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Recent advances in delivery of antifungal agents for therapeutic management of candidiasis. Biomed Pharmacother 2017; 96:1478-1490. [PMID: 29223551 DOI: 10.1016/j.biopha.2017.11.127] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 11/17/2017] [Accepted: 11/27/2017] [Indexed: 01/08/2023] Open
Abstract
Candidiasis is a fungal infection caused by yeasts that belong to the genus Candida. There are over twenty species of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans. Candida yeasts normally reside in the intestinal tract and can be found on mucous membranes and skin without causing infection; however, overgrowth of these organisms can cause symptoms to develop. Presence of other diseases that compromises the patient's immunity makes it more difficult to treat. Candidiasis is majorly divided into superficial infections (oral or vaginal) and systemic infections, also known as invasive candidiasis. The conventional therapeutic modalities used to treat candidiasis are associated with several side effects that limits the dose and dosing frequency. Development of novel drug delivery systems for reduction in dose and alleviation of side effects is an important strategy to improve the clinical efficacy and patient acceptability. This review gives a bird's eye view of the classification and current therapeutic regime of candidiasis. It presents the varied types of drug delivery systems that have been exploited for delivery of antifungal agents with measurable benefits. It also touches upon echinocandins a relatively new class of drugs that are amenable for translation into novel dosage forms with application against biofilm producing and fluconazole resistant strains contributing to a better therapeutic management of candidiasis.
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Kaur H, Chakrabarti A. Strategies to Reduce Mortality in Adult and Neonatal Candidemia in Developing Countries. J Fungi (Basel) 2017; 3:E41. [PMID: 29371558 PMCID: PMC5715942 DOI: 10.3390/jof3030041] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 07/13/2017] [Accepted: 07/16/2017] [Indexed: 02/07/2023] Open
Abstract
Candidemia, the commonest invasive fungal infection, is associated with high morbidity and mortality in developing countries, though the exact prevalence is not known due to lack of systematic epidemiological data from those countries. The limited studies report a very high incidence of candidemia and unique epidemiology with a different spectrum of Candida species. The recent global emergence of multi-drug resistant Candida auris is looming large as an important threat in hospitalized patients of developing countries. While managing candidemia cases in those countries several challenges are faced, which include poor infrastructure; compromised healthcare and infection control practices; misuse and overuse of antibiotics and steroids; lack of awareness in fungal infections; non-availability of advance diagnostic tests and antifungal drugs in many areas; poor compliance to antifungal therapy and stewardship program. Considering the above limitations, innovative strategies are required to reduce mortality due to candidemia in adults and neonates. In the present review, we have unraveled the challenges of candidemia faced by low resource countries and propose a ten part strategy to reduce mortality due candidemia.
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Affiliation(s)
- Harsimran Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.
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Menzel LP, Chowdhury HM, Masso-Silva JA, Ruddick W, Falkovsky K, Vorona R, Malsbary A, Cherabuddi K, Ryan LK, DiFranco KM, Brice DC, Costanzo MJ, Weaver D, Freeman KB, Scott RW, Diamond G. Potent in vitro and in vivo antifungal activity of a small molecule host defense peptide mimic through a membrane-active mechanism. Sci Rep 2017; 7:4353. [PMID: 28659617 PMCID: PMC5489528 DOI: 10.1038/s41598-017-04462-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 05/17/2017] [Indexed: 12/28/2022] Open
Abstract
Lethal systemic fungal infections of Candida species are increasingly common, especially in immune compromised patients. By in vitro screening of small molecule mimics of naturally occurring host defense peptides (HDP), we have identified several active antifungal molecules, which also exhibited potent activity in two mouse models of oral candidiasis. Here we show that one such compound, C4, exhibits a mechanism of action that is similar to the parent HDP upon which it was designed. Specifically, its initial interaction with the anionic microbial membrane is electrostatic, as its fungicidal activity is inhibited by cations. We observed rapid membrane permeabilization to propidium iodide and ATP efflux in response to C4. Unlike the antifungal peptide histatin 5, it did not require energy-dependent transport across the membrane. Rapid membrane disruption was observed by both fluorescence and electron microscopy. The compound was highly active in vitro against numerous fluconazole-resistant clinical isolates of C. albicans and non-albicans species, and it exhibited potent, dose-dependent activity in a mouse model of invasive candidiasis, reducing kidney burden by three logs after 24 hours, and preventing mortality for up to 17 days. Together the results support the development of this class of antifungal drug to treat invasive candidiasis.
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Affiliation(s)
- Lorenzo P Menzel
- Department of Oral Biology, University of Florida, Gainesville, FL, 32610, USA
| | | | - Jorge Adrian Masso-Silva
- Graduate School of Biomedical Sciences, New Jersey Medical School, Rutgers, Newark, NJ, 07101, USA
| | - William Ruddick
- Department of Oral Biology, University of Florida, Gainesville, FL, 32610, USA
| | - Klaudia Falkovsky
- Department of Oral Biology, New Jersey Dental School, Rutgers, Newark, NJ, 07101, USA
| | - Rafael Vorona
- Department of Oral Biology, University of Florida, Gainesville, FL, 32610, USA
| | - Andrew Malsbary
- Department of Oral Biology, New Jersey Dental School, Rutgers, Newark, NJ, 07101, USA
| | - Kartikeya Cherabuddi
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL, 32610, USA
| | - Lisa K Ryan
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL, 32610, USA
| | - Kristina M DiFranco
- Department of Oral Biology, University of Florida, Gainesville, FL, 32610, USA
| | - David C Brice
- Department of Oral Biology, University of Florida, Gainesville, FL, 32610, USA
| | | | - Damian Weaver
- Fox Chase Chemical Diversity Center, Doylestown, PA, USA
| | | | | | - Gill Diamond
- Department of Oral Biology, University of Florida, Gainesville, FL, 32610, USA.
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Gois PHF, Ferreira D, Olenski S, Seguro AC. Vitamin D and Infectious Diseases: Simple Bystander or Contributing Factor? Nutrients 2017; 9:E651. [PMID: 28672783 PMCID: PMC5537771 DOI: 10.3390/nu9070651] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/19/2017] [Accepted: 06/22/2017] [Indexed: 02/07/2023] Open
Abstract
Vitamin D (VD) is a fat-soluble steroid essential for life in higher animals. It is technically a pro-hormone present in few food types and produced endogenously in the skin by a photochemical reaction. In recent decades, several studies have suggested that VD contributes to diverse processes extending far beyond mineral homeostasis. The machinery for VD production and its receptor have been reported in multiple tissues, where they have a pivotal role in modulating the immune system. Similarly, vitamin D deficiency (VDD) has been in the spotlight as a major global public healthcare burden. VDD is highly prevalent throughout different regions of the world, including tropical and subtropical countries. Moreover, VDD may affect host immunity leading to an increased incidence and severity of several infectious diseases. In this review, we discuss new insights on VD physiology as well as the relationship between VD status and various infectious diseases such as tuberculosis, respiratory tract infections, human immunodeficiency virus, fungal infections and sepsis. Finally, we critically review the latest evidence on VD monitoring and supplementation in the setting of infectious diseases.
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Affiliation(s)
- Pedro Henrique França Gois
- Laboratory of Medical Research-LIM12, Nephrology Department, University of São Paulo School of Medicine, São Paulo CEP 01246-903, Brazil.
