Just finished watching the fantastic #IDWeek2020 session “Top Papers in Medical Mycology” by Drs. Jeniel Nett and @PeterGPappas, highly recommend watching. They covered notable papers, and I took a stab at high-level summaries with screenshots below. @MSG_ERC @IDSAInfo @SIDPharm
1) 10.1371/journal.ppat.1007460 – NDV-3A Vaccine protects mice against MDR-C. auris infection; N-terminus of Als3 protein (major adhesion/invasin from C. alb) formulated with alum; Anti-Als3 Abs in mice recognized C. auris in vitro, blocked biofilm/enhanced macrophage killing.
2) 10.1093/cid/ciaa016 – CSF early fungicidal activity as surrogate endpoint for Crypto mening. survival in trials. 738 pts w/ CM & serial LPs; EFA (pic1) measured thru d10 and pts with low EFA had sig. higher 18-wk mortality compared to higher EFA, also low EFA pts ~ low CD4s.
2) 10.1093/cid/ciaa016 – CSF early fungicidal activity as surrogate endpoint for Crypto mening. survival in trials. 738 pts w/ CM & serial LPs; EFA (pic1) measured thru d10 and pts with low EFA had sig. higher 18-wk mortality compared to higher EFA, also low EFA pts ~ low CD4s.
2) 10.1093/cid/ciaa016 – CSF early fungicidal activity as surrogate endpoint for Crypto mening. survival in trials. 738 pts w/ CM & serial LPs; EFA (pic1) measured thru d10 and pts with low EFA had sig. higher 18-wk mortality compared to higher EFA, also low EFA pts ~ low CD4s.
3a) 10.1038/s41586-019-1608-2 – Fungal mycobiome -> panc oncogenesis via mann binding lectin; Mycobiota expansion a/w panc ductal adeno CA; Despite expansion in burden, decreased diversity w/ inc Malassezia (20% pop.); AmB admin led to several anti-onc changes (pic 2).
3a) 10.1038/s41586-019-1608-2 – Fungal mycobiome -> panc oncogenesis via mann binding lectin; Mycobiota expansion a/w panc ductal adeno CA; Despite expansion in burden, decreased diversity w/ inc Malassezia (20% pop.); AmB admin led to several anti-onc changes (pic 2).
3a) 10.1038/s41586-019-1608-2 – Fungal mycobiome -> panc oncogenesis via mann binding lectin; Mycobiota expansion a/w panc ductal adeno CA; Despite expansion in burden, decreased diversity w/ inc Malassezia (20% pop.); AmB admin led to several anti-onc changes (pic 2).
3a) 10.1038/s41586-019-1608-2 – Fungal mycobiome -> panc oncogenesis via mann binding lectin; Mycobiota expansion a/w panc ductal adeno CA; Despite expansion in burden, decreased diversity w/ inc Malassezia (20% pop.); AmB admin led to several anti-onc changes (pic 2).
3b) Rechallenge w/ Malassezia -> inc tum wt/progression, but similar not shown for Aspergillus/Candida/Saccharo. Mannose binding lectin might be culpable -> fung recognition/complement activation/tum growth. Expression a/w dec surv in database pts. MBL disruption ~ inc survival.
4) 10.1128/JCM.01661-19 – Blastomycosis in S. Africa by B. percursus/emzantsi 1967-2014; Review of 20 “B. dermatiditis” cases; Clinical data (pic 1), all w/ extra-pulm dz, higher than expect for B. derm. Sequencing revealed B. percursus/emzantsi, significance (pic 2)
4) 10.1128/JCM.01661-19 – Blastomycosis in S. Africa by B. percursus/emzantsi 1967-2014; Review of 20 “B. dermatiditis” cases; Clinical data (pic 1), all w/ extra-pulm dz, higher than expect for B. derm. Sequencing revealed B. percursus/emzantsi, significance (pic 2)
4) 10.1128/JCM.01661-19 – Blastomycosis in S. Africa by B. percursus/emzantsi 1967-2014; Review of 20 “B. dermatiditis” cases; Clinical data (pic 1), all w/ extra-pulm dz, higher than expect for B. derm. Sequencing revealed B. percursus/emzantsi, significance (pic 2)
5) 10.1007/s11046-020-00431-2 – Redrawing endemic mycoses map; list of endemic mycoses (pic 1); Histo (pic 2), Blasto (pic 3) Coccy (pic 4). Summary, maps are changing with better reporting/improved diagnostics, climate change, migration/travel.
5) 10.1007/s11046-020-00431-2 – Redrawing endemic mycoses map; list of endemic mycoses (pic 1); Histo (pic 2), Blasto (pic 3) Coccy (pic 4). Summary, maps are changing with better reporting/improved diagnostics, climate change, migration/travel.
5) 10.1007/s11046-020-00431-2 – Redrawing endemic mycoses map; list of endemic mycoses (pic 1); Histo (pic 2), Blasto (pic 3) Coccy (pic 4). Summary, maps are changing with better reporting/improved diagnostics, climate change, migration/travel.
5) 10.1007/s11046-020-00431-2 – Redrawing endemic mycoses map; list of endemic mycoses (pic 1); Histo (pic 2), Blasto (pic 3) Coccy (pic 4). Summary, maps are changing with better reporting/improved diagnostics, climate change, migration/travel.
5) 10.1007/s11046-020-00431-2 – Redrawing endemic mycoses map; list of endemic mycoses (pic 1); Histo (pic 2), Blasto (pic 3) Coccy (pic 4). Summary, maps are changing with better reporting/improved diagnostics, climate change, migration/travel.
