Mycopathologia最新文献

{"title":"Survival in Immunocompromised Adults with Pneumocystis jirovecii Pneumonia: A Multicenter ID-IRI Study.","authors":"Yasemin Cag, Hulya Caskurlu, Handan Ankarali, Antonio Cascio, Botond Lakatos, Aron Lakatos, Roxana Cernat, Abdullah Umut Pekok, Ergys Ramosaco, Sholpan Kulzhanova, Cristiana Oprea, Massimiliano Lanzafame, Atousa Hakamifard, Hamed Azhdari Tehrani, Nevin İnce, Rusmir Baljic, Bilal Ahmad Rahimi, Gokhan Vatansever, Meltem Tasbakan, Halenur Vural-Akbal, Ricardo Fernandez, Claudia Quiles, Sevil Alkan, Arjan Harxhi, Irina Magdalena Dumitru, Nesibe Korkmaz, Aisha Al Naqbi, Tarsila Vieceli, Gulden Eser-Karlidag, Reham Khedr, Goffredo Angioni, Fahad Almajid, Rosa Fontana Del Vecchio, Ahmet Cem Yardımcı, Hakan Erdem","doi":"10.1007/s11046-026-01099-w","DOIUrl":"10.1007/s11046-026-01099-w","url":null,"abstract":"<p><strong>Purpose: </strong>Pneumocystis jirovecii pneumonia (PJP) is a life-threatening opportunistic infection in immunocompromised patients. The aim of this study was to identify risk factors associated with in-hospital 30-day all-cause mortality among PJP in patients with HIV and hematologic malignancies where PJP is the most prevalent.</p><p><strong>Methods: </strong>We conducted a multicenter, international, retrospective cohort study of consecutive hospitalized patients aged > 17 years with PJP between January 1, 2010, and March 1, 2024. Only patients with laboratory-confirmed PJP were included.</p><p><strong>Results: </strong>Overall, 156 patients were included to study. Of the 156 patients, 115 (73.7%) were male, and the median age was 43 years (IQR 35-52). Of the patients, 130 (83.3%) were people living with HIV, including 126 newly diagnosed cases, while 26 (16.7%) had hematologic malignancies. Overall, PJP prophylaxis was used in only 4.5% of patients. According to the immunofluorescence assay or conventional staining methods used as the reference standard, the positivity rate of P. jirovecii PCR in BAL samples was 96.4%. Intensive care unit admission was required for 60 patients (38.5%), of whom 51 (85.0%) required mechanical ventilation. The overall in-hospital 30-day all-cause mortality rate was 14.1%. In the multivariable logistic regression analysis, higher respiratory rate (OR 1.092; 95% CI 1.002-1.190), higher SOFA score (OR 1.757; 95% CI 1.311-2.356), increased neutrophil count (OR 1.332; 95% CI 1.141-1.555), pleural effusion on chest X-ray (OR 7.268; 95% CI 1.382-38.212), and a prior history of PJP (OR 19.537; 95% CI 1.462-261.2) were independently associated with increased in-hospital 30-day all-cause mortality.</p><p><strong>Conclusions: </strong>Our findings indicate that greater clinical severity and respiratory compromise are associated with increased mortality risk, underscoring the value of early recognition of high-risk patients to guide timely management.</p>","PeriodicalId":19017,"journal":{"name":"Mycopathologia","volume":"191 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Candidozyma auris Infection and Colonization in a Tertiary Pediatric Intensive Care Unit: A Single-Center Experience.","authors":"Döndü Nilay Penezoğlu, Gül Arga, Belkıs Hatice İnceli, Hülya Akat, Merve Havan, Duygu Öcal, Zeynep Ceren Karahan, Halil Özdemir, Tanıl Kendirli, Ergin Çiftçi","doi":"10.1007/s11046-026-01106-0","DOIUrl":"10.1007/s11046-026-01106-0","url":null,"abstract":"<p><p>Candidozyma auris is a multidrug-resistant yeast that can cause invasive infections and healthcare-associated outbreaks. This retrospective study evaluated seven pediatric patients in whom C. auris was detected in a tertiary pediatric intensive care unit in Türkiye between February 2023 and February 2024. The mean age of the patients was 95.71 ± 80.52 months. Five patients had chronic illnesses and a history of multiple hospitalizations. C. auris was isolated from blood (five isolates), urine (three isolates), skin swab (three isolates), and catheter tip (one isolate) cultures. At initial evaluation, one patient was classified as colonized, whereas six were diagnosed with clinically significant C. auris infections, including bloodstream infection, catheter-related bloodstream infection, and urinary tract infection. Of the five patients, three were initially diagnosed with urinary tract infection; however, one of these patients was ultimately considered to have urinary colonization rather than infection. Six patients received antifungal therapy. Five were treated for candidemia, and two of these patients also had concurrent urinary tract infection. All isolates were susceptible to echinocandins. Two patients died due to C. auris-related candidemia. Herein, we present our experience in controlling a suspected healthcare-associated C. auris outbreak and the treatment approaches implemented following the first identified C. auris case in our hospital.