- Nephrology Department, Royal Brisbane and Women's Hospital, Herston QLD 4029, Australia.
| | - Daniela Ferreira
- Laboratory of Medical Research-LIM12, Nephrology Department, University of São Paulo School of Medicine, São Paulo CEP 01246-903, Brazil.
| | - Simon Olenski
- Nephrology Department, Royal Brisbane and Women's Hospital, Herston QLD 4029, Australia.
| | - Antonio Carlos Seguro
- Laboratory of Medical Research-LIM12, Nephrology Department, University of São Paulo School of Medicine, São Paulo CEP 01246-903, Brazil.
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Jafari M, Salari S, Pakshir K, Zomorodian K. Exoenzyme activity and possibility identification of Candida dubliniensis among Candida albicans species isolated from vaginal candidiasis. Microb Pathog 2017. [PMID: 28642006 DOI: 10.1016/j.micpath.2017.06.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Vulvovaginal candidiasis (VVC) or vaginal candidiasis is a common fungal infection of the genitals causing inflammation, irritation, itching, and vaginal discharge. Common yeast infections are caused by the yeast species C. albicans. However, there are other species of Candida such as C. dubliniensis which are considered as the causative agents of this infection. Hydrolytic enzymes such as proteinase and coagulase are known as virulence factors. The aim of this study was the molecular confirmation and differentiation of C. dubliniensis among C. albicans strains isolated from women with vulvovaginal candidiasis by PCR-Restriction Fragment Length Polymorphism (PCR-RFLP) and the evaluation of proteinase and coagulase activities. METHODS A total of 100 C. albicans strains isolated from women with vulvovaginal candidiasis referred to Shiraz medical clinics were enrolled in the study. All the isolates were primarily identified by conventional methods. PCR-RFLP method was used for the confirmation and identification of C. albicans and C. dubliniensis. Moreover, in vitro proteinase and coagulase activities of these isolates were evaluated using bovine serum albumin media and classical rabbit plasma tube test. RESULTS As a result, PCR-RFLP identified 100% of the isolates as C. albicans, and no C. dubliniensis could be identified in this study. 84% of the isolates showed proteinase activity, whereas coagulase activity was only detected in 5% of the isolates. CONCLUSIONS This study reveals that C. dubliniensis plays no role in vaginal candidiasis in Iranian patients. Proteinase production could be an essential virulence factor in C. albicans pathogenicity, but coagulase activity has less potential in this matter.
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Affiliation(s)
- Maryam Jafari
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samira Salari
- Research Center for Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran; Department of Medical Mycology and Parasitology, School of Medicine, Medical University of Kerman, Kerman, Iran.
| | - Keyvan Pakshir
- Basic Sciences in Infectious Diseases Research Center, Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Kamiar Zomorodian
- Basic Sciences in Infectious Diseases Research Center, Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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[new multiplex PCR for species-specific diagnosis of human candidiasis]. BIOMEDICA 2017; 37:200-208. [PMID: 28527284 DOI: 10.7705/biomedica.v37i2.3202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 06/01/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Candidiases is a group of opportunistic infections caused by yeasts belonging to the genus Candida. Candida albicans is the most prevalent species in both superficial and deep infections, however, the clinical importance of non-albicans Candida has increased during the last decade, driving an urgent need for diagnostic tests that allow for species-level resolution and selection of the optimum therapeutic approach. OBJECTIVE To design and to optimize a new multiplex PCR assay for the simultaneous identification of the five most relevant species of Candida involved in human candidiasis etiology. MATERIALS AND METHODS For primers design, the physical and thermodynamic restrictions that affect multiplex PCR performance were analyzed using Gene Runner and Mult-PSOS. As templates, the internal transcribed region 2 (ITR2) was selected for C. albicans (AJ249486.1), and topoisomerase II (TOPII) for C. parasilopsis (AB049144.1), C. krusei (AB049139.1), C. tropicalis (AB049141.1), and C. guillermondii (AB049145.1). We used ATCC strains of all these five species and clinical isolates as templates. RESULTS We designed ten oligonucleotides for the simultaneous amplification of the Candida species. The electrophoresis band profile was: C. albicans (206 bp), C. guillermondii (244 bp), C. tropicalis (474 bp), C. parasilopsis (558 bp), and C. krusei (419 bp). CONCLUSION The new multiplex PCR assay designed in this study allowed a simultaneous and efficient amplification of the amplicons corresponding to the five species of Candida under study, with an adequate resolution in standard agarose gel.
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Millot M, Girardot M, Dutreix L, Mambu L, Imbert C. Antifungal and Anti-Biofilm Activities of Acetone Lichen Extracts against Candida albicans. Molecules 2017; 22:molecules22040651. [PMID: 28422057 PMCID: PMC6154547 DOI: 10.3390/molecules22040651] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/06/2017] [Accepted: 04/14/2017] [Indexed: 01/09/2023] Open
Abstract
Candida albicans is a commensal coloniser of the human gastrointestinal tract and an opportunistic pathogen, especially thanks to its capacity to form biofilms. This lifestyle is frequently involved in infections and increases the yeast resistance to antimicrobials and immune defenses. In this context, 38 lichen acetone extracts have been prepared and evaluated for their activity against C. albicans planktonic and sessile cells. Minimum inhibitory concentrations of extracts (MICs) were determined using the broth microdilution method. Anti-biofilm activity was evaluated using tetrazolium salt (XTT) assay as the ability to inhibit the maturation phase (anti-maturation) or to eradicate a preformed 24 h old biofilm (anti-biofilm). While none of the extracts were active against planktonic cells, biofilm maturation was limited by 11 of the tested extracts. Seven extracts displayed both anti-maturation and anti-biofilm activities (half maximal inhibitory concentrations IC50_mat and IC50_biof ≤ 100 µg/mL); Evernia prunastri and Ramalina fastigiata were the most promising lichens (IC50_mat < 4 µg/mL and IC50_biof < 10 µg/mL). Chemical profiles of the active extracts performed by thin layer chromatography (TLC) and high performance liquid chromatography (HPLC) have been analyzed. Depsides, which were present in large amounts in the most active extracts, could be involved in anti-biofilm activities. This work confirmed that lichens represent a reservoir of compounds with anti-biofilm potential.
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Affiliation(s)
- Marion Millot
- Laboratoire de Chimie des Substances Naturelles, Faculté de Pharmacie, 2 rue du Dr Marcland, 87025 Limoges, France.
| | - Marion Girardot
- Laboratoire Ecologie et Biologie des Interactions, Equipe Microbiologie de l'Eau, Université de Poitiers, UMR CNRS 7267, F-86073 Poitiers, France.
| | - Lucile Dutreix
- Laboratoire Ecologie et Biologie des Interactions, Equipe Microbiologie de l'Eau, Université de Poitiers, UMR CNRS 7267, F-86073 Poitiers, France.
| | - Lengo Mambu
- Laboratoire de Chimie des Substances Naturelles, Faculté de Pharmacie, 2 rue du Dr Marcland, 87025 Limoges, France.
| | - Christine Imbert
- Laboratoire Ecologie et Biologie des Interactions, Equipe Microbiologie de l'Eau, Université de Poitiers, UMR CNRS 7267, F-86073 Poitiers, France.
