BACKGROUND:Mycotoxigenic Aspergillus species are primary contaminants in food and feed. Growing health concerns regarding synthetic chemical preservatives have driven interest in essential oil (EO) constituents as natural alternatives. However, the specific impact of these compounds on fungal growth dynamics remains insufficiently understood. AIMS:This study quantitatively evaluated the growth-kinetic responses of four major mycotoxigenic species, namely Aspergillus flavus, Aspergillus parasiticus, Aspergillus niger, and Aspergillus carbonarius, when exposed to selected essential oil constituents. METHODS:Fungal growth was monitored in vitro under treatment with D-limonene, thymol, 1,8-cineol, cuminaldehyde, and linalool (250-1000 mg/kg). Growth kinetics were analyzed using a two-phase linear model to estimate lag phase duration (λ) and specific growth rate (µ). Additionally, mycelial growth inhibition and conidial germination assays were conducted to validate antifungal efficacy. RESULTS:All tested constituents induced dose-dependent alterations in growth kinetics. Thymol and cuminaldehyde demonstrated the most potent inhibitory effects, significantly extending the lag phase and reducing growth rates across all species. Notably, thymol completely suppressed A. parasiticus growth at 750 mg/kg and extended the A. flavus lag phase to 6.01 days. Cuminaldehyde reduced the A. carbonarius growth rate to 6.83 mm/day. While D-limonene showed moderate inhibition, 1,8-cineol and linalool were the least effective. At 1000 mg/kg, both thymol and cuminaldehyde achieved 100% inhibition of conidial germination in all species. CONCLUSIONS:Growth-kinetic modeling is a highly sensitive tool for differentiating the efficacy of natural antifungal agents. The significant disruption of growth patterns by phenolic (thymol) and aldehydic (cuminaldehyde) compounds underscores their potential for the targeted, predictive control of Aspergillus in food and feed systems.
BACKGROUND:Although COVID-19-associated pulmonary aspergillosis (CAPA) has been well characterized in Europe and North America, data from Latin America remain scarce, despite the region's high COVID-19 burden. AIMS:This systematic review compiles all published CAPA cases from Latin America, providing a comprehensive analysis of clinical characteristics, diagnostic practices, treatment patterns, and mortality risk factors across the region. METHODS:A systematic review was conducted on 32 studies, encompassing a total of 575 CAPA cases from Latin America. Data were extracted from PubMed, Embase, and LILACS (search date: March 7, 2024), following Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Individual and aggregate patient data were used. RESULTS:Most cases originated from Argentina, Brazil, Chile, and Mexico. Patients were predominantly male (72.6%), with hypertension (39.8%), obesity (38.1%), and diabetes (35.3%) as leading comorbidities. Probable CAPA accounted for 81.9% of cases, with Aspergillus fumigatus identified in 58.5%. Antifungal treatment, mainly voriconazole (57.5%), was administered in 75.5% of cases. Overall mortality was 50.1%. In the multivariate analysis, higher galactomannan (GM) levels in bronchoalveolar lavage (BAL) were independently associated with mortality (OR: 1.40; 95% CI: 1.04-2.03; p=0.045). CONCLUSIONS:This is the most comprehensive analysis of CAPA in Latin America to date, revealing high mortality despite antifungal treatment and limited diagnostic access. The presence of GM in BAL was independently associated with death, reinforcing its prognostic value. These findings underscore the urgent need for improved diagnostic strategies and targeted interventions in resource-limited settings.
We hereby present the case of a 53-year-old HIV-positive man who had poor adherence to antiretroviral treatment for 15 years. He was referred to the hospital due to weight loss, skin lesions suggestive of Kaposi's sarcoma, poor general health, and confusion. After a lumbar puncture, treatment for meningeal tuberculosis was initiated on an empirical basis. A few days later he developed fever and, due to several risk factors, fungemia was suspected. After the fungus was isolated in blood culture, special tests were performed for definitive identification. Despite treatment, the patient died of fungemia due to a non-Candida yeast-like fungus, which has a high mortality rate in this patient group.
