Fungal Disease Epidemiology: Current State and Future Prospects

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Epidemiology".

Deadline for manuscript submissions: 18 July 2024 | Viewed by 14273

Special Issue Editor


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Guest Editor
Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, Gulu P.O. Box 166, Uganda
Interests: fungal diseases epidemiology; aspergillosis; cryptococcosis ; neglected fungal diseases; point-of-care tests

Special Issue Information

Dear Colleagues,

Fungal diseases have become an important global public health problem in the past few decades, affecting high-, low-, and middle-income countries. There are several risk factors for invasive fungal diseases, the disease burden is substantial, and mortality due to fungal diseases remains high—comparable to or even higher than those due to infectious diseases such as malaria, tuberculosis, and HIV/AIDS. Fungal diseases due to Aspergillus, Cryptococcus, Pneumocystis, Candida, and agents of mucormycosis are the leading causes of morbidity and mortality—particularly in the settings of immunosuppression due to chemotherapy, cancers, HIV/AIDS, and other underlying disorders. The Global Action for Fungal Infection has attempted to enumerate the burden of fungal disease in several countries across the world. However, empirical studies remain scarce, and continued surveillance for fungal diseases is key to determine the trends of these important causes of mortality and morbidity. This Special Issue welcomes original contributions and reviews of the current state of fungal diseases at the global level, and aims to suggest a way forward in the effort to curb the growing burden of fungal diseases.

Dr. Felix Bongomin
Guest Editor

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Keywords

  • epidemiology
  • aspergillosis
  • candidiasis
  • mucormycosis

Published Papers (7 papers)

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Research

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11 pages, 695 KiB  
Article
Changing Trends in the Incidence and Clinical Features of Pneumocystis jirovecii Pneumonia in Non-HIV Patients before and during the COVID-19 Era and Risk Factors for Mortality between 2016 and 2022
by Jin Suk Kang
Life 2023, 13(6), 1335; https://doi.org/10.3390/life13061335 - 7 Jun 2023
Cited by 1 | Viewed by 1366
Abstract
Fungal superinfections have been reported in patients with coronavirus disease 2019 (COVID-19). We analyzed the incidence and clinical characteristics of Pneumocystis jirovecii pneumonia (PCP) in non-human immunodeficiency virus patients at a tertiary hospital between 2016 and 2022 to evaluate the impact of the COVID-19 [...] Read more.
Fungal superinfections have been reported in patients with coronavirus disease 2019 (COVID-19). We analyzed the incidence and clinical characteristics of Pneumocystis jirovecii pneumonia (PCP) in non-human immunodeficiency virus patients at a tertiary hospital between 2016 and 2022 to evaluate the impact of the COVID-19 pandemic on PCP. The study period was divided into pre-COVID-19 and COVID-19 eras based on the pandemic declaration by the World Health Organization. Among the 113 patients included, the incidence of PCP in the COVID-19 era (37/1000 patient-years) was significantly higher than that in the pre-COVID-19 era (13.1/1000 patient-years) (p < 0.001). Co-infection with invasive pulmonary aspergillosis (IPA) also increased (2.4% vs. 18.3%, p = 0.013). Independent risk factors for PCP-related mortality were previous glucocorticoid use, hypoxemia, acute kidney injury, and IPA co-infection. Risk factors for IPA in patients with PCP included previous use of tyrosine kinase inhibitors, COVID-19 infection within 30 days, leukopenia, and intensive care unit admission. In the COVID-19 era, 12 (16.9%) patients with PCP had a history of COVID-19 infection within 90 days; however, infection was not associated with mortality. Active evaluation of patients with suspected PCP and assessment of IPA co-infection risk may help improve the outcomes of patients with PCP. Full article
(This article belongs to the Special Issue Fungal Disease Epidemiology: Current State and Future Prospects)
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Review