</p>","PeriodicalId":19017,"journal":{"name":"Mycopathologia","volume":"191 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning Based on DeepLabv3+ for Automated Identification, Segmentation, and Quantification of Fungi in Clinical Fluorescence Microscopy Images.","authors":"Baiyinzi Du, Wenjie Fang, Fen Shu, Kaisu Pan, Yanan Xu, Yanqing Zheng, Yuan Gao, Kai Ma, Wanwan Pan, Yingping Lin, Haibin Wu, Mingwei Du, Wanqing Liao, Tiancheng Chen, Weihua Pan","doi":"10.1007/s11046-026-01100-6","DOIUrl":"10.1007/s11046-026-01100-6","url":null,"abstract":"<p><strong>Background: </strong>Fungal fluorescence microscopy using Calcofluor White is a rapid and sensitive diagnostic tool for fungal infections. However, manual microscopic examination is limited by high subjectivity, observer fatigue, poor reproducibility, and a heavy reliance on professional expertise-particularly in high-throughput clinical screening.</p><p><strong>Objectives: </strong>To develop and validate a DeepLabv3+-based deep learning model for the automated identification, precise segmentation, and quantification of fungal hyphae and spores in clinical fluorescence microscopy images.</p><p><strong>Methods: </strong>A total of 60,484 fungal fluorescence images were collected from 1863 clinical specimens across seven medical centers. Of these, 38,494 images were used for model training, while 2561 independent images were selected for clinical validation. Blinded manual microscopy by expert technicians served as the gold standard. The model's diagnostic performance, stability, and agreement were evaluated.</p><p><strong>Results: </strong>The model demonstrated robust diagnostic performance, with an accuracy of 90.32%, precision of 91.58%, recall (sensitivity) of 92.42%, and specificity of 88.39%. The Youden index was 0.8081, with an area under the curve (AUC) of 0.91, indicating substantial agreement (Kappa = 0.798). The system exhibited excellent stability across repeated tests and automatically generated quantitative counts of hyphae and spores.</p><p><strong>Conclusions: </strong>This DeepLabv3+-based deep learning system provides an accurate, stable, and high-throughput approach for clinical fungal fluorescence microscopy. It can standardize diagnostic procedures and improve efficiency for diagnosing superficial and suspected invasive fungal infections, serving as a reliable auxiliary diagnostic tool.</p>","PeriodicalId":19017,"journal":{"name":"Mycopathologia","volume":"191 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coccidioidomycosis in Patients Treated with Dupilumab: A Descriptive Case Series.","authors":"Samuel P Volk, Janis E Blair","doi":"10.1007/s11046-026-01103-3","DOIUrl":"10.1007/s11046-026-01103-3","url":null,"abstract":"<p><p>A Th2-favored phenotype can predispose individuals to symptomatic and disseminated coccidioidomycosis. Dupilumab, which impedes Th2 immunity, is sometimes used adjunctively for disseminated coccidioidomycosis. To determine whether dupilumab alters the clinical course of coccidioidomycosis, we retrospectively reviewed records of 1,561 patients who received dupilumab; 42 had coccidioidomycosis diagnosed from October 6, 2018, through July 16, 2025 (Mayo Clinic [Phoenix, Arizona]). Eleven patients received dupilumab before having symptomatic coccidioidomycosis, and 3 received dupilumab before asymptomatic coccidioidomycosis was identified. Twenty-eight patients received dupilumab after coccidioidomycosis was diagnosed: 16 were asymptomatic and seropositive, without reactivation on dupilumab, and 12 had ongoing symptoms (most eventually resolved). No patients had adjunctive dupilumab treatment. Three patients had disseminated coccidioidomycosis: 2 initiated dupilumab after coccidioidomycosis was diagnosed and 1 before, and each eventually had symptomatic improvement. We did not observe patterns of coccidioidomycosis worsening after dupilumab initiation or an increased prevalence of coccidioidomycosis among patients already receiving dupilumab.