Candidemia is a highly prevalent invasive fungal infection caused primarily by C. albicans, C. parapsilosis, C. glabrata (currently Nakaseomyces glabratus), C. tropicalis, and C. krusei (currently Pichia kudriavzevii). Risk factors for the development of candidemia include steroid-induced immunosuppression used in solid organ or hematopoietic transplantation, and neutropenia secondary to infectious or tumorous processes. Alterations in the gut microbiota in people living with HIV, caused by antiretroviral therapy, increase the possibility of colonization by C. albicans. Likewise, the presence of a central venous catheter, parenteral nutrition, and abdominal surgery stand out as the main risk factors for the development of candidemia. New diagnostic tools have been developed for the diagnosis of this mycosis that allow the identification of the main species, from improvements in conventional stains such as calcofluor white, which increases sensitivity, as well as technologies such as T2 Candida, MoiM assay, biomarker panel (1,3 β-D-glucan, C-reactive protein, presepsin, and procalcitonin), and, more recently, the development of biosensors for the identification of Candida spp. Regarding treatment, the use of micafungin and anidulafungin in patients with obesity defined by a BMI > 30 kg/m² has shown higher survival rates and therapeutic success. Meanwhile, newer antifungals such as rezafungin and fosmanogepix have demonstrated excellent results in the treatment of these patients. Therefore, this review aims to update the epidemiology and risk factors of candidemia, as well as analyze the diagnostic tools and treatments currently available.

COVID-19-associated pulmonary aspergillosis (CAPA) has had a high incidence. In addition, it has been associated with prolonged hospital stays, as well as several predisposing risk factors, such as fungal factors (nosocomial organism, the size of the conidia, and the ability of the Aspergillus spp. of colonizing the respiratory tract), environmental factors (remodeling in hospitals, use of air conditioning and negative pressure in intensive care units), comorbidities, and immunosuppressive therapies. In addition to these factors, SARS-CoV-2 per se is associated with significant dysfunction of the patient’s immune system, involving both innate and acquired immunity, with reduced CD4+ and CD8+ T cell counts and cytokine storm. Therefore, this review aims to identify the factors influencing the fungus so that coinfection with SARS-CoV-2 can occur. In addition, we analyze the predisposing factors in the fungus, host, and the immune response alteration due to the pathogenicity of SARS-CoV-2 that causes the development of CAPA.

Using orthopedic devices or prosthetic joints to treat various conditions is expected in a Traumatology and Orthopedics Unit. Recently, the materials used to build these different devices have evolved; however, pathogens can still infect these materials. Additionally, the immune system has limitations when defending against these pathogens, which results in bacterial infections like Staphylococcus aureus, Methicillin-susceptible Staphylococcus aureus (MSSA) and Methicillin-resistant Staphylococcus aureus (MRSA). A total of 276 patients who attended the Traumatology and Orthopedics Unit of our hospital from 1 June 2018 to 1 June 2019, were included in the present study. Our study analyzed the incidence of S. aureus and other bacterial pathogens in the surgical sites of patients with orthopedic implants, as well as the most used types of implants and implant materials. The specimens obtained from the surgical sites of the patients were cultured in anaerobic and aerobic media for subsequent identification using their phenotypic characteristics. Subsequently, antibiotic susceptibility tests were performed to establish the appropriate treatment. The primary pathogens identified were Staphylococcus aureus (26.4%), followed by Escherichia coli (21.0%) and Staphylococcus epidermidis (15.8%). The most commonly used implants were plates (41.7%), followed by endomedullary nails (20%), Kirschner wires (14.1%), and fixators (10.1%). As for the anatomical regions of the implants, the most frequent sites were the legs, followed by the thighs, wrists, and ankles. The pathogens were more susceptible to ciprofloxacin (95%), clindamycin (89%), and cefotaxime (86%). S. aureus is the primary infectious agent in our hospital, with an incidence of 26.4% after the placement of orthopedic implants. Although its incidence was lower compared to other tertiary hospitals, it is necessary to improve aseptic techniques in such a way as to reduce the incidence of this pathogen further.

