Rationale:Candida auris is a potential emerging pathogen among Candida and causes serious health threats globally.Patient concerns:We reported a case of vulvovaginal candidiasis caused by Candida auris.A 26-year-old f...Rationale:Candida auris is a potential emerging pathogen among Candida and causes serious health threats globally.Patient concerns:We reported a case of vulvovaginal candidiasis caused by Candida auris.A 26-year-old female presented with complaints of vaginal discharge,itching and low back pain.Diagnosis:High vaginal swab culture yielded Candida.The strain was confirmed as Candida auris by amplification and sequencing the internal transcribed spacer region.Antifungal susceptibility testing revealed that the isolate was resistant to fluconazole,amphotericin B and clotrimazole and susceptible to ketoconazole and nystatin.The isolate also exhibited biofilm forming ability.Interventions:Her symptoms did not subside with initial management with fluconazole and clotrimazole.Later,she was started on ketoconazole therapy.The patient responded well to ketoconazole.Outcome and lessons:To the best of our knowledge,this is the first report about the presence of a drug resistant biofilm forming Candida auris strain isolated from a vaginal swab sample from Chennai area.Biofilm forming ability might contribute to its drug resistance.Nucleic acid analysis helps in rapid and accurate identification of such rare species.展开更多
Candida auris since it discovery in 2009 is becoming a severe threat to human health due to its very quickly spread, its worldwide high resistance to systemic antifungal drugs. In resource-constrained settings where s...Candida auris since it discovery in 2009 is becoming a severe threat to human health due to its very quickly spread, its worldwide high resistance to systemic antifungal drugs. In resource-constrained settings where several conditions are met for its emergence and spread, this worrisome fungus could cause large hospital and/or community-based outbreaks. This review aimed to summarize the available data on C. auris in Africa focusing on its epidemiology and antifungal resistance profile. Major databases were searched for articles on the epidemiology and antifungal resistance profile of C. auris in Africa. Out of 2,521 articles identified 22 met the inclusion criteria. In Africa, nearly 89% of African countries have no published data on C. auris. The prevalence of C. auris in Africa was 8.74%. The case fatality rate of C. auris infection in Africa was 39.46%. The main C. auris risk factors reported in Africa were cardiovascular disease, renal failure, diabetes, HIV, recent intake of antimicrobial drugs, ICU admissions, surgery, hemodialysis, parenteral nutrition and indwelling devices. Four phylogenetic clades were reported in Africa, namely clades I, II, III and IV. Candida auris showed a pan-African very high resistance rate to fluconazole, moderate resistance to amphotericin B, and high susceptibility to echinocandins. Finally, C. auris clade-specific mutations were observed within the ERG2, ERG3, ERG9, ERG11, FKS1, TAC1b and MRR1 genes in Africa. This systematic review showed the presence of C. auris in the African continent and a worrying unavailability of data on this resilient fungus in most African countries.展开更多
Background: Superficial candidiasis is a very frequent opportunistic disease caused by yeasts of the genus Candida. Among Candida types, some, such as Candida auris, have developed resistance to several antifungal age...Background: Superficial candidiasis is a very frequent opportunistic disease caused by yeasts of the genus Candida. Among Candida types, some, such as Candida auris, have developed resistance to several antifungal agents. The objective of this study was to determine the hospital frequency of superficial candidiasis diagnosed at the CHU Fann and to investigate the presence of C. auris among the identified Candida strains. Methods: A cross-sectional study was conducted from February to June 2019. It involved all patients received at the Parasitology-Mycology laboratory of the CHU of Fann for suspected superficial candidiasis. Nails, skin, and vaginal specimens were subjected to direct examination and culture to identify yeasts of the genus Candida. The Candida strains were then tested by molecular biology targeting the specific C. auris ITS2 region. Results: A total of 1196 patients were examined. One thousand two hundred and five specimens (1205) were collected, including 1042 vaginal specimens, 92 nail specimens, and 71 skin specimens. Superficial candidiasis was diagnosed in 408 patients (37%). Women (34.52%) and patients under 30 years of age (39.60%) were the most affected. Yeasts of the genus Candida were found in 411 specimens (349 vaginal swabs, 36 nail fragments, and 26 skin flakes) by routine mycological techniques. The Candida albicans complex (C. albicans, C. dubliniensis, and C. africana) represented 75.91% of the Candida strains isolated. Molecular biology did not identify C. auris. Conclusion: Superficial candidiasis remains very common in hospitals in Senegal. Candida auris was not found in our study. Due to its rapid spread, surveillance is necessary to prevent epidemics in our hospitals.展开更多
