Nelesh Govender
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neleshg.bsky.social
Nelesh Govender
@neleshg.bsky.social
I study fungal and bacterial diseases. Prof at Wits. @nihr Global Health Research Prof. Hon Prof at MRC-CMM @uniofexeter, City-St George's and UCT. On sabbatical from NICD. MD, micro, epi 🌈
🎉to Charlotte Rabault - she published this after a 6-month fellowship in Joburg

In patients aged >90 days, prior antifungal use was associated with non-susceptible Candida bloodstream infection (OR 2.02). In young infants, hospital transmission was more influential.

wwwnc.cdc.gov/eid/article/...
September 27, 2025 at 10:29 AM
Abstracts, Clinical Conundrums and FungArt for the Fungal Update conference in London (March 2026) are all now open for submission: mycologyconference.co.uk/abstracts/
Abstracts – Fungal Update: Mycology Conference
mycologyconference.co.uk
September 9, 2025 at 5:05 PM
Reposted by Nelesh Govender
Genomic epidemiology of Histoplasma in Africa

Rutendo Mapingo ... @neleshg.bsky.social Daniel Matute

Three genetically distinct lineages identified among African Histoplasma isolates

journals.asm.org/doi/10.1128/...
August 5, 2025 at 1:45 PM
Results from our CAST-NET cohort study published. Excellent national coverage of cryptococcal antigen screening in SA but real challenges to act on CrAg+ results to exclude meningitis and dispense pre-emptive antifungals

journals.lww.com/jaids/abstra...
July 17, 2025 at 11:46 AM
Jayne Ellis presenting data from our cohort with CD4 <100 undergoing CrAg screening in SA at #IAS2025 (poster 2803)

59% (86/146) had CMV viraemia - strongly & independently associated with ⬆️mortality, more than quadrupling odds of death at 6-months (adjusted OR 4.02, 95%CI 1.27-12.7)
July 14, 2025 at 8:36 AM
During 2016–2023, among 21,195 US patients who tested positive for Candida auris skin colonisation, 6.9% were subsequently found to have a positive clinical specimen, 2.8% from blood

Probably an underestimate but useful to know

wwwnc.cdc.gov/eid/article/...
Progression from <em>Candida auris</em> Colonization Screening to Clinical Case Status, United States, 2016–2023
<em>C. auris</em> Colonization Screening to Clinical Case
wwwnc.cdc.gov
July 14, 2025 at 8:30 AM
Reposted by Nelesh Govender
We brought together teams from 13 neonatal sepsis surveillance studies, conducted across 35 sites in South Asia and Africa, to pool data and estimate prevalence of capsule and O types amongst #Klebsiella pneumoniae causing sepsis in newborns, using Bayesian modelling.
July 1, 2025 at 9:47 AM
Reposted by Nelesh Govender
I'm super happy to share this preprint on ‘Distribution of capsule and O types in #Klebsiella pneumoniae causing neonatal sepsis in Africa and South Asia: meta-analysis of genome-predicted serotype prevalence and potential vaccine coverage’
doi.org/10.1101/2025...
Distribution of capsule and O types in Klebsiella pneumoniae causing neonatal sepsis in Africa and South Asia: meta-analysis of genome-predicted serotype prevalence and potential vaccine coverage
Background: Klebsiella pneumoniae causes ~20% of sepsis in neonates, with ~40% crude mortality. A vaccine administered to pregnant women, protecting against 70% of K. pneumoniae infections, could aver...
doi.org
July 1, 2025 at 9:45 AM
Congrats to Serisha Naicker & our 🌍CryptoADAPT team
at Wits, UP, SUN, Imperial, CISM, UZ, Duke for the new @wellcometrust.bsky.social grant

Excited to dig into the environmental diversity of Cryptococcus in Africa

www.wits.ac.za/news/latest-...
2025-06 - Investigating fungi and what makes them dangerous - Wits University
www.wits.ac.za
June 27, 2025 at 11:59 AM
Reposted by Nelesh Govender
Must read from @stephanienolen.bsky.social @nytimes.com:

From #SouthAfrica Built a Medical Research Powerhouse. Trump Cuts Have Demolished It. www.nytimes.com/2025/06/17/h...
South Africa Built a Medical Research Powerhouse. Trump Cuts Have Demolished It.
www.nytimes.com
June 17, 2025 at 10:38 AM
Hosted by a full panel of trial investigators from the @effecttrial.bsky.social
Join us for our next CME webinar focusing on Cryptococcal Case-Based Discussions. Register here bit.ly/3FIJ5Ql for Thursday and here bit.ly/4569GRU for Tuesday
@neleshg.bsky.social #HIVCare
June 4, 2025 at 4:12 PM
Great updates and learning at the histoplasmosis working group meeting at the tail end of ISHAM triennial conference

And new targets will be set...
May 25, 2025 at 3:36 PM
Great to contribute to this week's Naked Scientist podcast on the rising tide of fungal diseases

www.thenakedscientists.com/podcasts/nak...
The rising tide of fungal diseases
Are we ready to fight off a new world of infections?
www.thenakedscientists.com
May 20, 2025 at 5:00 PM
Congratulations Lottie
May 20, 2025 at 4:57 PM
"Considering this conflicting evidence, there is equipoise to support a clinical trial in which persons with AHD without overt symptoms suggestive of histoplasmosis and with Histoplasma antigenuria are randomized to pre-emptive antifungal therapy or to observation."
Histoplasmosis remains an important cause of AIDS-related deaths in many regions

Histoplasma antigen tests are now cheap, accessible, and can be done at POC

Are such assays ready to be used for routine screening of patients with advanced HIV?