</p>","PeriodicalId":19017,"journal":{"name":"Mycopathologia","volume":"191 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Efficacy of Calcofluor White Staining Versus PAS and GMS Staining for Human Sporotrichosis in FFPE Specimens.","authors":"Lina Li, Lijie Zhang, Shiyou Du, Shuai Zhang, Shoumin Zhang, Hongwei Liu, Jianguo Li, Yuping Ran","doi":"10.1007/s11046-026-01102-4","DOIUrl":"10.1007/s11046-026-01102-4","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the diagnostic efficacy of calcofluor white (CFW) staining for sporotrichosis using archival formalin-fixed paraffin-embedded (FFPE) specimens, compared with conventional histochemical stains.</p><p><strong>Methods: </strong>A total of 75 FFPE specimens collected between 2010 and 2023 from patients with culture- or sequencing-confirmed sporotrichosis cases were enrolled, with 70 specimens from non-fungal infection cases using as controls. Serial tissue sections were stained with CFW, periodic acid-Schiff (PAS), and Gomori methenamine silver (GMS) staining, respectively. The detection rates, diagnostic accuracy metrics, and storage duration effects were assessed.</p><p><strong>Results: </strong>CFW staining yielded a fungal detection rate of 78.6% (59/75), which was significantly higher than those of PAS (38.6%, 29/75) and GMS (28.0%, 21/75) (χ²=42.85, P<0.0001) staining. Diagnostic accuracy analysis revealed CFW staining had 78.6% sensitivity, 98.5% specificity, 98.3% positive predictive value, and 81.1% negative predictive value. The fluorescent signal of CFW staining remained stable for at least of 6 months. Additionally, the positive detection rates were not affected by long-term storage (> 10 years: 71.4%; 5-10 years: 70.3%; <5 years: 88.2%; P=0.083).</p><p><strong>Conclusions: </strong>For archival FEPE specimens, CFW staining exhibits superior sensitivity and excellent specificity for sporotrichosis detection, which enables rapid diagnosis and effectively reduces the risk of misdiagnosis. Considering its technical simple operation, long-term stability, and being compatible with conventional histological examination, CFW staining serves as a valuable adjunctive diagnostic tool, particularly in sporotrichosis- endemic regions. Further prospective multicenter studies were required to validate its clinical application value.</p>","PeriodicalId":19017,"journal":{"name":"Mycopathologia","volume":"191 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Species Distribution of Candida Bloodstream Infections in a Comprehensive Cancer Center, 2008-2023.","authors":"Mohammad El-Atoum, George L Chen, Brahm H Segal, John P Bonnewell, Nikolaos G Almyroudis","doi":"10.1007/s11046-026-01088-z","DOIUrl":"10.1007/s11046-026-01088-z","url":null,"abstract":"<p><strong>Introduction: </strong>Candida bloodstream infections remain a significant complication of malignancies and their therapies.</p><p><strong>Aim: </strong>To investigate the epidemiology of Candida species causing bloodstream infections in patients with malignancies.</p><p><strong>Methods: </strong>We retrospectively reviewed bloodstream infections due to Candida from July 2008 to June 2023 in patients admitted under hematological, solid tumor and surgical services. Common species included C. albicans, Nakaseomyces glabratus (formerly C. glabrata), Pichia kudriavzevii (formerly C. krusei), C. parapsilosis complex and C. tropicalis. The rest were classified as uncommon.</p><p><strong>Results: </strong>Incidence of candidemia was 0.46 episodes per 1,000 patients-days of admission. Of 265 episodes of candidemia, 102 (38.5%) occurred in patients under hematological services, 59 (22.3%) under solid tumor and 104 (39.2%) under surgical services. Among 271 available isolates, C. albicans was the predominant species, accounting for 96 (35.4%). N. glabratus (formerly C. glabrata) was the dominant species in 15 (55.6%) episodes of candidemia following triazole exposure (p: 0.008) and C. parapsilosis the dominant in 15 (34.9%) following echinocandin exposure (p: < .001). Candidemia due to uncommon Candida species occurred in 22 (8.3%) episodes for the total cohort and in 17 (16.7%) in patients with hematological malignancies (p: < .001). Multivariable logistic regression analysis identified neutropenia (OR 4.5 [95% CI 1.7-11.9]) as independent predictor of candidemia caused by uncommon species.</p><p><strong>Conslusion: </strong>Candidemia due to uncommon species occurred with higher frequency in patients with malignancies, with the highest rates observed among those with hematological malignancies.