BACKGROUND:Candidozyma auris (formerly Candida auris)is an emerging multidrug-resistant fungal pathogen that has spread globally since its first identification in 2009 and is now classified as a critical-priority pathogen by the World Health Organization. Distinct genetic clades are associated with variations in geographic distribution, antifungal susceptibility, and resistance mechanisms; however, clade-specific evidence remains fragmented. AIMS:To systematically map global evidence on clade diversity, antifungal susceptibility patterns, resistance mechanisms, and clinical implications of Candidozyma auris. METHODS:A scoping review was conducted following PRISMA-ScR guidelines. Peer-reviewed primary studies published between 2009 and September 2025 were included if they reported clade attribution and antifungal susceptibility or resistance data. PubMed/MEDLINE, Scopus, and Web of Science were searched. Two reviewers independently screened studies and extracted data using a standardized form. RESULTS:Of 2,050 records identified, 105 studies met inclusion criteria, representing 29 countries and diverse study designs. Whole-genome sequencing was the most common typing method. Antifungal susceptibility varied substantially across clades. High fluconazole resistance was consistently reported (MIC 4 to >256 μg/mL). Echinocandins generally retained activity, although reduced susceptibility associated with FKS1 mutations was observed. Resistance mechanisms primarily involved mutations in ERG11, FKS1, and efflux-related genes. Studies also reported challenges in healthcare-associated transmission, environmental persistence, and diagnostic misidentification. CONCLUSIONS:Candidozyma auris exhibits marked clade-dependent variability in antifungal susceptibility and resistance mechanisms. These findings support the need for clade-informed interpretation of susceptibility data, standardized surveillance, improved diagnostics, and development of novel antifungal therapies.
BACKGROUND:Isavuconazole is a broad-spectrum antifungal used for the treatment of critical fungal infections like invasive aspergillosis and mucormycosis. In 2019, isavuconazole was approved as an orphan drug in Mexico. AIMS:Médica Sur Hospital is a tertiary-level hospital in Mexico City where we have had access to isavuconazole since its approval. Five years after approval, we decided to study its clinical outcomes in real-world settings. METHODS:We conducted a retrospective observational study of a cohort of adult patients treated with isavuconazole in our hospital from 2019 to 2024. RESULTS:We included data from 25 patients meeting the inclusion criteria, with a mean age of 57 years. Eight patients had hematologic disease, eleven presented with COVID-19-associated pulmonary aspergillosis (CAPA), and six patients had an invasive fungal infection in the intensive care unit (according to FUNDICU). The mean duration of isavuconazole use was 12.3 days (± 10.3 days). The main reasons for using isavuconazole were the ease of prescription (ten patients), as primary therapy in aspergillosis (six patients), after withdrawal of other triazole because of adverse events (three patients), a need to change to oral antifungal after an intravenous antifungal therapy (four patients), and as prophylaxis in stem cell transplantation (two patients). CONCLUSIONS:Results on the use of isavuconazole in real-world clinical practice have shown that it is both well-tolerated and effective in a hospital setting in Mexico.
BACKGROUND:The rapid dissemination of Candidozyma auris (previously known as Candida auris) and its multidrug resistance profile poses a significant challenge in therapy once it contributes to a mortality of 30-60% of infected patients. AIMS:This study aimed to evaluate the in vitro and in vivo antifungal activity of Cymbopogon nardus (L.) Rendle essential oil and citral oil, both free and incorporated into liposomes, against C. auris. METHODS:The liposomes were composed of a lipid phase containing soy phosphatidylcholine, ergosterol, cholesterol and oleylamine, along with an aqueous phase consisting of PBS. The liposome was characterized by measuring the following features: hydrodynamic size, polydispersity index, zeta potential, transmission electron microscopy, infrared vibrational spectroscopy, thermogravimetry and differential scanning calorimetry, and transmission electron microscopy. The antifungal activity of the C. nardus essential oil, the citral oil and liposome-loaded compounds was determined by minimum inhibitory concentration (MIC), biofilm assay and by a Galleria mellonella infection model. G. mellonella was also used to assess acute in vivo toxicity. RESULTS:The liposomes exhibited sizes ranging from 218.8 to 261.7nm, polydispersity index <0.5, and a positive zeta potential. Furthermore, the liposomes showed good stability and a lipid layer in the outer region. Citral showed the best antifungal activity, with MIC 62.5μg/mL, being the compound selected for its incorporation into liposomes, which further improved its antifungal potential. Citral and citral-liposomes showed important metabolic inhibition in mature biofilms (20%). No acute toxicity was observed for either sample in G. mellonella, and citral-liposomes showed promising antifungal action in the G. mellonella infection model. CONCLUSIONS:Liposomes represent a promising strategy for the safe and effective delivery of citral to control C. auris infection.
