Short Tandem Repeat Genotyping and Antifungal Susceptibility Testing of Latin American Isolates.

is emerging as one of the most common species causing opportunistic infections in Latin America. Outbreak events caused by were reported, and antifungal resistant isolates are on the rise. In order to investigate population genomics and look into antifungal resistance, we applied a short tandem repeat (STR) genotyping scheme and antifungal susceptibility testing (AFST) to 230 clinical and environmental isolates from Latin American countries.

Quandaries of deciding when to change first-line therapy in invasive pulmonary aspergillosis.

We read the excellent viewpoint by Slavin et al. (J Antimicrob Chemother 2022; 77: 16-23) that draws upon the experience of an advisory board of notable experts to comprehensively address many of the clinical factors that drive the need for changes in antifungal therapy for invasive aspergillosis (IA). As noted by the authors, there remains a paucity of quality data to support many of the decisions faced by clinicians managing patients with IA.

The emerging threat antifungal-resistant in humans, animals, and environment.

Antifungal resistance in humans, animals, and the environment is an emerging problem. Among the different fungal species that can develop resistance, is ubiquitous and causes infections in animals and humans. In Asia and some Latin American countries, is among the most common species related to candidemia, and mortality rates are usually above 40%.

A Brazilian Inter-Hospital Candidemia Outbreak Caused by Fluconazole-Resistant in the COVID-19 Era.

Horizontal transmission of fluconazole-resistant (FRCP) through healthcare workers' hands has contributed to the occurrence of candidemia outbreaks worldwide. Since the first COVID-19 case in Brazil was detected in early 2020, hospitals have reinforced hand hygiene and disinfection practices to minimize SARS-CoV-2 contamination. However, a Brazilian cardiology center, which shares ICU patients with a cancer center under a FRCP outbreak since 2019, reported an increased FRCP candidemia incidence in May 2020.

COVID-19-associated aspergillosis in a Brazilian referral centre: Diagnosis, risk factors and outcomes.

Background: COVID-19 patients on mechanical ventilation are at risk to develop invasive aspergillosis. To provide additional data regarding this intriguing entity, we conducted a retrospective study describing risk factors, radiology and prognosis of this emerging entity in a Brazilian referral centre.

Methods: This retrospective study included intubated (≥18 years) patients with COVID-19 admitted from April 2020 until July 2021 that had bronchoscopy to investigate pulmonary co-infections.

Nanopore Genome Sequencing and Variant Analysis of the Susceptible Candida auris Strain L1537/2020, Salvador, Brazil.

Candida auris has been reported worldwide, but only in December 2020, the first strain from a COVID-19 patient in Brazil was isolated. Here, we describe the genome sequence of this susceptible C. auris strain and performed variant analysis of the genetic relatedness with strains from other geographic localities.

Environmental Clonal Spread of Azole-Resistant with Erg11-Y132F Mutation Causing a Large Candidemia Outbreak in a Brazilian Cancer Referral Center.

Clonal outbreaks due to azole-resistant (ARCP) isolates have been reported in numerous studies, but the environmental niche of such isolates has yet to be defined. Herein, we aimed to identify the environmental niche of ARCP isolates causing unremitting clonal outbreaks in an adult ICU from a Brazilian cancer referral center. sensu stricto isolates recovered from blood cultures, pericatheter skins, healthcare workers (HCW), and nosocomial surfaces were genotyped by multilocus microsatellite typing (MLMT).

Emergence of in Brazil in a COVID-19 Intensive Care Unit.

In December 2020, emerged in Brazil in the city of Salvador. The first two colonized patients were in the same COVID-19 intensive care unit. Antifungal susceptibility testing showed low minimal inhibitory concentrations of 1 µg/mL, 2 µg/mL, 0.

Paracoccidioidomycosis in Immunocompromised Patients: A Literature Review.

(PCM) is an endemic mycosis found in Latin America that causes systemic disease mostly in immunocompetent hosts. A small percentage of PCM occurs in immunocompromised patients where low clinical suspicion of the infection, late diagnosis, and uncertainties about its management are factors that negatively impact their outcomes. We conducted a literature review searching reports on PCM associated to HIV, cancer, maligned hemopathies, solid organ transplantation, and immunotherapies, in order to check for peculiarities in terms of natural history and challenges in the clinical management of PCM in this population.

An Azole-Resistant Outbreak: Clonal Persistence in the Intensive Care Unit of a Brazilian Teaching Hospital.

The incidence of candidemia by the complex has increased considerably in recent decades, frequently related to use of indwelling intravascular catheters. The ability of this pathogen to colonize healthcare workers (HCW)' hands, and to form biofilm on medical devices has been associated with the occurrence of nosocomial outbreaks and high mortality rates. Fluconazole has been the leading antifungal drug for the treatment of invasive candidiasis in developing countries.

Evaluation of Vitek MS for Differentiation of and Genotypes.

and are the main pathogenic species of invasive cryptococcosis among the species. Taxonomic studies have shown that these two taxa have different genotypes or molecular types with biological and ecoepidemiological peculiarities. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been proposed as an alternative method for labor-intensive methods for and genotype differentiation.

Chronic Meningitis and Hydrocephalus due to in Immunocompetent Adults: A Challenging Entity.

Chronic meningitis caused by sp. is occasionally described in immunosuppressed patients. We report the challenges in diagnosing and managing 2 nonimmunocompromised patients with hydrocephalus and chronic meningitis caused by .

Evaluating and Improving Vitek MS for Identification of Clinically Relevant Species of Trichosporon and the Closely Related Genera Cutaneotrichosporon and Apiotrichum.

species are relevant etiologic agents of hospital-acquired infections. High mortality rates are attributed to deep-seated infections in immunocompromised individuals, making fast and accurate species identification relevant for hastening the discovery of best-targeted therapy. Recently, taxonomy has been reassessed, and three genera have been proposed for the pathogenic species: , , and Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has replaced old phenotypic methods for microorganism identification in clinical laboratories, but spectral profile databases have to be evaluated and improved for optimal species identification performance.

Rapid identification of moulds and arthroconidial yeasts from positive blood cultures by MALDI-TOF mass spectrometry.

Moulds and arthroconidial yeasts are potential life-threatening agents of fungemia in immunocompromised patients. Fast and accurate identification (ID) of these pathogens hastens initiation of targeted antifungal therapy, thereby improving the patients' prognosis. We describe a new strategy that enabled the identification of moulds and arthroconidial yeasts directly from positive blood cultures by MALDI-TOF mass spectrometry (MS).

Evaluation of VITEK 2 for discriminating Trichosporon species: misidentification of Trichosporon non-T. asahii.

The VITEK 2 system was evaluated for the identification of 74 Trichosporon invasive and non-invasive clinical isolates, comparing its results with the IGS1 sequencing. The system correctly identified Trichosporon asahii but not non-T. asahii isolates, which represented nearly 50% of the invasive infections in our nosocomial setting.