Current Epidemiological Trends of Invasive Fungal Infections

A special issue of Journal of Fungi (ISSN 2309-608X).

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 14314

Special Issue Editors


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Guest Editor
Infectious Diseases Service, Department of Medicine, and Institute of Microbiology, Lausanne University Hospital, Lausanne, Switzerland
Interests: mechanisms of resistance in Aspergillus, Candida and Mucorales; epidemiology of invasive fungal infections; novel diagnostic approaches of invasive fungal infections
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Guest Editor
AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
Interests: epidemiology of invasive fungal infection; identification and antifungal susceptibility testing of Aspergillus spp. and Candida spp.; antifungal innate immunity; host/fungal pathogen interactions

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Guest Editor
Transplant Infectious Diseases Unit, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
Interests: epidemiology; diagnosis and treatment of invasive fungal infections; hematopoeitic cell transplant; leukemia; solid organ transplant

Special Issue Information

Dear Colleagues,

Invasive fungal infections (IFIs) emerged as major opportunistic infections in the second half of the twentieth century along with the development of anticancer chemotherapies, hematopoietic stem cell/solid organ transplantation and the spread of human immunodeficiency virus (HIV). Invasive candidiasis (Candida spp.) is one of the most frequent healthcare-associated infections. Invasive aspergillosis (Aspergillus spp.) and mucormycosis (Mucorales) represent a major threat for hematologic cancer patients, while pneumocystosis (Pneumocystis jirovecii) and cryptococcosis (Cryptococcus neoformans) remain the cause of a considerable burden of mortality among HIV patients in developing countries.

The epidemiology of IFI is constantly evolving, and the observed rising incidence and diversity of IFIs may result from several factors, such as the increased activity of transplantation, the diversification of patients with long-term immunosuppression, the advent of novel anti-cancer molecules, and the progresses made in the invasive supportive management of intensive care unit patients with severe underlying conditions.

Finally, the widespread use of antifungal agents in medicine, veterinary science, industry, and agriculture exerts a selective pressure leading to the emergence of novel more resistant fungal pathogens or to the development of antifungal resistance. Thus, azole resistance among Aspergillus fumigatus, the emergence of the multiresistant yeast Candida auris, and the recent recognition of aspergillosis/mucormycosis complicating severe influenza or COVID-19 are examples of the multiple challenges that fungi currently present to the medical community. The aim of this Special Issue of the Journal of Fungi is to provide an updated overview of the current epidemiological trends of IFIs, as well as their diagnostic and therapeutic challenges.

Dr. Frederic Lamoth
Dr. Arnaud Fekkar
Dr. Dionysios Neofytos
Guest Editors

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Keywords

  • emerging mycoses
  • antifungal resistance
  • aspergillosis
  • candidiasis
  • mucormycosis

Published Papers (3 papers)

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Research

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40 pages, 522 KiB  
Article
Invasive Fungal Diseases in Africa: A Critical Literature Review
by Felix Bongomin, Bassey E. Ekeng, Winnie Kibone, Lauryn Nsenga, Ronald Olum, Asa Itam-Eyo, Marius Paulin Ngouanom Kuate, Francis Pebalo Pebolo, Adeyinka A. Davies, Musa Manga, Bright Ocansey, Richard Kwizera and Joseph Baruch Baluku
J. Fungi 2022, 8(12), 1236; https://doi.org/10.3390/jof8121236 - 22 Nov 2022
Cited by 8 | Viewed by 5133
Abstract
Invasive fungal diseases (IFDs) are of huge concern in resource-limited settings, particularly in Africa, due to the unavailability of diagnostic armamentarium for IFDs, thus making definitive diagnosis challenging. IFDs have non-specific systemic manifestations overlapping with more frequent illnesses, such as tuberculosis, HIV, and [...] Read more.
Invasive fungal diseases (IFDs) are of huge concern in resource-limited settings, particularly in Africa, due to the unavailability of diagnostic armamentarium for IFDs, thus making definitive diagnosis challenging. IFDs have non-specific systemic manifestations overlapping with more frequent illnesses, such as tuberculosis, HIV, and HIV-related opportunistic infections and malignancies. Consequently, IFDs are often undiagnosed or misdiagnosed. We critically reviewed the available literature on IFDs in Africa to provide a better understanding of their epidemiology, disease burden to guide future research and interventions. Cryptococcosis is the most encountered IFD in Africa, accounting for most of the HIV-related deaths in sub-Saharan Africa. Invasive aspergillosis, though somewhat underdiagnosed and/or misdiagnosed as tuberculosis, is increasingly being reported with a similar predilection towards people living with HIV. More cases of histoplasmosis are also being reported with recent epidemiological studies, particularly from Western Africa, showing high prevalence rates amongst presumptive tuberculosis patients and patients living with HIV. The burden of pneumocystis pneumonia has reduced significantly probably due to increased uptake of anti-retroviral therapy among people living with HIV both in Africa, and globally. Mucormycosis, talaromycosis, emergomycosis, blastomycosis, and coccidiomycosis have also been reported but with very few studies from the literature. The emergence of resistance to most of the available antifungal drugs in Africa is yet of huge concern as reported in other regions. IFDs in Africa is much more common than it appears and contributes significantly to morbidity and mortality. Huge investment is needed to drive awareness and fungi related research especially in diagnostics and antifungal therapy. Full article
(This article belongs to the Special Issue Current Epidemiological Trends of Invasive Fungal Infections)