Purpose: Recently, Candida haemulonii complex (Candida haemulonii, Candida duobushaemulonii and Candida haemulonii var. vulnera) and two genetically close species (Candida pseudohaemulonii and Candida auris) have emer...Purpose: Recently, Candida haemulonii complex (Candida haemulonii, Candida duobushaemulonii and Candida haemulonii var. vulnera) and two genetically close species (Candida pseudohaemulonii and Candida auris) have emerged as an opportunistic fungal pathogen associated with various infectious diseases of humans, and most of those isolates have displayed antifungal resistance. Because it is difficult to differentiate these microorganisms by a current technique, unfortunately, it is important to establish a method for identifying them accurately. The purpose of the present study was to design species-specific primers in order to identify and detect C. auris, C. pseudohaemulonii, and C. haemulonii complex, i.e. , C. haemulonii, C. duobushaemulonii and C. haemulonii var. vulnera using a multiplex PCR. Methods: Polymerase chain reaction (PCR) primers were designed based on partial sequences of the 26S rRNA, 18S rRNA, and RPB1 genes and ITS region of five Candida species. Results: The multiplex PCR method developed in this study was able to distinguish five Candida species clearly. Conclusion: Our developed one-step multiplex PCR method is accurate, specific, cost-effective, time-saving, and works without requiring DNA extraction.展开更多
Objective:Candida auris(C.auris)is an important fungal pathogen with high rates of transmissibility,mortality,and drug resistance.However,studies on its pathogenicity,host-pathogen interactions,and macrophage immune r...Objective:Candida auris(C.auris)is an important fungal pathogen with high rates of transmissibility,mortality,and drug resistance.However,studies on its pathogenicity,host-pathogen interactions,and macrophage immune responses against C.auris are still limited.This study compared the immune response induced by Candida albicans(C.albicans)and C.auris,and explored the inflammation mechanisms of macrophages induced by C.auris.Methods:We used bone marrow derived macrophages(BMDMs)from mouse and peripheral blood mononuclear cells(PBMCs)from human being as the cell model.Flow cytometry was used to compare the phagocytosis rates of C.albicans and C.auris by BMDMs and PBMCs,as well as the differences in reactive oxygen species(ROS)release levels.Quantitative real-time PCR was used to compare the differences in the expression levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and IL-1β.After BMDMs were stimulated with different concentrations of C.auris for various durations,quantitative real-time PCR was used to detect the changes in the expression levels of IL-6,TNF-α,and IL-1β,and ELISA was employed to measure the secretion levels of IL-6,TNF-α,and IL-1β.After co-culturing C.auris with BMDMs for 30 minutes,western blotting was used to detect the phosphorylation levels of Syk,IκBα,and ERK.Laser confocal microscopy was used to observe the nuclear translocation of NF-κB p65,and flow cytometry was utilized to detect the expression of Toll-like receptor 2(TLR2),TLR4,and Dectin-1 on BMDMs.BMDMs were pre-treated with TLR4 receptor inhibitor(TAK-242),TLR2 receptor inhibitor(C29),and Syk inhibitor(piceatannol)for 1 hour respectively.After BMDMs were stimulated with C.auris,flow cytometry was used to detect ROS and phagocytosis rates,and quantitative real-time PCR and ELISA were used to detect the expression levels of IL-6 and TNF-αmRNA and protein secretion.The t test or one-way analysis of variance was used for statistical analysis.Results:Macrophages showed a lower phagocytosis rate(P<0.01 for BMDMs;P<0.001 for PBMCs),ROS production(P<0.05),and expression of proinflammatory cytokines like IL-6(P<0.05),TNF-α(P<0.01)and IL-1β(P<0.05)against C.auris when compared with C.albicans.BMDMs were stimulated with C.auris at different concentrations C.auris(BMDMs:C.auris=1:5,1:10,1:20)and for different durations(2,4,and 8 hours),it was found that the expression levels of IL-6 and TNF-αmRNA were positively correlated with the concentration and duration of C.auris stimulation.The protein levels of IL-6,TNF-α,and IL-1βin the supernatant were all significantly increased.Stimulation of BMDMs by C.auris can induce the phosphorylation of Syk,IκBα,and ERK,the nuclear translocation of NF-κB p65,as well as the expression of TLR2,TLR4,and Dectin-1.By pretreating BMDMs with the inhibitor of TLR4,TLR2,and Syk,we verified that the expression and secretion of IL-6,TNF-α,and IL-1βstimulated by C.auris depended on the activation of TLR2,TLR4,Dectin-1,and downstream signaling pathways.TLR2,TLR4,and Dectin-1 participated in the recognition and phagocytosis of C.auris.Dectin-1 was the most important receptor in mediating immune response,while TLR4 was the most critical receptor in influencing the inflammatory response.Conclusion:C.auris induced a lower level of phagocytosis,production of reactive oxygen species,and expression of inflammatory factors than C.albicans,and that TLR2,TLR4,and Dectin-1 played important roles in the induction of inflammation.展开更多
