Invasive Fungal Diseases of Combat Wounds: Burden, Epidemiology, and Mycology DOI Creative Commons
Ashleigh Roberds,

Alexander G. Bobrov,

Riina Rautemaa‐Richardson

et al.

Mycopathologia, Journal Year: 2024, Volume and Issue: 189(6)

Published: Nov. 21, 2024

Abstract During the last two decades, wound invasive fungal diseases (WIFDs) have reemerged as important causes of mortality and morbidity in military personnel civilian casualties war areas. Historically, mycotic infections acquired combat operations during Vietnam War were associated with burn wounds. Modern related WIFDs are almost exclusively severe traumatic events which encompass blast exposure primary mechanism injury subsequent extremity amputation extensive blood loss. Such often lead to deep tissue necrosis, long hospitalizations, surgeries, more amputation. Studies among U.S. Operation Enduring Freedom (Afghanistan) demonstrated incidence rates approximately 7% crude 8.5%. also seen U.K. returning from Afghanistan common current Ukraine Gaza conflicts. Mucorales , Aspergillus Fusarium species predominant WIFDs. These molds opportunistic pathogens thrive patients immune system imbalances following injury. They ubiquitous environmental fungi found a variety soils but there significant regional differences depending on local soil type, vegetation, climate. The management is complicated by limited efficacy antifungals many these emerging antifungal resistance globally. This review provides an overview global burden, epidemiology, clinical features combat-related aim provide better understanding threat posed for wounded Service Members civilians.

Language: Английский

Impact of climate change and natural disasters on fungal infections DOI Creative Commons
Danila Seidel, Sebastian Wurster, Jeffrey D. Jenks

et al.

The Lancet Microbe, Journal Year: 2024, Volume and Issue: 5(6), P. e594 - e605

Published: March 19, 2024

The effects of climate change and natural disasters on fungal pathogens the risks for diseases remain incompletely understood. In this literature review, we examined how fungi are adapting to an increase in Earth's temperature becoming more thermotolerant, which is enhancing fitness virulence. Climate creating conditions conducive emergence new priming adapt previously inhospitable environments, such as polluted habitats urban areas, leading geographical spread some traditionally non-endemic areas. also contributing increases frequency severity disasters, can trigger outbreaks pathogens. populations mostly affected socially vulnerable. More awareness, research, funding, policies part key stakeholders needed mitigate disaster-related diseases.

Language: Английский

Citations

60
Novel antifungals and treatment approaches to tackle resistance and improve outcomes of invasive fungal disease DOI
Martin Hoenigl, Amir Arastehfar, Maiken Cavling Arendrup

et al.

Clinical Microbiology Reviews, Journal Year: 2024, Volume and Issue: 37(2)

Published: April 11, 2024

SUMMARYFungal infections are on the rise, driven by a growing population at risk and climate change. Currently available antifungals include only five classes, their utility efficacy in antifungal treatment limited one or more of innate acquired resistance some fungi, poor penetration into "sequestered" sites, agent-specific side effect which require frequent patient reassessment monitoring. Agents with novel mechanisms, favorable pharmacokinetic (PK) profiles including good oral bioavailability, fungicidal mechanism(s) urgently needed. Here, we provide comprehensive review agents, both improved known mechanisms actions new currently clinical development for treating invasive yeast, mold (filamentous fungi),

Language: Английский

Citations

34
Social determinants of health as drivers of fungal disease DOI Creative Commons
Jeffrey D. Jenks, Juergen Prattes, Sebastian Wurster

et al.

EClinicalMedicine, Journal Year: 2023, Volume and Issue: 66, P. 102325 - 102325

Published: Nov. 18, 2023

Disparities in social determinants of health (SDOH) play a significant role causing inequities globally. The physical environment, including housing and workplace can increase the prevalence spread fungal infections. A number professions are associated with increased infection risk low pay, which may be linked to crowded sub-optimal living conditions, exposure organisms, lack access quality care, for infection. Those involved displaced from areas armed conflict have an invasive Lastly, plant pathogens already threaten food security, will become more problematic global climate change. Taken together, disparities SDOH contracting More emphasis needs placed on systematic approaches better understand impact reducing these disparities.

