The battle against fungi: lessons in antifungal stewardship from COVID 19 times

International Journal of Antimicrobial Agents, Journal Year: 2023, Volume and Issue: 62(1), P. 106846 - 106846

Published: May 13, 2023

The COVID-19 pandemic has highlighted the detrimental effect of secondary pathogens in patients with a primary viral insult. In addition to superinfections bacterial pathogens, invasive fungal infections were increasingly reported. diagnosis pulmonary always been challenging; however, it became even more problematic setting COVID-19, particularly regarding interpretation radiological findings and mycology test results these infections. Moreover, prolonged hospitalization ICU, coupled underlying host factors. such as preexisting immunosuppression, use immunomodulatory agents, compromise, caused additional vulnerability this patient population. addition, heavy workload, redeployment untrained staff, inconsistent supply gloves, gowns, masks during outbreak made harder for healthcare workers strictly adhere preventive measures infection control. Taken together, factors favored patient-to-patient spread infections, those by Candida auris, or environment-to-patient transmission, including nosocomial aspergillosis. As associated increased morbidity mortality, empirical treatment was overly used abused COVID-19-infected patients, potentially contributing resistance pathogens. aim paper focus on essential elements antifungal stewardship three COVID-19-associated candidemia (CAC), -pulmonary aspergillosis (CAPA), -mucormycosis (CAM).

Language: Английский

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Post-COVID-19 Fungal Infection in the Aged Population

Vaccines, Journal Year: 2023, Volume and Issue: 11(3), P. 555 - 555

Published: Feb. 27, 2023

Coronavirus disease 2019 (COVID-19) infection is currently a great cause of concern for the healthcare sector around globe. SARS-CoV-2 an RNA virus that causes serious associated with numerous adverse effects and multiple complications different organs systems during its pathogenic cycle in humans. Individuals affected by COVID-19, especially elderly populations immunocompromised people, are greatly vulnerable to opportunistic fungal pathogens. Aspergillosis, invasive candidiasis, mucormycosis widespread coinfections COVID-19 patients. Other infections rare but exhibiting increased incidence current scenario include caused Pneumocystis jirovecii, Histoplasma sp., Cryptococcus etc. By producing virulent spores, these pathogens increase severity morbidity fatality rates patients globally. These generally occur recovering from infection, resulting rehospitalization. Older individuals at higher risk developing infections. This review focuses on understanding prevalent patients, people. We have also highlighted important preventive methods, diagnostic approaches, prophylactic measures

Language: Английский

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Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A RetrospectiveObservational Study

Tropical Medicine and Infectious Disease, Journal Year: 2025, Volume and Issue: 10(5), P. 124 - 124

Published: May 6, 2025

COVID-19-associated invasive fungal infections (CAIFIs) contribute to increased mortality and morbidity rates. This study explores the epidemiology, laboratory parameters, radiological characteristics, treatments, 30-day risks of CAIFI in critically ill intubated patients while also evaluating factors associated with prolonged mechanical ventilation (PMV) this population. Adults admitted a tertiary hospital from 1 April 2021 31 March 2022 who were diagnosed severe COVID-19, required ventilation, developed infection (IFI) during hospitalization analyzed retrospective cohort study. Among 150 patients, 65 (43.3%) PMV, an in-hospital rate 64%. Candida albicans (47%) Aspergillus fumigatus (27%) most prevalent pathogens. Multivariate analysis revealed that COVID-19 vaccination (adjusted odds ratio, aOR = 0.155, 95% confidence interval, CI 0.029–0.835, p 0.030) higher serum protein levels (aOR 0.900, 0.819–0.989, 0.028) significantly reduced risk PMV. Meanwhile, elevated glucose (hazard HR 1.047, 1.003–1.093, 0.036) neutrophil-to-lymphocyte ratio (HR 1.024, 1.009–1.039, 0.002) correlated greater risk. Tracheostomy emerged as protective factor, reducing 0.273, 0.127–0.589, 0.001). In single-center study, exhibit high rate. Clinicians should maintain vigilance for IFI ventilation.

Language: Английский

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Incidence and Outcome of Fungal Infections in Patients Receiving Extracorporeal Membrane Oxygenation: A Review of the Literature

Published: May 3, 2025

Language: Английский

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Invasive Candidiasis Coinfection in Patients with Severe COVID-19 Disease: Scoping Review

Pathogens, Journal Year: 2025, Volume and Issue: 14(5), P. 466 - 466

Published: May 10, 2025

Coinfection rates of candidiasis in patients affected by COVID-19 had a significantly increase during the sanitary contingency. The objective this scoping review is to analyze available scientific evidence around coinfection invasive hospitalized with severe disease. Online databases such as PubMed, EBSCO, SciFinder, Scopus, and SciELO were used different studies published from January 2020 December 2022, selecting 48 publications that reported comorbidity between study variable. Based on PRISMA-ScR extension for reviews, we identified more than half (57%) observational, descriptive, analytic studies, while 43% systematic reviews. Overall, up 169,468 adult admitted intensive care unit examined. was due mainly Candida albicans (75%), but some species Meyerozyma parapsilosis (formerly parapsilosis); guilliermondii guilliermondii); Nakaseomyces glabratus glabrata); tropicalis; dubliniensis; Clavispora lusitaniae lusitaniae); Pichia kudriavzevii krusei). We concluded infected SARS-CoV-2 higher incidence fungal coinfections, thus increasing mortality rate, disease severity, length hospital stay unit.