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Pu S, Niu S, Zhang C, Xu X, Qin M, Huang S, Zhang L. Epidemiology, antifungal susceptibilities, and risk factors for invasive candidiasis from 2011 to 2013 in a teaching hospital in southwest China. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2017; 50:97-103. [DOI: 10.1016/j.jmii.2015.01.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 12/11/2014] [Accepted: 01/12/2015] [Indexed: 12/29/2022]
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Santos TF, de Jesus JB, Neufeld PM, Jordão AK, Campos VR, Cunha AC, Castro HC, de Souza MCBV, Ferreira VF, Rodrigues CR, Abreu PA. Exploring 1,2,3-triazole derivatives by using in vitro and in silico assays to target new antifungal agents and treat Candidiasis. Med Chem Res 2017. [DOI: 10.1007/s00044-017-1789-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Motoa G, Muñoz JS, Oñate J, Pallares CJ, Hernández C, Villegas MV. Epidemiology of Candida isolates from Intensive Care Units in Colombia from 2010 to 2013. Rev Iberoam Micol 2016; 34:17-22. [PMID: 27810262 DOI: 10.1016/j.riam.2016.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 11/25/2015] [Accepted: 02/12/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The frequency of Candida isolates as a cause of hospital infections has risen in recent years, leading to high rates of morbidity and mortality. The knowledge of the epidemiology of those hospital acquired fungal infections is essential to implement an adequate antifungal therapy. AIMS To describe the epidemiology of Candida infections in Intensive Care Units (ICUs) from a surveillance network in Colombia. METHODS Information was collected from the microbiology laboratories of 20 tertiary healthcare institutions from 10 Colombian cities using the Whonet® software version 5.6. A general descriptive analysis of Candida species and susceptibility profiles focusing on fluconazole and voriconazole was completed between 2010 and 2013, including a sub-analysis of healthcare associated infections (HAIs) during the last year. RESULTS Candida isolates made up 94.5% of the 2680 fungal isolates considered, with similar proportions for Candida albicans and non-C. albicans Candida species (48.3% and 51.7%, respectively). Among the latter, Candida tropicalis (38.6%) and Candida parapsilosis (28.5%) were the most frequent species. Of note, among the blood isolates C. albicans was not the main species. Most of the species isolated were susceptible to fluconazole and voriconazole. From the HAIs reported, 25.5% were caused by Candida; central line-associated bloodstream infection was the most common HAI (58.8%). There were no statistically significant differences regarding length of hospital stay and device days among HAIs. CONCLUSIONS In ICUs of Colombia, non-C. albicans Candida species are as frequent as C. albicans, except in blood samples where non-C. albicans Candida isolates predominate. Further studies are needed to evaluate Candida associated risk factors and to determine its clinical impact.
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Affiliation(s)
- Gabriel Motoa
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
| | - Juan Sebastián Muñoz
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
| | - José Oñate
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia; Department of Internal Medicine, School of Medicine, Universidad del Valle, Cali, Colombia; Centro Medico Imbanaco, Cali, Colombia
| | | | - Cristhian Hernández
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
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Pang YK, Ip M, You JHS. Potential clinical and economic outcomes of active beta-D-glucan surveillance with preemptive therapy for invasive candidiasis at intensive care units: a decision model analysis. Eur J Clin Microbiol Infect Dis 2016; 36:187-194. [DOI: 10.1007/s10096-016-2796-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 09/16/2016] [Indexed: 11/29/2022]
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Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework. Infect Immun 2016; 84:2724-39. [PMID: 27430274 DOI: 10.1128/iai.00469-16] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Historically, the nature and extent of host damage by a microbe were considered highly dependent on virulence attributes of the microbe. However, it has become clear that disease is a complex outcome which can arise because of pathogen-mediated damage, host-mediated damage, or both, with active participation from the host microbiota. This awareness led to the formulation of the damage response framework (DRF), a revolutionary concept that defined microbial virulence as a function of host immunity. The DRF outlines six classifications of host damage outcomes based on the microbe and the strength of the immune response. In this review, we revisit this concept from the perspective of Candida albicans, a microbial pathogen uniquely adapted to its human host. This fungus commonly colonizes various anatomical sites without causing notable damage. However, depending on environmental conditions, a diverse array of diseases may occur, ranging from mucosal to invasive systemic infections resulting in microbe-mediated and/or host-mediated damage. Remarkably, C. albicans infections can fit into all six DRF classifications, depending on the anatomical site and associated host immune response. Here, we highlight some of these diverse and site-specific diseases and how they fit the DRF classifications, and we describe the animal models available to uncover pathogenic mechanisms and related host immune responses.
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Morsy N, Al Sherif EA, Abdel-rassol TM. Phytochemical analysis of Calotropis procera with antimicrobial activity investigation. MAIN GROUP CHEMISTRY 2016. [DOI: 10.3233/mgc-160206] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Nagy Morsy
- Department of Chemistry, Faculty of Sciences and Arts, Khulais, King Abdulaziz University, Kingdom of Saudi Arabia
- Department of Chemistry, Faculty of Sciences and Arts, Khulais, University of Jeddah, Kingdom of Saudi Arabia
- Department of Chemistry of Natural Compounds, National Research Centre, Dokki, Cairo, Egypt
| | - Emad A. Al Sherif
- Department of Biology, Faculty of Sciences and Arts, Khulais, King Abdulaziz University, Kingdom of Saudi Arabia
- Department of Biology, Faculty of Sciences and Arts, Khulais, University of Jeddah, Kingdom of Saudi Arabia
- Department of Botany, Faculty of Science, BeniSuef University, BeniSuef, Egypt
| | - Tayseer M.A. Abdel-rassol
- Department of Biology, Faculty of Sciences and Arts, Khulais, King Abdulaziz University, Kingdom of Saudi Arabia
- Department of Botany & Microbiology, Faculty of Science, Suez Canal University, Egypt
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He ZX, Shi LC, Ran XY, Li W, Wang XL, Wang FK. Development of a Lateral Flow Immunoassay for the Rapid Diagnosis of Invasive Candidiasis. Front Microbiol 2016; 7:1451. [PMID: 27679622 PMCID: PMC5020066 DOI: 10.3389/fmicb.2016.01451] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 08/30/2016] [Indexed: 12/11/2022] Open
Abstract
Early and accurate diagnosis of invasive candidiasis (IC) is very important. In this study, a lateral flow immunoassay (LFIA) was developed to detect antibody against Candida albicans enolase (Eno). Colloidal gold particle labeled mouse anti human IgG (1.0 mg/L) was used as the detector reagent. Recombinant enolase (rEno, 1.0 mg/L) and goat anti IgG (1.0 mg/L) were immobilized in test and control lines, respectively, of a nitrocellulose membrane, acting as the capture reagents. The LFIA was used to detect anti Eno in 38 sera from clinically proven IC patients, as well as in 50 healthy control subjects. Compared with an indirect ELISA designed as a reference test, the specificity and sensitivity of the LFIA were 98.2 and 84.8%, respectively. Excellent agreement between the results obtained by ELISA and the LFIA (κ = 0.851) was observed in this study. In addition, the agreement between the blood culture results and LFIA test is strong (κ = 0.658). The data presented in the study indicate that the LFIA test is a suitable tool for the serological surveillance of IC in the field or in poorly equipped laboratories.
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Affiliation(s)
- Zheng-Xin He
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
| | - Lan-Chun Shi
- Department of Biochemistry, Bethune Medical NCO School of PLA Shijiazhuang, China
| | - Xiang-Yang Ran
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
| | - Wei Li
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
| | - Xian-Ling Wang
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
| | - Fu-Kun Wang
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
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Dropulic LK, Lederman HM. Overview of Infections in the Immunocompromised Host. Microbiol Spectr 2016; 4:10.1128/microbiolspec.DMIH2-0026-2016. [PMID: 27726779 PMCID: PMC8428766 DOI: 10.1128/microbiolspec.dmih2-0026-2016] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Indexed: 12/12/2022] Open
Abstract
Understanding the components of the immune system that contribute to host defense against infection is key to recognizing infections that are more likely to occur in an immunocompromised patient. In this review, we discuss the integrated system of physical barriers and of innate and adaptive immunity that contributes to host defense. Specific defects in the components of this system that predispose to particular infections are presented. This is followed by a review of primary immunodeficiency diseases and secondary immunodeficiencies, the latter of which develop because of a specific illness or condition or are treatment-related. The effects of treatment for neoplasia, autoimmune diseases, solid organ and stem cell transplants on host defenses are reviewed and associated with susceptibility to particular infections. In conclusion, an approach to laboratory screening for a suspected immunodeficiency is presented. Knowledge of which host defects predispose to specific infections allows clinicians to prevent, diagnose, and manage infections in their immunocompromised patients most effectively.