Dear Editor,Pathogenic fungi often undergo rapid morphological transitions to adapt to dynamic environments during infections and in natural habitats(Biswas et al.,2007;Prasad and Tippana,2023).These phenotypic transi...Dear Editor,Pathogenic fungi often undergo rapid morphological transitions to adapt to dynamic environments during infections and in natural habitats(Biswas et al.,2007;Prasad and Tippana,2023).These phenotypic transitions are primarily driven by environmental cues through nongenetic alterations,including epigenetic,transcriptional,and post-transcriptional modifications(Biswas et al.,2007).展开更多
The aim of this research paper is to model the effects of misidentification in the transmissiondynamics of the super yeast, Candida auris (or C. auris), among patients receivingtreatment in the Intensive Care Units (I...The aim of this research paper is to model the effects of misidentification in the transmissiondynamics of the super yeast, Candida auris (or C. auris), among patients receivingtreatment in the Intensive Care Units (ICUs). The mathematical analysis is carried outby obtaining the reproduction number of the C. auris model using the next generationmatrix and utilizing it as a threshold value to establish the local and global stabilityproperties at the points of equilibria. The numerical investigations carried out in thispaper establish the outcomes of the effect of variations in the values of important parameterson the dynamics of C. auris colonization and infections in the health care settings.The corresponding results from the numerical simulations are illustrated graphically.展开更多
Background:Candida auris infections pose a threat to public health,necessitating increased awareness in China.This study aimed to analyze the strains of C.auris,assess the infection status,and investigate clinical cha...Background:Candida auris infections pose a threat to public health,necessitating increased awareness in China.This study aimed to analyze the strains of C.auris,assess the infection status,and investigate clinical characteristics and risk factors for mortality.Methods:A retrospective analysis was conducted on 18 patients with Candida auris infection.We focused on evaluating basic characteristics,strain sources,and antibacterial susceptibility test results.Statistical methods were used to determine clinical features and identify risk factors for death.Results:The strain type,composition ratio,and specimen source of C.auris were not associated with mortality.Neither the infection index nor the length of hospitalization showed an association with the prognosis.However,significant risk factors for mortality included cerebral infarction,cardiac disease,renal dysfunction,hypoproteinemia,and anemia(all p<0.05).Conclusions:Cerebral infarction,cardiac disease,renal dysfunction,hypoproteinemia,and anemia are significant risk factors for death in C.auris infections.These findings indicate the importance of recognizing and addressing these factors in the clinical management of C.auris infection.展开更多
Developing novel anti-infective drugs is essential to combat antimicrobial resistance,address emerging pathogens,and safeguard global health against evolving infectious threats.A recent publication in the esteemed jou...Developing novel anti-infective drugs is essential to combat antimicrobial resistance,address emerging pathogens,and safeguard global health against evolving infectious threats.A recent publication in the esteemed journal Nature by Qisen Deng et al.reported on the comprehensive evaluation of the therapeutic efficacy of mandimycin against multidrug-resistant(MDR)fungal pathogens.The polyene macrolide antifungal antibiotic,mandimycin,was discovered using a phylogeny-guided natural-product discovery platform.Authors utilized various in vivo mouse models such as systemic and soft-tissue infections to assess the antifungal activity of mandimycin.The efficacy was measured by quantifying the fungal burden in major organs and assessing survival rates.In systemic infections,mandimycin demonstrated significant dose-dependent antifungal efficacy,as compared to amphotericin B,particularly in cases where the latter was ineffective against MDR C.auris.Furthermore,mandimycin showed a favorable safety profile,with low toxicity and no observed side effects at effective doses.The study's findings contribute valuable insights into the potential of mandimycin as a novel antifungal agent,offering hope for improved treatment options against challenging fungal infections.The results pave the way for further research and clinical applications in the fight against antifungal resistance.展开更多
