Nucleic Acid Tools for Invasive Fungal Disease Diagnosis
AbstractPurpose of ReviewThis review has incorporated the knowledge and experience of the leads of each of the laboratory working parties of the fungal PCR initiative in order to provide up-to-date information on the performance and developments of PCR methods for the detection of fungi that commonly cause invasive fungal disease (IFD).Recent FindingsMolecular diagnosis of IFD enhances the current repertoire of mycological investigations. Providing superior sensitivity and turn-around-time over classical approaches, yet maintaining the benefits of classical tests (e.g. species level identification and identifying resistanc...
Source: Current Fungal Infection Reports - January 20, 2020 Category: Infectious Diseases Source Type: research
An Approach to Suspected Invasive Fungal Infection in Patients with Hematologic Malignancy and HCT Recipients with Persistent Neutropenic Fever Despite Mold-Active Prophylaxis
AbstractPurpose of ReviewThis review offers an approach to managing suspected invasive fungal infection (IFI) in a febrile neutropenic patient with hematologic malignancy or hematopoietic cell transplantation (HCT) while on mold-active prophylaxis. We take into consideration host characteristics, new diagnostic tools, and available therapeutics.Recent FindingsDespite use of anti-Aspergillus prophylactic agents, invasive aspergillosis is the most commonly reported IFI breaking through common prophylactic agents including the newest azole, isavuconazole. While more fungal diagnostic modalities are available, how to best inco...
Source: Current Fungal Infection Reports - January 20, 2020 Category: Infectious Diseases Source Type: research
Usefulness of Yeast Cell Counting and Lack of Clinical Correlation of the Antifungal Susceptibility Testing Results in Management of Aids-associated Cryptococcal Meningitis
AbstractPurpose of ReviewCryptococcal meningitis is one of the most seriously opportunistic infections in people living with HIV. We evaluated clinical and laboratorial features (minimum inhibitory concentrations for fluconazole, initial fungal burden in cerebrospinal fluid) and risk factors associated with in-hospital mortality.Recent FindingsThere is no good evidence for the use of minimum inhibitory concentrations for fluconazole in routine practice for the management of cryptococcosis patients. Counting yeast cells at cerebrospinal fluid can predict positive culture by not death.SummaryData from 46 cryptococcal meningi...
Source: Current Fungal Infection Reports - January 20, 2020 Category: Infectious Diseases Source Type: research
Epidemiology of Pneumocystis jirovecii Pneumonia in Venezuela
AbstractPurpose of the ReviewThe aim of this work is to contribute to the knowledge of the epidemiology of pneumocystosis orPneumocystis jirovecii pneumonia (PCP) in Venezuela, by an updated review of the information currently available.Recent FindingsThe PCP epidemiology in Venezuela is not formally known. There is no national surveillance program for mycosis, and systemic mycoses are not mandatory notification diseases. Efforts made to record the disease in our country have not been sufficient; therefore, there is a sub-registry. All the information carried out prevents comparisons with other reports due to the variation...
Source: Current Fungal Infection Reports - January 15, 2020 Category: Infectious Diseases Source Type: research
Applying Pharmacogenomics to Antifungal Selection and Dosing: Are We There Yet?
AbstractPurpose of ReviewThis review summarizes recent literature for applying pharmacogenomics to antifungal selection and dosing, providing an approach to implementing antifungal pharmacogenomics in clinical practice.Recent FindingsThe Clinical Pharmacogenetics Implementation Consortium published guidelines onCYP2C19 and voriconazole, with recommendations to use alternative antifungals or adjust voriconazole dose with close therapeutic drug monitoring (TDM). Recent studies demonstrate an association betweenCYP2C19 phenotype and voriconazole levels, clinical outcomes, and adverse events. Additionally,CYP2C19-guided preemp...
Source: Current Fungal Infection Reports - January 15, 2020 Category: Infectious Diseases Source Type: research
Combination Therapy for Invasive Fungal Infections
AbstractPurpose of the ReviewThe purpose of this review is to summarize and evaluate relevant literature on combination antifungal therapy for invasive fungal infections (IFIs).Recent FindingsCryptococcal meningitis has the largest body and highest quality in support of combination therapy with amphotericin B and flucytosine. More recent data in treatment of invasive aspergillosis suggest combination therapy with voriconazole and echinocandins may be effective in select patients. Quality studies are needed to define combination therapy in rare mold infections.SummaryMultiple strategies have been employed to optimize treatm...
Source: Current Fungal Infection Reports - January 15, 2020 Category: Infectious Diseases Source Type: research
Extrapolating Antifungal Animal Data to Humans —Is It Reliable?
This article aimed to review animal models of antifungals and identifies human literature to assess if the extrapolation of results is reliable.Recent FindingsAnimal studies have helped identify area under the concentration curve to minimum inhibitory concentration ratio targets for new drugs and formulations such as isavuconazole and delayed-release posaconazole that have translated to successful outcomes in humans. Models have also been influential in the identification of possible combination therapies for the treatment of aspergillosis, such as voriconazole and echinocandins. However, challenges are endured with animal...
Source: Current Fungal Infection Reports - January 15, 2020 Category: Infectious Diseases Source Type: research
Small-Molecule Protein Kinases Inhibitors and the Risk of Fungal Infections
AbstractPurpose of ReviewThis review discusses fungal infections associated with licenced small-molecule protein kinase inhibitors. For each major drug class, the mechanism of action and targeted pathways and the impact on host defence against fungi are described.Recent FindingsProtein kinase inhibitors are successfully used in the treatment of malignancies and immune-mediated diseases, targeting signalling pathways for a broad spectrum of cytokines and growth-stimuli. These agents predispose to fungal infections by the suppression of integral components of the adaptive and innate immune response.SummaryThe greatest risk o...