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12 pages, 251 KiB  
Review
Histoplasmosis in Taiwan: Case Summary and Literature Review
by Jui-Chi Hsu, Po-Hsun Chang, Chien-Hsiang Tai and Yi-Chun Chen
Life 2024, 14(6), 738; https://doi.org/10.3390/life14060738 - 7 Jun 2024
Viewed by 360
Abstract
Histoplasmosis is a global infection caused by the thermally dimorphic fungus, Histoplasma capsulatum complex. It is endemic in the United States, as well as in Central and South America. In Taiwan, histoplasmosis is rare, with the first reported case not occurring until 1977. [...] Read more.
Histoplasmosis is a global infection caused by the thermally dimorphic fungus, Histoplasma capsulatum complex. It is endemic in the United States, as well as in Central and South America. In Taiwan, histoplasmosis is rare, with the first reported case not occurring until 1977. We summarized a total of 17 cases reported in Taiwan over the past 40 years and provided detailed descriptions for four probable indigenous cases. Due to the lack of rapid diagnostic tools and clinical suspicion, histoplasmosis may be underdiagnosed in Taiwan. We recognize that a limitation of our review is the lack of data on the environmental surveillance for H. capsulatum complex in Taiwan. Conducting a further phylogenetic analysis on both environmental and clinical isolates would provide valuable evidence for the region. Full article
(This article belongs to the Special Issue Fungal Disease Epidemiology: Current State and Future Prospects)
13 pages, 501 KiB  
Review
Dermatophyte Infections Worldwide: Increase in Incidence and Associated Antifungal Resistance
by Caroline Kruithoff, Ahmed Gamal, Thomas S. McCormick and Mahmoud A. Ghannoum
Life 2024, 14(1), 1; https://doi.org/10.3390/life14010001 - 19 Dec 2023
Cited by 4 | Viewed by 3321
Abstract
The increase in incidence of superficial fungal infections combined with the emergence of antifungal resistance represents both a global health challenge and a considerable economic burden. Recently, dermatophytes, the main culprit causing superficial fungal infections, have started to exhibit antifungal resistance. This can [...] Read more.
The increase in incidence of superficial fungal infections combined with the emergence of antifungal resistance represents both a global health challenge and a considerable economic burden. Recently, dermatophytes, the main culprit causing superficial fungal infections, have started to exhibit antifungal resistance. This can be observed in some of the most common species such as Trichophyton rubrum and Trichophyton mentagrophytes. Importantly, the new subspecies, known as Trichophyton indotineae, has been reported to show high resistance to terbinafine, a first-line treatment for dermatophyte infections. Compounding these issues is the realization that diagnosing the causative infectious agents requires using molecular analysis that goes beyond the conventional macroscopic and microscopic methods. These findings emphasize the importance of conducting antifungal susceptibility testing to select the appropriate antifungal necessary for successful treatment. Implementing these changes may improve clinical practices that combat resistant dermatophyte infections. Full article
(This article belongs to the Special Issue Fungal Disease Epidemiology: Current State and Future Prospects)
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22 pages, 2042 KiB  
Review
The Fungal and Bacterial Interface in the Respiratory Mycobiome with a Focus on Aspergillus spp.
by Anna Rozaliyani, Budhi Antariksa, Fariz Nurwidya, Jamal Zaini, Findra Setianingrum, Firman Hasan, Husna Nugrahapraja, Humaira Yusva, Heri Wibowo, Anom Bowolaksono and Chris Kosmidis
Life 2023, 13(4), 1017; https://doi.org/10.3390/life13041017 - 14 Apr 2023
Cited by 3 | Viewed by 2384
Abstract
The heterogeneity of the lung microbiome and its alteration are prevalently seen among chronic lung diseases patients. However, studies to date have primarily focused on the bacterial microbiome in the lung rather than fungal composition, which might play an essential role in the [...] Read more.
The heterogeneity of the lung microbiome and its alteration are prevalently seen among chronic lung diseases patients. However, studies to date have primarily focused on the bacterial microbiome in the lung rather than fungal composition, which might play an essential role in the mechanisms of several chronic lung diseases. It is now well established that Aspergillus spp. colonies may induce various unfavorable inflammatory responses. Furthermore, bacterial microbiomes such as Pseudomonas aeruginosa provide several mechanisms that inhibit or stimulate Aspergillus spp. life cycles. In this review, we highlighted fungal and bacterial microbiome interactions in the respiratory tract, with a focus on Aspergillus spp. Full article
(This article belongs to the Special Issue Fungal Disease Epidemiology: Current State and Future Prospects)
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15 pages, 1165 KiB  
Review
The Role of Yeasts in Human Health: A Review
by Cátia Filipa Caetano, Carlos Gaspar, José Martinez-de-Oliveira, Ana Palmeira-de-Oliveira and Joana Rolo
Life 2023, 13(4), 924; https://doi.org/10.3390/life13040924 - 31 Mar 2023
Cited by 3 | Viewed by 2917
Abstract
The microbiome consists mostly of bacteria, but new evidence and developments in sequencing methods have shown that fungi play an important role in human health and in the stability of the microbiota. Scientific knowledge about the role of commensal fungi in intestinal, oral, [...] Read more.
The microbiome consists mostly of bacteria, but new evidence and developments in sequencing methods have shown that fungi play an important role in human health and in the stability of the microbiota. Scientific knowledge about the role of commensal fungi in intestinal, oral, vaginal and cutaneous communities has been increasing; however, more studies are still needed to better understand their action in these niches. To date, fungal research focuses primarily on opportunistic diseases caused by fungal species, leaving unclear the possible role of fungi as an integral part of the microbiota. Although they are much less abundant than bacteria, fungi such as species belonging to the genus Candida, Malassezia, Rhodotorula and Cryptococcus are some of the yeasts that have been in the focus of the scientific community because they inhabit various niches. In this review, we have summarized the current information about the yeasts that inhabit the human body, including some of the diseases that they can cause when the microbiota becomes unstable. Full article
(This article belongs to the Special Issue Fungal Disease Epidemiology: Current State and Future Prospects)
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16 pages, 568 KiB  
Review
Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021
by Bassey E. Ekeng, Asa E. Itam-Eyo, Iriagbonse I. Osaigbovo, Adilia Warris, Rita O. Oladele, Felix Bongomin and David W. Denning
Life 2023, 13(3), 689; https://doi.org/10.3390/life13030689 - 3 Mar 2023
Cited by 5 | Viewed by 1833
Abstract
Gastrointestinal histoplasmosis (GIH) is infrequently described in people without underlying HIV infection. We aimed to compare the clinical presentation of GIH in people with and without HIV infection. We conducted a literature search of published cases of GIH from 2001–2021 and found 212 [...] Read more.
Gastrointestinal histoplasmosis (GIH) is infrequently described in people without underlying HIV infection. We aimed to compare the clinical presentation of GIH in people with and without HIV infection. We conducted a literature search of published cases of GIH from 2001–2021 and found 212 cases. Of these, 142 (67.0%) were male, and 124 (58.5%) had HIV infection. Most cases were from North America (n = 88, 41.5%) and South America (n = 79, 37.3%). Of the 212 cases, 123 (58.0%) were included in both clinical and pathological analyses. The remainder were excluded as details about clinical and pathological findings were not available. Of the 123 cases, 41 had HIV infection while 82 were without HIV infection. The diagnosis was predominantly by histopathology (n = 109, 88.6%). A significant proportion of people with HIV infection had abdominal pain as the most predominant symptom of GIH compared to those without HIV infection (65.9% versus 41.9%, p < 0.05). The colon was the most affected site with a slightly higher proportion in those with HIV infection compared with cases without HIV infection (46.3% versus 42.7%). The commonest pathologic findings were caecal and ileal ulcers. Caecal ulcers were significantly more frequent in cases with HIV infection compared to those without HIV (32.1% versus 7.1%, p < 0.05). Despite being more common in people with HIV infection, GIH also affects people without HIV infection with similar clinical presentations. Full article
(This article belongs to the Special Issue Fungal Disease Epidemiology: Current State and Future Prospects)
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Other