基金Financial support to PN from the Department of Biotechnology(DBT),Ministry of science and Technology,New Delhi(BT/PR/23592/MED/29/1203/2017)
文摘Rationale:Candida auris is a potential emerging pathogen among Candida and causes serious health threats globally.Patient concerns:We reported a case of vulvovaginal candidiasis caused by Candida auris.A 26-year-old female presented with complaints of vaginal discharge,itching and low back pain.Diagnosis:High vaginal swab culture yielded Candida.The strain was confirmed as Candida auris by amplification and sequencing the internal transcribed spacer region.Antifungal susceptibility testing revealed that the isolate was resistant to fluconazole,amphotericin B and clotrimazole and susceptible to ketoconazole and nystatin.The isolate also exhibited biofilm forming ability.Interventions:Her symptoms did not subside with initial management with fluconazole and clotrimazole.Later,she was started on ketoconazole therapy.The patient responded well to ketoconazole.Outcome and lessons:To the best of our knowledge,this is the first report about the presence of a drug resistant biofilm forming Candida auris strain isolated from a vaginal swab sample from Chennai area.Biofilm forming ability might contribute to its drug resistance.Nucleic acid analysis helps in rapid and accurate identification of such rare species.
文摘Candida auris since it discovery in 2009 is becoming a severe threat to human health due to its very quickly spread, its worldwide high resistance to systemic antifungal drugs. In resource-constrained settings where several conditions are met for its emergence and spread, this worrisome fungus could cause large hospital and/or community-based outbreaks. This review aimed to summarize the available data on C. auris in Africa focusing on its epidemiology and antifungal resistance profile. Major databases were searched for articles on the epidemiology and antifungal resistance profile of C. auris in Africa. Out of 2,521 articles identified 22 met the inclusion criteria. In Africa, nearly 89% of African countries have no published data on C. auris. The prevalence of C. auris in Africa was 8.74%. The case fatality rate of C. auris infection in Africa was 39.46%. The main C. auris risk factors reported in Africa were cardiovascular disease, renal failure, diabetes, HIV, recent intake of antimicrobial drugs, ICU admissions, surgery, hemodialysis, parenteral nutrition and indwelling devices. Four phylogenetic clades were reported in Africa, namely clades I, II, III and IV. Candida auris showed a pan-African very high resistance rate to fluconazole, moderate resistance to amphotericin B, and high susceptibility to echinocandins. Finally, C. auris clade-specific mutations were observed within the ERG2, ERG3, ERG9, ERG11, FKS1, TAC1b and MRR1 genes in Africa. This systematic review showed the presence of C. auris in the African continent and a worrying unavailability of data on this resilient fungus in most African countries.
文摘Background: Superficial candidiasis is a very frequent opportunistic disease caused by yeasts of the genus Candida. Among Candida types, some, such as Candida auris, have developed resistance to several antifungal agents. The objective of this study was to determine the hospital frequency of superficial candidiasis diagnosed at the CHU Fann and to investigate the presence of C. auris among the identified Candida strains. Methods: A cross-sectional study was conducted from February to June 2019. It involved all patients received at the Parasitology-Mycology laboratory of the CHU of Fann for suspected superficial candidiasis. Nails, skin, and vaginal specimens were subjected to direct examination and culture to identify yeasts of the genus Candida. The Candida strains were then tested by molecular biology targeting the specific C. auris ITS2 region. Results: A total of 1196 patients were examined. One thousand two hundred and five specimens (1205) were collected, including 1042 vaginal specimens, 92 nail specimens, and 71 skin specimens. Superficial candidiasis was diagnosed in 408 patients (37%). Women (34.52%) and patients under 30 years of age (39.60%) were the most affected. Yeasts of the genus Candida were found in 411 specimens (349 vaginal swabs, 36 nail fragments, and 26 skin flakes) by routine mycological techniques. The Candida albicans complex (C. albicans, C. dubliniensis, and C. africana) represented 75.91% of the Candida strains isolated. Molecular biology did not identify C. auris. Conclusion: Superficial candidiasis remains very common in hospitals in Senegal. Candida auris was not found in our study. Due to its rapid spread, surveillance is necessary to prevent epidemics in our hospitals.