Language: Английский

Citations

27
Outbreak of Fusarium solani Meningitis in Immunocompetent Persons Associated With Neuraxial Blockade in Durango, Mexico, 2022–2023 DOI Creative Commons
Gabriel García-Rodríguez, Célida Duque-Molina,

Irasema Kondo-Padilla

et al.

Open Forum Infectious Diseases, Journal Year: 2024, Volume and Issue: 11(2)

Published: Jan. 3, 2024

Abstract Background Fungal meningitis can be associated with epidural anesthesia procedures. Fusariosis is a rare infection typically affecting immunocompromised patients and rarely causes meningitis. During 2022–2023, public health officials responded to large outbreak of Fusarium solani in Durango, Mexico. Methods The response epidemiological clinical features affected by this were described. Coordinated actions addressed identify the etiological agent, determine its drug susceptibility, develop diagnostic tests, implement protocols. Retrospective analyses variables outcomes performed association better patient survival. Results A total 1801 persons exposed identified, whom 80 developed was found 3 brain biopsies showed susceptibility voriconazole amphotericin B. After F polymerase chain reaction (PCR) implementation, 57 PCR-screened, 31 (38.8%) had positive result. Most female (95%), cesarean section most common surgical procedure (76.3%). case fatality rate 51.3% (41 patients) median hospitalization duration 39.5 days (interquartile range, 18–86 days). Seventy-one (88.8%) received voriconazole/amphotericin B 64 subjects (80%) additionally steroids. Cox regression analysis an increased lethality risk who antifungal treatment after 5 (hazard ratio, 2.1 [95% confidence interval, 1.01–4.48], P < .05). Conclusions Durango unprecedented medical challenge. Timely effective healthcare management survival outcomes.

Language: Английский

Citations

14
Universal digital high-resolution melting for the detection of pulmonary mold infections DOI Creative Commons

Tyler Goshia,

April Aralar, Nathan P. Wiederhold

et al.

Journal of Clinical Microbiology, Journal Year: 2024, Volume and Issue: 62(6)

Published: May 2, 2024

ABSTRACT Invasive mold infections (IMIs) are associated with high morbidity, particularly in immunocompromised patients, mortality rates between 40% and 80%. Early initiation of appropriate antifungal therapy can substantially improve outcomes, yet early diagnosis remains difficult to establish often requires multidisciplinary teams evaluating clinical radiological findings plus supportive mycological findings. Universal digital high-resolution melting (U-dHRM) analysis may enable rapid robust diagnoses IMI. A universal fungal assay was developed for U-dHRM used generate a database melt curve signatures 19 clinically relevant pathogens. machine learning algorithm (ML) trained automatically classify these pathogen curves detect novel curves. Performance assessed on 73 bronchoalveolar lavage samples from patients suspected Novel were identified by micropipetting reactions Sanger sequencing amplicons. achieved 97% overall organism identification accuracy turnaround time ~4 hrs. detected pathogenic molds ( Aspergillus , Mucorales Lomentospora Fusarium ) 73% 30 classified as IMI, including mixed infections. Specificity optimized requiring the number sample be > 8 volume 1 mL, which resulted 100% specificity 21 at-risk without showed promise separate or combination diagnostic approach standard tests. U-dHRM’s speed, ability simultaneously identify quantify pathogens polymicrobial samples, emerging opportunistic aid treatment decisions, improving patient outcomes. IMPORTANCE Improvements diagnostics invasive urgently needed. This work presents new molecular detection that addresses technical workflow challenges provide fast detection, identification, quantification could inform

Language: Английский

Citations

9
Advanced genetic techniques in fungal pathogen research DOI Creative Commons
Robbi L. Ross, Felipe H. Santiago‐Tirado

mSphere, Journal Year: 2024, Volume and Issue: 9(4)

Published: March 12, 2024

ABSTRACT Although fungi have been important model organisms for solving genetic, molecular, and ecological problems, recently, they are also becoming an source of infectious disease. Despite their high medical burden, fungal pathogens understudied, relative to other pathogenic microbes, less is known about how gene functions contribute This due, in part, a lack powerful genetic tools study these organisms. In turn, this has resulted inappropriate treatments diagnostics poor disease management. There variety reasons studies were challenging fungi, but recent years, most them overcome or advances made circumvent barriers. minireview, we highlight the discovery biology potential new antifungals created comprehensively pathogens.

