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 studys 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 Peoples 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 disorder marked by low levels of CD4 T lymphocytes without an identifiable cause like HIV infection or other immunodeficiencies. This study aims to understand the natural history of ICL, examining changes in CD4 T cell counts and the development of infections, autoimmune diseases, or malignancies over time. Researchers also seek to explore the immune profile and possible genetic causes of ICL while providing standard care to manage infections. Participants include ICL patients as well as their blood relatives and household contacts. The study involves initial comprehensive evaluations including medical history, physical exams, various specialist consultations, blood tests for immune and genetic markers, urine tests, and infection assessments. Follow-up visits occur approximately every 12 months or more often if needed, continuing for at least 4 years and up to 10 years to monitor disease progression and immune status. During participation, patients undergo regular blood sampling to measure CD4 T cell counts and other immune parameters, along with evaluations for infections and autoimmune symptoms. Researchers also collect tissue samples and conduct genetic testing. The study measures outcomes such as CD4 levels, immune cell function, and correlations with infections or other health issues. Participants receive ongoing monitoring and treatment as appropriate, with the total involvement lasting from 4 to 10 years.

Cryptococcosis is a fungal infection that primarily affects immunocompromised individuals, such as those with AIDS or organ transplants, but a significant number of cases occur in previously healthy adults without known immune defects. This research aims to investigate the immune deficits and genetic factors that may predispose healthy adults to cryptococcosis. The study includes patients with cryptococcosis, their genetically related family members, and healthy volunteers to compare immune and genetic responses. Participants will undergo various sample collections including saliva, blood, eyebrow hair, cerebrospinal fluid, and nail clippings. Patients receive standard medical care and may be treated with corticosteroids or immunosuppressants if inflammation causes neurological damage. Family members and healthy volunteers will provide samples for genetic and immunologic testing to better understand susceptibility and immune responses. The study also examines differences between patients with central nervous system involvement and those with non-CNS disease. Throughout the study, participants are monitored with clinical evaluations and various testing methods to characterize the disease spectrum, immune mechanisms, and genetic predispositions over 1 to 5 years. Outcomes measured include clinical disease features, immune and genetic factors, and inflammation effects. Samples may be stored for future research, and patients with predisposing immune conditions are excluded to focus on previously healthy adults. Participation involves ongoing assessments as clinically indicated, with no investigational treatments administered.

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.

Researchers are gathering detailed information on invasive fungal infections caused by emerging fungi worldwide. This observational registry aims to identify the fungal species responsible in different regions, understand how the disease presents, and document the diagnostic methods used. It also seeks to describe treatment approaches and their effectiveness, as well as promote sharing of clinical fungal samples and develop molecular tools for better strain identification. This registry collects data through a web-based platform where cases of invasive fungal infections confirmed by culture, histopathology, antigen, or DNA evidence are recorded. The focus is on emerging fungal infections, excluding common fungi like Candida, Cryptococcus neoformans, Pneumocystis jiroveci, and endemic fungal infections. Participants are not receiving specific treatments through this study instead, their clinical information and diagnostic results are documented for analysis. Participants provide clinical data that include diagnostic procedures and treatment regimens used. Researchers monitor treatment effectiveness at 90 days from diagnosis as the primary outcome. The study involves no direct intervention and continues to collect data over time to improve understanding of these infections. Participation duration varies as the registry is ongoing, with data collected at diagnosis and follow-up points.

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 systems 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.