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Candidemia is the predominant form of invasive candidiasis and the most frequently occurring serious fungal infection in critically ill patients in Intensive Care Units (ICU). Studies carried out in Latin America reveal a higher incidence of candidemia and higher mortality rates when compared to North America or Europe. This highlights the need to develop guidelines for correctly diagnosing and treating candidemia in critically ill patients in the ICU. These guidelines are part of the efforts to implement antifungal optimization programs in the region to obtain better clinical outcomes and promote rational antifungal use. This evidence-based clinical standard, established through expert consensus for the Latin American context, contains recommendations and algorithms for diagnosing and treating candidemia in critically ill ICU patients., Competing Interests: Conflicts of interest The following authors declared that they have no conflict of interest: MSJ, CDB, RRR, CJEA, LCN. The following authors declared conflicts of interest: JAC (Pfizer), MCV (Pfizer), PMP (GlaxoSmithKline), MN (Mundipharma, Knight Therapeutics, Cidara Therapeutics), CAA (Moderna, Merck Sharp & Dohme, GlaxoSmithKline, Becton Dickinson, Pfizer), FQT (IMMY, Sandoz, Mundipharma), RR (Gilead Sciences, Gador, Pfizer), RRF (Pfizer, Gilead Sciences, Merck Sharp & Dohme), FR (Gilead Sciences, Janssen: Pharmaceutical Companies of Johnson & Johnson), PC (Pfizer, Merck Sharp & Dohme), DEC (IMMY), LECP (Knight Therapeutics), JZ (Pfizer), ARH (Octapharma, Pfizer, Medtronic), ALC (Grant from the Research Support Foundation of the State of São Paulo [FAPESP], number 2021/10,599–3), without identifying declared interests that could be considered potentially conflicting with the primary interest of this EBCS., (Copyright © 2024 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Mucormycosis is an aggressive, invasive fungal infection caused by moulds in the order Mucorales. Early diagnosis is key to improving patient prognosis, yet relies on insensitive culture or non-specific histopathology. A pan-Mucorales specific monoclonal antibody (mAb), TG11, was recently developed. Here, we investigate the spatio-temporal localisation of the antigen and specificity of the mAb for immunohistochemistry., Methods: We use immunofluorescence (IF) microscopy to assess antigen localisation in eleven Mucorales species of clinical importance and live imaging of Rhizopus arrhizus germination. Immunogold transmission electron microscopy (immunoTEM) reveals the sub-cellular location of mAb TG11 binding. Finally, we perform immunohistochemistry of R. arrhizus in an ex vivo murine lung infection model alongside lung infection by Aspergillus fumigatus., Results: IF revealed TG11 antigen production at the emerging hyphal tip and along the length of growing hyphae in all Mucorales except Sakasenea. Timelapse imaging revealed early antigen exposure during spore germination and along the growing hypha. ImmunoTEM confirmed mAb TG11 binding to the hyphal cell wall only. The TG11 mAb specifically stained Mucorales but not Aspergillus hyphae in infected murine lung tissue., Conclusions: TG11 detects early hyphal growth and has valuable potential for diagnosing mucormycosis by enhancing discriminatory detection of Mucorales in tissue., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Candida auris can persist for long periods on hospital surfaces and on the skin. C. auris has the ability to form drug-resistant biofilms, which can substantially impact on patient outcome. In comparison to Candida albicans, C. auris has a lower capacity to form biofilms in in vitro models and a higher capacity when tested on animal skin models. Intraspecies variation is shown to exist, with some clinical isolates having greater biofilm capabilities than others. There is a need for models that closely mimic the real niches where infection occurs on human patients. This protocol describes, in detail, a human skin model to study C. auris biofilm formation using catheterized and non-catheterized skin., (© 2022. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)