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Affiliation(s)
- Lesia K Dropulic
- The National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of Intramural Research, Bethesda, MD 20892
| | - Howard M Lederman
- Departments of Pediatrics, Medicine, and Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287
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Aghdam MRF, Sund S. Invasive Esophageal Candidiasis with Chronic Mediastinal Abscess and Fatal Pneumomediastinum. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:466-71. [PMID: 27389822 PMCID: PMC4939855 DOI: 10.12659/ajcr.898053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Invasive candidiasis is a potential problem for patients receiving long-term immunosuppressive treatment. Psoriatic arthritis is one of many chronic diseases that can be successfully treated with immunosuppressive drugs, in spite of a documented and accepted risk for infectious complications. Critical awareness of possible infection must be part of the surveillance of such patients. CASE REPORT This is the case of a 68-year-old Norwegian male, treated with long-term immunosuppression for psoriatic arthritis, hospitalized with acute subcutaneous and mediastinal emphysema of unknown cause. He died of acute respiratory failure with circulatory collapse shortly after admission. The autopsy revealed mediastinal and subcutaneous emphysema and a mediastinal abscess containing Candida with probable entrance from the esophagus. CONCLUSIONS We consider invasive candidiasis of the esophagus to be the cause of both the chronic abscess and the acute mediastinal emphysema. This case illustrates the importance of awareness of invasive candidiasis as a possible complication in a patient with long-term immunosuppression.
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Affiliation(s)
| | - Ståle Sund
- Department of Pathology, Førde Central Hospital, Førde, Norway
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68
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Kassem AA, Mohsen AM, Ahmed RS, Essam TM. Self-nanoemulsifying drug delivery system (SNEDDS) with enhanced solubilization of nystatin for treatment of oral candidiasis: Design, optimization, in vitro and in vivo evaluation. J Mol Liq 2016. [DOI: 10.1016/j.molliq.2016.02.081] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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69
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Jin L, Bai X, Luan N, Yao H, Zhang Z, Liu W, Chen Y, Yan X, Rong M, Lai R, Lu Q. A Designed Tryptophan- and Lysine/Arginine-Rich Antimicrobial Peptide with Therapeutic Potential for Clinical Antibiotic-Resistant Candida albicans Vaginitis. J Med Chem 2016; 59:1791-9. [PMID: 26881456 DOI: 10.1021/acs.jmedchem.5b01264] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
New therapeutic agents for Candida albicans vaginitis are urgently awaiting to be developed because of the increasing antibiotic resistance of C. albicans. Antimicrobial peptides (AMPs) are one of the most promising choices for next-generation antibiotics. In this study, novel peptides were designed based on snake venom antimicrobial peptide cathelicidin-BF to promote anti-C. albicans activity and decrease side-effects. The designing strategies include substitutions of charged or hydrophobic amino acid residues for noncharged polar residues to promote antimicrobial activity and insertion of a hydrophobic residue in the hydrophilic side of the helix structure to reduce hemolysis. A designed tryptophan and lysine/arginine-rich cationic peptide 4 (ZY13) (VKRWKKWRWKWKKWV-NH2) exhibited excellent antimicrobial activity against either common strain or clinical isolates of antibiotic-resistant C. albicans with little hemolysis. Peptide 4 showed significant therapeutic effects on vaginitis in mice induced by the infection of clinical antibiotic-resistant C. albicans. The approaches herein might be useful for designing of AMPs.
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Affiliation(s)
- Lin Jin
- Life Sciences College of Nanjing Agricultural University , Nanjing 210095, Jiangsu, China
| | - Xuewei Bai
- Life Sciences College of Nanjing Agricultural University , Nanjing 210095, Jiangsu, China
| | - Ning Luan
- Life Sciences College of Nanjing Agricultural University , Nanjing 210095, Jiangsu, China
| | - Huimin Yao
- Life Sciences College of Nanjing Agricultural University , Nanjing 210095, Jiangsu, China
| | - Zhiye Zhang
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology , Kunming 650223, Yunnan, China.,Joint Laboratory of Natural Peptide of University of Science and Technology of China and Kunming Institute of Zoology, Chinese Academy of Sciences , Kunming 650223, Yunnan, China
| | - Weihui Liu
- Life Sciences College of Nanjing Agricultural University , Nanjing 210095, Jiangsu, China
| | - Yan Chen
- Life Sciences College of Nanjing Agricultural University , Nanjing 210095, Jiangsu, China
| | - Xiuwen Yan
- Life Sciences College of Nanjing Agricultural University , Nanjing 210095, Jiangsu, China
| | - Mingqiang Rong
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology , Kunming 650223, Yunnan, China.,Joint Laboratory of Natural Peptide of University of Science and Technology of China and Kunming Institute of Zoology, Chinese Academy of Sciences , Kunming 650223, Yunnan, China
| | - Ren Lai
- Life Sciences College of Nanjing Agricultural University , Nanjing 210095, Jiangsu, China.,Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology , Kunming 650223, Yunnan, China.,Joint Laboratory of Natural Peptide of University of Science and Technology of China and Kunming Institute of Zoology, Chinese Academy of Sciences , Kunming 650223, Yunnan, China
| | - Qiumin Lu
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology , Kunming 650223, Yunnan, China.,Joint Laboratory of Natural Peptide of University of Science and Technology of China and Kunming Institute of Zoology, Chinese Academy of Sciences , Kunming 650223, Yunnan, China
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70
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Sanguinetti M, Posteraro B, Lass-Flörl C. Antifungal drug resistance among Candida species: mechanisms and clinical impact. Mycoses 2016; 58 Suppl 2:2-13. [PMID: 26033251 DOI: 10.1111/myc.12330] [Citation(s) in RCA: 254] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 03/23/2015] [Indexed: 11/29/2022]
Abstract
The epidemiology of Candida infections has changed in recent years. Although Candida albicans is still the main cause of invasive candidiasis in most clinical settings, a substantial proportion of patients is now infected with non-albicans Candida species. The various Candida species vary in their susceptibility to the most commonly used antifungal agents, and the intrinsic resistance to antifungal therapy seen in some species, along with the development of acquired resistance during treatment in others, is becoming a major problem in the management of Candida infection. A better understanding of the mechanisms and clinical impact of antifungal drug resistance is essential for the efficient treatment of patients with Candida infection and for improving treatment outcomes. Herein, we report resistance to the azoles and echinocandins among Candida species.