Candida infections are among the most common fungal diseases globally, with candidemia posing a serious threat in hospitalized and immunocompromised patients. In Portugal, though Candida albicans is the predominant species identified, other species such as Candida parapsilosis and Nakaseomyces glabratus (formerly Candida glabrata) are increasingly detected, particularly in intensive care units and patients with invasive devices. Emerging multidrug-resistant strains, notably Candidozyma auris (formerly Candida auris), have raised significant concern, with the first Portuguese cases reported recently. Surveillance studies suggest that antifungal resistance rates are generally low, though fluconazole resistance in C. parapsilosis is a concern, since ERG11 mutations were recently detected in several isolates. Echinocandins are recommended as first-line therapy, yet availability is uneven across healthcare centers. Beyond candidemia, superficial infections like vulvovaginal candidiasis and onychomycosis remain highly frequent. Active research in Portugal on Candida biology, virulence, and novel therapies, have been conducting for different research groups. Strengthening surveillance, rapid diagnostics, molecular identification, and infection control measures, alongside mandatory notification of C. auris, are critical for effective management. Integrated strategies under a "One Health" framework are essential to mitigate morbidity, mortality, and resistance trends associated with Candida infections.
BACKGROUND:Recreational coastal waters are widely used for leisure activities and require systematic microbiological monitoring to ensure the safety of bathers. However, such surveillance has traditionally focused on fecal indicator bacteria, whereas fungal communities remain largely neglected by regulatory and governmental agencies. AIMS:This study aimed to identify 18 yeasts isolated from three tourist beaches in Rio de Janeiro, Brazil, and to evaluate their antifungal susceptibility, biofilm-forming capacity and growth in saline conditions. METHODS:The molecular identification of the isolates was performed by sequencing the ITS1-5.8S-ITS2 rDNA region. Antifungal susceptibility was determined using the broth microdilution method. Biofilm formation was assessed in 96-well microtiter plates using crystal violet, safranin and XTT. Growth under different salt concentrations was also evaluated. RESULTS:Fungal isolates were identified as Candida parapsilosis species complex (n=5), Candida tropicalis (n=4), Nakaseomyces glabratus (formerly Candida glabrata; n=2), Candidozyma haemuli species complex (formerly Candida haemulonii species complex; n=2), Wickerhamiella infanticola (n=2), and one isolate each of Candida palmioleophila, Candida ecuadorensis and Pichia manshurica. Resistance to azoles was observed in C. tropicalis, N. glabratus, C. haemuli and C. palmioleophila, with variable susceptibility to other antifungals. C. parapsilosis and C. ecuadorensis isolates were susceptible to all tested antifungals. W. infanticola isolates exhibited low MIC values against the antifungals tested, while P. manshurica exhibited elevated MICs to fluconazole and flucytosine. All yeasts formed biofilms on plastic and tolerated NaCl concentrations of up to 7.5%. CONCLUSIONS:These findings demonstrate the presence of clinically relevant opportunistic yeasts in recreational seawater. The isolates exhibited antifungal resistance, salt tolerance and the ability to form biofilms, all of which pose a potential public health concern.
BACKGROUND:Sporothrix brasiliensis is an emerging fungal pathogen whose environmental reservoirs remain unclear. There are hypothesized reservoirs involving seabirds. CASE REPORT:We report the first detection of S. brasiliensis in a Macronectes giganteus specimen rescued in southern Brazil. The fungus was isolated from the cloaca and identified by polymerase chain reaction (PCR) and sequencing. Short tandem repeat (STR) genotyping revealed a distinct profile of the isolate compared to previously described strains. The results revealed that the isolate possessed a wild-type susceptibility profile to amphotericin B and itraconazole, and a non-wild-type susceptibility profile to terbinafine. CONCLUSIONS:Findings suggest that migratory seabirds and marine environments may influence S. brasiliensis dissemination, underscoring the need for broader One Health surveillance at a global level.
