The Management of Chronic Pulmonary Aspergillosis: The UK National Aspergillosis Centre Approach
AbstractPurpose of ReviewChronic pulmonary aspergillosis (CPA) is a serious long-term fungal disease of the lung with a worldwide prevalence. Treatment of CPA is not straightforward given the often-multiple associated co-morbidities, complex clinical picture, drug interactions, toxicities and intolerances.Recent FindingsFirst line treatment is oral itraconazole or voriconazole. In the event of intolerance or toxicity, patients may be swapped from itraconazole to voriconazole or vice versa. In the event of resistance or further intolerance, third line treatment with posaconazole could be initiated. In those with pan-azole r...
Source: Current Fungal Infection Reports - November 13, 2017 Category: Infectious Diseases Source Type: research
Clinical Implications of Candida Biofilms
AbstractPurpose of ReviewIn this review, we will assess what is currently known aboutCandida biofilms, its epidemiology and impact on clinical practice, and the biology underlying biofilm-related antifungal drug resistance. We also review potential antifungal lock therapies and discuss what avenues are available for future discoveries for the prevention and eradication of fungal biofilms.Recent FindingsThere is a multitude of in vitro tests of agents againstCandida biofilms, but many of these studies have not demonstrated their utility against otherCandida species and/or their efficacy in in vivo systems. This makes it par...
Source: Current Fungal Infection Reports - October 30, 2017 Category: Infectious Diseases Source Type: research
Cryptococcus neoformans Epidemiological Cutoff Values
AbstractPurpose of ReviewThe purpose of this review is to provide a current view of the importance of the determination and use of epidemiological cutoff values (ECVs) forCryptococcus neoformans, since there are no clinical breakpoints (CBPs).Recent FindingsECVs have been proposed for some antifungal agents andC. neoformans, using standardized methodologies by the Clinical and Laboratory Standards Institute (CLSI) and by the European Committee for Antimicrobial Susceptibility Testing (EUCAST), based on the distribution of minimum inhibitory concentrations (MICs). There is no sufficient evidence for the determination of ECV...
Source: Current Fungal Infection Reports - October 30, 2017 Category: Infectious Diseases Source Type: research
Candida auris : Antifungal Multi-Resistant Emerging Yeast
AbstractPurpose of ReviewThe purpose of this review is to contribute to the knowledge about the existence ofCandida auris as an emerging pathogenic fungus, multi-resistant to antifungal, and causing health care-associated infections (HCAI).Recent FindingsC. auris emerges as yeast with clonal transmission resistance to three families of commonly used antifungals, mainly azoles (fluconazole and voriconazole), diminishing therapeutic options for the treatment of fungal infections. In 2009,C. auris was isolated for the first time in Japan and by the time of this review, it has been reported in different countries in Africa, Am...
Source: Current Fungal Infection Reports - October 26, 2017 Category: Infectious Diseases Source Type: research
What Is New? Recent Knowledge on Fungal Extracellular Vesicles
AbstractPurpose of ReviewFungal extracellular vesicles (EVs) were first characterized a decade ago. Knowledge in this field expanded rapidly and although several questions remain unanswered, it is now clear that EVs play fundamental biological roles in fungi. In this manuscript, we update the reader with the most recent information on the participation of EVs in fungal physiology and pathogenesis.Recent FindingsFungal EVs were initially associated with the transport of macromolecules across the cell wall and extracellular delivery of virulence factors. However, recent findings indicate that they might also participate in p...
Source: Current Fungal Infection Reports - October 26, 2017 Category: Infectious Diseases Source Type: research
A Comprehensive Analysis of MALDI-TOF MS and Ribosomal DNA Sequencing for Identification of Clinical Yeasts
AbstractPurpose of ReviewThe purpose of this study is to analyze the current knowledge about matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) identification of clinical yeasts comparing with the ribosomal DNA sequencing identification. We also review the lasts taxonomical and nomenclature changes of clinical yeasts.Recent FindingsIn most studies, the two main commercially available, MALDI Biotyper and VITEK MS, correctly identified more than 90% of yeasts isolates. Most drawbacks are due to low discrimination between closely related species or due to a lack of the reference main s...
Source: Current Fungal Infection Reports - October 26, 2017 Category: Infectious Diseases Source Type: research
Contribution of the National Mycology Laboratory Network to Surveillance of Cryptococcosis in Argentina
AbstractPurpose of ReviewCryptococcal meningitis is the most common fungal infection of the central nervous system and the third most frequent neurological complication in AIDS patients. To understand the Argentinean epidemiology of cryptococcosis, several efforts have been made by the National Reference Laboratory in Clinical Mycology.Recent FindingsIn Argentina, reports of distribution and frequency ofCryptococcus neoformans andCryptococcus gattii isolates are scarce and very little is known about its circulating genotypes and mating types. The National Mycology Laboratory Network and the National Reference Laboratory in...