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Affiliation(s)
| | - Brunella Posteraro
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria
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71
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He ZX, Chen J, Li W, Cheng Y, Zhang HP, Zhang LN, Hou TW. Serological response and diagnostic value of recombinant candida cell wall protein enolase, phosphoglycerate kinase, and β-glucosidase. Front Microbiol 2015; 6:920. [PMID: 26441862 PMCID: PMC4564733 DOI: 10.3389/fmicb.2015.00920] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/21/2015] [Indexed: 11/20/2022] Open
Abstract
There are no specific signs and symtoms for invasive candidiasis (IC), which makes its diagnosis a challenge. Efforts have been made for decades to establish serological assays for rapid diagnosis of IC, but none of them have found widespread clinical use. Using a systemic candiasis murine model, serological response to recombinant proteins of enolase (rEno1), phosphoglycerate kinase (rPgk1), and β-glucosidase (rBgl2) were evaluated and rEno1 was found to possess the strongest immunoreactivity, followed by rPgk1 and rBgl2. Likewise, IgG antibody titers to rEno1, rPgk1, and rBgl2 in the positive sera of proven IC patients were determined by ELISA. Results show anti-rEno1 antibody possesses the highest titer, followed by rPgk1 and rBgl2. Antibodies against rEno1, rPgk1, and rBgl2 were detected by ELISA tests in a group of 52 proven IC patients or 50 healthy subjects, The sensitivity, specificity, positive and negative predictive values were 88.5, 90.0, 90.2, and 88.2% for anti-rEno1 detection, 86.5, 92.0, 91.8, and 86.8% for anti-rPgk1 detection, and 80.8, 90.0, 89.4, and 81.8% for anti-rBgl2 detection, respectively. The data clearly demonstrate that the recombinant proteins of Eno1, Pgk1, and Bgl2 are promising candidates for IC serodiagnosis. There's great possibility that the recombinant Eno1 will be more applicable in serodiagnosis and vaccine research on account of its strong serological response.
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Affiliation(s)
- Zheng-Xin He
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
| | - Jing Chen
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
| | - Wei Li
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
| | - Yan Cheng
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
| | - Hai-Pu Zhang
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
| | - Li-Na Zhang
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
| | - Tian-Wen Hou
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA Shijiazhuang, China
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72
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Neonatal Candidiasis: New Insights into an Old Problem at a Unique Host-Pathogen Interface. CURRENT FUNGAL INFECTION REPORTS 2015; 9:246-252. [PMID: 26779297 DOI: 10.1007/s12281-015-0238-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Candida species are the leading cause of invasive fungal infections in premature infants. Associated with substantial morbidity and mortality, these infections represent serious and sometimes catastrophic complications in the course of hospitalization of a preterm infant in the neonatal intensive care unit. Although virulence factors of Candida and the host defense mechanisms that are important in protection from candidiasis have been the subject of intensive study, considerably less is known about the features of this disease that are specific to premature neonates. As animal models for neonatal candidiasis have been developed, efforts to understand the similarities and differences of candidiasis in the neonatal host relative to other immunocompromised patients have begun to provide insights to these questions.
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73
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Wróbel TM, Kosikowska U, Kaczor AA, Andrzejczuk S, Karczmarzyk Z, Wysocki W, Urbańczyk-Lipkowska Z, Morawiak M, Matosiuk D. Synthesis, Structural Studies and Molecular Modelling of a Novel Imidazoline Derivative with Antifungal Activity. Molecules 2015; 20:14761-76. [PMID: 26287137 PMCID: PMC6332182 DOI: 10.3390/molecules200814761] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 07/14/2015] [Accepted: 08/10/2015] [Indexed: 12/19/2022] Open
Abstract
Six novel imidazoline derivatives were synthesized and tested in antifungal assays. One of the compounds, N-cyclohexyl-2-imino-3-(4-nitrophenyl)imidazolidine-1-carboxamide showed moderate activity against several clinical strains of Candida albicans. Its structure was solved by X-ray crystallography and its mode of action was deduced using molecular modelling. It was found to be similar to that of fluconazole. The potential for further optimization including SAR of the compound is briefly discussed.
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Affiliation(s)
- Tomasz M. Wróbel
- Department of Synthesis and Chemical Technology of Pharmaceutical Substances, Medical University of Lublin, Chodzki 4a, 20-093 Lublin, Poland; E-Mails: (A.A.K.); (D.M.)
| | - Urszula Kosikowska
- Department of Pharmaceutical Microbiology, Medical University of Lublin, Chodzki 1, 20-093 Lublin, Poland; E-Mails: (U.K.); (S.A.)
| | - Agnieszka A. Kaczor
- Department of Synthesis and Chemical Technology of Pharmaceutical Substances, Medical University of Lublin, Chodzki 4a, 20-093 Lublin, Poland; E-Mails: (A.A.K.); (D.M.)
- School of Pharmacy, University of Eastern Finland, Yliopistonranta 1, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Sylwia Andrzejczuk
- Department of Pharmaceutical Microbiology, Medical University of Lublin, Chodzki 1, 20-093 Lublin, Poland; E-Mails: (U.K.); (S.A.)
| | - Zbigniew Karczmarzyk
- Department of Chemistry, Siedlce University of Natural Sciences and Humanities, 3 Maja 54, 08-110 Siedlce, Poland; E-Mails: (Z.K.); (W.W.)
| | - Waldemar Wysocki
- Department of Chemistry, Siedlce University of Natural Sciences and Humanities, 3 Maja 54, 08-110 Siedlce, Poland; E-Mails: (Z.K.); (W.W.)
| | - Zofia Urbańczyk-Lipkowska
- Institute of Organic Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warszawa, Poland; E-Mails: (Z.U.-L.); (M.M.)
| | - Maja Morawiak
- Institute of Organic Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warszawa, Poland; E-Mails: (Z.U.-L.); (M.M.)
| | - Dariusz Matosiuk
- Department of Synthesis and Chemical Technology of Pharmaceutical Substances, Medical University of Lublin, Chodzki 4a, 20-093 Lublin, Poland; E-Mails: (A.A.K.); (D.M.)
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74
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Sparber F, LeibundGut-Landmann S. Interleukin 17-Mediated Host Defense against Candida albicans. Pathogens 2015; 4:606-19. [PMID: 26274976 PMCID: PMC4584276 DOI: 10.3390/pathogens4030606] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 08/06/2015] [Accepted: 08/07/2015] [Indexed: 12/13/2022] Open
Abstract
Candida albicans is part of the normal microbiota in most healthy individuals. However, it can cause opportunistic infections if host defenses are breached, with symptoms ranging from superficial lesions to severe systemic disease. The study of rare congenital defects in patients with chronic mucocutaneous candidiasis led to the identification of interleukin-17 (IL-17) as a key factor in host defense against mucosal fungal infection. Experimental infections in mice confirmed the critical role of IL-17 in mucocutaneous immunity against C. albicans. Research on mouse models has also contributed importantly to our current understanding of the regulation of IL-17 production by different cellular sources and its effector functions in distinct tissues. In this review, we highlight recent findings on IL-17-mediated immunity against C. albicans in mouse and man.
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Affiliation(s)
- Florian Sparber
- Section of Immunology, Institute of Virology, University of Zürich, Winterthurerstrasse 266a, Zürich, CH-8057, Switzerland.
| | - Salomé LeibundGut-Landmann
- Section of Immunology, Institute of Virology, University of Zürich, Winterthurerstrasse 266a, Zürich, CH-8057, Switzerland.
