The Experts below are selected from a list of 288 Experts worldwide ranked by ideXlab platform
Martin Hoenigl - One of the best experts on this subject based on the ideXlab platform.
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european confederation of Medical Mycology expert consult an ecmm excellence center initiative
Mycoses, 2020Co-Authors: Philipp Koehler, Martin Hoenigl, Jean-pierre Gangneux, David W Denning, Blandine Denis, Dimitrios P Kontoyiannis, Robert Krause, Katrien Lagrou, Cornelia LassflorlAbstract:OBJECTIVES: Difficult-to-treat invasive fungal infections require infectious diseases expert consultation to improve treatment outcome and increase survival rates. METHODS: The European Confederation of Medical Mycology (ECMM) intends to provide expert help free of charge by a newly founded ECMM Expert Consultation Service for Medical centres around the globe seeking advice when there is no fungal infection consultant available. The expert consult will provide recommendations and broad expertise on difficult-to-treat invasive fungal infections (eg azole-resistant Aspergillus species, Candida auris, mucormycosis) to improve diagnostic and therapeutic management and outcome. RESULTS: The initiative plans global outreach through video conferencing between ECMM Excellence Centers and treating physicians. FungiScope((R)) registries will be used to structure case information and to evaluate the impact of the collegial advice system at regular intervals. Advice will follow recent guidelines, and EQUAL Scores will be used to measure guideline adherence. CONCLUSIONS: Infectious diseases expert consultation should be an integral component of care for patients with difficult-to-treat invasive fungal infections. The ECMM Expert Consult will attend to this matter on a global scale.
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european confederation of Medical Mycology expert consult an ecmm excellence center initiative
Mycoses, 2020Co-Authors: Philipp Koehler, Martin Hoenigl, Jean-pierre Gangneux, David W Denning, Blandine Denis, Dimitrios P Kontoyiannis, Robert Krause, Katrien Lagrou, Cornelia LassflorlAbstract:OBJECTIVES: Difficult to treat invasive fungal infections require infectious diseases (ID) expert consultation to improve treatment outcome and increase survival rates. METHODS: The European Confederation of Medical Mycology (ECMM) intends to provide expert help free of charge by a newly founded ECMM Expert Consultation Service for Medical centers around the globe seeking advice when there is no fungal infection consultant available. The expert consult will provide recommendations and broad expertise on difficult to treat invasive fungal infections (e.g. azole-resistant Aspergillus species, Candida auris, mucormycosis etc.) to improve diagnostic and therapeutic management and outcome. RESULTS: The initiative plans global outreach through video conferencing between ECMM Excellence Centers and treating physicians. FungiScope® registries will be used to structure case information and to evaluate the impact of the collegial advice system at regular intervals. Advice will follow recent guidelines and EQUAL Scores will be used to measure guideline adherence. CONCLUSIONS: Infectious diseases expert consultation should be an integral component of care for patients with difficult to treat invasive fungal infections. The ECMM Expert Consult will attend to this matter on a global scale.
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defining breakthrough invasive fungal infection position paper of the mycoses study group education and research consortium and the european confederation of Medical Mycology
Mycoses, 2019Co-Authors: Oliver A Cornely, Sharon C.-a. Chen, Martin Hoenigl, Dimitrios P Kontoyiannis, Cornelia Lassflorl, Orla C Morrissey, George Richard ThompsonAbstract:: Breakthrough invasive fungal infections (IFIs) have emerged as a significant problem in patients receiving systemic antifungals; however, consensus criteria for defining breakthrough IFI are missing. This position paper establishes broadly applicable definitions of breakthrough IFI for clinical research. Representatives of the Mycoses Study Group Education and Research Consortium (MSG-ERC) and the European Confederation of Medical Mycology (ECMM) reviewed the relevant English literature for definitions applied and published through 2018. A draft proposal for definitions was developed and circulated to all members of the two organisations for comment and suggestions. The authors addressed comments received and circulated the updated document for approval. Breakthrough IFI was defined as any IFI occurring during exposure to an antifungal drug, including fungi outside the spectrum of activity of an antifungal. The time of breakthrough IFI was defined as the first attributable clinical sign or symptom, mycological finding or radiological feature. The period defining breakthrough IFI depends on pharmacokinetic properties and extends at least until one dosing interval after drug discontinuation. Persistent IFI describes IFI that is unchanged/stable since treatment initiation with ongoing need for antifungal therapy. It is distinct from refractory IFI, defined as progression of disease and therefore similar to non-response to treatment. Relapsed IFI occurs after treatment and is caused by the same pathogen at the same site, although dissemination can occur. These proposed definitions are intended to support the design of future clinical trials and epidemiological research in clinical Mycology, with the ultimate goal of increasing the comparability of clinical trial results.
