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Refractory fungal infection: Three case reports highlighting good practice.
Med Mycol Case Rep
December 2024
Public Health Wales Mycology Reference Laboratory, University Hospital of Wales, Heath Park Way, CF14 4XW, Cardiff, United Kingdom.
Refractory invasive fungal disease is a significant clinical problem, with high morbidity, mortality and costs. The complex causes of refractory infection include breakthrough infection due to antifungal resistance (both innate and acquired), suboptimal therapy and impaired immune responses in critically ill or immunocompromised patients. This case series details three reports on the identification and management of refractory fungal infections, two cases of azole resistance and one case of resistant candidiasis, highlighting the importance of accurate diagnosis, monitoring, implementation of biomarkers (serological markers, PCR), antifungal susceptibility testing and antifungal stewardship to optimise management and minimise risks of emergence of drug resistance.
View Article and Find Full Text PDFAntifungal stewardship in the UK: where are we now?
JAC Antimicrob Resist
February 2025
Public Health Wales Mycology Reference Laboratory, UHW, Heath Park, Cardiff CF14 4XW, UK.
Background: Antifungal stewardship (AFS) is the judicious use of today's antifungal agents with the aim of improving patient outcomes and preserving their future effectiveness. Antifungal resistance (AFR) is increasing globally, with more patients at risk of Invasive Fungal Disease (IFD), highlighting the urgent need to standardize AFS practices in the UK. The aim of this position paper is to understand the current AFS landscape in the UK.
View Article and Find Full Text PDFAntifungal susceptibility profile of Candida species and uncommon yeasts from drug abusers with oral candidiasis.
BMC Oral Health
December 2024
Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
In Iran, there is limited information regarding the species distribution and antifungal susceptibility profiles of yeast isolates from drug addicts suffering from oral candidiasis (OC). In this study, 104 yeast isolates, including 98 Candida species and 6 uncommon yeasts, were collected from 71 drug abusers with OC. The susceptibility profiles of Candida spp.
View Article and Find Full Text PDFAudit for antifungal treatment usage in adults with invasive fungal infection: A prospective observational study.
Indian J Med Microbiol
December 2024
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India. Electronic address:
Objective: The antifungal audit aimed to evaluate antifungal usage in a tertiary care center. It focused on patient profiles, the appropriateness of antifungal use, associated adverse drug reactions, reasons for suboptimal usage, and the economic burden caused by prolonged non-optimal antifungal use.
Methodology: Conducted at All India Institute of Medical Sciences, New Delhi, India from January 2019 to December 2020, the study evaluated systemic antifungal use in 100 hospitalized adults with invasive fungal infections.
Invasive Candidiasis.
Infect Dis Clin North Am
December 2024
University of Alabama at Birmingham, 1900 University Boulevard, 223 THT, Birmingham, AL 35294, USA. Electronic address:
Invasive candidiasis (IC) is a term that refers to a group of infectious syndromes caused by a variety of Candida species, 6 of which cause the vast majority of cases globally. Candidemia is probably the most commonly recognized syndrome associated with IC; however, Candida species can cause invasive infection of any organ, especially visceral organs, vasculature, bones and joints, eyes, and central nervous system. The optimal use of these newer diagnostics coupled with a thoughtful clinical assessment of at-risk patients and the judicious use of effective antifungal therapy is a key to achieving good antifungal stewardship and improved patient outcomes.
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