Invasive mycoses present significant medical challenges, with new populations at risk and the emergence of antifungal resistance. Therapeutic options for antifungal treatment are limited and further complicated by drug-drug interactions, toxicity, and constraints in administration routes. Despite the urgent need for more antifungal drugs, few new antifungal drugs have been introduced over the past decades. Nevertheless, there is hope on the horizon, with new antifungal drugs approved or in late-stage clinical trials.In this review, we critically examine the antifungal activity of rezafungin, a new-generation echinocandin with distinctive PK/PD properties, including high stability that enables once-weekly dosing, as well as elevated peak concentrations (Cmax) and area under the curve (AUC) values, and its therapeutic utility in the treatment of invasive candidiasis. We focus on its mechanism of action, as well as on its broad spectrum of activity against emergent species of Candida and other pathogenic fungi. Additionally, we highlight its utility in the treatment of candidemia and other forms of invasive candidiasis in various medical settings, and the potential future roles of rezafungin and the unmet needs in this field.
BACKGROUND:Fungal infections affect especially to patients with cancer and those who are immunocompromised. AIMS:We analyzed the prevalence of filamentous fungi in patients at Ankara Oncology Education and Research Hospital from 2022 to 2024; antifungal susceptibility tests were also carried out. METHODS:Filamentous fungi were analyzed by MALDI-TOF (matrix-assisted laser desorption ionization-time of flight), and antifungal susceptibility was tested by the broth microdilution method. RESULTS:Filamentous fungi were recovered from 66 (6.5%) of 1020 samples: 31(47%) deep tracheal aspirates, 13 (19.7%) sputum, 10 (15.2%) ear swabs, nine (13.6%) biopsies, and three (4.5%) bronchoalveolar lavage samples. Filamentous fungi other than Aspergillus grew from 10 (15.2%) samples, while Aspergillus species were recovered in 56 (84.8%). Of the 56 Aspergillus, 21 (31.8%) were Aspergillus fumigatus, 15 (22.7%) were Aspergillus flavus, 14 (21.2%) were Aspergillus niger, three (4.5%) were Aspergillus terreus, and one strain (1.5%) each of the following species were identified: Aspergillus tamarii, Aspergillus nidulans, and Aspergillus calidoustus. Of 66 patients from whom a fungal isolate was recovered, 50 (75.8%) had cancer. Minimum inhibitory concentrations (MICs) were determined in 45 (80.4%) Aspergillus isolates. Eight (8/19) A. fumigatus, seven (7/13) A. flavus, and three (3/11) A. niger were non-wild type (WT) according to amphotericin B MIC values. Four (4/13) A. flavus and two (2/19) A. fumigatus were non-WT according to itraconazole MIC values. One (1/13) A. flavus was non-WT according to voriconazole MIC value. CONCLUSIONS:The filamentous fungi recovered from the patients showed high antifungal MIC/MEC values, and some isolates had high amphotericin B MICs. Voriconazole was effective in vitro against A. fumigatus.
BACKGROUND:The innate immune response and cytokine milieu in airway mucosa, mediated by bronchial epithelial cells, are critical in determining susceptibility or protection against cryptococcosis. In experimental models, Th2 and Th1 responses are linked to susceptibility and protection, respectively, while the roles of other cytokines remain less understood. AIMS:To evaluate the in vitro effects of IL-4, IFN-γ, and IL-27 (100ng/mL) on human bronchial epithelial cells (BEAS-2B) infected with a strain of Cryptococcus neoformans sensu stricto (multiplicities of infection [MOI] 1-100). METHODS:Cells were stimulated with each cytokine, followed by C. neoformans infection (MOI 100). After 24h, supernatants were collected to measure CCL2, IL-6, and IL-8 production. STAT1 and STAT6 activation was analyzed by flow cytometry. Phagocytosis and colony-forming unit assays assessed fungal internalization and growth. RESULTS:Cytokine-stimulated, infected cells displayed reduced IL-6 and/or CCL2 production and decreased STAT6 activation (IL-4) or STAT1 activation (IL-27, IFN-γ) compared with cells stimulated with C. neoformans sensu stricto or cytokines alone. IL-27 reduced fungal internalization, while IL-4 and IFN-γ increased it. All cytokines promoted higher fungal growth. CONCLUSIONS:The interaction of bronchial epithelial cells stimulated with IL-4, IFN-γ, or IL-27, with yeasts of C. neoformans induced an anti-inflammatory profile in the cells that impaired STAT activation and favored fungal proliferation. These findings suggest that certain cytokine environments within the airway epithelium may create conditions conducive to C. neoformans persistence, potentially influencing the progression of the infection.