Aspergillosis is one of the most common fungal infections worldwide, caused by various species belonging to the genus Aspergillus, affecting both immunocompetent and immunocompromised individuals. The objective of this review was to provide an update on the last five years regarding various aspects of this mycosis, including epidemiology, risk factors, diagnosis, susceptibility, and treatment. The results showed that aspergillosis is distributed throughout the world. Furthermore, A. terreus was found to be an increasing causative agent in cases of aspergillosis, along with other less common species. Regarding clinical forms, particularly in the case of Allergic Bronchopulmonary Aspergillosis (ABPA), it is necessary to consider patients with structural lung impairment (Chronic Obstructive Pulmonary Disease (COPD) and Interstitial Lung Diseases). Meanwhile, newly identified risk factors for the development of aspergillosis include chronic obstructive pulmonary disease (odds ratio 1.88) and interstitial lung disease (OR 3.71). Furthermore, the main diagnostic methodologies for aspergillosis were polymerase chain reaction (PCR), matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF), and next-generation sequencing (NGS). Additionally, the usefulness of isavuconazole compared to voriconazole was demonstrated, representing a better alternative for the treatment of aspergillosis, while novel antifungals such as olorofim and fosmanogepix show excellent results in the management of aspergillosis. Due to the discovery of new risk factors, coupled with antifungal resistance in Aspergillus spp. and the wide variety of diagnostic tools, individualized assessment of aspergillosis cases is necessary for the appropriate management of this mycosis.

Candida auris possesses distinctive features that facilitate its persistence and transmission in healthcare settings, causing outbreaks of infection that are difficult to treat. So, emphasis has been placed on implementing measures for controlling, eliminating, and preventing fungal transmission, such as environmental disinfection and patient decolonization. This review aimed to understand and analyze the agents for environmental disinfection and patient decolonization reported in the last 5 years. The PubMed database was reviewed, using the terms “Candida auris”, “disinfection”, and “decolonization”. Only original papers, published between 2020–2025, in English or Spanish, that included relevant information on the topic, were selected. After the selection process, 52 articles were chosen to analyze the agents for environmental disinfection and decolonization of C. auris. Natural and synthetic disinfectants and ultraviolet radiation were reported for the environmental disinfection, with variable efficacy, depending on factors such as concentration and exposure time. Natural and synthetic antiseptics were also reported for decolonization, with varying efficacy. For example, 2% chlorhexidine shows a 0.5 log reduction, while at concentrations >10% it is >4 log. However, most have only been tested in animal models. Based on the review, Far-UV-C radiation (222 nm) is safe and appropriate to mitigate (up to 1 log reduction) the spread of C. auris in the hospital setting. However, it is important to consider that the cost and limited availability of the device present a barrier to its implementation. Patient decolonization is still challenging nowadays due to the absence of agents with proven high efficacy in humans.

The objective of this work was to use the random amplification of the polymorphic DNA–polymerase chain reaction (RAPD-PCR) technique to select polymorphic patterns through qualitative and quantitative analyses to differentiate the species A. flavus, A. fumigatus, A. niger and A. tubingensis. Twenty-seven Aspergillus isolates from different species were typified using phenotypic (macro- and micromorphology) and genotypic (partial BenA gene sequencing) methods. Thirty-four primers were used to obtain polymorphic patterns, and with these a qualitative analysis was performed to select the primers that presented species-specific patterns to distinguish each species. For the quantitative selection, a database was built from the polymorphic patterns and used for the construction of logistic regression models; later, the model that presented the highest value of sensitivity against specificity was evaluated through ROC curves. The qualitative selection showed that the primers OPA-19, P54, 1253 and OPA-02 could differentiate the species. A quantitative analysis was carried out through logistic regression, whereby a species-specific correlation of sensitivity and specificity greater than 90% was obtained for the primers: OPC-06 with a 96.32% match to A. flavus; OPF-01 with a 100% match to A. fumigatus; OPG-13 with a 98.01% match to A. tubingensis; and OPF-07 with a 99.71% match to A. niger. The primer OPF-01 discriminated the four species as well as closely related species. The quantitative methods using the selected primers allowed discrimination between species and showed their usefulness for genotyping some of the species of medical relevance belonging to the genus Aspergillus.