Fusarium is widely distributed in the environment and is involved with plant and animal diseases. In humans, several species and species complexes (SC) are related to fusariosis, i.e., F. solani SC, F. oxysporum SC, F. fujikuroi SC, F. dimerum, F. chlamydosporum, F. incarnatum-equiseti , and F. sporotrichoides . We aimed to investigate the susceptibility of Fusarium clinical isolates to antifungals and azole fungicides and identify the species. Forty-three clinical Fusarium isolates were identified by sequencing translation elongation factor 1-alpha ( TEF1 α) gene. Antifungal susceptibility testing was performed to the antifungals amphotericin B, itraconazole, voriconazole, posaconazole, and isavuconazole, and the azole fungicides difenoconazole, tebuconazole, and propiconazole. The isolates were recovered from patients with median age of 36 years (range 2–78 years) of which 21 were female. Disseminated fusariosis was the most frequent clinical form ( n = 16, 37.2%) and acute lymphoblastic leukemia ( n = 7; 16.3%) was the most commonly underlying condition. A few species described in Fusarium solani SC have recently been renamed in the genus Neocosmospora , but consistent naming is yet not possible. Fusarium keratoplasticum FSSC 2 ( n = 12) was the prevalent species, followed by F. petroliphilum FSSC 1 ( n = 10), N. gamsii FSSC 7 ( n = 5), N. suttoniana FSSC 20 ( n = 3), F. solani sensu stricto FSSC 5 ( n = 2), Fusarium sp. FSSC 25 ( n = 2), Fusarium sp. FSSC 35 ( n = 1), Fusarium sp. FSSC18 ( n = 1), F. falciforme FSSC 3+4 ( n = 1), F. pseudensiforme ( n = 1), and F. solani f. xanthoxyli ( n = 1). Amphotericin B had activity against most isolates although MICs ranged from 0.5 to 32 μg mL -1 . Fusarium keratoplasticum showed high MIC values (8–>32 μg mL -1 ) for itraconazole, voriconazole, posaconazole, and isavuconazole. Among agricultural fungicides, difenoconazole had the lowest activity against FSSC with MICs of >32 μg mL -1 for all isolates.

Cryptococcus neoformans is an opportunistic basidiomycete yeast that causes life-threatening infections as meningoencephalitis primarily in immunocompromised hosts, generally associated with AIDS. The source of this organism is mainly pigeon excreta; however, other avian species' excreta are implicated as a source of this yeast. The occurrence of C. neoformans and Cryptococcus gattii in bird excreta in the state of Paraná in Brazil was determined in this study. A total of 141 samples of Passerine and Psittacine excreta from captive birds were collected. Additionally, 25 clinical samples from Hospital de Clínicas, in the state of Paraná were also analyzed. The determination of molecular and mating type of the isolates was performed by PCR fingerprinting, multiplex PCR, and mating type PCR. Cryptococcus neoformans var. grubii (VNI) was isolated from 36 (25.53%) of Passerine and Psittacine excreta samples. Almost all clinical samples, except one (C. gattii VGI), were classified as C. neoformans var. grubii (VNI). All environmental and clinical isolates were mating type alpha. These findings reinforce that, besides pigeon excreta, the excreta of these birds can also be a reservoir of C. neoformans in domestic and public environments and is of zoonotic importance to immunocompromised patients.

Vulvovaginal candidiasis affects women of reproductive age, which represents approximately 15–25% of vaginitis cases. The present study aimed to isolate and characterize yeast from the patients irrespective of the presentation of clinical symptoms. The isolates were subjected to in vitro susceptibility profile and characterization by molecular markers, which intended to assess the distribution of species. A total of 40 isolates were obtained and identified through the CHROMagar, API20aux and by ITS and D1/D2 regions sequencing of DNAr gene. Candida albicans strains were genotyped by the ABC system and the isolates were divided into two genotypic groups. The identity of the C. albicans, C. glabrata, C. guilliermondii, C. kefyr and Saccharomyces cerevisiae isolates was confirmed by the multilocus analysis. The strains of Candida, isolated from patients with complications, were found to be resistant to nystatin but sensitive to fluconazole, amphotericin B and ketoconazole, as observed by in vitro sensitivity profile. The isolates from asymptomatic patients, i.e., the colonized group, showed a dose-dependent sensitivity to the anti-fungal agents, fluconazole and amphotericin B. However, the isolates of C. albicans that belong to distinct genotypic groups showed the same in vitro susceptibility profile.

We report 3 cases of patients with Candida haemulonii isolates that were obtained from hemocultures. In 2 of the 3 cases, isolates exhibited resistance to echinocandins and fluconazole. This is the first report of an echinocandin-resistant species of this fungus in pediatric patients. CASE REPORTSC ase 1. A female Down syndrome patient aged 1 year and 7 months and diagnosed with cardiopathy (total atrioventricular septal defect) was hospitalized on 24 November 2009 for total surgical correction. During surgery, a double-lumen central venous catheter (CVC) was inserted in the right internal jugular vein. The patient exhibited good postsurgical recovery; the CVC was withdrawn and she was discharged from the intensive care unit (ICU) on 7 December 2009. Subsequently, she presented with chylothorax and was readmitted into the ICU 3 days later for drainage. Her fever was treated with cefepime and then vancomycin. On 14 December 2009, a new CVC was inserted, without any complications. A blood culture (BC) from the catheter was positive for coagulase-negative Staphylococcus. A new BC was obtained, and treatment with amphotericin B deoxycholate and meropenem was initiated. The BC showed growth of Candida haemulonii. Ultrasonography showed pleural effusion with septations; surgical debridement was performed to remove necrotic tissue from the lung apex. On 13 January 2010, a new episode of sepsis occurred, with the BC testing positive for C. haemulonii. Amphotericin B deoxycholate was replaced with liposomal amphotericin B and fluconazole. The patient exhibited good clinical recovery with this new antifungal treatment and completed 20 days of treatment. She was discharged on 12 February 2010 after the results of 2 BCs were negative.Case 2. A 9-year-old female patient was hospitalized on 9 April 2010 with febrile neutropenia following chemotherapy for Ewing's sarcoma. She was treated with piperacillin-tazobactam according to the institutional protocol for febrile neutropenia. Three days later, she was underwent an odontological evaluation due to a suspected dental abscess, which confirmed the suspicion; she subsequently required drainage. On the next day, the antibiotic was replaced with imipenem. On the seventh and eighth day of admission, she had a fever of approximately 38°C. On the 10th day of admission, an echocardiogram showed an image on the interatrial septum, which suggested vegetation or a thrombus, and subsequently, vancomycin treatment was initiated. On the 19th day of admission, an echocardiography showed an increase in the size of the vegetation. Antibiotics were maintained through peripheral venous access (PVA). On the 22nd day, she presented with fever (38.5°C) and hyperemia at the PVA site together with pain at the insertion point of the catheter, and a new BC was collected. The culture showed the presence of C. haemulonii, probably due to phlebitis at the PVA site. Amphotericin B deoxycholate was administered for 14 days. The patient exhibited resolution of endocarditis after 28 days of antibiotics; the B...