The epidemiology of candidemia varies geographically, and there is still scarce data on the epidemiology of candidemia in Latin America (LA). After extensive revision of medical literature, we found reliable and robust information on the microbiological aspects of candidemia in patients from 11 out of 21 medical centers from LA countries and 1 out of 20 from Caribbean countries/territories. Based on 40 papers attending our search strategy, we noted that C. albicans remains the most common species causing candidemia in our region, followed by C. parapsilosis and C. tropicalis. In Argentina, Brazil, and Colombia, a trend towards an increase in frequency of C. glabrata candidemia was observed. Although resistance rates to fluconazole is under 3%, there was a slight increase in the resistance rates to C. albicans, C. parapsilosis and C. tropicalis isolates. Echinocandin resistance has been reported in a few surveys, but no single study confirmed the resistant phenotype reported by using molecular methods. We highlight the importance of conducting continuous surveillance studies to identify new trends in terms of species distribution of Candida and antifungal resistance related to episodes of candidemia in LA. This information is critical for helping clinicians to prevent and control Candida bloodstream infections in their medical centers.

Antimicrobial resistance (AMR) in Candida species is an emerging global health threat. This study aims to document the implementation of standardized surveillance tools from the Global Antimicrobial Resistance and Use Surveillance System (GLASS) and to describe the distribution and antifungal resistance profiles of Candida species in bloodstream infections generated through the study outputs. The GLASS-Fungi pilot was a multicentre observational demonstration study where twenty-four laboratories were invited to collect and share Candida bloodstream infections (BSIs) data with the World Health Organization (WHO) using a standardized surveillance protocol and WHONET software. Data were collected for patients with laboratory-confirmed Candida bloodstream infections between January 2017 and July 2021. Participating sites were trained to collect, deduplicate, and report clinical and microbiological data. Patient demographic and microbiological data were summarized using descriptive statistics. The percent distribution of Candida species and resistance profiles were analysed with a 95% confidence interval (CI) calculated using robust standard errors clustered at the site level. Participating sites shared experiences with using the standardised GLASS surveillance tools and procedures through structured feedback forms and consultative meetings. This study was not designed to support causal inference or population-level generalization; analyses are descriptive and intended to illustrate outputs generated through pilot surveillance implementation. Fourteen laboratories from 13 countries contributed data from 3447 patients with candidemia. Overall, Candida albicans was the predominant species (37.6%; 95% CI: 33.8–41.5). C. albicans was most common in the Americas, Europe, and Africa, whereas Candida tropicalis was more prevalent in Southeast Asia. Candida auris was detected by two laboratories in Southeast Asia and Africa. Among isolates with interpretable antifungal susceptibility testing (AFST) results and corresponding established breakpoints, 13.6% (95% CI: 10.1–17.2%) were resistant to at least one antifungal, with fluconazole resistance highest among C. parapsilosis isolates (29.7%; 95% CI: 18.2–41.2). Challenges to scaling up fungal AMR surveillance globally included limited fungal laboratory testing capacity, restricted access to antifungal susceptibility testing, and lack of sustained funding, particularly in low and middle-income countries. The study was a global, multi-centre initiative to systematically collect and report surveillance data on Candida BSIs using standardised data collection tools and reporting procedures. The study identified major training capacity and infrastructure gaps. Addressing those is an essential step for anticipating and responding to emerging invasive fungal infections. This work was supported by the United States Centers for Disease Control and Prevention.

Highlights Fifteen liver transplant patients presented with oral candidiasis. The two prevalent types of candidiasis were atrophic and pseudomembranous. Candida albicans and Candida glabrata were the most prevalent species. Most isolates were susceptible to antifungal agents. ABSTRACT Objective: This study aimed to verify oral candidiasis, identify the causative species, and investigate the antifungal susceptibility of yeasts isolated from liver transplant patients. Methods: A descriptive analysis of 97 patients who underwent liver transplantation was conducted at a hospital. Two clinical examinations

A 49-year-old patient with changes in the nails of the hallux for 10 years was diagnosed with onychomycosis. The identity of the causative agent was confirmed as Cladosporium halotolerans from the Cladosporium sphaerospermum species complex using molecular techniques. MALDI-TOF identified the agent as C. sphaerospermum complex species. Overall, species such as onychomycosis agents should attract special attention to avoid mistakes in the identification process while considering a probable contaminant as responsible for the disease. These species deserve attention since

Histoplasma capsulatum is a saprophytic dimorphic fungus that causes histoplasmosis, a systemic infectious disease of relevance to public health. Bats can be important agents in the epidemiological cycle of the disease since they act as reservoirs of microorganisms. The aim of this study was to detect Histoplasma capsulatum in the lung tissue of bats captured in urban forest fragments in the municipality of Rio Branco, Acre, in the Western Amazon. Twenty-two bat species were captured from five urban forest fragments. The samples taken were subjected to histopathological, mycological, and molecular analysis. Among the 96 animals analyzed, the fungus was detected in 32.29% (31/96). This was the first study to detect the pathogen in bats in the Western Amazon. It is also the first record of the fungus being detected in six bat species. The state of Acre is located in a region with a rich diversity of bats. Furthermore, this area is constantly suffering from climatic and environmental changes that can favor the emergence and re-emergence of diseases. Thus, active epidemiological research and surveillance of neglected fungal infections are essential, especially considering the concept of One Health.

Background: Hepatitis delta (HDV) is the most severe form of chronic viral hepatitis, with rapid progression to cirrhosis and hepatocellular carcinoma, and remains neglected in the Amazon Basin. The state of Acre, in the Western Brazilian Amazon, is endemic for HDV, with a high prevalence of genotype 3 (HDV-3). This study aimed to analyze epidemiological data, quantify HDV RNA, identify genotypes, and describe the phylogeny and phylogeography of HDV in Acre. Methods: This cross-sectional study included patients positive for HBsAg and anti-HDV under follow-up at the Specialized Assistance Service (SAE) in Rio Branco, Acre, between March and November 2023. Blood samples were collected for HDV RNA quantification using one-step RT-qPCR. Samples with detectable viremia (Ct ≤ 30) underwent Nested-PCR, Sanger sequencing, phylogenetic analysis (Maximum Likelihood), temporal signal evaluation, and Bayesian phylogeographic reconstruction. Results: Among 108 patients (median age 43; 55.6% female), HDV RNA was detected in 48.1%, with viral loads ranging from 140 to 24,000,000 copies/mL. Of these, 55.8% had >100,000 copies/mL. Genotyping (n = 41) identified exclusively HDV-3. Phylogenetic analysis revealed genetic heterogeneity among HDV-3 isolates, with the formation of two major phylogenetic clades. Bayesian analysis estimated tMRCA around 1818 and suggested dispersion from Amazonas to Acre and neighboring regions. Conclusion: HDV-3 predominates in Acre with high genetic diversity, indicating sustained viral circulation in the Western Amazon and reinforcing the need for improved surveillance and diagnosis.