Recent Trends in the Epidemiology of Fungal Infections

Seagle, Emma E; Williams, Samantha; Chiller, Tom

doi:10.1016/j.idc.2021.03.001

Cited by 54 publications

(57 citation statements)

References 141 publications

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“…C. auris was isolated in the following surveillance samples: axillary-rectal (46/153; 30.1%), axillary (22/28; 78.6%), inguinal (15/24; 62.5%), rectal (6/24; 25.0%), pharyngeal swabs (5/89; 5.6%), BAS (3/8; 37.5%), urine (3/5; 60.0%), and nasal swab (1/21; 4.8%). As for the environmental samples, a total of 33 C. auris were isolated (15.6%) in bed/bed rail (12 positive samples), medical devices (8), bedside table (7), computer keyboards/mice (3), and perfusion pumps (3). In four environmental samples, C. auris was detected in CC-Plus, with a colony count of 1-10 yeast colonies, but showed no growth in CC.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the patients with candidemia are critically ill, and have underlying diseases [ 3 ], and mortality rates for these patients are reported to be high: between 40% and 70% [ 3 , 4 , 5 , 6 ]. Additionally, epidemiological trends show a dramatic increase in the prevalence of fungal infections, with the identification of new at-risk groups, which is moreover worsened with the fact that the isolation of multidrug-resistant species is rising, as is the case of the emergence of the novel multidrug-resistant pathogenic yeast Candida auris [ 7 ]. Moreover, some fungal species, such as C. auris , have been shown to display good patient-to-patient transmission and prolonged environmental persistence in clinical settings, causing major outbreaks, especially in intensive care units (ICU) [ 8 , 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Novel Chromogenic Medium CHROMagarTM Candida Plus for Detection of Candida auris and Other Candida Species from Surveillance and Environmental Samples: A Multicenter Study

García

Palop

Martin

et al. 2022

JoF

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Epidemiological trends show a dramatic increase in the prevalence of fungal infections, and in the isolation of multidrug-resistant species, such as Candida auris. CHROMagarTM Candida (CC; CHROMagar, Paris, France) and other chromogenic media, which are widely used in the clinical laboratory because they allow a rapid identification of most Candida species. Recently, CHROMagarTM Candida Plus (CC-Plus; CHROMagar, Paris, France) was developed to detect and differentiate C. auris in addition to other major clinical Candida species, such as C. albicans, C. tropicalis, C. glabrata, or C. krusei. C. auris colonies display a differential light blue color with a blue halo. A multicentric study was designed to evaluate the performance of the CC-Plus medium in the detection of Candida species in patients’ surveillance and environmental samples from three Spanish hospitals with active C. auris outbreaks. A total of 364 patients’ surveillance samples and 212 environmental samples were tested. Samples were inoculated in CC and CC-Plus in parallel, and the plates were read at 24 and 48 h. All recovered colonies were presumptively identified according to colony color described by manufacturer, and the definitive identification was performed by mass spectrometry at 48 h. A total of 134 C. auris isolates were obtained (101 from patients’ surveillance samples, and 33 from environmental samples). Sensitivity, specificity, and predictive positive and negative values were 99.5%, 100%, 100%, and 99.1%, respectively, for the main clinical Candida species, showing that CC-Plus is comparable to CC, with the advantage of being able to differentiate C. auris from C. parapsilosis. Furthermore, CC-Plus was able to detect one C. albicans, one C. glabrata, and eight C. auris that did not grow in CC. Additionally, the yeast colonies were generally larger, suggesting that this novel medium could be a richer medium, and suitable for surveillance and environmental cultures of C. auris and other clinically relevant Candida species.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Novel Chromogenic Medium CHROMagarTM Candida Plus for Detection of Candida auris and Other Candida Species from Surveillance and Environmental Samples: A Multicenter Study

García

Palop

Martin

et al. 2022

JoF

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“…Although Candida and Aspergillus species remain the most common causative agents of invasive fungal diseases, there has been a worrying increase in regional fungal diseases and infections with invasive fungi of the genera Blastomyces , Coccidioides , Histoplasma , Cryptococcus , Pneumocystis , and Sporothrix [ 32 ]. New fungal diseases caused by fungi from different taxonomic groups are constantly emerging.…”