Source: Current Fungal Infection Reports - October 25, 2017 Category: Infectious Diseases Source Type: research
Time-Kill Curves Studies with Amphotericin B Against Cryptococcus neoformans / C . gattii Species Complex Clinical Isolates
AbstractPurpose of ReviewWe reviewed data on amphotericin B (AmB) tolerance amongCryptococcus neoformans/C.gattii species complex clinical isolates and present our results of large recent study on this issue.Recent FindingsThe standard method to detect antifungal susceptibility is based on MIC (minimal inhibitory concentration) determination; however, there is no interpretative clinical breakpoints defined for antifungal agents againstCryptococcus species, and to date, there is no correlation of MIC and clinical response. The time-kill curves (TKC) methodology seems to provide some correlation with outcome and it could ide...
Source: Current Fungal Infection Reports - October 25, 2017 Category: Infectious Diseases Source Type: research
Candida haemulonii sensu lato: Update of the Determination of Susceptibility Profile in Argentina and Literature Review
AbstractPurpose of reviewThis review summarizes the information available ofCandida haemulonii sensu lato, and updates the in vitro susceptibility profile of the isolates of these species from Argentina.C. haemulonii sensu lato causes fungemia in low frequency in adults and children; however, the knowledge about this emerging yeast is relevant since it is considered as a multi-resistant pathogen.Recent findingsThe discovery of new antifungal molecules, the determination of epidemiological cutoff value and clinical breakpoints for some yeasts of clinical impact, and the update of techniques to determine thein vitro suscepti...
Source: Current Fungal Infection Reports - October 25, 2017 Category: Infectious Diseases Source Type: research
Heteroresistance to Fluconazol in Clinical and Environmental Brazilian Strains of Cryptococcus neoformans / C. gattii Species Complex
AbstractPurpose of StudyTo review the literature on heteroresistance to fluconazole (FLC) and investigate the level of heteroresistance to FLC (LHF), we analyzed 100 clinical and environmental BrazilianCryptococcus strains.Recent FindingsHeteroresistance is a phenomenon described as the emergence of resistant subpopulation cells within a single susceptible strain that can tolerate higher concentrations of fluconazole above the minimal inhibitory concentration (MIC) level.SummaryWe found lower FLC-MICs (0.12 –64 mg/L) than LHF (8–128 mg/L). Highly heteroresistant adapted subpopulations (256 mg/L) was found in minorit...
Source: Current Fungal Infection Reports - October 25, 2017 Category: Infectious Diseases Source Type: research
Detection of Cryptic Candida Species Recognized as Human Pathogens Through Molecular Biology Techniques
AbstractPurpose of ReviewThe aim of this review is to evaluate these molecular-based methods able to identify pathogenic crypticCandida spp. focusing on those that demonstrated to be useful in clinical laboratory settings.Recent FindingsIt is long known that someCandida spp. are genetically heterogeneous. Firstly, individual species were divided into groups based on differences on the sequence of some genes. Later, those groups were designated as cryptic species and defined as phenotypically indistinguishable species that are only identified by their DNA sequences. Many commonCandida spp. are now considered complexes forme...
Source: Current Fungal Infection Reports - October 25, 2017 Category: Infectious Diseases Source Type: research
Erratum to: Harnessing Whole Genome Sequencing in Medical Mycology
(Source: Current Fungal Infection Reports)
Source: Current Fungal Infection Reports - October 23, 2017 Category: Infectious Diseases Source Type: research
Real-Life Challenges to the Use of Antifungal Agents in Hematology Patients
AbstractPurpose of ReviewOne of the more serious complications of hematology and allogeneic hematopoietic stem cell transplant patients is the development of invasive fungal infections (IFIs).Recent FindingsDue to the widespread use of prophylaxis active againstCandida spp. in these populations, infections due to invasive molds, such as aspergillosis and mucormycosis, have become more predominant. Several real-life challenges complicate the optimal prophylaxis and management of patients who develop invasive mold infections. Selection of agents in this setting requires careful consideration to the strength of evidence, cert...
Source: Current Fungal Infection Reports - October 17, 2017 Category: Infectious Diseases Source Type: research
Onychomycosis and Immunodepression
AbstractPurpose of ReviewThis review summarizes the most relevant information on onychomycosis in patients with immunosuppressive disorders and also compares the distinctive characteristics and approach with the general population.Recent FindingsOnychomycosis in immunocompromised patients has a similar clinical presentation to the one in the general population, yet there are still differences. For instance, the white variety also known as mycotic leukonychia is characteristic among the group, being more common among patients with HIV/AIDS. Proximal subungual onychomycosis (PSO) and white superficial onychomycosis (WSO) hav...
Source: Current Fungal Infection Reports - October 12, 2017 Category: Infectious Diseases Source Type: research
Onychomycoses in a Military Population in Brazil
This study aimed to isolate and characterize filamentous fungi onychomycosis agents in a military population assisted at a hospital outpatient clinic.Recent FindingsIn onychomycosis, the fungi colonize the subungual region causing thickening, discoloration, or cracking of the nail bed. Samples were collected from patients with clinical sights of onychomycosis.SummaryAmong 80 samples collected, 50 (62.5%) had positive culture. Isolated dermatophytes (86%) wereTrichophyton rubrum (21; 42%),T. mentagrophytes var.interdigitale (19; 38%), andMicrosporum gypseum (3; 6%) and non-dermatophyte molds wereFusarium spp. (1; 2%),Scytal...
Source: Current Fungal Infection Reports - October 9, 2017 Category: Infectious Diseases Source Type: research