We have thoughts 🤔

🔓 academic.oup.com/cid/advance-...
Histoplasma antigen screening in advanced HIV disease
Ilan S Schwartz, Alessandro C Pasqualotto; Histoplasma antigen screening in advanced HIV disease, Clinical Infectious Diseases, , ciaf238, https://doi.org/
academic.oup.com
May 15, 2025 at 7:12 PM
Reposted by Nelesh Govender
"How can WHO be expected to serve the whole world on the same budget as one hospital in a mid-sized European city?"

www.statnews.com/2025/05/14/w...
WHO trims top management ranks amid financial crunch
The WHO, which faces an extraordinary financial crunch in the wake of the U.S. withdrawal from the agency, has dramatically trimmed its top management.
www.statnews.com
May 14, 2025 at 3:13 PM
Reposted by Nelesh Govender
Thanks for sharing.

There was also a recent State of the Art review in CID on the topic academic.oup.com/cid/article/...
State-of-the-Art Review: Use of Antimicrobials at the End of Life
Abstract. Navigating antibiotics at the end of life is a challenge for infectious disease (ID) physicians who remain deeply committed to providing patient-
academic.oup.com
May 8, 2025 at 3:24 PM
In 2008, my wonderful 84-year-old grandmother died in hospital with perforated diverticulitis. I was a newly-qualified clinical microbiologist then. When it became clear that she wouldn't recover, I asked for her to be transferred out of ICU, to receive palliative care and to stop antibiotics...
May 8, 2025 at 1:51 PM
Bad news...

"A draft budget for the department [HHS], obtained by The New York Times, proposes axing two journals published by the Centers for Disease Control and Prevention: Emerging Infectious Diseases and Preventing Chronic Disease."
April 30, 2025 at 2:46 PM
Reposted by Nelesh Govender
Plasma Microbial Cell-free DNA Metagenomic Sequencing for Diagnosis of Invasive Fungal Diseases Among High-risk Outpatient and Inpatient Immunocompromised Hosts

#IDSky
Plasma Microbial Cell-free DNA Metagenomic Sequencing for Diagnosis of Invasive Fungal Diseases Among High-risk Outpatient and Inpatient Immuno
New and minimally invasive tools to aid the diagnosis of invasive fungal diseases (IFD) are urgently needed as the immunocompromised population at highest risk increases. Advancements in molecular technology have rendered new diagnostics more readily available for clinical use.
bit.ly
April 26, 2025 at 1:33 AM
Cryptococcal Meningitis Treatment Beyond HIV: Recognizing the need for Individualized Immune-Based Strategies

Hyunah Yoon, Liise-anne Pirofsky, @drboulware.bsky.social

In non-HIV-associated CM, ⬇️ing immunosuppression --> ⬆️ inflammation --> 🧠 damage.

academic.oup.com/cid/advance-... #TxID #IDSky
April 26, 2025 at 7:27 AM
It's staggering what has unravelled in a matter of months
April 24, 2025 at 2:06 PM
Reposted by Nelesh Govender
Fungi can protect the environment, grow food and even develop new medicines. 🍄

But they can also cause disease.

As climate change spreads pathogenic fungi to new places, more people worldwide will be at risk.

Learn more in our explainer ⤵️
wellcome.org/news/will-cl...
Will climate change lead to more fungal infections? | News | Wellcome
Fungi can keep us healthy or cause disease. As climate change drives fungi to adapt, learn how we can harness the benefits and tackle the threats.
wellcome.org
April 24, 2025 at 1:10 PM
Nice cover of Emerging Infectious Diseases Journal, highlighting the still-mysterious fungal kingdom, a small % of which causes deadly human infections

"Nature alone is antique, and the oldest art a mushroom" -https://wwwnc.cdc.gov/eid/article/31/5/ac-3105_article
April 24, 2025 at 2:03 PM
Recruiting inpatients living w/ HIV into ADVANCE GERMS-SA cohort study in Johannesburg @raewake.bsky.social

Screened 2000, enrolled >500 so far. Primary outcome: incidence severe infections

AHD-associated sepsis & AMR summarised in a new @mbio.bsky.social mGem: journals.asm.org/doi/10.1128/...
mGem: Sepsis and antimicrobial resistance in the context of advanced HIV disease | mBio
People with advanced HIV disease (AHD; defined among adults as a CD4 cell count &lt;200 cells/µL or a World Health Organization [WHO] stage 3 or 4 clinical event) are at increased risk of hospitalizat...
journals.asm.org
April 24, 2025 at 12:04 PM