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75
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Ding X, Yan D, Sun W, Zeng Z, Su R, Su J. Epidemiology and risk factors for nosocomial Non-Candida albicans candidemia in adult patients at a tertiary care hospital in North China. Med Mycol 2015; 53:684-90. [PMID: 26229153 DOI: 10.1093/mmy/myv060] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 06/02/2015] [Indexed: 01/08/2023] Open
Abstract
Nosocomial candidemia extends the length of hospital stay, increases the costs of medical care, and is associated with a high mortality rate. Epidemiological data that assist in the choice of initial therapy may help to improve the prognosis. The present study was undertaken to investigate the epidemiology of nosocomial candidemia and identify risk factors for nosocomial candidemia caused by C. albicans and non-albicans Candida species (NAC). A retrospective chart review was undertaken to analyze cases of nosocomial candidemia treated at the Beijing Friendship Hospital between January 2008 and December 2012. All cases of candidemia were identified using the previously published criteria. Among 106 patients analyzed, 53.8% had nosocomial candidemia caused by NAC. Candida albicans was the most common causative agent, accounting for 46.2% of all cases, followed by C. glabrata (25.5%), C. tropicalis (15.1%), C. parapsilosis (10.4%) and C. Krusei (0.9%). Comparison of nosocomial C. albicans and NAC candidemia by multivariate logistic regression showed that factors independently associated with nosocomial NAC candidemia included exposure to azole agents (odds ratio [OR]: 3.359; 95% confidence interval [CI]: 1.136-10.154; P = .031) and artificial surgical implants (OR: 37.519; 95% CI: 2.5-562.998; P = .009). A significant risk factor for nosocomial C. albicans candidemia was cancer surgery (OR: 0.075; 95% CI: 0.013-0.437; P = .004). Clinical and epidemiological differences in the risk factors between nosocomial candidemia caused by C. albicans and NAC should be considered when selecting an initial antifungal regimen for the treatment of adult patients. This should be undertaken before the availability of species identification and/or antifungal susceptibility results.
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Affiliation(s)
- Xiurong Ding
- Department of Clinical Laboratory, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Donghui Yan
- Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing100050, China
| | - Wei Sun
- Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing100050, China
| | - Zhaoyin Zeng
- Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing100050, China
| | - Ruirui Su
- Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing100050, China
| | - Jianrong Su
- Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing100050, China
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76
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Alp S, Arikan-Akdagli S, Gulmez D, Ascioglu S, Uzun O, Akova M. Epidemiology of candidaemia in a tertiary care university hospital: 10-year experience with 381 candidaemia episodes between 2001 and 2010. Mycoses 2015; 58:498-505. [DOI: 10.1111/myc.12349] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/06/2015] [Accepted: 03/26/2015] [Indexed: 01/02/2023]
Affiliation(s)
- Sehnaz Alp
- Faculty of Medicine; Department of Infectious Diseases and Clinical Microbiology; Hacettepe University; Ankara Turkey
| | - Sevtap Arikan-Akdagli
- Faculty of Medicine; Department of Medical Microbiology; Hacettepe University; Ankara Turkey
| | - Dolunay Gulmez
- Faculty of Medicine; Department of Medical Microbiology; Hacettepe University; Ankara Turkey
| | - Sibel Ascioglu
- Faculty of Medicine; Department of Infectious Diseases and Clinical Microbiology; Hacettepe University; Ankara Turkey
| | - Omrum Uzun
- Faculty of Medicine; Department of Infectious Diseases and Clinical Microbiology; Hacettepe University; Ankara Turkey
| | - Murat Akova
- Faculty of Medicine; Department of Infectious Diseases and Clinical Microbiology; Hacettepe University; Ankara Turkey
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77
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Variable incidence of candidemia in patients admitted to ICUs or medical wards of large tertiary-care Italian hospitals. Clin Microbiol Infect 2015; 21:e71-2. [PMID: 26027915 DOI: 10.1016/j.cmi.2015.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 05/19/2015] [Indexed: 11/21/2022]
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78
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Lipid Biosynthetic Genes Affect Candida albicans Extracellular Vesicle Morphology, Cargo, and Immunostimulatory Properties. EUKARYOTIC CELL 2015; 14:745-54. [PMID: 26024904 DOI: 10.1128/ec.00054-15] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 05/23/2015] [Indexed: 11/20/2022]
Abstract
Microbial secretion is integral for regulating cell homeostasis as well as releasing virulence factors during infection. The genes encoding phosphatidylserine synthase (CHO1) and phosphatidylserine decarboxylase (PSD1 and PSD2) are Candida albicans genes involved in phospholipid biosynthesis, and mutations in these genes affect mitochondrial function, cell wall thickness, and virulence in mice. We tested the roles of these genes in several agar-based secretion assays and observed that the cho1Δ/Δ and psd1Δ/Δ psd2Δ/Δ strains manifested less protease and phospholipase activity. Since extracellular vesicles (EVs) are surrounded by a lipid membrane, we investigated the effects of these mutations on EV structure, composition, and biological activity. The cho1Δ/Δ mutant releases EVs comparable in size to wild-type EVs, but EVs from the psd1Δ/Δ psd2Δ/Δ strain are much larger than those from the wild type, including a population of >100-nm EVs not observed in the EVs from the wild type. Proteomic analysis revealed that EVs from both mutants had a significantly different protein cargo than that of EVs from the wild type. EVs were tested for their ability to activate NF-κB in bone marrow-derived macrophage cells. While wild-type and psd1Δ/Δ psd2Δ/Δ mutant-derived EVs activated NF-κB, the cho1Δ/Δ mutant-derived EV did not. These studies indicate that the presence and absence of these C. albicans genes have qualitative and quantitative effects on EV size, composition, and immunostimulatory phenotypes that highlight a complex interplay between lipid metabolism and vesicle production.
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79
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Paulovičová L, Paulovičová E, Bystrický S. Immunological basis of anti-Candida vaccines focused on synthetically prepared cell wall mannan-derived manno-oligomers. Microbiol Immunol 2015; 58:545-51. [PMID: 25154867 DOI: 10.1111/1348-0421.12195] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/06/2014] [Accepted: 08/22/2014] [Indexed: 12/14/2022]
Abstract
The increasing incidence of diseases caused by Candida species and complications in individuals with impaired immunity require new strategies for candidiasis treatment and prevention. The available therapies are often of limited effectiveness in immunocompromised patients, resulting in treatment failures, chronic infections and high mortality rates. Research directed at identifying the composition of an effective vaccine is required. Mannan forms the outermost layer of the Candida cell wall and has an essential role in modulation of anti-Candida host immune responses. Therefore, Candida cell wall mannan and synthetically prepared manno-oligomer-based glycoconjugates are the foci of attention in vaccine candidate development. Almost all of the existing human vaccines mediate protection through neutralizing antibodies. Th1-based and/or Th17-based cellular immune responses, rather than antibody-mediated immunity, mediate protection against candidiasis. Findings of published studies indicate that analysis of cellular immune responses as well as antibody responses is necessary when assessing the immunomodulatory properties of manno-oligomer-based glycoconjugates that are potential anti-Candida vaccine candidates.
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Affiliation(s)
- Lucia Paulovičová
- Institute of Chemistry, Department of Immunochemistry of Glycoconjugates, Slovak Academy of Sciences, Bratislava, Slovakia
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80
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Cohen N, Seo SK. Role of antimicrobial prophylaxis during treatment of adults with acute leukemia. Int J Hematol Oncol 2015. [DOI: 10.2217/ijh.15.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Patients with acute leukemia (AL) are at high risk for developing bacterial, viral and fungal infections during chemotherapy. Because these infections cause considerable morbidity and mortality, prevention is attractive. In recent decades, several trials have established the benefit of prophylactic antimicrobials in patients with AL. Administration of prophylactic fluoroquinolone, acyclovir and triazole is recommended in neutropenic patients with AL by both the USA and European national guidelines. The potential for antimicrobial resistance as a long-term consequence of prophylaxis, however, is a concern. The recent development of nonculture-based diagnostic tests for invasive fungal infections has made early diagnosis and targeted treatment a promising future strategy as an alternative to mold-active prophylaxis.
