Current Opinion in Infectious Diseases,
Journal Year:
2023,
Volume and Issue:
36(6), P. 427 - 435
Published: Sept. 21, 2023
Purpose
of
review
Mucormycosis
(MCR)
is
a
common
opportunistic
mold
infection,
and
Mucorales
were
recently
designated
by
WHO
as
priority
pathogens.
The
interest
in
this
infection
has
risen
significantly
since
the
major
outbreak
MCR
context
COVID-19
pandemic,
particularly
India.
Herein,
we
summarize
(last
24
months)
published
information
regarding
clinical
aspects
MCR.
Recent
findings
disease
remains
protean
its
presentation,
difficult
to
diagnose,
challenging
treat.
In
2021,
cases
COVID-19-associated
mucormycosis
(CAM)
exploded
India
during
manifested
primarily
sino-orbital
or
sino-cerebral
disease.
Its
classic
risk
factors
included
triad
COVID-19,
uncontrolled
diabetes
mellitus
use
corticosteroids.
Despite
difficulties
timely
diagnosis
MCR,
significant
progress
been
made
with
molecular
techniques
blood
assist
earlier
diagnosis,
which
can
facilitate
appropriate
therapy
improve
outcomes.
addition,
advances
have
imaging
stage
disease,
determining
what
types
multimodal
are
required
depending
on
staging,
tissue-based
identification
Mucorales.
Summary
Although
outlook
for
improved,
effective
new
antifungals,
stratification,
optimal
multimodality
approaches
remain
an
unmet
need.
bioRxiv (Cold Spring Harbor Laboratory),
Journal Year:
2024,
Volume and Issue:
unknown
Published: Feb. 21, 2024
ABSTRACT
Zygomycetous
fungal
infections
pose
an
emerging
medical
threat
among
individuals
with
compromised
immunity
and
metabolic
abnormalities.
Our
pathophysiological
understanding
of
these
infections,
particularly
the
role
cell
walls
in
growth
immune
response,
remains
limited.
Here
we
conducted
multidimensional
solid-state
NMR
analysis
to
examine
five
Mucorales
species,
including
key
mucormycosis
causative
agents
like
Rhizopus
Mucor
species.
We
show
that
rigid
core
wall
primarily
comprises
highly
polymorphic
chitin
chitosan,
minimal
quantities
β-glucans
linked
a
specific
subtype.
Chitosan
emerges
as
pivotal
molecule
preserving
hydration
dynamics.
Some
proteins
are
entrapped
within
this
semi-crystalline
chitin/chitosan
layer,
stabilized
by
sidechains
hydrophobic
amino
acid
residues,
situated
distantly
from
β-glucans.
The
mobile
domain
contains
galactan-
mannan-based
polysaccharides,
along
polymeric
α-fucoses.
Treatment
synthase
inhibitor
nikkomycin
removes
β-glucan-chitin/chitosan
complex,
leaving
other
chitosan
allomorphs
untouched
while
simultaneously
thickening
rigidifying
wall.
These
findings
shed
light
on
organization
emphasize
necessity
for
deeper
diverse
families
synthases
deacetylases
potential
targets
novel
antifungal
therapies.
Research Square (Research Square),
Journal Year:
2024,
Volume and Issue:
unknown
Published: March 15, 2024
Abstract
Background
Isavuconazole
is
a
new
drug
used
to
treat
fungal
infections.
This
study
aims
describe
isavuconazole
pharmacokinetics
in
critically
ill
patients,
assess
the
potential
influence
of
patient
covariates,
and
evaluate
relationship
with
clinical
efficacy
safety.
Methods
We
conducted
prospective,
observational
patients
treated
intravenous
for
at
least
48
hours.
Samples
were
collected
between
48–96
hours
onset
treatment,
predose
(Cmin),
1
hour
(Cmax)
12
(C50)
after
last
dose.
Plasma
concentration
was
determined
by
high-performance
liquid
chromatography
fluorescence
detector.
The
plasma
microbiological
outcome,
safety
evaluated.
covariates
such
as
age,
sex,
weight,
SAPS3,
creatinine,
bilirubin,
liver
enzymes
extracorporeal
devices
(continuous
re-emplace
renal
therapy
(CRRT)
membrane
oxygenation
(ECMO))
analysed.
Population
pharmacokinetic
modelling
performed
using
NONMEN®.
Results
A
total
71
samples
from
24
Mean
Cmin
1.76
(1.02)
mg/L.
Twenty-one
(87.5%)
reached
optimal
therapeutic
target,
while
three
(12.5%)
below
best
described
one-compartimental
model
first-order
elimination.