文摘Purpose: Recently, Candida haemulonii complex (Candida haemulonii, Candida duobushaemulonii and Candida haemulonii var. vulnera) and two genetically close species (Candida pseudohaemulonii and Candida auris) have emerged as an opportunistic fungal pathogen associated with various infectious diseases of humans, and most of those isolates have displayed antifungal resistance. Because it is difficult to differentiate these microorganisms by a current technique, unfortunately, it is important to establish a method for identifying them accurately. The purpose of the present study was to design species-specific primers in order to identify and detect C. auris, C. pseudohaemulonii, and C. haemulonii complex, i.e. , C. haemulonii, C. duobushaemulonii and C. haemulonii var. vulnera using a multiplex PCR. Methods: Polymerase chain reaction (PCR) primers were designed based on partial sequences of the 26S rRNA, 18S rRNA, and RPB1 genes and ITS region of five Candida species. Results: The multiplex PCR method developed in this study was able to distinguish five Candida species clearly. Conclusion: Our developed one-step multiplex PCR method is accurate, specific, cost-effective, time-saving, and works without requiring DNA extraction.
基金supported by National Natural Science Foundation of China(82103749,82173432)CAMS Innovation Fund for Medical Sciences(CIFMS-2021-I2M-1-001).
文摘Objective:Candida auris(C.auris)is an important fungal pathogen with high rates of transmissibility,mortality,and drug resistance.However,studies on its pathogenicity,host-pathogen interactions,and macrophage immune responses against C.auris are still limited.This study compared the immune response induced by Candida albicans(C.albicans)and C.auris,and explored the inflammation mechanisms of macrophages induced by C.auris.Methods:We used bone marrow derived macrophages(BMDMs)from mouse and peripheral blood mononuclear cells(PBMCs)from human being as the cell model.Flow cytometry was used to compare the phagocytosis rates of C.albicans and C.auris by BMDMs and PBMCs,as well as the differences in reactive oxygen species(ROS)release levels.Quantitative real-time PCR was used to compare the differences in the expression levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and IL-1β.After BMDMs were stimulated with different concentrations of C.auris for various durations,quantitative real-time PCR was used to detect the changes in the expression levels of IL-6,TNF-α,and IL-1β,and ELISA was employed to measure the secretion levels of IL-6,TNF-α,and IL-1β.After co-culturing C.auris with BMDMs for 30 minutes,western blotting was used to detect the phosphorylation levels of Syk,IκBα,and ERK.Laser confocal microscopy was used to observe the nuclear translocation of NF-κB p65,and flow cytometry was utilized to detect the expression of Toll-like receptor 2(TLR2),TLR4,and Dectin-1 on BMDMs.BMDMs were pre-treated with TLR4 receptor inhibitor(TAK-242),TLR2 receptor inhibitor(C29),and Syk inhibitor(piceatannol)for 1 hour respectively.After BMDMs were stimulated with C.auris,flow cytometry was used to detect ROS and phagocytosis rates,and quantitative real-time PCR and ELISA were used to detect the expression levels of IL-6 and TNF-αmRNA and protein secretion.The t test or one-way analysis of variance was used for statistical analysis.Results:Macrophages showed a lower phagocytosis rate(P<0.01 for BMDMs;P<0.001 for PBMCs),ROS production(P<0.05),and expression of proinflammatory cytokines like IL-6(P<0.05),TNF-α(P<0.01)and IL-1β(P<0.05)against C.auris when compared with C.albicans.BMDMs were stimulated with C.auris at different concentrations C.auris(BMDMs:C.auris=1:5,1:10,1:20)and for different durations(2,4,and 8 hours),it was found that the expression levels of IL-6 and TNF-αmRNA were positively correlated with the concentration and duration of C.auris stimulation.The protein levels of IL-6,TNF-α,and IL-1βin the supernatant were all significantly increased.Stimulation of BMDMs by C.auris can induce the phosphorylation of Syk,IκBα,and ERK,the nuclear translocation of NF-κB p65,as well as the expression of TLR2,TLR4,and Dectin-1.By pretreating BMDMs with the inhibitor of TLR4,TLR2,and Syk,we verified that the expression and secretion of IL-6,TNF-α,and IL-1βstimulated by C.auris depended on the activation of TLR2,TLR4,Dectin-1,and downstream signaling pathways.TLR2,TLR4,and Dectin-1 participated in the recognition and phagocytosis of C.auris.Dectin-1 was the most important receptor in mediating immune response,while TLR4 was the most critical receptor in influencing the inflammatory response.Conclusion:C.auris induced a lower level of phagocytosis,production of reactive oxygen species,and expression of inflammatory factors than C.albicans,and that TLR2,TLR4,and Dectin-1 played important roles in the induction of inflammation.
