Cryptococcosis

Patients with leukemia and neutropenia are at high risk for invasive fungal infections (IFI), which can lead to serious health problems and high mortality. Due to severe thrombocytopenia, invasive diagnostic procedures are often too risky for these patients. Diagnosis usually relies on lung findings from computed tomography and serologic tests for fungal components, but these methods have limited accuracy. This research aims to identify specific volatile biomarkers in the breath of leukemia patients with proven or probable IFI using a technology called secondary electrospray ionization high-resolution mass spectrometry (SESI-HRMS). The study observes patients grouped by their IFI status according to EORTC guidelines: no IFI, possible IFI (clinical or radiological suspicion without microbiological proof), probable IFI (clinical or radiological suspicion with indirect microbiological evidence), and proven IFI (definitive histological or microbiological evidence). The investigational approach involves analyzing patients’ breath samples with SESI-HRMS to detect volatile biomarkers linked to IFI. Participants will provide breath samples during their hospital stay, typically lasting two weeks or longer due to chemotherapy. Researchers will measure novel biomarkers in breath over about three weeks to evaluate their ability to detect IFI. They will assess the sensitivity and specificity of these biomarkers and how early IFI can be anticipated. The study is observational, focusing on collecting and analyzing breath metabolome data without altering patient treatment.

Researchers are conducting a nationwide observational study in Denmark to track and understand infections of the central nervous system (CNS) among adults aged 18 years and older. This study systematically registers clinical characteristics and outcomes of all community-acquired CNS infections diagnosed or treated at infectious disease departments across the country since January 1, 2015. The aim is to monitor trends in infections such as bacterial meningitis, viral meningitis, encephalitis, brain abscess, neuroborreliosis, and neurosyphilis, among others. The study involves collecting detailed information on diagnosis at admission, symptoms, timing and type of diagnostic tests like lumbar puncture and cranial imaging, and treatments given. These treatments and diagnostic procedures are determined by local physicians and are not standardized across sites. The study ensures data quality through regular case reviews and annual checks of hospital records using specific diagnosis codes to identify CNS infection cases. Participants are monitored for outcomes using the Glasgow Outcome Scale at various time points depending on the infection type, such as 2 weeks for neurosyphilis and 8 weeks for brain abscess. Data on timing of hospital admission, diagnostic procedures, and antibiotic treatment are collected from hospital records. The study's main measure is the yearly incidence of CNS infections, capturing clinical course and patient outcomes to improve understanding of these serious infections over time.

This research aims to evaluate the effectiveness and safety of two types of antifungal drugs, amphotericin B and azoles, in patients with invasive fungal disease. The study collects medical records, demographic details, and clinical data from patients treated at Sichuan Provincial People's Hospital between 2021 and 2024 to compare these treatments. The purpose is to better understand how these drugs perform in real clinical settings to inform future care. Patients receive treatment with either polyene antifungal drugs, such as amphotericin B or its cholesteryl sulphate complex, or azole antifungal drugs, including triazoles or imidazoles. The dosage and length of treatment for both drug types are determined by clinicians based on clinical practice. The study is observational, recording outcomes as patients undergo their prescribed treatments. Participants contribute by allowing access to their medical records and clinical data for analysis. Researchers assess the clinical success rate at the end of treatment and up to one year afterward. Safety is monitored during treatment, at day 14, and at day 28 after treatment starts. The study does not involve additional interventions or procedures, focusing on data collection and evaluation over several months.

Idiopathic CD4+ lymphocytopenia (ICL) is a condition marked by low levels of CD4+ T cells, which can increase the risk of infections, autoimmune diseases, and cancers. Researchers aim to understand the natural history of ICL by examining how CD4+ counts change over time, the onset of related infections and autoimmune issues, and possible genetic causes. The study also looks at the immune system status of patients and how it relates to disease development. The study involves patients with confirmed ICL, their blood relatives, and household contacts. Participants receive standard care to manage opportunistic infections. Initial visits include medical history, physical exams, blood tests, urine tests, and specialized evaluations as needed. Follow-up visits occur about once a year and continue for 4 to 10 years to monitor immune function and disease progression. Participants will undergo regular blood tests to measure CD4+ T cell counts and other immune markers, along with physical and rheumatology exams. Researchers will collect samples for immunologic, genetic, and microbiome analyses. The primary measure is CD4+ T cell count, tracked annually. The study monitors the effects of ICL over time and the relationship between immune status and infections or other conditions.

Cryptococcosis is a fungal infection that mainly affects people with weakened immune systems, like those with AIDS or organ transplants, but about one-third of cases occur in individuals without known immune problems. This research focuses on understanding immune system defects and genetic factors that may make previously healthy adults susceptible to cryptococcosis. The study aims to explore the pathophysiology and immune responses in these patients, including genetic screening of their relatives and comparison with healthy volunteers. Participants include three groups: previously healthy adults diagnosed with cryptococcosis without known immune defects, their blood relatives, and healthy adult volunteers. Various samples such as blood, saliva, cerebrospinal fluid, eyebrow hair, and nail clippings will be collected. Patients will receive standard medical care and may receive corticosteroids or immunosuppressive treatments if inflammation causes neurological damage. Genetic and immunologic testing will be performed to identify immune abnormalities and genetic susceptibility. Participants will be closely monitored with various tests to understand disease progression and immune responses. Healthy volunteers and relatives will also undergo testing to serve as comparison groups. The study will measure clinical disease spectrum and investigate immunological and genetic mechanisms over 1 to 5 years. Participants may be seen frequently as needed to manage their condition, and samples will be stored for future research.