Section: Difference Of Sex and Gender Of The Human Host In Susceptibi...mentioning

confidence: 99%

The Multifaceted Role of Mating Type of the Fungus and Sex of the Host in Studies of Fungal Infections in Humans

Kraševec

2022

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This review discusses the inclusion of sex and gender variables in studies of fungal infections in humans at the pathogen, host, and antifungal trial levels. The mating type of some fungi, or perhaps more likely the absence of the other, appears to be associated with some infections. Sexual and parasexual reproduction of some fungi is an important mechanism for the development of antifungal drug resistance. Host sex or gender influences the incidence of some infections such as aspergillosis, cryptococcosis, paracoccidioidomycosis, dermatophytosis, and candidiasis due to differences in immune response, behavior, and awareness for early detection and treatment. Participant sex (and age) is relevant not only in clinical antifungal trials but also in preclinical studies. The dimensions of sex and gender are important determinants throughout the fungal infection process and in approaches to prevent or treat these infections, as well as in development of antifungal drugs. Failure to consider sex and gender may be detrimental to the holistic understanding of the processes involved in fungal infection.

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“…The mortality rate of candidemia can vary according to the immune status, age and comorbidities of the host. The all-cause mortality in patients can be as high as 25%, reaching 32% among cases ≥65 years of age and up to 70% in fulminant sepsis [2,3]. Although Candida albicans has been the most common causative agent for a long time, epidemiologic variations due to geographic locations, treatment regimens and patient conditions have emerged and a shift toward non-albicans Candida species has been reported [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…The all-cause mortality in patients can be as high as 25%, reaching 32% among cases ≥65 years of age and up to 70% in fulminant sepsis [2,3]. Although Candida albicans has been the most common causative agent for a long time, epidemiologic variations due to geographic locations, treatment regimens and patient conditions have emerged and a shift toward non-albicans Candida species has been reported [2][3][4][5]. An increasing use of antifungals as a prophylactic and preemptive treatment may be a part of this trend, giving rise to azole non-susceptible species including the Candida glabrata species complex (SC) [2,5,6].…”

Section: Introductionmentioning

confidence: 99%

The Emergence of Echinocandin-Resistant Candida glabrata Exhibiting High MICs and Related FKS Mutations in Turkey

Sığ

Sönmezer

Gülmez

et al. 2021

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The frequency of invasive fungal infections shows a rising trend as well as a high morbidity and mortality. Among the causative agents, a shift toward the non-albicans Candida species including Candida glabrata species complex is being observed in several centers. Echinocandin resistance is increasingly published; however, isolates presenting with an in vitro resistance have not yet been reported from Turkey. We, herein, report the first FKS mutant and phenotypically echinocandin-resistant C. glabrata clinical strains from a single center in Turkey. In a 43-year-old female patient, several enterocutaneous fistulae developed after a long term hospitalization period and several complicated surgeries. She eventually required parenteral nutrition via a tunneled central venous catheter (CVC). Following a number of bacteremic and fungemic episodes as well as intensive antimicrobial interventions (including fluconazole, caspofungin and anidulafungin), a CVC-related candidemia caused by C. glabrata was detected. The isolated strain yielded high minimum inhibitory concentration (MIC) values for echinocandins and was categorized as resistant. A resistance-related mutation was detected in FKS2 HS1 (D666V). Blood cultures remained negative after the removal of the CVC and treatment with caspofungin and high-dose fluconazole. Following this first case, two additional C. glabrata strains with high echinocandin MICs were isolated from the urine cultures of two unrelated patients from different wards with different mutations in FKS2 HS1 (S663P and delF659). Our findings indicate that routine antifungal susceptibility testing is crucial and underlines the need for attention for the increasing trend of acquired echinocandin resistance in C. glabrata.

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Recent Trends in the Epidemiology of Fungal Infections

Cited by 54 publications

References 141 publications

Novel Chromogenic Medium CHROMagarTM Candida Plus for Detection of Candida auris and Other Candida Species from Surveillance and Environmental Samples: A Multicenter Study

Novel Chromogenic Medium CHROMagarTM Candida Plus for Detection of Candida auris and Other Candida Species from Surveillance and Environmental Samples: A Multicenter Study

The Multifaceted Role of Mating Type of the Fungus and Sex of the Host in Studies of Fungal Infections in Humans

The Emergence of Echinocandin-Resistant Candida glabrata Exhibiting High MICs and Related FKS Mutations in Turkey

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