Source: Current Fungal Infection Reports - December 3, 2019 Category: Infectious Diseases Source Type: research
The Use of Whole Genome and Next-Generation Sequencing in the Diagnosis of Invasive Fungal Disease
AbstractPurpose of ReviewThis review examines how next-generation nucleic acid sequencing (NGS) is being used in the diagnosis of invasive fungal disease (IFD) and how well its implementation compares to PCR-based diagnosis. The comparison allows for the assessment of the advantages and potential limitations of NGS in the diagnosis of IFD.Recent FindingsNGS is established as a method for sequencing of microbial genomes. It is increasingly being tested as a direct diagnostic method from various sample types including samples such as plasma, formalin fixed and paraffin embedded specimens, and bronchoalveolar lavage. In these...
Source: Current Fungal Infection Reports - November 26, 2019 Category: Infectious Diseases Source Type: research
From Culture to Fungal Biomarkers: the Diagnostic Route of Fungal Infections in Children with Primary Immunodeficiencies
AbstractPurpose of ReviewTo provide an overview of the diagnostic tests available to identify invasive fungal disease (IFD) in children with a primary immunodeficiency and to evaluate the relative strengths and weaknesses of those tests.Recent FindingsNovel tools to aid the diagnosis of IFD, such as fungal PCRs and lateral flow devices (forAspergillus spp.), are emerging. However, the paucity of high-quality, multicentre clinical trials evaluating the performance of these diagnostic tools, particularly in the paediatric cohort of interest, remains a challenge. Children with primary immunodeficiencies are seldom referenced ...
Source: Current Fungal Infection Reports - November 26, 2019 Category: Infectious Diseases Source Type: research
The Manaus Declaration: Current Situation of Histoplasmosis in the Americas, Report of the II Regional Meeting of the International Histoplasmosis Advocacy Group
AbstractPurpose of ReviewThe aim of this report is to summarize the conclusions of the II Regional Meeting on Histoplasmosis in the Americas held in Manaus, Brazil, on March 22 –24, 2019.Recent FindingsPersons living with advanced HIV are at high risk for developing histoplasmosis. Clinical signs and symptoms of this disease are often non-specific, making it difficult to establish a diagnosis. Although with the recent technological advances, in vitro diagnostics and medicines for histoplasmosis are often not available in many regions around the world. In addition, histoplasmosis is often not included in HIV care and trea...
Source: Current Fungal Infection Reports - November 26, 2019 Category: Infectious Diseases Source Type: research
Genetic Variation and Fungal Infection Risk: State of the Art
AbstractPurpose of ReviewFungal infections cause significant mortality in patients with acquired immunodeficiencies including AIDS, hematological malignancies, transplantation, and receipt of corticosteroids, biologics or small-molecule kinase inhibitors that impair key immune pathways. The contribution of several such pathways in antifungal immunity has been uncovered by inherited immunodeficiencies featuring profound fungal susceptibility. Furthermore, the risk of fungal infection in patients with acquired immunodeficiencies may be modulated by single nucleotide polymorphisms (SNPs) in immune-related genes. This review o...
Source: Current Fungal Infection Reports - November 26, 2019 Category: Infectious Diseases Source Type: research
Updates on the Treatment of Non- Aspergillus Hyaline Mold Infections
AbstractPurpose of ReviewThis review summarizes both the recent and relevant studies about the treatment of non-Aspergillus hyaline molds.Recent FindingsGiven the rarity of these infections, there have been no large randomized clinical trials regarding the most effective antifungal therapy.SummaryAlthough there are more data for the treatment ofFusarium andScedosporium, there are limited data with case reports that address the other rare hyalohyphomycetes. As we develop improved diagnostic techniques and larger fungal registries, we may be able to determine efficacious treatment modalities. We hope that future research wil...
Source: Current Fungal Infection Reports - November 25, 2019 Category: Infectious Diseases Source Type: research
Diagnostic Aspects of Chronic Pulmonary Aspergillosis: Present and New Directions
AbstractPurpose of ReviewDiagnosis of chronic pulmonary aspergillosis (CPA) is important since many diseases have a similar appearance, but require different treatment. This review presents the well-established diagnostic criteria and new laboratory diagnostic approaches that have been evaluated for the diagnosis of this condition.Recent FindingsRespiratory fungal culture is insensitive for CPA diagnosis. There are many new tests available, especially new platforms to detectAspergillus IgG. The most recent innovation is a lateral flow device, a point-of-care test that can be used in resource-constrained settings. Chest rad...
Source: Current Fungal Infection Reports - November 24, 2019 Category: Infectious Diseases Source Type: research
Adult Tinea Capitis: a Clinical Entity in Increasing Frequency
AbstractPurpose of ReviewThis review summarizes the fungal literature currently available for adult tinea capitis (ATC), as well as providing data for clinical practice.Recent FindingsAvailable studies in ATC are scarce; however, they provide essential information for treating ATC.SummaryTreatment of TC is effective; however, it needs a minimum of 1 month to watch clinical efficacy. Systemic treatment is often needed to favor drug penetration to the deepest part of the hair follicle. The newest oral antifungal has higher efficacy rates than conventional therapy, as well as much shorter duration of treatment but at higher...
Source: Current Fungal Infection Reports - November 24, 2019 Category: Infectious Diseases Source Type: research