6) 10.1093/cid/ciaa1380 – STRIVE reza vs. capso for candidemia/candidiasis; Design (pic 1) two reza arms vs caspo w/ step-down fluc; High dose reza (400/wk) stopped after review unblinded early data; Overall cure d14 similar among groups (pic 2), no concerning safety trends.
6) 10.1093/cid/ciaa1380 – STRIVE reza vs. capso for candidemia/candidiasis; Design (pic 1) two reza arms vs caspo w/ step-down fluc; High dose reza (400/wk) stopped after review unblinded early data; Overall cure d14 similar among groups (pic 2), no concerning safety trends.
6) 10.1093/cid/ciaa1380 – STRIVE reza vs. capso for candidemia/candidiasis; Design (pic 1) two reza arms vs caspo w/ step-down fluc; High dose reza (400/wk) stopped after review unblinded early data; Overall cure d14 similar among groups (pic 2), no concerning safety trends.
7) 10.1093/cid/ciaa1204 – Phase 2 VT-1161 (oteseconazole) for acute VVC; Novelty in VT-1161 = higher specificity fungal CYP51, half-life >60 DAYS; Dose-finding (3 regimens) vs. fluc 150 x1 (Small n = 55), similar response rate, lower Cx (+) relapse w/ VT. Conclusions (pic1).
8) 10.1093/infdis/jiaa394 – Core recs for antifungal stewardship by @MSGERC; 7 core ASP elements specific to antifungals (1 leadership 2 accountability 3 expertise 4 education 5 ID C/s & bundles (pic 1), audits 6 surveillance 7 reporting/feedback; Encourage reading.
9) 10.1093/cid/ciaa826 –Superiority of Mp1p antigen EIA vs BACTEC bcx for dx of talaromycosis; The basics (pic 1), delay in dx/tx problematic. Samples from Cx + pts used. No Ag x-reactivity w/ other fungs. ROC curve (pic 2), superior to BCx, urine/serum can be used, ~6d quicker.
9) 10.1093/cid/ciaa826 –Superiority of Mp1p antigen EIA vs BACTEC bcx for dx of talaromycosis; The basics (pic 1), delay in dx/tx problematic. Samples from Cx + pts used. No Ag x-reactivity w/ other fungs. ROC curve (pic 2), superior to BCx, urine/serum can be used, ~6d quicker.
9) 10.1093/cid/ciaa826 –Superiority of Mp1p antigen EIA vs BACTEC bcx for dx of talaromycosis; The basics (pic 1), delay in dx/tx problematic. Samples from Cx + pts used. No Ag x-reactivity w/ other fungs. ROC curve (pic 2), superior to BCx, urine/serum can be used, ~6d quicker.
10) 10.1093/cid/ciz193 – Longitudinal non-HIV cryptococcosis in US n=145,CNS=71, 2/3 proven,1/3 prob; Characteristics (pic1),presentation – most w/o fever, neurologic/pulm sx varied by site; CrAg higher in CNS, delayed dx common, neuro complications (pic2), mortality (pic3).
10) 10.1093/cid/ciz193 – Longitudinal non-HIV cryptococcosis in US n=145,CNS=71, 2/3 proven,1/3 prob; Characteristics (pic1),presentation – most w/o fever, neurologic/pulm sx varied by site; CrAg higher in CNS, delayed dx common, neuro complications (pic2), mortality (pic3).
10) 10.1093/cid/ciz193 – Longitudinal non-HIV cryptococcosis in US n=145,CNS=71, 2/3 proven,1/3 prob; Characteristics (pic1),presentation – most w/o fever, neurologic/pulm sx varied by site; CrAg higher in CNS, delayed dx common, neuro complications (pic2), mortality (pic3).
10) 10.1093/cid/ciz193 – Longitudinal non-HIV cryptococcosis in US n=145,CNS=71, 2/3 proven,1/3 prob; Characteristics (pic1),presentation – most w/o fever, neurologic/pulm sx varied by site; CrAg higher in CNS, delayed dx common, neuro complications (pic2), mortality (pic3).
11a) 10.1093/cid/ciaa1298 – National strategy for CAPA Diagnosis in ICU; Prospective cohort, SOC = serum/BAL GM, Asp PCR, B-Dgluc, blood/deep resp Cx; Tx per discretion of MD. Among 135 screened, 51 (37%) ±1 pos mycologic test (30 Asp); Sig RF = high-dose ster, underlyin resp dz;
11b) Varying degree of IA by definition (pic 1), mortality sig higher in pts classified as having IFD, CAPA 57.9% (lower w/ approp tx), yeast infxns 47% (lower w/ approp tx). Conclusions (pic 2), need more prosp. data, accurate dx requires consistently applied definition.
11b) Varying degree of IA by definition (pic 1), mortality sig higher in pts classified as having IFD, CAPA 57.9% (lower w/ approp tx), yeast infxns 47% (lower w/ approp tx). Conclusions (pic 2), need more prosp. data, accurate dx requires consistently applied definition.
11b) Varying degree of IA by definition (pic 1), mortality sig higher in pts classified as having IFD, CAPA 57.9% (lower w/ approp tx), yeast infxns 47% (lower w/ approp tx). Conclusions (pic 2), need more prosp. data, accurate dx requires consistently applied definition.
Concluding remarks: It is a very exciting time in medical mycology and antifungal therapeutics! The antifungal pipeline is promising (fosmano, olorfim, ibrexafungerp, VT-1161, reza, oral ampho, etc.). Stay tuned! @IDSAInfo @SIDPharm @MSG_ERC @FungalDoc @GermHunterMD @ErinMcCreary
You can follow @MattDavis138.
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