Tehran University Medical Journal

Background: Candida auris is a globally emerging yeast pathogen that has shown not only resistance to most anti-fungal drugs but also thermo-tolerance to temperatures higher than the mammalian’s body temperature. Although it has been only a decade since the fungus was identified, its spread of infections has been rapid and quasi-epidemics have been reported. Co-occurrences of the fungus infections in all five continents are one of the strangest aspects of this fungus. All isolates, despite slight genetic differences, belong to a common genetic ancestor. However, different clades appear to have independent evolutionary paths. We have discussed the relationship between the acquired thermal tolerance of C. auris and the environmental temperature changes with the genetic affinities of the isolates.
Methods: This basic science survey was carried out at the Shiraz University of medical sciences from July to December 2019. Phylogenetic analysis was used to compare the temperature sensitivity of C. auris and the species with which it is genetically related. The sequences of Internal transcribed spacer (ITS) region and the growth temperature ranges for C. auris and yeasts belonging to the Candida haemulonis complex as well as other environmental yeasts isolated from different geographical areas of the world were randomly selected and evaluated. Their phylogenetic relationship was investigated with the mapping of the phylogenetic tree based on ITS sequences.

Methods: The systematic review study was conducted from 11 July 2023 to 04 February 2024 in Zahedan, Iran. To extract articles on fungal infections, the vocabulary of selected Medical Subjects Headings (Mesh), other specialized literature was determined and a search strategy was formulated in three databases, Web Science, Scopus, and PubMed, without any time limitation. In addition, the articles were analyzed according to the research objectives, types of fungal infections encountered in immunocompromised patients, their incidence in different immunocompromised patient groups, diagnostic and detection strategies, treatment methods and other background information. Results: A 15 number of related articles were included. The most common type of study was case report. From the lens of Aspergillus and mucormycosis fungal infections, they were given more attention, and in terms of the type of immunodeficiency, patients with a history of diabetes, including groups of diabetic patients, cancer groups, AIDS patients, and some groups with genetic disorders, were investigated in the studies. Appropriate treatment methods; particularly the use of corticosteroid drugs such as methylprednisolone as intravenous injection, systemic antifungal drugs such as liposomal amphotericin B, Antifungal treatment using high-dose amphotericin B, the use of prophylactic drugs, and isolation of the damaged tissue are recommended as the best treatment strategies. In order to prevent fungal infections in groups of Immunocompromised Patients, it is recommended to use simple hygiene Recommendations. Conclusion: Analyzing the conditions of cocvid-19 patients and recognizing effective treatment strategies is inevitable, especially in the post- COVID era. A review of the literature showed that prevention and control of fungal infections after covid-19 was critical among immunodeficiency patients and the use of the recommended treatment method for their lifecycle continuity should be more considered by health care providers, health system managers and health policy makers.