No
factor,
including
CRRT
or
ECMO
support,
had
significantly
impact
on
parameters.
observed
level
effectiveness
adverse
event
appearance.
Conclusions
use
established
doses
accompanied
levels
within
range.
confidence
remained
independent
demographic,
clinical,
factors
did
not
affect
drug´s
ACS Infectious Diseases,
Journal Year:
2024,
Volume and Issue:
10(5), P. 1431 - 1457
Published: April 29, 2024
Mucormycosis,
a
rare
but
deadly
fungal
infection,
was
an
epidemic
during
the
COVID-19
pandemic.
The
rise
in
cases
(COVID-19-associated
mucormycosis,
CAM)
is
attributed
to
excessive
steroid
and
antibiotic
use,
poor
hospital
hygiene,
crowded
settings.
Major
contributing
factors
include
diabetes
weakened
immune
systems.
main
manifesting
forms
of
CAM─cutaneous,
pulmonary,
deadliest,
rhinocerebral─and
disseminated
infections
elevated
mortality
rates
85%.
Recent
focus
lies
on
small-molecule
inhibitors
due
their
advantages
over
standard
treatments
like
surgery
liposomal
amphotericin
B
(which
carry
several
long-term
adverse
effects),
offering
potential
central
nervous
system
penetration,
diverse
targets,
simpler
dosing
owing
small
size,
rendering
ability
traverse
blood–brain
barrier
via
passive
diffusion
facilitated
by
phospholipid
membrane.
Adaptation
versatility
mucormycosis
are
multitude
virulence
factors,
enabling
pathogen
dynamically
respond
various
environmental
stressors.
A
comprehensive
understanding
these
mechanisms
imperative
for
devising
effective
therapeutic
interventions
against
this
highly
opportunistic
that
thrives
immunocompromised
individuals
through
its
angio-invasive
nature.
Hence,
Review
delineates
principal
it
employs
persist
challenging
host
environments,
current
progress
developing
them.
Antibiotics,
Journal Year:
2024,
Volume and Issue:
13(8), P. 706 - 706
Published: July 29, 2024
Isavuconazole
is
used
to
treat
fungal
infections.
This
study
aims
describe
isavuconazole
pharmacokinetics
in
critically
ill
patients
and
evaluate
their
relationship
with
clinical
efficacy
patient
safety.
We
conducted
a
prospective,
observational
treated
intravenous
isavuconazole.
Samples
were
collected
at
predose
(Cmin),
1
h
(Cmax)
12
(C50)
after
the
last
dose.
The
plasma
concentration
was
determined
by
high-performance
liquid
chromatography.
between
microbiological
outcomes
safety
evaluated.
influence
of
covariates
(age,
sex,
weight,
SAPS3,
creatinine,
liver
enzymes
extracorporeal
devices:
continuous
renal
replacement
therapy
(CRRT)
membrane
oxygenation
(ECMO))
analysed.
Population
pharmacokinetic
modelling
performed
using
NONMEN
Current Opinion in Infectious Diseases,
Journal Year:
2023,
Volume and Issue:
36(6), P. 427 - 435
Published: Sept. 21, 2023
Purpose
of
review
Mucormycosis
(MCR)
is
a
common
opportunistic
mold
infection,
and
Mucorales
were
recently
designated
by
WHO
as
priority
pathogens.
The
interest
in
this
infection
has
risen
significantly
since
the
major
outbreak
MCR
context
COVID-19
pandemic,
particularly
India.
Herein,
we
summarize
(last
24
months)
published
information
regarding
clinical
aspects
MCR.
Recent
findings
disease
remains
protean
its
presentation,
difficult
to
diagnose,
challenging
treat.
In
2021,
cases
COVID-19-associated
mucormycosis
(CAM)
exploded
India
during
manifested
primarily
sino-orbital
or
sino-cerebral
disease.
Its
classic
risk
factors
included
triad
COVID-19,
uncontrolled
diabetes
mellitus
use
corticosteroids.
Despite
difficulties
timely
diagnosis
MCR,
significant
progress
been
made
with
molecular
techniques
blood
assist
earlier
diagnosis,
which
can
facilitate
appropriate
therapy
improve
outcomes.
addition,
advances
have
imaging
stage
disease,
determining
what
types
multimodal
are
required
depending
on
staging,
tissue-based
identification
Mucorales.
Summary
Although
outlook
for
improved,
effective
new
antifungals,
stratification,
optimal
multimodality
approaches
remain
an
unmet
need.