Language: Английский

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Description of Cryptococcosis Following SARS-CoV-2 Infection: A Disease Survey Through the Mycosis Study Group Education and Research Consortium (MSG-19)

Clinical Infectious Diseases, Journal Year: 2023, Volume and Issue: 78(2), P. 371 - 377

Published: Sept. 15, 2023

Abstract Background Invasive fungal infections have been described throughout the COVID-19 pandemic. Cryptococcal disease after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reported in several isolated case reports and 1 larger series. We sought to describe cryptococcal following SARS-CoV-2 through establishing a database investigate underlying risk factors, manifestations, outcomes. Methods created crowdsourced call for cases solicited Mycoses Study Group Education Research Consortium, Centers Disease Control Prevention Emerging Infectious Diseases Network, infectious diseases Twitter groups. Data were collected web-based secure REDCap survey without personal identifiers. Results Sixty-nine identified submitted by 29 separate institutional sites. Cryptococcosis was diagnosed median of 22 days (interquartile range, 9–42 days) infection. Mortality among those available follow-up 72% (26/36) immunocompetent group 48% (15/31) immunocompromised (likelihood ratio, 4.01; P = .045). observed correlation between manifestation (central nervous system infection, proven/probable disseminated disease, respiratory) mortality (P .002). Conclusions The rate 59% patients cryptococcosis is higher than that modern Cryptococcus cohorts. There an association status manifestations as well mortality. Moreover, our series emphasizes need clinical laboratory assessment opportunistic beyond 30 when concerning symptoms develop.

Language: Английский

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Fungal Infections Identified with Multiplex PCR in Severe COVID-19 Patients during Six Pandemic Waves

Medicina, Journal Year: 2023, Volume and Issue: 59(7), P. 1253 - 1253

Published: July 5, 2023

Background and Objectives: With an increasing number of severe COVID-19 cases presenting with secondary fungal infections, this study aimed to determine the prevalence co-infections in patients across six waves, identify most common pathogens associated COVID-19, explore any potential links between patient characteristics, therapeutic strategies, type infection. Materials Methods: A retrospective analysis was conducted on admitted Infectious Diseases Pulmonology Hospital, “Victor Babes”, Romania, March 2020 August 2022. Samples were collected from respiratory specimens, blood, urine, after which a standard nucleic acid extraction protocol employed. Patients divided into groups without identified using multiplex PCR. The compared based demographic data, comorbidities, pandemic wave number, clinical outcomes. Results: Out 288 patients, 96 (33.3%) had Candida spp. being common. infections higher rates obesity (35.4% vs. 21.4%, p = 0.010) Charlson comorbidity index (CCI > 2) (37.5% vs 25.0%, 0.027). Ventilator use significantly infection group (45.8% 18.8%; < 0.001), as ICU admission (39.6% 26.6%; 0.024) mortality (32.3% 12.0%; 0.001). distribution different species varied no statistical significance (p 0.209). risk notably increased degree drug resistance (OR for three or more resistances 6.71, second, fourth, fifth waves 3.72, 3.61, 4.08, respectively, all Aspergillus Mucor 4.61 6.08, both Conclusions: Our indicates significant presence among that is morbidity mortality, particularly drug-resistant infections. These findings underline necessity comprehensive diagnostic approaches tailored treatment strategies managing especially during specific particular Further research required understand implications these their management.

Language: Английский

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Fungal Lesions of the Oral Mucosa Diagnosis and Management

Oral and Maxillofacial Surgery Clinics of North America, Journal Year: 2023, Volume and Issue: 35(2), P. 271 - 281

Published: Feb. 15, 2023

Language: Английский

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Fungal pathogens and COVID-19

Current Opinion in Microbiology, Journal Year: 2023, Volume and Issue: 75, P. 102365 - 102365

Published: Aug. 23, 2023

Language: Английский

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Invasive pulmonary aspergillosis with candidiasis: usefulness of molecular and ultrastructural morphological analysis on FFPE tissue for invasive fungal infections

Medical Molecular Morphology, Journal Year: 2023, Volume and Issue: 56(2), P. 144 - 151

Published: Feb. 20, 2023

Language: Английский

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