Invasive Candidiasis, 2nd Edition

A special issue of Journal of Fungi (ISSN 2309-608X). This special issue belongs to the section "Fungal Pathogenesis and Disease Control".

Deadline for manuscript submissions: closed (15 July 2023) | Viewed by 3302

Special Issue Editor

Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
Interests: medical microbiology; infectious diseases; invasive candidiasis; septicemia; antimicrobial resistance; biomarkers; flow cytometry; microbiological diagnostic; epidemiology; public health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Invasive candidiasis is a very serious Candida spp. infection and includes candidemia (bloodstream and other sterile body site infections) and deep-seated infections, which may be localized or lead to secondary candidemia. Mortality rates associated with invasive candidiasis can range from 35 to 75%, and despite efforts to introduce new antifungal agents, candidiasis has not decreased in the past two decades, especially in intensive care units. The main factors contributing to this problem are the difficulty in diagnosis due to the nonspecific clinical symptoms of systemic fungal infections, delayed laboratory detection methods, and subsequent delays in the initiation of adequate antifungal therapy.

This Special Issue aims to highlight the importance of new diagnostic tools and antifungal drugs in the management of invasive candidiasis. Original research or reviews papers on host–pathogen interactions and antifungal resistance are also welcome.

Dr. Sofia Costa de Oliveira
Guest Editor

Manuscript Submission Information

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Keywords

  • antifungal drugs
  • antifungal resistance
  • diagnostic tools
  • biofilms
  • candidemia
  • antifungal stewardship

Published Papers (2 papers)

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Research

16 pages, 1103 KiB  
Article
Virulence Traits and Azole Resistance in Korean Candida auris Isolates
by Seung A. Byun, Yong Jun Kwon, Ga Yeong Lee, Min Ji Choi, Seok Hoon Jeong, Dokyun Kim, Min Hyuk Choi, Seung-Jung Kee, Soo Hyun Kim, Myung Geun Shin, Eun Jeong Won and Jong Hee Shin
J. Fungi 2023, 9(10), 979; https://doi.org/10.3390/jof9100979 - 28 Sep 2023
Cited by 1 | Viewed by 941
Abstract
We analyzed the virulence traits and azole resistance mechanisms of 104 Candida auris isolates collected from 13 Korean hospitals from 1996 to 2022. Of these 104 isolates, 96 (5 blood and 91 ear isolates) belonged to clade II, and 8 (6 blood and [...] Read more.
We analyzed the virulence traits and azole resistance mechanisms of 104 Candida auris isolates collected from 13 Korean hospitals from 1996 to 2022. Of these 104 isolates, 96 (5 blood and 91 ear isolates) belonged to clade II, and 8 (6 blood and 2 other isolates) belonged to clade I. Fluconazole resistance (minimum inhibitory concentration ≥32 mg/L) was observed in 68.8% of clade II and 25.0% of clade I isolates. All 104 isolates were susceptible to amphotericin B and three echinocandins. In 2022, six clade I isolates indicated the first nosocomial C. auris cluster in Korea. Clade II C. auris isolates exhibited reduced thermotolerance at 42 °C, with diminished in vitro competitive growth and lower virulence in the Galleria mellonella model compared to non-clade II isolates. Of the 66 fluconazole-resistant clade II isolates, several amino acid substitutions were identified: Erg11p in 14 (21.2%), Tac1Ap in 2 (3.0%), Tac1Bp in 62 (93.9%), and Tac1Bp F214S in 33 (50.0%). Although there were a limited number of non-clade II isolates studied, our results suggest that clade II C. auris isolates from Korean hospitals might display lower virulence traits than non-clade II isolates, and their primary fluconazole resistance mechanism is linked to Tac1Bp mutations. Full article
(This article belongs to the Special Issue Invasive Candidiasis, 2nd Edition)
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11 pages, 302 KiB  
Article
Prognostic Trends and Current Challenges in Candidemia: A Comparative Analysis of Two Multicenter Cohorts within the Past Decade
by Caroline Agnelli, Thaís Guimarães, Teresa Sukiennik, Paulo Roberto Passos Lima, Mauro José Salles, Giovanni Luís Breda, Flavio Queiroz-Telles, Marcello Mihailenko Chaves Magri, Ana Verena Mendes, Luís Fernando Aranha Camargo, Hugo Morales, Viviane Maria de Carvalho Hessel Dias, Flávia Rossi and Arnaldo Lopes Colombo
J. Fungi 2023, 9(4), 468; https://doi.org/10.3390/jof9040468 - 13 Apr 2023
Cited by 1 | Viewed by 1684
Abstract
Candidemia remains a major public health challenge due to its high mortality rates, especially in developing countries. Monitoring epidemiological trends may provide insights for better clinical outcomes. This study aimed to describe trends in the epidemiology, therapeutic practices, and mortality in candidemia through [...] Read more.
Candidemia remains a major public health challenge due to its high mortality rates, especially in developing countries. Monitoring epidemiological trends may provide insights for better clinical outcomes. This study aimed to describe trends in the epidemiology, therapeutic practices, and mortality in candidemia through a retrospective comparative analysis between two surveillance cohorts of all candidemic adults at eleven tertiary hospitals in Brazil, from 2010–2011 (Period I) versus 2017–2018 (Period II). A total of 616 cases were diagnosed, with 247 being from Period II. These patients were more likely to have three or more coexisting comorbidities [72 (29.1%) vs. 60 (16.3%), p < 0.001], had a prior history of in-hospital admissions more often [102 (40.3%) vs. 79 (21.4%), p = 0.001], and presented with candidemia earlier after admission, within 15 days (0–328) vs. 19 (0–188), p = 0.01. Echinocandins were more frequently prescribed [102 (41.3%) vs. 50 (13.6%), p = 0.001], but time to antifungal initiation [2 days (0–14) vs. 2 (0–13), p = 0.369] and CVC removal within 48 h [90/185 (48.6%) vs. 148/319 (46.4%), p = 0.644] remained unchanged. Additionally, many patients went untreated in both periods I and II [87 (23.6%) vs. 43 (17.4%), p = 0.07], respectively. Unfortunately, no improvements in mortality rates at 14 days [123 (33.6%) vs. 93 (37.7%), p = 0.343] or at 30 days [188 (51.4%) vs. 120 (48.6%), p = 0.511] were observed. In conclusion, mortality rates remain exceedingly high despite therapeutic advances, probably associated with an increase in patients’ complexity and suboptimal therapeutic interventions. Management strategies should be tailored to suit epidemiological changes, expedite diagnosis to reduce the number of untreated eligible patients and guarantee early antifungal initiation and source control. Full article
(This article belongs to the Special Issue Invasive Candidiasis, 2nd Edition)
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