Candidozyma auris (formerly Candida auris) has emerged within just over a decade as one of the most relevant multidrug-resistant fungal pathogens affecting human health worldwide. Its pathogenicity, capacity for skin colonization, environmental persistence, and resistance to antifungal drugs and disinfectants have all contributed to its consolidation as a leading cause of healthcare-associated outbreaks. Nevertheless, increasing evidence indicates that C. auris should not be viewed solely as a nosocomial yeast, but rather as part of a broader environmental continuum encompassing natural habitats, anthropogenic niches, and multiple host species. Environmental isolates have been documented in coastal wetlands, wastewater systems, agricultural products, as well as in diverse animals - including companion animals, reptiles, amphibians, and insects - supporting its classification as a sapronotic pathogen. The near-simultaneous emergence of distinct clades across continents strongly suggests that climate change, agricultural azole exposure, and ecological adaptation have collectively selected strains exhibiting thermotolerance, antifungal resistance, and cross-kingdom persistence, thereby enabling recurrent spillover into human populations. Recent advances in wastewater-based epidemiology demonstrate that C. auris can be detected at the community level, often preceding clinical recognition, while animal colonization underscores its overlooked role in pathogen maintenance and transmission networks. This review synthesizes current evidence on the ecological, evolutionary, and epidemiological determinants of C. auris, positioning outbreaks as amplification phenomena within interconnected ecological systems rather than isolated nosocomial events. Adoption of a One Health framework, integrating environmental, veterinary, and human health surveillance, will be essential for predictive outbreak modeling, early detection, and the development of sustainable strategies to mitigate the ongoing and future threats posed by this emerging fungal pathogen.
BACKGROUND:Sporotrichosis is a subcutaneous mycosis caused by the traumatic inoculation of dimorphic fungi from the genus Sporothrix. Traditional diagnostic methods, including direct microscopy and fungal culture, are time-consuming, require specialized expertise, and may yield false-negative results. AIMS:This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of the enzyme-linked immunosorbent assay (ELISA) technique in detecting sporotrichosis in humans and animals. METHODS:A comprehensive literature search was conducted across PubMed, LILACS, EMBASE, Scopus, Web of Science, ScienceDirect, CAPES Periodicals, and the Cochrane Library using both free-text terms and MeSH descriptors. The methodological quality of the studies included was assessed using the QUADAS-2 tool. Pooled sensitivity and specificity were estimated using a random-effects model. Secondary outcomes included the positive and negative likelihood ratios and the diagnostic odds ratio (DOR). RESULTS:Twelve studies met the inclusion criteria, comprising 1612 samples (1350 human and 262 feline). ELISA demonstrated a pooled sensitivity of 91% (95% CI: 85-94) and specificity of 90% (95% CI: 86-93), with a DOR of 94.2 (95% CI: 46.9-189.1). Subgroup analysis revealed higher diagnostic performance in feline samples, particularly when crude antigen extracts and combined fungal forms were used. CONCLUSIONS:ELISA exhibits high diagnostic accuracy for sporotrichosis in both human and veterinary contexts. Its performance, especially in feline hosts, supports its potential role as a reliable diagnostic alternative to conventional methods.