Review

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20 pages, 1471 KiB  
Review
Diagnosis and Treatment of Invasive Aspergillosis Caused by Non-fumigatus Aspergillus spp.
by Jannik Stemler, Christina Többen, Cornelia Lass-Flörl, Jörg Steinmann, Katharina Ackermann, Peter-Michael Rath, Michaela Simon, Oliver Andreas Cornely and Philipp Koehler
J. Fungi 2023, 9(4), 500; https://doi.org/10.3390/jof9040500 - 21 Apr 2023
Cited by 7 | Viewed by 4177
Abstract
With increasing frequency, clinical and laboratory-based mycologists are consulted on invasive fungal diseases caused by rare fungal species. This review aims to give an overview of the management of invasive aspergillosis (IA) caused by non-fumigatus Aspergillus spp.—namely A. flavus, A. terreus, [...] Read more.
With increasing frequency, clinical and laboratory-based mycologists are consulted on invasive fungal diseases caused by rare fungal species. This review aims to give an overview of the management of invasive aspergillosis (IA) caused by non-fumigatus Aspergillus spp.—namely A. flavus, A. terreus, A. niger and A. nidulans—including diagnostic and therapeutic differences and similarities to A. fumigatus. A. flavus is the second most common Aspergillus spp. isolated in patients with IA and the predominant species in subtropical regions. Treatment is complicated by its intrinsic resistance against amphotericin B (AmB) and high minimum inhibitory concentrations (MIC) for voriconazole. A. nidulans has been frequently isolated in patients with long-term immunosuppression, mostly in patients with primary immunodeficiencies such as chronic granulomatous disease. It has been reported to disseminate more often than other Aspergillus spp. Innate resistance against AmB has been suggested but not yet proven, while MICs seem to be elevated. A. niger is more frequently reported in less severe infections such as otomycosis. Triazoles exhibit varying MICs and are therefore not strictly recommended as first-line treatment for IA caused by A. niger, while patient outcome seems to be more favorable when compared to IA due to other Aspergillus species. A. terreus-related infections have been reported increasingly as the cause of acute and chronic aspergillosis. A recent prospective international multicenter surveillance study showed Spain, Austria, and Israel to be the countries with the highest density of A. terreus species complex isolates collected. This species complex seems to cause dissemination more often and is intrinsically resistant to AmB. Non-fumigatus aspergillosis is difficult to manage due to complex patient histories, varying infection sites and potential intrinsic resistances to antifungals. Future investigational efforts should aim at amplifying the knowledge on specific diagnostic measures and their on-site availability, as well as defining optimal treatment strategies and outcomes of non-fumigatus aspergillosis. Full article
(This article belongs to the Special Issue Current Epidemiological Trends of Invasive Fungal Infections)
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15 pages, 662 KiB  
Review
The Changing Landscape of Invasive Fungal Infections in ICUs: A Need for Risk Stratification to Better Target Antifungal Drugs and the Threat of Resistance
by Julien Poissy, Anahita Rouzé, Marjorie Cornu, Saad Nseir and Boualem Sendid
J. Fungi 2022, 8(9), 946; https://doi.org/10.3390/jof8090946 - 9 Sep 2022
Cited by 8 | Viewed by 4114
Abstract
The landscape of invasive candidiasis and invasive aspergillosis has changed dramatically in intensive care units over the past two decades. Today, we are faced with new risk factors such as the emergence of resistance, but are also equipped with new therapeutic strategies and [...] Read more.
The landscape of invasive candidiasis and invasive aspergillosis has changed dramatically in intensive care units over the past two decades. Today, we are faced with new risk factors such as the emergence of resistance, but are also equipped with new therapeutic strategies and diagnostic tools which are changing epidemiological data and diagnostic algorithms. Some common points need to be addressed: (i) the best way to use microbiological tools and to integrate their results in decisional algorithms; (ii) the need to find the optimum balance between under-diagnosis and overtreatment; (iii) and the need to decipher pathophysiology. In this short review, we will try to illustrate these points. Full article
(This article belongs to the Special Issue Current Epidemiological Trends of Invasive Fungal Infections)
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