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the role of Medical Mycology societies in combating invasive fungal infections in low and middle income countries a nigerian model
Mycoses, 2019Co-Authors: Rita O Oladele, Iriagbonse I Osaigbovo, Olusola Ayanlowo, Oliver A Cornely, Arunaloke Chakrabarti, Martin Hoenigl, David W DenningAbstract:: The discipline of Medical Mycology has become increasingly relevant in the face of the rising incidence of invasive fungal infections (IFI), which pose diagnostic and therapeutic challenges for contemporary Medical practice. While firmly established in developed countries, Medical Mycology remains obscure in many low- and middle-income countries (LMICs). With a teeming vulnerable populace and an incidence rate of 11.8%, Nigeria has one of the highest estimated burdens of invasive fungal infections (IFIs) in the world. Regardless, the scourge of IFIs has remained silent due to a combination of factors principal amongst which are a lack of awareness and dearth in personnel skilled in diagnosis. The present narrative examines the status of Medical Mycology practice in Nigeria and chronicles the journey to change the status quo spurred by the Leading International Fungal Education (LIFE)-facilitated burden estimate paper and culminating in the birth of the Medical Mycology Society of Nigeria (MMSN), the pioneer national Medical Mycology society in Africa. The prospects of tackling the IFI challenge are highlighted from the perspective of the nascent society.
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global guidelines and initiatives from the european confederation of Medical Mycology to improve patient care and research worldwide new leadership is about working together
Mycoses, 2018Co-Authors: Nelesh P Govender, Alexandre Alanio, Sharon C.-a. Chen, Esther Segal, Arunaloke Chakrabarti, Martin Hoenigl, Jean-pierre Gangneux, Ferry HagenAbstract:Invasive mycoses present a global challenge with expansion into new hosts, emergence of new pathogens, and development of multidrug resistance. In parallel, new antifungal agents and advanced laboratory diagnostic systems are being developed. In response to these evolving challenges, the European Confederation of Medical Mycology (ECMM) is committed to providing international expertise, guidance, and leadership with the key objectives of improving diagnosis, treatment, outcome, and survival of persons with invasive fungal diseases. Representing 25 affiliated National Medical Mycology Societies, the ECMM has developed several major ways to achieving these critical objectives: (a) tasking specific Medical Mycology working groups; (b) founding the ECMM Academy and Fellow program (FECMM); (c) expanding the goals of ECMM beyond the European region; (d) implementing the ECMM Excellence Centre Initiative in Europe; and (e) the ECMM Global Guidelines and Neglected Orphan Disease Guidance Initiatives focusing on mucormycosis, rare mould diseases, rare yeast diseases, and endemic mycoses. We believe that these important initiatives and other strategies of the ECMM will advance the field of Medical Mycology and improve the outcome of patients with invasive mycoses worldwide.
M A Viviani - One of the best experts on this subject based on the ideXlab platform.
