The Road Ahead: Advancing Antifungal Vaccines and Addressing Fungal Infections in the Post-COVID World DOI
Xiaolong Gong, Mohmmad Younus Wani, Abdullah S. Al‐Bogami

et al.

ACS Infectious Diseases, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 10, 2024

In impoverished nations, the COVID-19 pandemic has led to a widespread occurrence of deadly fungal diseases like mucormycosis. The limited availability effective antifungal treatments and emergence drug-resistant strains further exacerbate situation. Factors such as systemic steroid use, intravenous drug misuse, overutilization broad-spectrum antimicrobials contribute prevalence hospital-acquired infections caused by fungi. Fungal exploit compromised immune status employ intricate mechanisms evade surveillance. response involves innate adaptive systems, leading phagocytic complement-mediated elimination However, resistance antifungals poses challenge, highlighting importance prophylaxis therapeutic vaccination. Understanding host-fungal immunological interactions developing vaccines are vital in combating infections. Further research is needed address high mortality morbidity associated with multidrug-resistant pathogens develop innovative treatment drugs vaccines. This review focuses on global epidemiological burden infections, interactions, recent advancements vaccine development road ahead.

Language: Английский

Viral reactivations and fungal infections in nonresolving acute respiratory distress syndrome DOI Creative Commons
Lenn Maessen, L.S. Boers, Jannes Heylen

et al.

European Respiratory Review, Journal Year: 2025, Volume and Issue: 34(175), P. 240153 - 240153

Published: Jan. 1, 2025

Acute respiratory distress syndrome (ARDS) is a condition affecting 10% of patients requiring admission to the intensive care unit and results from endothelial dysfunction, alveolar epithelial injury unbalanced inflammation, leading exudative pulmonary oedema. A significant portion these experience lung that fails resolve. Persistent or worsening failure beyond 5 days after initiation mechanical ventilation referred as nonresolving ARDS. Viral fungal pathogens can exploit hyperinflammatory environment altered immune landscape in ARDS, perpetuating cycle ongoing inflammation injury, thereby contributing progression towards persistence even previously immunocompetent patients. This review discusses significance, pathophysiology, diagnostic challenges key knowledge gaps concerning various viral with particular focus on influenza-associated COVID-19-associated aspergillosis reactivation Herpesviridae , such cytomegalovirus herpes simplex virus. Diagnosing infections challenging due their nonspecific clinical presentation inability current tests distinguish between colonisation asymptomatic shedding clinically reactivations. deeper understanding complex interplay host system context combined advances therapeutic strategies, has potential enhance management prognosis

Language: Английский

Citations

0
Fungal Pulmonary Coinfections in COVID-19: Microbiological Assessment, Inflammatory Profiles, and Clinical Outcomes DOI Creative Commons

Petrinela Daliu,

Iulia Bogdan, Ovidiu Roşca

et al.

Biomedicines, Journal Year: 2025, Volume and Issue: 13(4), P. 864 - 864

Published: April 3, 2025

Background and Objectives: Secondary pulmonary fungal infections in coronavirus disease 2019 (COVID-19) remain underexplored despite emerging reports linking them to heightened morbidity. Comorbidities, steroid use, prolonged hospital stays can predispose patients opportunistic fungi. This study aimed evaluate the impact of coinfection on inflammatory markers, severity, antifungal resistance profiles, outcomes hospitalized COVID-19 patients. Methods: retrospective observational enrolled 280 adults (≥18 years) with real-time polymerase chain reaction (RT-PCR)-confirmed admitted a tertiary care center (January 2023–December 2024). Patients were divided into COVID-19-only group (n = 216) COVID–fungal 64) based bronchoalveolar lavage, sputum, and/or blood culture positivity for pathogens. Inflammatory markers (C-reactive protein (CRP), procalcitonin, neutrophil-to-lymphocyte ratio, systemic immune inflammation index) severity scores (Acute Physiology Chronic Health Evaluation II, CURB-65 score, National Early Warning Score) measured. We assessed susceptibilities recorded ICU admissions, ventilation, length stay, mortality. Results: Aspergillus fumigatus (31.3%), Candida albicans (28.1%), Cryptococcus neoformans (7.8%), Pneumocystis jirovecii (6.3%), Mucorales (6.3%) dominated; glabrata, tropicalis, mixed also noted. Multidrug-resistant (MDR) isolates or triazoles occurred 25.0% cultures. The COVID-19–fungal showed significantly higher CRP (85.7 vs. 71.6 mg/L, p < 0.001), procalcitonin (2.4 1.3 ng/mL, APACHE II (18.6 14.8, 0.001). intensive-care unit admissions (39.1% 19.9%, 0.004) mechanical ventilation (26.6% 10.2%, 0.01) more frequent coinfection. Mortality trended at rate (15.6% 7.4%, 0.06). Conclusions: Pulmonary coinfections intensify milieu, elevate scores, lead ICU-level interventions identification, guided by culture-based molecular diagnostics, alongside prompt therapy, could mitigate adverse outcomes. These findings underscore critical need proactive surveillance rigorous stewardship managing severe pneumonia.