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23 pages, 472 KiB  
Systematic Review
Clinical Cases of Coccidioidomycosis in the Americas in the Period 1950–2021: Epidemiology Data, Diagnosis, and Treatment
by María del Rocío Reyes-Montes, Adriana Anel León-García, María Guadalupe Frías-De-León, Gustavo Acosta-Altamirano, Erika Paola Sánchez-Saavedra, Isai Victoriano-Pastelín, Beatriz Meraz-Ríos and Esperanza Duarte-Escalante
Life 2023, 13(11), 2109; https://doi.org/10.3390/life13112109 - 24 Oct 2023
Viewed by 1080
Abstract
Coccidioidomycosis, caused by Coccidioides immitis and C. posadasii, causes significant morbidity and mortality, both in immunocompetent and immunocompromised people, mainly in endemic areas. The present work analyzed its epidemiology, diagnostic methods, and treatment by reviewing clinical cases published from 1950 to 2021. [...] Read more.
Coccidioidomycosis, caused by Coccidioides immitis and C. posadasii, causes significant morbidity and mortality, both in immunocompetent and immunocompromised people, mainly in endemic areas. The present work analyzed its epidemiology, diagnostic methods, and treatment by reviewing clinical cases published from 1950 to 2021. Fifty-nine articles were included, corresponding to 275 clinical cases. The results showed a higher incidence of coccidioidomycosis in the male gender than the female gender. The most affected age group was 31–40 years, and the most reported clinical presentation was disseminated with greater involvement in cutaneous and subcutaneous tissue, followed by the CNS, bone system, and peritoneum. The species most frequently reported was C. immitis. The most used treatment was azoles, followed by their combination with amphotericin B, monotherapy with amphotericin B, and alternative medicine. This work shows that epidemiological data outside the USA are still scarce. Serological tests are the preferred diagnostic method in daily medical practice, and cultures remain the gold standard. The treatment for coccidioidomycosis is ketoconazole and amphotericin B, individually or in combination. Full article
(This article belongs to the Special Issue Fungal Disease Epidemiology: Current State and Future Prospects)
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