Immunologic Diagnosis of Endemic Mycoses

Almeida‐Paes, Rodrigo; Bernardes-Engemann, Andréa Reis; Motta, Beatriz da Silva; Pizzini, Cláudia Vera; Almeida, Marcos de Abreu; Muniz, Mauro de Medeiros; Dias, Renata Alves Barcelos; Zancopé‐Oliveira, Rosely Maria

doi:10.3390/jof8100993

Cited by 15 publications

(17 citation statements)

References 190 publications

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“…Gp43, de 43 kDa, es el principal antígeno específico de superficie utilizado en pruebas serológicas que tienen una sensibilidad entre el 85 y el 100 %. Sin embargo, se han informado falsos negativos en pacientes infectados con P. lutzii, probablemente, por cambios genéticos de la especie que disminuyen la expresión de gp43, así como resultados falsos positivos por reacciones cruzadas con otros hongos (28)(29)(30)(31).…”

Section: Diagnósticounclassified

Diagnóstico micológico de paracoccidioidomicosis en un hospital de área no endémica: metodología clásica y molecular

Fernández,

Toranzo,

Farias

et al. 2023

biomedica

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Introducción. La paracoccidioidomicosis es una micosis sistémica y endémica en Latinoamérica. El cambio climático y el movimiento migratorio del huésped enfatizan la necesidad de optimizar el diagnóstico de esta infección.Objetivo. Evaluar la implementación de la detección de ADN de Paracoccidioides spp. al diagnóstico micológico de pacientes con sospecha de paracoccidioidomicosis.Materiales y métodos. Estudio retrospectivo con datos de laboratorio de pacientes con sospecha de paracoccidioidomicosis en un hospital de área no endémica.Resultados. Se analizaron los resultados de las muestras de 19 pacientes con sospecha clínica de paracoccidioidomicosis. El 90 % de los pacientes había nacido o visitado un área endémica de esta micosis en Latinoamérica. En 14 pacientes varones adultos se confirmó paracoccidioidomicosis por diagnóstico convencional. El examen directo fue positivo en 12 pacientes con enfermedad comprobada y en 4 de ellos se obtuvo crecimiento del hongo. Se detectaron anticuerpos contra Paracoccidioides spp. en ocho pacientes con la enfermedad. Se realizó PCR anidada con muestras de 14 pacientes para detectar ADN de Paracoccidioides spp. En 9 de los 10 pacientes con diagnóstico convencional de paracoccidioidomicosis se obtuvo una prueba de PCR positiva.Conclusiones. La implementación de técnicas moleculares para detectar ADN de Paracoccidioides spp. complementa el diagnóstico convencional de paracoccidioidomicosis y permite instaurar el tratamiento antifúngico, sobre todo en los casos clínicos donde no se observa la presencia del hongo en las muestras clínicas. La migración actual de poblaciones humanas dificulta el diagnóstico de paracoccidioidiomicosis y otras infecciones endémicas, por lo que se requiere optimizar el diagnostico micológico en los laboratorios clínicos para tratar pacientes con este tipo micosis desatendida.

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Section: Diagnósticounclassified

Diagnóstico micológico de paracoccidioidomicosis en un hospital de área no endémica: metodología clásica y molecular

Fernández,

Toranzo,

Farias

et al. 2023

biomedica

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“…1 , 2 , 3 , 4 , 5 The current method for diagnosis of these fungal infections used by many laboratories is microscopic examination. 6 , 7 , 8 , 9 However, final diagnosis may be inconclusive due to the similar morphologies of different genera and among individual species within a genus. Biochemical tests, selective fungal culture media, and extended incubation may be required to obtain the correct identification.…”

Section: Introductionmentioning

confidence: 99%

“…One study focuses on detecting hyphae, which is defining a structure of fungal infections. 7 Another study focuses on classifying the infections based on microscopic morphology. 11 Koo et al 10 presented automated detection of superficial fungal infections (i.e., hyphae) from microscopic images with 40x and 100x magnifications using an object detection convolutional neural network (CNN).…”

Section: Introductionmentioning

confidence: 99%

Classification of fungal genera from microscopic images using artificial intelligence

Rahman¹,

Clinch²,

Reynolds³

et al. 2023

Journal of Pathology Informatics

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“…Other vulnerable groups include the elderly population and intensive care unit patients with severely debilitating conditions, namely respiratory viral infections such as Coronavirus disease (COVID-19) and influenza, which underlie the development of COVID-19associated aspergillosis (CAPA) [10,11] and influenza-associated aspergillosis (IAPA) [12]. Traveling to and from endemic regions, whose climate and general conditions are favorable to the development of specific infections, including coccidioidomycosis, histoplasmosis, paracoccidioidomycosis and cryptococcosis (Cryptococcus gatti), further potentiates the dissemination of endemic mycoses to nonendemic areas [13][14][15], which in the case of Portugal, might be due to the high number of South American and African citizens [14].…”

Section: Introductionmentioning

confidence: 99%

Clinical mycology capacity and access to antifungal treatment in Portugal

Fernandes,

Carvalho,

Salmanton-García

et al. 2023

Preprint

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The success of the clinical management of invasive fungal diseases (IFD) is highly dependent on the availability of suitable tools for the timely and accurate diagnosis for effective treatment. Unfortunately, the lack of appropriate diagnostic tools remains still one major hurdle contributing to the high mortality rates associated with these infections. An in-depth analysis of the ability of European institutions to promptly and accurately diagnose IFD was previously conducted to identify limitations and aspects to improve. Here, we evaluated and discuss the specific case of Portugal, for which, to our knowledge, there are no reports describing the national mycological diagnostic capacity and access to antifungal treatments. Data from 16 Portuguese medical institutions were collected via an online electronic case report form covering different parameters, including institution profile, self-perceived IFD incidence, target patients, diagnostic methods and reagents, and available antifungals. The majority of participating institutions (69%) reported a low-very low incidence of IFD, with Candida spp. indicated as the most relevant fungal pathogen, followed by Aspergillus spp., and Cryptococcus spp. All the institutions had access to culture and microscopy, whereas 94% and 88% were able to run antigen-detection assays and molecular tests, respectively. Regarding the antifungal availability in the country, 100% of the institutions capable of providing antifungal therapy, declared to have access to at least one formulation. However, echinocandins were only available at 85% of the sites. Therapeutic drug monitoring (TDM) was reported to remain a very restricted practice in Portugal, being available in 19% of the institutions, with the TDM of itraconazole and posaconazole performed in only 6% of them. Importantly, despite some of these resources being well-represented among Portuguese institutions, most of them are outsourced to external entities. With the exception of TDM, Portugal appears to be well-prepared with regard to the overall capacity to diagnose and treat IFD. Future efforts should focus on promoting the widespread availability of TDM and improved access to multiple classes of antifungals, to further improve patient outcomes.

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Immunologic Diagnosis of Endemic Mycoses

Cited by 15 publications

References 190 publications

Diagnóstico micológico de paracoccidioidomicosis en un hospital de área no endémica: metodología clásica y molecular

Diagnóstico micológico de paracoccidioidomicosis en un hospital de área no endémica: metodología clásica y molecular

Classification of fungal genera from microscopic images using artificial intelligence

Clinical mycology capacity and access to antifungal treatment in Portugal

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