Metagenomic Next-Generation Sequencing of Plasma for Diagnosis of COVID-19-Associated Pulmonary Aspergillosis

Journal of Clinical Microbiology, Journal Year: 2023, Volume and Issue: 61(3)

Published: Feb. 21, 2023

Timely diagnosis remains an unmet need in non-neutropenic patients at risk for aspergillosis, including those with COVID-19-associated pulmonary aspergillosis (CAPA), which its early stages is characterized by tissue-invasive growth of the lungs limited angioinvasion. Currently available mycological tests show sensitivity when testing blood specimens.

Language: Английский

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Fungal infection profile in critically ill COVID-19 patients: a prospective study at a large teaching hospital in a middle-income country

BMC Infectious Diseases, Journal Year: 2023, Volume and Issue: 23(1)

Published: April 18, 2023

Critically ill COVID-19 patients are highly susceptible to opportunistic fungal infection due many factors, including virus-induced immune dysregulation, host-related comorbidities, overuse and misuse of antibiotics or corticosteroids, modulator drugs, the emergencies caused by pandemic. This study aimed assess incidence, identify potential risk examine impact coinfection on outcomes admitted intensive care unit (ICU).A prospective cohort 253 critically aged 18 years older isolation ICU Zagazig University Hospitals over a 4-month period from May 2021 August was conducted. The detection carried out.Eighty-three (83) (32.8%) were diagnosed with coinfection. Candida most frequently isolated fungus in 61 (24.1%) patients, followed molds, which included Aspergillus 11 (4.3%) mucormycosis five (1.97%), six (2.4%) other rare fungi. Poor diabetic control, prolonged high-dose steroids, multiple comorbidities all possible factors for [OR (95% CI) = 10.21 (3.43-30.39), 14.1 (5.67-35.10), 14.57 (5.83-33.78), 4.57 (1.83-14.88), respectively].Fungal is common complication ICU. Candidiasis, aspergillosis, COVID-19-associated infections have great mortality rates.

Language: Английский

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Advances in the treatment of invasive fungal disease

PLoS Pathogens, Journal Year: 2023, Volume and Issue: 19(5), P. e1011322 - e1011322

Published: May 4, 2023

With over 300 million severe cases and 1.5 deaths annually, invasive fungal diseases (IFDs) are a major medical burden source of global morbidity mortality. The World Health Organization (WHO) recently released the first-ever priority pathogens list including 19 pathogens, considering perceived public health importance. Most pathogenic fungi opportunistic cause in patients under immunocompromised conditions such as HIV infection, cancer, chemotherapy, transplantation, immune suppressive drug therapy. Worryingly, mortality caused by IFDs continuously on rise due to limited available antifungal therapies, emergence resistance, increase population that is vulnerable IFDs. Moreover, COVID-19 pandemic worsened globe threat it predisposes secondary life-threatening fungi. In this mini-review, we provide perspective advances strategies for combating with therapies.

Language: Английский

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Race and ethnicity: Risk factors for fungal infections?

PLoS Pathogens, Journal Year: 2023, Volume and Issue: 19(1), P. e1011025 - e1011025

Published: Jan. 5, 2023

Racial and ethnic identities, largely understood as social rather than biologic constructs, may impact risk for acquiring infectious diseases, including fungal infections. Risk factors include genetic immunologic differences such aberrations in host immune response, polymorphisms, epigenomic stemming from environmental exposures underlying determinants of health. In addition, certain racial groups be predisposed to diseases that increase infections, well disparities healthcare access health insurance. this review, we analyzed identities race ethnicity they relate severe disease invasive mold infections aspergillosis appear related health, although polymorphisms contribute some circumstances. Although black African American individuals at high superficial Candida cryptococcosis, the reasons are unclear underling healthcare, other socioeconomic disparities. all endemic fungi likely socioeconomic, disparities, mechanisms play a role well, particularly disseminated coccidioidomycosis.

Language: Английский

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Treatment of Invasive Aspergillosis: How It’s Going, Where It’s Heading

Mycopathologia, Journal Year: 2023, Volume and Issue: 188(5), P. 667 - 681

Published: April 26, 2023

Abstract Despite improvements in treatment and diagnostics over the last two decades, invasive aspergillosis (IA) remains a devastating fungal disease. The number of immunocompromised patients hence vulnerable hosts increases, which is paralleled by emergence rise IA cases. Increased frequencies azole-resistant strains are reported from six continents, presenting new challenge for therapeutic management. Treatment options currently consist three classes antifungals (azoles, polyenes, echinocandins) with distinctive advantages shortcomings. Especially settings difficult to treat IA, comprising drug tolerance/resistance, limiting drug–drug interactions, and/or severe underlying organ dysfunction, novel approaches urgently needed. Promising drugs late-stage clinical development, including olorofim (a dihydroorotate dehydrogenase inhibitor), fosmanogepix Gwt1 enzyme ibrexafungerp triterpenoid), opelconazole (an azole optimized inhalation) rezafungin echinocandin long half-life time). Further, insights pathophysiology yielding immunotherapy as potential add-on therapy. Current investigations show encouraging results, so far mostly preclinical settings. In this review we discuss current strategies, give an outlook on possible pharmaceutical options, and, lastly, provide overview ongoing research IA.

Language: Английский

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