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the european confederation of Medical Mycology ecmm survey of candidaemia in italy in vitro susceptibility of 375 candida albicans isolates and biofilm production
Journal of Antimicrobial Chemotherapy, 2005Co-Authors: A M Tortorano, Anna Prigitano, E Biraghi, M A VivianiAbstract:OBJECTIVES: To investigate the in vitro antifungal susceptibility pattern of 375 Candida albicans bloodstream isolates recovered during the European Confederation of Medical Mycology survey of candidaemia performed in Lombardia, Italy and to test the ability to form biofilm. METHODS: In vitro susceptibility to flucytosine, fluconazole, itraconazole, posaconazole, voriconazole and caspofungin was performed by broth microdilution following the NCCLS guidelines. Biofilm production was measured using the XTT reduction assay in 59 isolates selected as representative of different patterns of susceptibility to flucytosine and azoles. RESULTS: MICs (mg/L) at which 90% of the strains were inhibited were < or =0.25 for flucytosine, 0.25 for caspofungin, 4 for fluconazole and 0.06 for itraconazole, voriconazole and posaconazole. Flucytosine resistance was detected in five isolates and was associated with serotype B in 2/29 and serotype A in 3/346. Resistance to fluconazole was detected in 10 isolates; nine of these exhibited reduced susceptibility to the other azoles. Among the 10 patients with fluconazole-resistant C. albicans bloodstream infection, only one, an AIDS patient, had been previously treated with fluconazole. Biofilm production was observed in 23 isolates (39%) and was significantly associated with serotype B. No relationship was detected with the pattern of antifungal susceptibility. CONCLUSIONS: Resistance is uncommon in C. albicans isolates recovered from blood cultures, while biofilm production is a relatively frequent event. Periodic surveillance is warranted to monitor the incidence of in vitro antifungal resistance as well as of biofilm production.
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the european confederation of Medical Mycology ecmm survey of candidaemia in italy antifungal susceptibility patterns of 261 non albicans candida isolates from blood
Journal of Antimicrobial Chemotherapy, 2003Co-Authors: A M Tortorano, Anna Prigitano, E Biraghi, A. L. Rigoni, M A VivianiAbstract:OBJECTIVES: To analyse the in vitro antifungal susceptibility of 261 non-albicans Candida bloodstream strains isolated during the European Confederation of Medical Mycology survey of candidaemia performed in Lombardia, Italy (September 1997-December 1999). METHODS: In vitro susceptibility to flucytosine, fluconazole, itraconazole, posaconazole and voriconazole was determined using the broth microdilution method described in the NCCLS M27-A guidelines. Etest strips were used to assess susceptibility to amphotericin B. In vitro findings were correlated with the patient's underlying condition and previous antifungal treatment. RESULTS: MICs (mg/L) at which 90% of the strains were inhibited were, respectively, 2 for flucytosine, 8 for fluconazole, 0.5 for itraconazole, 0.25 for voriconazole and 0.25 for posaconazole. Amphotericin B MIC endpoints were <0.50 mg/L in all the isolates tested. Flucytosine resistance was detected in 19 isolates (7%), mainly among Candida tropicalis strains (30%). Innate or secondary fluconazole resistance was detected in 13 strains (5%). Among the 13 patients with fluconazole-resistant Candida bloodstream infection, three were HIV positive, including one treated with fluconazole for oral candidosis; the four who were HIV negative had received the azole during the 2 weeks preceding the candidaemia. Cross-resistance among fluconazole and other azoles was a rare event. CONCLUSIONS: Resistance is still uncommon in non-albicans Candida species recovered from blood cultures. However, in fungaemias caused by C. tropicalis, Candida glabrata and Candida krusei, there is a high prevalence of resistance to fluconazole and flucytosine. Fluconazole resistance should be suspected in patients treated previously with azoles, mainly those with advanced HIV infection.
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The European Confederation of Medical Mycology ECMM) survey of candidaemia in Italy: antifungal susceptibility patterns of 261 non-albicans Candida isolates from blood
The Journal of antimicrobial chemotherapy, 2003Co-Authors: A M Tortorano, Anna Prigitano, E Biraghi, A. L. Rigoni, M A VivianiAbstract:Objectives: To analyse the in vitro antifungal susceptibility of 261 non-alblcans Candida bloodstream strains isolated during the European Confederation of Medical Mycology survey of candidaemia performed in Lombardia, Italy (September 1997-December 1999). Methods: In vitro susceptibility to flucytosine, fluconazole, itraconazole, posaconazole and voriconazole was determined using the broth microdilution method described in the NCCLS M27-A guidelines. Etest strips were used to assess susceptibility to amphotericin B. In vitro findings were correlated with the patient's underlying condition and previous antifungal treatment. Results: MICs (mg/L) at which 90% of the strains were inhibited were, respectively, 2 for flucytosine, 8 for fluconazole, 0.5 for itraconazole, 0.25 for voriconazole and 0.25 for posaconazole. Amphotericin B MIC endpoints were
A M Tortorano - One of the best experts on this subject based on the ideXlab platform.