BACKGROUND:In China, the isolation rate of fluconazole-resistant isolates of Candida tropicalis, together with fatality in cases of bloodstream infections due to this yeast, have increased annually. AIMS:This study investigates the clinical characteristics, risk factors, and prognostic factors of fluconazole-resistant C. tropicalis bloodstream infections (BSI). METHODS:A retrospective study analyzed clinical data of patients with C. tropicalis BSI from July 2013 to June 2019, focusing on clinical characteristics, risk factors, treatment regimens, and prognosis. Univariate analysis of risk factors and prognosis was conducted using χ2 test or Fisher's exact tests. Binary logistic regression model for risk factors, and Cox regression method for prognosis, were used for multivariate analysis. RESULTS:The study enrolled 100 patients with C. tropicalis BSI, including 44 fluconazole-resistant and 56 fluconazole-sensitive cases; 64 patients were cured and 36 died, resulting in a mortality rate of 36%. Logistic regression analysis identified exposure to azole antifungal agents during the 2 weeks prior to the onset of the BSI as a risk factor for fluconazole resistance. Cox regression analysis showed that hematological malignancy, fluconazole-resistant strains, indwelling catheters, and chronic obstructive pulmonary disease were independent risk factors for patient mortality. Conversely, targeted therapy with sensitive antifungal agents and removal of drainage tubes were protective factors for survival. CONCLUSIONS:Azole exposure led to the development of fluconazole resistance in C. tropicalis BSI; hematologic malignancies, azole resistance, chronic obstructive pulmonary disease and having intravenous catheters increased mortality rate. The use of echinocandins or amphotericin B and catheter removal improved outcomes, underscoring the need for early resistance detection and targeted treatment.
BACKGROUND:During the COVID-19 pandemic, Rhizopus arrhizus and Rhizopus homothallicus were identified as causative agents of rhino-cerebral mucormycosis in COVID-19 patients. Clinical management typically includes surgical debridement and antifungal treatment, with amphotericin B (AMB) and posaconazole (PCZ) as primary options. However, long-term use of AMB can lead to toxicity, necessitating PCZ as a follow-up treatment. AIMS:This study aimed to examine the combined effect of AMB and PCZ on R. homothallicus. METHODS:The combined effect of AmB and PCZ on R. homothallicus was studied by examining their minimum inhibitory concentration (MIC) values, fractional inhibitory concentration index (FICI), spore germination properties, viability, and intracellular reactive oxygen species accumulation; Raman spectroscopy was also performed. RESULTS:The MIC values for AmB and PCZ were 4 and 8μg/mL, respectively, with a combined MIC of 2μg/mL and an FICI index of <0.28. The germination rates at MIC values after 48h of exposure were 28% for AmB, 36% for PCZ, and only 3% for the combination. Viability assays revealed dead sporangiospores following combination treatment. AmB and its combination generated more ROS (68.18% and 64.45%, respectively) than did PCZ alone (42.6%). CONCLUSIONS:Combination therapy reduced the AMB dose without loss of efficacy, suggesting a synergistic effect against R. homothallicus. These results may support this alternative strategy to mitigate the side effects of AMB.
BACKGROUND:Infective endocarditis caused by Trichosporon inkin is an exceptionally rare fungal infection, particularly in immunocompetent patients. This microorganism is part of the normal microbiota of the skin and gastrointestinal tract, but can cause invasive infections associated with prosthetic devices or complex clinical conditions. Reported cases in the literature are scarce, making it difficult to establish standardized diagnostic and therapeutic guidelines. CASE REPORT:We report the case of an immunocompetent female patient with rheumatic fever due to which she underwent a mitral valve replacement procedure using a mechanical prosthesis, who developed infective endocarditis caused by T. inkin. The initial diagnosis was delayed due to misinterpretation as contaminant of the fungal isolate recovered. The patient developed intracerebral hemorrhage and was considered high-risk for surgical intervention; thus, medical management was pursued. The microorganism was finally identified by MALDI-TOF mass spectrometry, a validated tool for identifying Trichosporon species. The patient received voriconazole, with favorable clinical response, followed by prolonged suppressive fluconazole therapy. CONCLUSIONS:This is the second case reported in the Americas and the fifth worldwide of T. inkin infective endocarditis in an immunocompetent patient. It highlights the importance of considering this pathogen in prosthetic valve endocarditis in cases of unusual culture results, and demonstrates the diagnostic value of MALDI-TOF. Long-term antifungal therapy with triazoles, particularly voriconazole followed by fluconazole, may be an effective alternative for patients who are not surgical candidates.
