Uncommon, or rare, yeast infections are on the rise given increasing numbers of patients who are immunocompromised or seriously ill. The major pathogens include those of the genera Geotrichum, Saprochaete, Magnusiomyces, and Trichosporon (ie, basidiomycetes) and Kodamaea, Malassezia, Pseudozyma (ie, now Moesziomyces or Dirkmeia), Rhodotorula, Saccharomyces, and Sporobolomyces (ie, ascomycetes). A considered approach to the complex, multidisciplinary management of infections that are caused by these pathogens is essential to optimising patient outcomes; however, management guidelines are either region-specific or require updating. In alignment with the One World-One Guideline initiative to incorporate regional differences, experts from diverse geographical regions analysed publications describing the epidemiology and management of the previously mentioned rare yeasts. This guideline summarises the consensus recommendations with regards to the diagnostic and therapeutic options for patients with these rare yeast infections, with the intent of providing practical assistance in clinical decision making. Because there is less clinical experience of patients with rare yeast infections and studies on these patients were not randomised, nor were groups compared, most recommendations are not robust in their validation but represent insights by use of expert opinions and in-vitro susceptibility results. In this Review, we report the key features of the epidemiology, diagnosis, antifungal susceptibility, and treatment outcomes of patients with Geotrichum, Saprochaete, Magnusiomyces, and Trichosporon spp infections.
- MeSH
- antifungální látky terapeutické užití MeSH
- Ascomycota MeSH
- celosvětové zdraví * MeSH
- hostitel s imunodeficiencí MeSH
- lidé MeSH
- mitosporické houby MeSH
- mykózy * diagnóza farmakoterapie epidemiologie MeSH
- směrnice jako téma * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Natural antibodies (Abs) can target host glycans on the surface of pathogens. We studied the evolution of glycan-reactive B cells of rhesus macaques and humans using glycosylated HIV-1 envelope (Env) as a model antigen. 2G12 is a broadly neutralizing Ab (bnAb) that targets a conserved glycan patch on Env of geographically diverse HIV-1 strains using a unique heavy-chain (VH) domain-swapped architecture that results in fragment antigen-binding (Fab) dimerization. Here, we describe HIV-1 Env Fab-dimerized glycan (FDG)-reactive bnAbs without VH-swapped domains from simian-human immunodeficiency virus (SHIV)-infected macaques. FDG Abs also recognized cell-surface glycans on diverse pathogens, including yeast and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike. FDG precursors were expanded by glycan-bearing immunogens in macaques and were abundant in HIV-1-naive humans. Moreover, FDG precursors were predominately mutated IgM+IgD+CD27+, thus suggesting that they originated from a pool of antigen-experienced IgM+ or marginal zone B cells.
- MeSH
- B-lymfocyty imunologie MeSH
- COVID-19 imunologie MeSH
- dimerizace MeSH
- epitopy imunologie MeSH
- genové produkty env - virus lidské imunodeficience chemie genetika imunologie MeSH
- glykoprotein S, koronavirus imunologie MeSH
- glykosylace MeSH
- HIV infekce imunologie MeSH
- HIV protilátky imunologie MeSH
- HIV-1 imunologie MeSH
- imunoglobuliny - Fab fragmenty chemie imunologie MeSH
- lidé MeSH
- Macaca mulatta MeSH
- neutralizující protilátky imunologie MeSH
- polysacharidy chemie imunologie MeSH
- receptory antigenů B-buněk chemie MeSH
- SARS-CoV-2 imunologie MeSH
- široce neutralizující protilátky imunologie MeSH
- vakcíny imunologie MeSH
- virus opičí imunodeficience genetika imunologie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
