Immuno-Mycologics

This study documents the first reported cases of Candida (Candidozyma)auris in the Dominican Republic, isolated from both a critically ill human patient and a captive dolphin. Antifungal susceptibility testing from dolphin isolate showed elevated minimum inhibitory concentrations (MIC) of fluconazole but low MICs of other antifungals, including the novel drugs rezafungin, ibrexafungerp and manogepix. Whole genome sequencing (WGS) of the dolphin isolate allocated it to clade I, but surprisingly did not show any known mutations that confer azole resistance, suggesting a mechanism different from mutations in the genes studied. The concurrent emergence of C. auris in human and animal hosts underscores the importance of a One Health approach, emphasizing the interconnectedness of human, animal, and environmental health, and the need for strengthened surveillance and rigorous infection control measures across medical and veterinary settings.

Coccidiomycosis is a potentially life-threatening fungal infection endemic to certain regions of Argentina. The infection is caused by Coccidioides spp. and is primarily diagnosed by Coccidioides antibody (Ab) detection. Access to rapid, highly accurate diagnostic testing is critical to ensure prompt antifungal therapy. The sōna Coccidioides Ab Lateral Flow Assay (LFA) performs faster and requires less laboratory infrastructure and equipment compared with other Ab detection assays, potentially providing a substantial improvement for rapid case screening in coccidioidomycosis-endemic regions; however, validation of this test is needed. Thus, we aimed to evaluate the analytical performance of the sōna Coccidioides Ab (LFA) and compare agreement with anti-Coccidioides Ab detection assays. A total of 103 human sera specimens were tested, including 25 specimens from patients with coccidioidomycosis and 78 from patients without coccidioidomycosis. The sōna Coccidioides Ab Lateral Flow Assay (LFA) was performed with a sensitivity of 88%, and specificity and accuracy of 87%. Furthermore, the Coccidioides Ab LFA had good agreement with other anti-Coccidioides Ab detection assays. Our findings suggest the sōna Coccidioides Ab LFA has satisfactory performance and may be useful for diagnosing coccidioidomycosis in endemic regions.