</p>","PeriodicalId":19017,"journal":{"name":"Mycopathologia","volume":"191 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics, Diagnosis, and Treatment of Central Nervous System Candidiasis: A Systematic Review of 418 Cases.","authors":"Guilherme Diogo Silva, Mariane Taborda, Wdson Luis Lima Kruschewsky, Leonardo Torioni, Mariane Cappellini Stricagnolo, Bernardo Ferreira Camilo, Isadora Campos de Sousa Abreu, Isabela Cristina Oliveira Silva, Nadine Correia Silva Santos, Gabriel Diniz Resende, Marcello Mihailenko Chaves Magri, Adriana Satie Gonçalves Kono Magri, Li-Ping Zhu, Vitor Falcão de Oliveira","doi":"10.1007/s11046-026-01097-y","DOIUrl":"10.1007/s11046-026-01097-y","url":null,"abstract":"<p><strong>Background: </strong>Central nervous system (CNS) candidiasis is a rare but life-threatening complication of invasive candidiasis. However, current knowledge derives mainly from isolated case reports, and no comprehensive synthesis has been previously performed.</p><p><strong>Methods: </strong>We conducted a systematic review of published cases of CNS candidiasis. PubMed and Embase were searched without language or date restrictions. Eligible cases required microbiological or histopathological confirmation of Candida spp. and evidence of CNS involvement on cerebrospinal fluid (CSF) analysis or neuroimaging. Demographic, clinical, radiological, laboratory, therapeutic, and outcome data were extracted. We compared mortality and non-mortality groups, paediatric and adult patients, and diagnostic periods.</p><p><strong>Results: </strong>We identified 418 patients reported between 1945 and 2024 (median age, 21 years [IQR 0-46]; 62% male). Prior antibiotic use (53%), intravascular catheterization (31%), and neurosurgery (22%) were common risk factors. Neuroimaging was abnormal in 87% of cases, and cerebrospinal fluid was abnormal in 96%, typically showing neutrophilic or lymphocytic pleocytosis and low glucose. Nearly half of cases were pediatric (41% of very-low-birth-weight neonates), who more often had healthcare-associated risk factors and less often immunosuppressive conditions. Overall mortality was 35%, mostly within 30 days; older age was associated with higher mortality, whereas combination antifungal therapy and more recent diagnostic periods were associated with lower mortality in multivariate analysis. Over time, immunosuppression, non-albicans Candida species, and antifungal use increased, while autopsy-based diagnoses and mortality declined.</p><p><strong>Conclusion: </strong>CNS candidiasis is a rare but severe infection with challenging diagnosis and high mortality, emphasizing the importance of early recognition and appropriate antifungal therapy.</p>","PeriodicalId":19017,"journal":{"name":"Mycopathologia","volume":"191 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS‑CoV‑2 Associated Shifts in the Upper Respiratory Tract Mycobiome in Non-hospitalized Cases.","authors":"Siddharth Singh Tomar, Krishna Khairnar","doi":"10.1007/s11046-026-01096-z","DOIUrl":"10.1007/s11046-026-01096-z","url":null,"abstract":"<p><p>SARS‑CoV‑2 infection is associated with marked changes of the upper respiratory tract mycobiome. URT mycobiome Changes in non-hospitalized patients however, remains poorly defined. We performed shotgun metagenomic sequencing of 95 upper respiratory tract swab samples from 48 symptomatic SARS‑CoV‑2-positive individuals and 47 healthy controls from central India. Fungal diversity and community structure were compared using alpha- and beta-diversity analyses, while differential taxa were identified using prevalence-based testing and a Directional Significance Score (DSS). SARS‑CoV‑2-positive samples showed significantly higher fungal alpha diversity than controls, with increased Shannon diversity (p = 0.000319) and Simpson diversity (p = 0.017). Beta-diversity analysis showed significant separation between groups for both Bray-Curtis and Jaccard distances (PERMANOVA p = 0.001), with significant dispersion effects as well (PERMDISP p = 0.001). DSS analysis showed certain fungal taxa associated with the SARS-CoV-2 group, including enrichment of Candida orthopsilosis, Malassezia furfur, Aspergillus glaucus, Aspergillus terreus, and Aspergillus niger, while Malassezia arunalokei, Aspergillus chevalieri, and Aspergillus sydowii were enriched in controls. These findings indicate that SARS‑CoV‑2 infection is associated with URT mycobiome dysbiosis and enrichment of clinically relevant opportunistic fungi in community cases.