BACKGROUND:In Mexico, Cryptococcus gattii sensu lato has been identified as the etiologic agent in approximately 10.8% of cryptococcosis cases; however, its isolation from natural sources, which would confirm its existence in the environment, has not been successful. OBJECTIVE:To isolate C. gattii from environmental samples collected from trees within the movement area of a patient diagnosed with cryptococcosis caused by this species. METHODS:Based on a database of clinical isolates characterized as C. gattii, a patient was contacted and his route of movement was obtained; through a geospatial analysis, nearby trees were located. Tree hollows were sampled and the Cryptococcus isolates obtained were biochemically and genetically typed. RESULTS:Four Cryptococcus isolates were obtained from the trees Schinus molle, Erythrina coralloides and from a specimen of the genus Pinus: three of them were characterized as Cryptococcus neoformans sensu stricto and one as C. gattii sensu stricto. CONCLUSIONS:Using a geographic information system led to delimit an environmental sampling area, resulting in the first documented report in Mexico of the isolation of C. gattii genotype VGI in nature.
BACKGROUND:Fungal diseases caused by species of the genus Cryptococcus are a growing public health problem, with the species belonging to the Cryptococcus neoformans and Cryptococcus gattii complexes being the most common and studied. In recent years, other species belonging to related genera have emerged, including Naganishia diffluens. As there are few reports on this species, it is important to emphasize its significance, particularly given that it has been found in skin lesions in immunocompromised patients, as in the case presented here. This highlights the importance of paying due attention to this species and recognizing its clinical relevance. CASE REPORT:A 27-year-old male patient with a diagnosis of acute promyelocytic leukemia M3 (APL M3) experienced a febrile episode with skin lesions compatible with fungal infection, coinciding with marked neutropenia and the start of chemotherapy. Mycological analysis of skin lesions allowed the isolation of a fungus that was identified as N. diffluens. CONCLUSIONS:The increase in the frequency of N. diffluens infections can be attributed to the rising number of patients with risk factors. The use of new microbial identification tools, such as molecular biology, which made it possible to accurately identify the causative agent, is highlighted.
BACKGROUND:Dermatophytoses are transmissible infections that affect one billion people worldwide and have a significant impact on public health. Dermatophytes distribution evolves geographically and over time. Consequently, local epidemiology should be periodically assessed to control infection. AIMS:To describe the local distribution of dermatophytes and types of dermatophytosis through the analysis of samples from patients with suspected superficial mycoses, and to identify areas of improvement. METHODS:A retrospective epidemiological analysis of mycological culture results from skin, hair and nail samples referred to the mycology lab in the Hospital Clínico Universitario Lozano Blesa, Zaragoza (Spain) between 2020 and 2023 was performed, and the results statistically analyzed. RESULTS:4371 specimens (skin: 41.4%; hair: 5.1%; nails: 53.5%) were cultured using standard procedures. The demand for testing increased by 53% over a 4-year time period and a dermatophyte positivity rate of 16.7% (n=731) was found. The species distribution was the following: Trichophyton rubrum (56%), Trichophyton tonsurans (11.3%), Microsporum canis (11.8%), Trichophyton interdigitale (7%), Trichophyton. mentagrophytes (5.8%), Microsporum audouinii (3.8%) and other species (4.9%), with an anthropophilic to zoophilic ratio of 4:1. The dermatophytoses clinical forms found were tinea unguium (39.6%), associated to population over 45 years, tinea corporis (24.7%) and tinea capitis (10.6%), both associated to people with less than 16 years group, tinea pedis (17.5%), mainly observed in people aged 31-45 years; other forms accounted for 7.6%. Finally, the Emergency department requested 11.9% of the mycological tests. CONCLUSIONS:Local epidemiology of dermatophytoses highlights the predominance of anthropophilic species, whereas 35 years ago zoophilic species represented 80% of the isolates. Interestingly, mild superficial lesions are frequently and inappropriately brought to the Emergency department.