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the european confederation of Medical Mycology ecmm survey of candidaemia in italy in vitro susceptibility of 375 candida albicans isolates and biofilm production
Journal of Antimicrobial Chemotherapy, 2005Co-Authors: A M Tortorano, Anna Prigitano, E Biraghi, M A VivianiAbstract:OBJECTIVES: To investigate the in vitro antifungal susceptibility pattern of 375 Candida albicans bloodstream isolates recovered during the European Confederation of Medical Mycology survey of candidaemia performed in Lombardia, Italy and to test the ability to form biofilm. METHODS: In vitro susceptibility to flucytosine, fluconazole, itraconazole, posaconazole, voriconazole and caspofungin was performed by broth microdilution following the NCCLS guidelines. Biofilm production was measured using the XTT reduction assay in 59 isolates selected as representative of different patterns of susceptibility to flucytosine and azoles. RESULTS: MICs (mg/L) at which 90% of the strains were inhibited were < or =0.25 for flucytosine, 0.25 for caspofungin, 4 for fluconazole and 0.06 for itraconazole, voriconazole and posaconazole. Flucytosine resistance was detected in five isolates and was associated with serotype B in 2/29 and serotype A in 3/346. Resistance to fluconazole was detected in 10 isolates; nine of these exhibited reduced susceptibility to the other azoles. Among the 10 patients with fluconazole-resistant C. albicans bloodstream infection, only one, an AIDS patient, had been previously treated with fluconazole. Biofilm production was observed in 23 isolates (39%) and was significantly associated with serotype B. No relationship was detected with the pattern of antifungal susceptibility. CONCLUSIONS: Resistance is uncommon in C. albicans isolates recovered from blood cultures, while biofilm production is a relatively frequent event. Periodic surveillance is warranted to monitor the incidence of in vitro antifungal resistance as well as of biofilm production.
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epidemiology of candidaemia in europe results of 28 month european confederation of Medical Mycology ecmm hospital based surveillance study
European Journal of Clinical Microbiology & Infectious Diseases, 2004Co-Authors: A M Tortorano, E Biraghi, Javier Peman, H Bernhardt, Lena Klingspor, Christopher C Kibbler, Odile Faure, E Canton, K Zimmermann, S SeatonAbstract:In order to update the epidemiological and mycological profile of candidaemia in Europe, the European Confederation of Medical Mycology conducted a prospective, sequential, hospital population-based study from September 1997 to December 1999. A total of 2,089 cases were documented by 106 institutions in seven European countries. Rates of candidaemia ranging from 0.20 to 0.38 per 1,000 admissions were reported. Candida albicans was identified in 56% of cases. Non-albicans Candida species were most frequently isolated from patients with haematological malignancies (65%). With increasing age, an increasing incidence of Candida glabrata was seen. The 30-day mortality rate was 37.9%. The survey results underline the burden of candidaemia in a wide range of patient populations, confirm the importance of non-albicans species, and provide baseline data for future surveillance studies at a European level.
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the european confederation of Medical Mycology ecmm survey of candidaemia in italy antifungal susceptibility patterns of 261 non albicans candida isolates from blood
Journal of Antimicrobial Chemotherapy, 2003Co-Authors: A M Tortorano, Anna Prigitano, E Biraghi, A. L. Rigoni, M A VivianiAbstract:OBJECTIVES: To analyse the in vitro antifungal susceptibility of 261 non-albicans Candida bloodstream strains isolated during the European Confederation of Medical Mycology survey of candidaemia performed in Lombardia, Italy (September 1997-December 1999). METHODS: In vitro susceptibility to flucytosine, fluconazole, itraconazole, posaconazole and voriconazole was determined using the broth microdilution method described in the NCCLS M27-A guidelines. Etest strips were used to assess susceptibility to amphotericin B. In vitro findings were correlated with the patient's underlying condition and previous antifungal treatment. RESULTS: MICs (mg/L) at which 90% of the strains were inhibited were, respectively, 2 for flucytosine, 8 for fluconazole, 0.5 for itraconazole, 0.25 for voriconazole and 0.25 for posaconazole. Amphotericin B MIC endpoints were <0.50 mg/L in all the isolates tested. Flucytosine resistance was detected in 19 isolates (7%), mainly among Candida tropicalis strains (30%). Innate or secondary fluconazole resistance was detected in 13 strains (5%). Among the 13 patients with fluconazole-resistant Candida bloodstream infection, three were HIV positive, including one treated with fluconazole for oral candidosis; the four who were HIV negative had received the azole during the 2 weeks preceding the candidaemia. Cross-resistance among fluconazole and other azoles was a rare event. CONCLUSIONS: Resistance is still uncommon in non-albicans Candida species recovered from blood cultures. However, in fungaemias caused by C. tropicalis, Candida glabrata and Candida krusei, there is a high prevalence of resistance to fluconazole and flucytosine. Fluconazole resistance should be suspected in patients treated previously with azoles, mainly those with advanced HIV infection.
