Medical Mycology Update – 1-16 March 2026
Diagnostics, resistance, stewardship and clinically important signals
The first half of March 2026 shows several clear themes in medical mycology.
Candida resistance and surveillance are particularly prominent, especially for
Candida auris, Candida parapsilosis, and Candida tropicalis.
There is also continued refinement of fungal biomarker interpretation,
including important new data on (1,3)-beta-D-glucan and galactomannan.
In parallel, diagnostic stewardship, MIC interpretation, and decisions about
when to stop antifungal therapy are becoming more central to clinical practice.
Contents
- 1. Molecular diagnostics and biomarkers
- 2. Aspergillus and mould diagnostics
- 3. Candida, Candida auris and candidemia surveillance
- 4. Resistance, stewardship and laboratory practice
- 5. Notable clinical and case-based signals
- Key themes
1. Molecular diagnostics and biomarkers
False-positive beta-D-glucan in bacteremia
Highlights an important diagnostic pitfall where bacterial bloodstream infection can lead to false-positive results.
Beta-D-glucan performance in Candida parapsilosis candidemia
Suggests species-specific variability in biomarker sensitivity.
Galactomannan and beta-D-glucan in CAPA
Ongoing evaluation of serum biomarkers in critically ill COVID-19 patients.
Real-time PCR detection of circulating fungal DNA
Demonstrates emerging applications of panfungal PCR beyond classical populations.
2. Aspergillus and mould diagnostics
Azole persistence preceding resistance in Aspergillus fumigatus
Suggests treatment failure may occur before classical resistance mutations are detectable.
Aspergillus in tuberculosis-like presentations
Highlights diagnostic overlap between TB and aspergillosis.
Atypical aspergillosis presentation
Case illustrating diagnostic value of galactomannan and biopsy.
Cerebral aspergillosis diagnostic challenges
Delayed recognition and limited sensitivity remain key issues.
Mortality trends in invasive aspergillosis
Improvements may be threatened by resistance and changing host factors.
3. Candida, Candida auris and candidemia surveillance
Candida auris: resistant, persistent and global
Key overview of this major healthcare-associated pathogen.
Multidrug resistance in Candida auris
Explains mechanisms and clinical implications.
Predictors of resistant Candida infection
Supports risk-based antifungal stewardship.
Long-term candidemia surveillance studies
Show changing epidemiology and resistance patterns.
PubMed: 41794662
PubMed: 41804483
Azole-resistant Candida parapsilosis (genomic studies)
Evidence of hospital-associated resistant clones.
PubMed: 41793231
PubMed: 41840233
Resistant Candida tropicalis lineage
Combines resistance with immune evasion traits.
Rare yeast bloodstream infections
Highlights diversity and differing susceptibility profiles.
Candida endocarditis review
High-mortality condition requiring multimodal diagnostics.
4. Resistance, stewardship and laboratory practice
Antifungal susceptibility testing and MIC interpretation
Explains variability and limitations of MIC-based decision-making.
Fungal diagnostic stewardship
Highlights the importance of appropriate test use in immunocompromised patients.
Stopping antifungal therapy in IPA
Important emerging area of stewardship practice.
One Health and antifungal resistance
Links environmental azole use with clinical resistance.
5. Notable clinical and case-based signals
Trichosporon fungemia case series
Rare but high-mortality infection in immunocompromised patients.
Rhino-orbito-cerebral mucormycosis in new-onset diabetes
Classic but important diagnostic emergency.
Key themes
- Candida resistance remains a dominant theme, particularly C. auris and C. parapsilosis
- Stewardship is expanding to include diagnostics, MIC interpretation and stopping therapy
- Biomarker interpretation is becoming more nuanced, especially beta-D-glucan
- Aspergillus diagnostics increasingly focus on complex and atypical presentations
- Surveillance is becoming more genomic and system-focused