This research aims to monitor and identify invasive fungal infections among hospitalized patients in Bangladesh at two major tertiary care hospitals. It highlights the significant global burden of fungal diseases, especially among immunocompromised individuals, and the lack of ongoing national surveillance systems in Bangladesh. The study addresses challenges like insufficient diagnostic capacity and aims to improve data collection and infection prevention practices. The study involves collecting various clinical samples such as respiratory specimens, blood, urine, cerebrospinal fluid, wound swabs, and biopsy tissues from patients in intensive care, general medicine, surgery wards, and post-operative care. These samples will be tested in laboratories using microscopy, staining, culture, biochemical tests, and possibly molecular or immunological methods to identify fungal pathogens like Aspergillus, Histoplasma, Candida, Pneumocystis, Cryptococcus, and Mucormycetes. Participants include hospitalized patients of all ages with immunosuppressive conditions or risk factors for fungal infections. Consent will be obtained from patients or caregivers. The study will monitor the proportion of invasive fungal pathogens identified in these patients between July 2022 and September 2026. Data collection and testing will support improved diagnosis, management, and surveillance of fungal infections in Bangladesh.

The specific objectives are: 1. To determine the fungal species causing invasive fungal infection in different parts of the world. 2. To determine the clinical pattern of disease and document procedures performed for confirmation of the diagnosis. 3. To describe the therapeutic regimens used and their efficacy. 4. To share clinical isolates among the contributors of Fungiscope. 5. To develop molecular biology tools for identification of strains in histopathologically proven invasive fungal infection.

Researchers are studying mold invasive fungal infections, which can be deadly even with the best antifungal treatments. This research focuses on how immune checkpoint inhibitors, originally developed for cancer, might help restore the immune system's ability to fight these infections. The study aims to monitor the immune response, especially the markers on T cells, to find which patients might benefit from adding immunotherapy and the best time to start it. The study includes adult patients diagnosed with mold invasive fungal infections like aspergillosis, mucormycosis, fusariosis, or scedosporiosis, either newly diagnosed or not responding to standard antifungal treatment. Researchers will measure immune checkpoint markers on T cells and monocytes at enrollment, day 14, and week 6. For patients with aspergillosis or mucormycosis, they will also assess specific T cell functions, including cytokine production and proliferation, with and without an anti-PD1 antibody, at enrollment and week 6. Participants will undergo blood tests at these time points to evaluate their immune responses using flow cytometry and FLUOROSPOT assays. The study will correlate immune data with patients' underlying conditions, infection types, treatments, and outcomes. This detailed monitoring will help guide when and for whom immunotherapy might be added to antifungal treatment. The study is expected to continue until 2027, and participants will be followed closely throughout the study period.

Researchers are collecting information about patients with various infectious diseases to create a detailed database and biobank. This observational study focuses on illnesses such as bloodstream infections, central nervous system infections, bone and joint infections, endovascular infections, sexually transmitted infections, HIV infection, and emerging infectious diseases. The goal is to understand the clinical, laboratory, imaging, and microbiological features as well as treatment approaches, and to study factors affecting treatment success and disease outcomes. Participants will provide biological samples like blood, cerebrospinal fluid, and urine at the start of their infectious disease diagnosis. Data and samples will be collected at baseline, end of treatment, and six months later, or yearly for HIV patients. Additional collections may occur depending on disease progression or treatment changes. The study will record clinical scores, laboratory results, imaging, treatment details, drug levels, and outcomes including mortality and complications. Participants will be monitored through clinical and laboratory assessments at several time points including baseline, end of treatment, and follow-up visits. Researchers will use these data to analyze disease characteristics, treatment responses, and outcomes over time. The study aims to identify biomarkers, predictors of cure, and factors influencing mortality and complications. Participation involves donating samples and sharing medical information, with follow-up lasting at least six months or longer for some conditions.

Researchers are comparing two ways of giving polymyxin B to treat severe brain infections caused by carbapenem-resistant Gram-negative bacteria (CRGNB). The study looks at whether injecting the drug directly into the brain alone or combining this with an intravenous infusion works better to clear the infection and improve patient outcomes. It also measures the levels of polymyxin B in the cerebrospinal fluid (CSF) to understand how the drug acts in the body. Participants are divided into two groups. One group receives polymyxin B directly into the brain without an IV infusion. The other group receives polymyxin B both directly into the brain and through an IV infusion. All participants have an external ventricular drain to continuously drain CSF, and they must have been receiving polymyxin B treatment for at least five days before joining. During the study, researchers will monitor the 30-day mortality rate, bacterial clearance in the CSF at baseline, 1 week, 2 weeks, and 30 days after starting treatment, and the clinical cure rate at the end of treatment and 30 days afterward. Participants will be followed closely to assess how well the infection clears and to check safety. The study will continue until December 2026.