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The European Confederation of Medical Mycology ECMM) survey of candidaemia in Italy: antifungal susceptibility patterns of 261 non-albicans Candida isolates from blood
The Journal of antimicrobial chemotherapy, 2003Co-Authors: A M Tortorano, Anna Prigitano, E Biraghi, A. L. Rigoni, M A VivianiAbstract:Objectives: To analyse the in vitro antifungal susceptibility of 261 non-alblcans Candida bloodstream strains isolated during the European Confederation of Medical Mycology survey of candidaemia performed in Lombardia, Italy (September 1997-December 1999). Methods: In vitro susceptibility to flucytosine, fluconazole, itraconazole, posaconazole and voriconazole was determined using the broth microdilution method described in the NCCLS M27-A guidelines. Etest strips were used to assess susceptibility to amphotericin B. In vitro findings were correlated with the patient's underlying condition and previous antifungal treatment. Results: MICs (mg/L) at which 90% of the strains were inhibited were, respectively, 2 for flucytosine, 8 for fluconazole, 0.5 for itraconazole, 0.25 for voriconazole and 0.25 for posaconazole. Amphotericin B MIC endpoints were
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european confederation of Medical Mycology ecmm prospective survey of candidaemia report from one italian region
Journal of Hospital Infection, 2002Co-Authors: A M Tortorano, E Biraghi, A Astolfi, C Ossi, M Tejada, Claudio Farina, S Perin, C Bonaccorso, C Cavanna, A RaballoAbstract:An ECMM epidemiological prospective survey of candidaemia was performed in one Italian region (Lombardy; population: 8 924 870) by the National Society of Medical Mycology (FIMUA) from September 1997 to December 1999. In total, 569 episodes were reported with an overall rate of 0.38/1000 admissions, 4.4/100 000 patient days. Predisposing factors included presence of an intravascular catheter (89%), antibiotic treatment (88%), surgery (56%), intensive care (45%), solid tumour (28%), steroid treatment (15%), haematological malignancy (7%), HIV infection (6%), fetal immaturity (4%). Mucous membrane colonization preceded candidaemia in 83% of patients. Candida albicans was identified in 58% of cases, followed by Candida parapsilosis (15%), Candida glabrata (13%), Candida tropicalis (6%). Septic shock occurred in 95 patients. Crude mortality was 35%, the highest in C. tropicalis fungaemia (44%), the elderly (64%) and solid tumour cancer patients (43%). Intravascular catheter removal was associated with higher survival rate (71 vs. 47%). This survey underscores the importance of candidaemia in hospital settings.
Thomas G Mitchell - One of the best experts on this subject based on the ideXlab platform.
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Fundamental Medical Mycology.