Language: Английский

Citations

0
Aspergillus fumigatus biology, immunopathogenicity and drug resistance DOI
Frank L. van de Veerdonk, Agostinho Carvalho, Joost Wauters

et al.

Nature Reviews Microbiology, Journal Year: 2025, Volume and Issue: unknown

Published: May 2, 2025

Language: Английский

Citations

0
Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A RetrospectiveObservational Study DOI Creative Commons
Than Manh Hung, Thang Viet Dao,

Tiffany Cao

et al.

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

Citations

0
Impact of the COVID-19 Pandemic on Inpatient Antibiotic and Antifungal Drug Prescribing Volumes in Germany DOI Open Access
Winfried V. Kern,

Michaela Steib–Bauert,

Jürgen Baumann

et al.

Published: Aug. 12, 2024

Background: Previous studies have found variable impact of the coronavirus disease 2019 (COVID-19) pandem-ic on consumption antimicrobial drugs in human medicine, with trends several European countries differing between community and inpatient prescribing. Aim: This study analysed changes volumes use density antibacterial antifungal dis-pensed acute care hospitals Germany 2022. Methods: Surveillance data for four years available from 279 hospitals, among them 272 antifungals, were expressed as total daily doses or (daily per 100 patient/occupied bed days) year descriptively, using recommended hospital-adapted dose definitions (RDD) (as sensitivity analysis) WHO/ATC-defined (DDD). Hospitals stratified according to size (number beds) university affiliation, location (East, West, South). Results: There significant decreases both number patient days drug vol-umes 2020 through 2022 compared 2019. The relative 2020, 2021 -12.8%, -13.5%, -13.3% days, -9.7%, -11.0%, -10.1% RDD, respec-tively. Broad-spectrum betalactams, notably piperacillin-tazobactam carbapenems, increased volume unlike most other classes. resulting was slightly but significantly increas-ing pooled means (and medians) 43.3 (40.0) RDD/100 44.8 (41.7), 44.5 (40.80), 44.9 (41.7) 2022, respectively. Antifungal after peaked (differences +6.4%, mean values +22.9%, respectively). These similar different hospital strata comparable when DDD instead RDD used. Conclusions: Similar what has been observed a majority antibac-terial German decreased pandemic without rebound phenomenon In association restricted capacities presumably more immunocompromised general medi-cine patients, however, prescribing (primarily broad-spectrum) antibacterials increased.

Language: Английский

Citations

2
Impact of the COVID-19 Pandemic on Inpatient Antibiotic and Antifungal Drug Prescribing Volumes in Germany DOI Creative Commons
Winfried V. Kern,

Michaela Steib–Bauert,

Jürgen Baumann

et al.

Antibiotics, Journal Year: 2024, Volume and Issue: 13(9), P. 837 - 837

Published: Sept. 3, 2024

Previous studies found that the coronavirus disease 2019 (COVID-19) pandemic had a variable impact on consumption of antimicrobial drugs in human medicine, with trends several European countries differing between community and inpatient prescribing.

Language: Английский

Citations

2
The Road Ahead: Advancing Antifungal Vaccines and Addressing Fungal Infections in the Post-COVID World DOI
Xiaolong Gong, Mohmmad Younus Wani, Abdullah S. Al‐Bogami

et al.

ACS Infectious Diseases, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 10, 2024

In impoverished nations, the COVID-19 pandemic has led to a widespread occurrence of deadly fungal diseases like mucormycosis. The limited availability effective antifungal treatments and emergence drug-resistant strains further exacerbate situation. Factors such as systemic steroid use, intravenous drug misuse, overutilization broad-spectrum antimicrobials contribute prevalence hospital-acquired infections caused by fungi. Fungal exploit compromised immune status employ intricate mechanisms evade surveillance. response involves innate adaptive systems, leading phagocytic complement-mediated elimination However, resistance antifungals poses challenge, highlighting importance prophylaxis therapeutic vaccination. Understanding host-fungal immunological interactions developing vaccines are vital in combating infections. Further research is needed address high mortality morbidity associated with multidrug-resistant pathogens develop innovative treatment drugs vaccines. This review focuses on global epidemiological burden infections, interactions, recent advancements vaccine development road ahead.

Language: Английский

Citations

0