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Affiliation(s)
- Nina Cohen
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Susan K Seo
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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81
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Break TJ, Jaeger M, Solis NV, Filler SG, Rodriguez CA, Lim JK, Lee CCR, Sobel JD, Netea MG, Lionakis MS. CX3CR1 is dispensable for control of mucosal Candida albicans infections in mice and humans. Infect Immun 2015; 83:958-65. [PMID: 25547797 PMCID: PMC4333470 DOI: 10.1128/iai.02604-14] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 12/16/2014] [Indexed: 11/20/2022] Open
Abstract
Candida albicans is part of the normal commensal microbiota of mucosal surfaces in a large percentage of the human population. However, perturbations of the host's immune response or bacterial microbiota have been shown to predispose individuals to the development of opportunistic Candida infections. It was recently discovered that a defect in the chemokine receptor CX3CR1 increases susceptibility of mice and humans to systemic candidiasis. However, whether CX3CR1 confers protection against mucosal C. albicans infection has not been investigated. Using two different mouse models, we found that Cx3cr1 is dispensable for the induction of interleukin 17A (IL-17A), IL-22, and IL-23 in the tongue after infection, as well as for the clearance of mucosal candidiasis from the tongue or lower gastrointestinal (GI) tract colonization. Furthermore, the dysfunctional human CX3CR1 allele CX3CR1-M280 was not associated with development of recurrent vulvovaginal candidiasis (RVVC) in women. Taken together, these data indicate that CX3CR1 is not essential for protection of the host against mucosal candidiasis, underscoring the dependence on different mammalian immune factors for control of mucosal versus systemic Candida infections.
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Affiliation(s)
- Timothy J Break
- Fungal Pathogenesis Unit, Laboratory of Clinical Infectious Disease, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Martin Jaeger
- Radboud University Medical Center and Radboud Center for Infectious Diseases (RCI), Nijmegen, The Netherlands
| | - Norma V Solis
- Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, USA
| | - Scott G Filler
- Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, USA The David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Carlos A Rodriguez
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jean K Lim
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Chyi-Chia Richard Lee
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Jack D Sobel
- Department of Infectious Diseases, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Mihai G Netea
- Radboud University Medical Center and Radboud Center for Infectious Diseases (RCI), Nijmegen, The Netherlands
| | - Michail S Lionakis
- Fungal Pathogenesis Unit, Laboratory of Clinical Infectious Disease, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
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82
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Abstract
Only few Candida species, e.g., Candida albicans, Candida glabrata, Candida dubliniensis, and Candida parapsilosis, are successful colonizers of a human host. Under certain circumstances these species can cause infections ranging from superficial to life-threatening disseminated candidiasis. The success of C. albicans, the most prevalent and best studied Candida species, as both commensal and human pathogen depends on its genetic, biochemical, and morphological flexibility which facilitates adaptation to a wide range of host niches. In addition, formation of biofilms provides additional protection from adverse environmental conditions. Furthermore, in many host niches Candida cells coexist with members of the human microbiome. The resulting fungal-bacterial interactions have a major influence on the success of C. albicans as commensal and also influence disease development and outcome. In this chapter, we review the current knowledge of important survival strategies of Candida spp., focusing on fundamental fitness and virulence traits of C. albicans.
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Affiliation(s)
- Melanie Polke
- Research Group Microbial Immunology, Hans-Knoell-Institute, Jena, Germany; Department Microbial Pathogenicity Mechanisms, Hans-Knoell-Institute, Jena, Germany
| | - Bernhard Hube
- Department Microbial Pathogenicity Mechanisms, Hans-Knoell-Institute, Jena, Germany; Friedrich-Schiller-University, Jena, Germany; Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | - Ilse D Jacobsen
- Research Group Microbial Immunology, Hans-Knoell-Institute, Jena, Germany; Friedrich-Schiller-University, Jena, Germany
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83
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Karacaer Z, Oncul O, Turhan V, Gorenek L, Ozyurt M. A surveillance of nosocomial candida infections: epidemiology and influences on mortalty in intensive care units. Pan Afr Med J 2014; 19:398. [PMID: 25995794 PMCID: PMC4430144 DOI: 10.11604/pamj.2014.19.398.4960] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 11/27/2014] [Indexed: 11/23/2022] Open
Abstract
Introduction It was aimed to investigate the frequency of Candida infections (CI) in the intensive care units (ICU), to determine typing of candida to evaluate risk factors associated with CI and mortality, and to evaluate influence of CI on mortality. Methods The prospective cohort study was carried out between Jan 1, 2009 and Dec 31, 2010 in ICUs, and the patients were observed with active surveillance. VITEK 2 Compact System (BioMerieux, France) kits were used for the identification of isolates from various clinical samples. Results A total of 2362 patients had enrolled for 16135 patients-days into the study. During the study, 63 (27,5%) of patients developed 77 episodes of CI were observed. Of the patients; 54% were male, 46% were female. Duration of hospitalization (OR = 1,03, p = 0,007), hyperglycemia (OR = 17,93, p = 0,009), and co-infections (OR = 3,98, p = 0,001) were identified as independent risk factors for CI. The most common infections were bloodstream (53%). 77 of 135 candida strains was isolated as causative pathogens. C. albicans (63,6%) was the most frequent species. Overall mortality rate was 78%. The rates of mortality attributable to CI and candidemia were 27%, and 18,3% respectively. Species- specific mortality rates of C.albicans and C.tropicalis were determined as 12%. High APACHE II scores (OR = 1,37; p = 0,002), and the use of central venous catheter (OR = 9,01; p = 0,049) were assigned as independent risk factors for mortality. Conclusion CI is an important problem in our hospital. CI and associated mortality can be prevented by controlling of risk factors. Updating of epidemiological data is required for successful antifungal treatment.
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Affiliation(s)
- Zehra Karacaer
- Etimesgut Military Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Oral Oncul
- Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Vedat Turhan
- Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Levent Gorenek
- Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Mustafa Ozyurt
- Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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84
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Novickij V, Grainys A, Svediene J, Markovskaja S, Paskevicius A, Novickij J. Irreversible electropermeabilization of the human pathogen Candida albicans: an in-vitro experimental study. EUROPEAN BIOPHYSICS JOURNAL: EBJ 2014; 44:9-16. [PMID: 25381646 DOI: 10.1007/s00249-014-0996-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/14/2014] [Accepted: 10/28/2014] [Indexed: 12/22/2022]
Abstract
Pathogenic fungi cause many life-threatening infections, especially among individuals with immune system dysfunction. The antifungal drugs commonly used to suppress fungal pathogens can result in long-lasting and toxic therapy. In this work, irreversible electropermeabilization was used to investigate the dynamics of the decrease in Candida albicans colony vitality after application of a pulsed electric field (PEF) and use of antifungal drugs. The fungi were subjected to single 250-µs to 2-ms (0.5-2.5 kV/cm) pulses or repeated short 5-µs pulses, and efficacy was compared. It was shown that electropermeabilization combined with antifungal agents results in rapid and more effective treatment, eliminating more than 90% of C. albicans colony-forming units in a single procedure, which is advantageous in biomedicine. It was also observed that, because of application of PEF and use of the antifungal agents, the Candida cells form cell aggregates and average live cell size is reduced by as much as 53%.