Emerging Infectious Diseases, 2012Co-Authors: Thomas G MitchellAbstract:In Fundamental Medical Mycology, Errol Reiss, Jean Shadomy, and Marshall Lyon have produced a valuable new text. Drs Reiss and Shadomy are Medical mycologists who have extensive research and educational experience with the increasing spectrum of pathogenic fungi, including diagnosis of infections they cause and host defenses. Dr Lyon is an infectious diseases physician with clinical expertise in the epidemiology and management of opportunistic mycoses. This complementary team has produced a highly readable and comprehensive book, which they intend to be a text for Medical and graduate students, a resource for microbiology technologists, and a reference for physicians and researchers. The book has been carefully organized, and the extensive table of contents enables readers to quickly identify specific areas of interest. The first 3 chapters contain basic information describing fungi, diagnostic methods, and antifungal chemotherapy. The succeeding 19 chapters review specific mycoses, using a similar format that addresses the following topics: etiology, clinical manifestations, ecology of the fungi, epidemiology of the infections, pathogenicity, animal infections, treatment, and laboratory diagnosis. Each chapter provides instructive case histories and ends with references and review questions. The book also includes a helpful glossary. A book of this nature can be judged by its completeness, accuracy and timeliness of coverage, clarity of the writing, and ease with which information can be accessed. By all of these criteria, Fundamental Medical Mycology merits high marks. The book does a superlative job in addressing recent advances in Medical Mycology, which include identifying emerging pathogens, new antifungal drugs and strategies for their use; progress in molecular diagnostics; and up-to-date knowledge about host defenses against fungi, especially opportunistic pathogens. For a 1-volume text, this book provides excellent coverage of several critical areas: detailed methods of identifying fungi; descriptions of common and rare mycoses; the nuances of interpreting serologic tests; and ongoing progress in detecting diagnostic fungal antigens, nucleic acids, and signature proteins in clinical specimens. In addition, the authors provide superb, concise descriptions of the strain diversity of the major pathogenic species and the clinical and epidemiologic relevance of certain phylogenetic clades. Currently unresolved or controversial topics are clearly explained, such as fungal sinusitis and the etiology of Malassezia spp. infections. When information is available, each chapter summarizes the mechanisms of pathogenicity and confirmed virulence factors. The authors discuss advances in understanding the innate and adaptive immune responses to fungi at the tissue, cellular, and molecular levels (e.g., the role of Th17 immune responses in candidiasis). Another asset is the frequent but unobtrusive inclusion of key citations to assist anyone seeking additional information. The illustrations include diagrams, clinical photographs, and photomicrographs from a variety of sources as well as original figures. Rather than attempt pictorial consistency throughout, the authors have gleaned images for their relevance to the text. This book will serve Medical and graduate students who will value the book’s succinct, lucid coverage of key fungal infections, as well as instructive case vignettes and review questions. Clinical fellows and physicians will appreciate the readable summaries of specific mycoses, diagnostic procedures, common symptoms, and appropriate antifungal drugs. BioMedical scientists and educators in related fields will use this text as a resource for a quick review of specific topics.
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status of Medical Mycology education
Medical Mycology, 2003Co-Authors: William J. Steinbach, Thomas G Mitchell, Wiley A Schell, Thomas J. Walsh, Richard Coico, Ana Espinelingroff, John R PerfectAbstract:The number of immunocompromised patients and subsequent invasive fungal infections continues to rise. However, the education of future Medical mycologists to engage this growing problem is diminishing. While there are an increasing number of publications and grants awarded in Mycology, the time and detail devoted to teaching Medical Mycology in United States Medical schools are inadequate. Here we review the history in Medical Mycology education and the current educational opportunities. To accurately gauge contemporary teaching we also conducted a prospective survey of microbiology and immunology departmental chairpersons in United States Medical schools to determine the amount and content of contemporary education in Medical Mycology.
A. Restrepo - One of the best experts on this subject based on the ideXlab platform.
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Teaching Medical Mycology in the year 2000.
Medical mycology, 1998Co-Authors: Ricardo Negroni, Glenn Bulmer, D Ellis, John R. Graybill, A. RestrepoAbstract:Medical Mycology is of increasing interest to the basic scientist, pathologist, microbiologist and clinician. This interest has been prompted by the rising number of immunosuppressed patients with opportunistic fungal infections, the expanding boundaries of the so-called endemic mycoses, the recognition of several major new endemic mycoses and a variety of other emerging fungal infections, and the development of potent, non-toxic antifungal drugs to treat these infections. The world of Mycology is changing dramatically, especially in developing countries which have only limited resources to cope with the impact of the compromised host and the introduction of costly new antifungal drugs. Consequently, there is an urgent need to increase our effectiveness as teachers of Medical Mycology at all levels and in all regions of the world.