基金supported by the National Key Research and Development Program of China(2022YFC2303000,2021YFC2300400)the National Natural Science Foundation of China(31930005,82272359,32170194,32170193,82202546)the China Postdoctoral Science Foundation(2023M730684,2022M720804)。
文摘Dear Editor,Pathogenic fungi often undergo rapid morphological transitions to adapt to dynamic environments during infections and in natural habitats(Biswas et al.,2007;Prasad and Tippana,2023).These phenotypic transitions are primarily driven by environmental cues through nongenetic alterations,including epigenetic,transcriptional,and post-transcriptional modifications(Biswas et al.,2007).
文摘The aim of this research paper is to model the effects of misidentification in the transmissiondynamics of the super yeast, Candida auris (or C. auris), among patients receivingtreatment in the Intensive Care Units (ICUs). The mathematical analysis is carried outby obtaining the reproduction number of the C. auris model using the next generationmatrix and utilizing it as a threshold value to establish the local and global stabilityproperties at the points of equilibria. The numerical investigations carried out in thispaper establish the outcomes of the effect of variations in the values of important parameterson the dynamics of C. auris colonization and infections in the health care settings.The corresponding results from the numerical simulations are illustrated graphically.
文摘Background:Candida auris infections pose a threat to public health,necessitating increased awareness in China.This study aimed to analyze the strains of C.auris,assess the infection status,and investigate clinical characteristics and risk factors for mortality.Methods:A retrospective analysis was conducted on 18 patients with Candida auris infection.We focused on evaluating basic characteristics,strain sources,and antibacterial susceptibility test results.Statistical methods were used to determine clinical features and identify risk factors for death.Results:The strain type,composition ratio,and specimen source of C.auris were not associated with mortality.Neither the infection index nor the length of hospitalization showed an association with the prognosis.However,significant risk factors for mortality included cerebral infarction,cardiac disease,renal dysfunction,hypoproteinemia,and anemia(all p<0.05).Conclusions:Cerebral infarction,cardiac disease,renal dysfunction,hypoproteinemia,and anemia are significant risk factors for death in C.auris infections.These findings indicate the importance of recognizing and addressing these factors in the clinical management of C.auris infection.
基金the National Key Research and Development Program of China(2023YFD1700500)the College Student Research Training Program(202110307002T)Bayer Grants4Ag Initiative for their support.
文摘Developing novel anti-infective drugs is essential to combat antimicrobial resistance,address emerging pathogens,and safeguard global health against evolving infectious threats.A recent publication in the esteemed journal Nature by Qisen Deng et al.reported on the comprehensive evaluation of the therapeutic efficacy of mandimycin against multidrug-resistant(MDR)fungal pathogens.The polyene macrolide antifungal antibiotic,mandimycin,was discovered using a phylogeny-guided natural-product discovery platform.Authors utilized various in vivo mouse models such as systemic and soft-tissue infections to assess the antifungal activity of mandimycin.The efficacy was measured by quantifying the fungal burden in major organs and assessing survival rates.In systemic infections,mandimycin demonstrated significant dose-dependent antifungal efficacy,as compared to amphotericin B,particularly in cases where the latter was ineffective against MDR C.auris.Furthermore,mandimycin showed a favorable safety profile,with low toxicity and no observed side effects at effective doses.The study's findings contribute valuable insights into the potential of mandimycin as a novel antifungal agent,offering hope for improved treatment options against challenging fungal infections.The results pave the way for further research and clinical applications in the fight against antifungal resistance.
