrease in both the fungicidal activity of neutrophils and the proliferation of peripheral blood mononuclear cells.","authors":"Jeiser Marcelo Consuegra-Asprilla, Carolina Rodríguez-Echeverri, Daniela Herrera Posada, Beatriz L Gómez, Ángel González","doi":"10.1111/myc.13720","DOIUrl":"10.1111/myc.13720","url":null,"abstract":"<p><strong>Background: </strong>Recurrent vulvovaginal candidiasis (RVVC) is an important and underestimated fungal infection.</p><p><strong>Objective: </strong>We aimed to determine the fungicidal and proliferative capacities of neutrophils and peripheral blood mononuclear cells (PBMCs), respectively and the clinical and microbiological characteristics of a cohort of Colombian patients diagnosed with RVVC.</p><p><strong>Methods: </strong>A cross-sectional study was conducted. A total of 66 women were included (40 diagnosed with RVVC and 26 healthy women [HW]). Demographic and clinical data were recorded. Vaginal fluid samples were obtained for isolation, identification and antifungal susceptibility testing of Candida species using selective culture media and the Vitek 2.0® system. Blood samples were also obtained to evaluate cell subpopulations; furthermore, neutrophils and PBMCs were isolated to determine their fungicidal and proliferative capacities, respectively.</p><p><strong>Results: </strong>The median age was 29 (IQR: 34-23) for RVVC and 24 (IQR: 30-23) for HW. Only two species of the genus Candida were identified: Candida albicans (92.5%) and Candida lusitaniae (7.5%). Resistance to fluconazole, voriconazole, flucytosine and amphotericin B was observed on six C. albicans isolates and one C. lusitaniae isolate. Only the family history of vulvovaginal candidiasis was associated with RVVC occurrence. The RVVC group exhibited a significantly higher number of neutrophils but with lower fungicidal activity in comparison to HW; likewise, PBMCs from RVVC patients presented a lower proliferation index when stimulated with C. albicans.</p><p><strong>Conclusion: </strong>Contrary to what has been reported worldwide, in Colombian patients with RVVC, C. albicans was the main isolated species without increased antifungal resistance. The diminished fungicidal and proliferative capacities of neutrophils and PBMCs, respectively, could suggest a possible alteration in the innate and adaptive immune responses.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"67 4","pages":"e13720"},"PeriodicalIF":4.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318718","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":"Dermatophytes and skin dermatophytoses in Southeast Asia-First epidemiological survey from Cambodia.","authors":"Silke Uhrlaß, Sithach Mey, Daniela Koch, Hanna Mütze, Constanze Krüger, Michel Monod, Pietro Nenoff","doi":"10.1111/myc.13718","DOIUrl":"10.1111/myc.13718","url":null,"abstract":"<p><strong>Background: </strong>Dermatomycoses count to the most frequent dermatoses in Cambodia.</p><p><strong>Objectives: </strong>The aim of this survey was to investigate the occurrence of dermatophytes in this Southeast Asian country.</p><p><strong>Methods: </strong>From June 2017 to July 2018, skin scrapings were taken from 67 patients with superficial dermatophytosis for mycological diagnostics. Identification of dermatophytes was confirmed by sequencing of the 'internal transcribed spacer'-(ITS) region of the rDNA, and the gene of the Translation Elongation Factor (TEF)-1α.</p><p><strong>Results: </strong>Patients were suffering from tinea corporis and tinea inguinalis/cruris 42/67 (63%), tinea capitis/faciei 14/67 (21%), tinea corporis/capitis/faciei 6/67 (9%), tinea manuum/pedis 2/67 (3%), tinea pedis 2/67 (3%) and tinea manuum 1/67 (1%). Both, by culture and/or PCR, a dermatophyte was detected in 52 (78%) out of 67 samples. Culture positive were 42 (81%) of 52, PCR positive were 50 (96%). The following dermatophytes were found: Trichophyton (T.) rubrum, 36/52 strains (69%, 29 by culture), T. mentagrophytes/T. interdigitale (TM/TI) 9/52 (17%, six by culture) and Microsporum (M.) canis 5/52 strains (10%, by culture). One strain of Nannizzia (N.) incurvata 1/52 (2%) and N. nana 1/52 (2%) was isolated. Based on sequencing, we demonstrated that two T. mentagrophytes strains out of the nine TM/TI represented the new ITS genotype XXV Cambodia. We found one T. mentagrophytes strain genotype VIII (now, reclassified as T. indotineae). This isolate was terbinafine resistant, and it exhibited the amino acid substitution Phe397Leu in the squalene epoxidase. Three strains of T. interdigitale genotype II* were isolated.</p><p><strong>Conclusion: </strong>This is the first survey on epidemiology of dermatophytes in Cambodia. Currently, T. rubrum represents the most frequent species in Cambodia. One Indian strain genotype VIII T. mentagrophytes was found. A highlight was the first description of the new T. mentagrophytes genotype XXV Cambodia.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"67 4","pages":"e13718"},"PeriodicalIF":4.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318752","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":"The sphingolipid inhibitor myriocin increases Candida auris susceptibility to amphotericin B.","authors":"Hanna Stieber, Lara Junghanns, Hannah Wilhelm, Maria Batliner, Alexander Maximilian Aldejohann, Oliver Kurzai, Ronny Martin","doi":"10.1111/myc.13723","DOIUrl":"10.1111/myc.13723","url":null,"abstract":"<p><strong>Background: </strong>The emergence of the pathogenic yeast Candida auris is of global concern due to its ability to cause hospital outbreaks and develop resistance against all antifungal drug classes. Based on published data for baker's yeast Saccharomyces cerevisiae, sphingolipid biosynthesis, which is essential for maintaining membrane fluidity and formation of lipid rafts, could offer a target for additive treatment.</p><p><strong>Methods: </strong>We analysed the susceptibility of C. auris to myriocin, which is an inhibitor of the de novo synthesis of sphingolipids in eukaryotic cells in comparison to other Candida species. In addition, we combined sublethal concentrations of myriocin with the antifungal drugs amphotericin B and fluconazole in E-tests. Consequently, the combinatory effects of myriocin and amphotericin B were examined in broth microdilution assays.</p><p><strong>Results: </strong>Myriocin-mediated inhibition of the sphingolipid biosynthesis affected the growth of C. auris. Sublethal myriocin concentrations increased fungal susceptibility to amphotericin B. Isolates which are phenotypically resistant (≥2 mg/L) to amphotericin B became susceptible in presence of myriocin. However, addition of myriocin had only limited effects onto the susceptibility of C. auris against fluconazole.</p><p><strong>Conclusions: </strong>Our results show that inhibition of de novo sphingolipid biosynthesis increases the susceptibility of C. auris to amphotericin B. This may potentially enhance antifungal treatment options fighting this often resistant yeast pathogen.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"67 4","pages":"e13723"},"PeriodicalIF":4.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318719","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}