Language: Английский

Citations

5
Diagnosing fungal infections in clinical practice: a narrative review DOI
Sarah Sedik,

Stella Wolfgruber,

Martin Hoenigl

et al.

Expert Review of Anti-infective Therapy, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 13, 2024

Invasive fungal infections (IFI) present a major medical challenge, with an estimated 6.5 million cases annually, resulting in 3.8 deaths. Pathogens such as Aspergillus spp. Candida Mucorales Cryptococcus and other fungi species contribute to these infections, posing risks immunocompromised individuals. Early accurate diagnosis is crucial for effective treatment better patient outcomes.

Language: Английский

Citations

5
Update on diagnosis and treatment of fungal meningitis: lessons from recent outbreaks DOI

Paula Beltran-Reyes,

Luis Ostrosky‐Zeichner, María Fernanda González-Lara

et al.

Current Opinion in Infectious Diseases, Journal Year: 2024, Volume and Issue: 37(6), P. 437 - 442

Published: Sept. 3, 2024

Purpose of review Recently, fungal meningitis outbreaks have occurred in association with neuraxial and epidural anesthesia immunocompetent patients. Herein, we describe the course those outbreaks, their diagnosis, treatment, prognosis, lessons learned. Recent findings Two Fusarium solani during 2022–2023 were associated two distant cities Mexico (Durango Matamoros). The initial etiological agent identification was delayed due to insensitivity cultures. A qPCR validated positive 38% cerebrospinal fluid (CSF) samples from Durango, while BD-Glucan allowed early diagnosis index case Matamoros. Antifungal treatment voriconazole liposomal amphotericin B (L-AmB) recommended. Overall mortality 51%. Once cause confirmed, some patients received fosmanogepix. Summary Fungal filamentous fungi are usually direct inoculation. They result severe presentations high mortality. Early should be suspected, CSF testing screening is Aggressive antifungal based on susceptibility administered as possible. advent molecular diagnostic methods new drugs may allow for timely increasing chances survival.

Language: Английский

Citations

3
Antifungal pipeline: New tools for the treatment of mycoses DOI Creative Commons

Stella Wolfgruber,

Jon Salmanton‐García, Marius Paulin Ngouanom Kuate

et al.

Revista Iberoamericana de Micología, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

Citations

0
The Hidden Fortress: A Comprehensive Review of Fungal Biofilms with Emphasis on Cryptococcus neoformans DOI Creative Commons

Hope M. Pruitt,

Jinyi C. Zhu, Sean P. Riley

et al.

Journal of Fungi, Journal Year: 2025, Volume and Issue: 11(3), P. 236 - 236

Published: March 19, 2025

Biofilms are structurally organized communities of microorganisms that adhere to a variety surfaces. These produce protective matrices consisting polymeric polysaccharides, proteins, nucleic acids, and/or lipids promote shared resistance various environmental threats, including chemical, antibiotic, and immune insults. While algal bacterial biofilms more apparent in the scientific zeitgeist, many fungal pathogens also form biofilms. surprisingly common morphologically distinct from multicellular molds mushrooms normally associated with fungi instead an assemblage single-celled organisms. As collection yeast filamentous cells cloaked extracellular matrix, extreme threat public health, especially conjunction surgical implants. The encapsulated yeast, Cryptococcus neoformans, is opportunistic pathogen causes both pulmonary disseminated infections, particularly immunocompromised individuals. However, there emerging trend cryptococcosis among otherwise healthy C. neoformans forms diverse environments, within human hosts. Notably, biofilm association correlates increased expression multiple virulence factors host defenses antifungal treatments. Thus, it crucial develop novel strategies combat In this review, we discuss development treatment biofilms, particular focus on neoformans.

Language: Английский

Citations

0