</p>","PeriodicalId":19017,"journal":{"name":"Mycopathologia","volume":"191 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Reported Neonatal Invasive Candidozyma auris (Candida auris) Infection in Brazil: Successful Management, Evolving Amphotericin B Resistance, and Infection Containment.","authors":"Angelica Zaninelli Schreiber, Ana Luisa Perini Leme Giordano, Barbara Cipulo Legabão, Lais Pontes, Edson Aparecido da Luz, Giuliana D'Angelo Moreno, Gisele Giuliane Guedes, Stefânia Lucizani Pacífico, Mariana Marques Fernandes Moreira de Souza, Tânia Sueli de Andrade, Carolina Carvalho Ribeiro do Valle, Jamil Pedro de Siqueira Caldas","doi":"10.1007/s11046-026-01098-x","DOIUrl":"10.1007/s11046-026-01098-x","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the first neonatal invasive Candida auris infection in Brazil and its successful clinical and infection control management.</p><p><strong>Methods: </strong>Retrospective description of the clinical course, microbiological findings, antifungal susceptibility evolution, and follow-up of an extremely preterm infant.</p><p><strong>Results: </strong>A 25 + 4-week male neonate developed bloodstream and urinary C. auris infection during the first week of life. Progressive amphotericin B resistance in urine isolates required the addition of fluconazole. No secondary NICU cases occurred.</p><p><strong>Conclusion: </strong>Early diagnosis, serial susceptibility testing, and immediate containment measures enabled successful treatment and prevented nosocomial spread.</p>","PeriodicalId":19017,"journal":{"name":"Mycopathologia","volume":"191 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Molecular Epidemiology Study: Emergence and dissemination of Azole-Resistant Candida parapsilosis Sensu Stricto in Southern Brazil.","authors":"Luiza Souza Rodrigues, Sabrina da Conceição Barbosa, Ana Paula Santiago Chacon, Adriele Celine Siqueira, Gisele Aparecida Bernardi, Marcelo Pillonetto, Vania Aparecida Vicente, Lavinia Nery Villa Stangler Arend, Terezinha Inez Estivalet Svidzinski, Libera Maria Dalla-Costa","doi":"10.1007/s11046-026-01095-0","DOIUrl":"10.1007/s11046-026-01095-0","url":null,"abstract":"<p><p>Candida parapsilosis sensu stricto has emerged as a major cause of healthcare-associated candidemia, with increasing reports of fluconazole resistance worldwide. This resistance is most commonly associated with amino acid substitutions in Erg11p, particularly Y132F; however, regional variation in resistance mechanisms and clonal dissemination remains not fully understood. This study investigated the molecular epidemiology and genomic landscape of fluconazole-resistant C. parapsilosis in Paraná, Southern Brazil, over a 10-year period. A total of 54 resistant isolates identified between 2014 and 2024 were retrospectively analyzed; 51 viable isolates were confirmed by species identification, antifungal susceptibility testing, and microsatellite genotyping. A subset of 18 representative isolates underwent whole-genome sequencing for phylogenomic analysis. Variants in genes associated with azole resistance, including ERG11, MRR1, TAC1, CDR1, MDR1, ERG3, and ERG6, were characterized. Fluconazole resistance emerged in 2018 and increased thereafter. Phylogenomic analysis revealed two geographically structured lineages: a dominant clone circulating across multiple healthcare institutions in the Curitiba metropolitan area and a second lineage restricted to the northern region of the state. The dominant clone showed minimal genomic diversity (0-5 SNPs), consistent with long-term persistence. A conserved resistance profile was observed, with 17 of 18 sequenced isolates harboring the K143R substitution in Erg11p, while all retained the wild-type residue at position 132. The single isolate lacking ERG11 mutations carried a novel C849Y substitution in the Mrr1p regulator. These findings demonstrate the emergence and persistence of a highly clonal fluconazole-resistant C. parapsilosis lineage in Southern Brazil, characterized by a conserved K143R substitution independent of Y132F. The detection of closely related isolates across different hospitals underscores the need for regional genomic surveillance of hospital-adapted fungal pathogens.</p>","PeriodicalId":19017,"journal":{"name":"Mycopathologia","volume":"191 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}