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Affiliation(s)
- Vitalij Novickij
- High Magnetic Field Institute, Vilnius Gediminas Technical University, Naugarduko st. 41, 03227, Vilnius, Lithuania,
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85
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Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection. Case Rep Orthop 2014; 2014:986393. [PMID: 25295206 PMCID: PMC4176649 DOI: 10.1155/2014/986393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 09/01/2014] [Indexed: 11/17/2022] Open
Abstract
Candida osteomyelitis in the current literature is an emerging infection. The factors contributing to its emergence include a growing population of immunosuppressed patients, invasive surgeries, broad-spectrum antibiotics, injection drug users, and alcohol abuse. The diagnosis requires a high degree of suspicion. The insidious progression of infection and the nonspecificity of laboratory and radiologic findings may contribute to a delay in diagnosis. The current case concerns a 27-year-old man with a spinal cord injury who, after undergoing anterior cervical fixation and fusion surgery, developed postoperative systemic bacterial infection and required long-term antibiotic therapy. After six months, a CT scan demonstrated an almost complete anterior dislocation of the implants caused by massive bone destruction and reabsorption in Candida albicans infection. The patient underwent a second intervention consisting firstly of a posterior approach with C4-C7 fixation and fusion, followed by a second anterior approach with a corpectomy of C5 and C6, a tricortical bone grafting from the iliac crest, and C4-C7 plating. The antifungal therapy with fluconazole was effective without surgical debridement of the bone graft, despite the fact that signs of the bone graft being infected were seen from the first cervical CT scans carried out after one month.
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86
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Vazquez JA, Miceli MH, Alangaden G. Invasive fungal infections in transplant recipients. Ther Adv Infect Dis 2014; 1:85-105. [PMID: 25165546 DOI: 10.1177/2049936113491936] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Invasive fungal infections are an important cause of morbidity and mortality in hematopoietic stem cell transplant and solid organ transplant recipients. Evolving transplant modalities and techniques, complex and extensive immunosuppressant strategies, and the increased use of broad spectrum antifungal prophylaxis has greatly impacted the epidemiology and temporal pattern of invasive fungal infections in the transplant population. The goal of this article is to provide an up-to-date review of the most commonly encountered invasive fungal infections seen in transplant recipients, including epidemiology, risk factors, clinical features, diagnostic dilemmas, management and their overall influence on outcomes.
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Affiliation(s)
- Jose A Vazquez
- Division of Infectious Diseases, Department of Medicine, Henry Ford Hospital, 2799 West Grand Blvd, CFP-202, Detroit, MI 48202, USA
| | - Marisa H Miceli
- Division of Infectious Diseases, Department of Medicine, Henry Ford Hospital, Wayne State University School of Medicine, Detroit, MI, USA
| | - George Alangaden
- Division of Infectious Diseases, Department of Medicine, Henry Ford Hospital, Wayne State University School of Medicine, Detroit, MI, USA
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87
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Osteomyelitis Caused by Candida glabrata in the Distal Phalanx. Case Rep Orthop 2014; 2014:962575. [PMID: 25215255 PMCID: PMC4158280 DOI: 10.1155/2014/962575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 08/13/2014] [Indexed: 12/04/2022] Open
Abstract
Osteomyelitis caused by Candida glabrata is rare and its optimal treatment is unknown. Here we report a case of osteomyelitis caused by C. glabrata in the distal phalanx in a 54-year-old woman. Despite partial resection of the nail and administering a 1-month course of antibiotics for paronychia, the local swelling remained and an osteolytic lesion was found. C. glabrata osteomyelitis of the distal phalanx was later diagnosed after curettage. Thereafter, the patient was treated with antifungal agents for 3 months. The infection eventually resolved, and radiological healing of the osteolytic lesion was achieved. Antifungal susceptibility testing should be performed in the case of osteomyelitis caused by nonalbicans Candida species, due to their resistance to fluconazole.
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88
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Yildirim M, Sahin I, Oksuz S, Sencan I, Kucukbayrak A, Cakir S, Ozaydin C. Hand carriage of Candida occurs at lesser rates in hospital personnel who use antimicrobial hand disinfectant. ACTA ACUST UNITED AC 2014; 46:633-6. [DOI: 10.3109/00365548.2014.922694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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89
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Candida glabrata intra-abdominal candidiasis is characterized by persistence within the peritoneal cavity and abscesses. Infect Immun 2014; 82:3015-22. [PMID: 24799629 DOI: 10.1128/iai.00062-14] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The pathogenesis of Candida glabrata infections is poorly understood. We studied the pathogenesis of intra-abdominal candidiasis (IAC) in mice that were infected intraperitoneally with C. glabrata and sterile feces. C. glabrata BG2 (5 × 10(8) CFU) caused a 100% mortality rate. Sublethal inocula of BG2 (1 × 10(8) or 1 × 10(7) CFU) caused peritonitis that progressed to abscesses. Three clinical C. glabrata strains (5 × 10(8) CFU) caused 80 to 100% mortality rates, while a fourth (strain 346) caused a 29% mortality rate. Following sublethal inocula (1 × 10(7) CFU), the intra-abscess burdens of virulent strain 356 were ∼1 log greater than those of strain 346. A C. glabrata Δplb1-2 mutant (phospholipase B genes disrupted) killed mice as well as BG2 did. When sublethal inocula were used, however, the Δplb1-2 mutant was associated with more rapid abscess resolution and lower intra-abscess burdens; these findings were reversed by PLB1 and PLB2 reinsertion. The Δplb1-2 mutant was also more susceptible than BG2 to killing by human neutrophils in vitro. BG2 and the Δplb1-2 mutant were indistinguishable during hematogenously disseminated candidiasis. C. albicans SC5314 was more virulent than C. glabrata BG2 during IAC, causing a 100% mortality rate following a challenge with 5 × 10(7) CFU. In contrast, a sublethal inoculum (1 × 10(7) CFU) of BG2 caused less neutrophil infiltration and greater burdens in peritoneal fluid than SC5314 did and abscesses that persisted longer and contained greater burdens. In conclusion, a mouse model of C. glabrata IAC mimics disease in humans and distinguishes the relative virulence of clinical and gene disruption strains. C. glabrata differed from C. albicans during IAC by being less lethal and eliciting dampened neutrophil responses but resulting in more persistent peritonitis and abscesses.
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90
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Abstract
The number of immunosuppressive patients has increased significantly in recent years. These patients are at risk for opportunistic infections, especially fungal infections. Candidiasis is one of the most frequent fungal infections determined in these immunosuppressive patients and its epidemiology has changed over the last two decades. Recently, new antifungal agents and new therapy strategies such as antifungal prophylaxis, secondary prophylaxis, and preemptive therapy have come into use. These changes resulted in the alteration of Candida species causing invasive infections. The incidence of Candida albicans was decreased in many countries, especially among patients with immunosuppressive disorders, while the incidence of species other than C. albicans was increased. In this review, incidence, risk factors, and species distribution of invasive candidiasis are discussed.
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Affiliation(s)
- Nur Yapar
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
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91
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Hundalani S, Pammi M. Invasive fungal infections in newborns and current management strategies. Expert Rev Anti Infect Ther 2014; 11:709-21. [DOI: 10.1586/14787210.2013.811925] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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92
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Lee PY, Gam LH, Yong VC, Rosli R, Ng KP, Chong PP. Identification of immunogenic proteins of Candida parapsilosis by serological proteome analysis. J Appl Microbiol 2014; 116:999-1009. [PMID: 24299471 DOI: 10.1111/jam.12408] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 11/24/2013] [Accepted: 11/27/2013] [Indexed: 02/03/2023]
Abstract
AIMS Systemic candidiasis is the leading fungal bloodstream infection, and its incidence has been on the rise. Recently, Candida parapsilosis has emerged as an increasingly prevalent fungal pathogen, but little is known about its antigenic profile. Hence, the current work was performed to discover immunogenic proteins of C. parapsilosis using serological proteome analysis. METHODS AND RESULTS Cell wall proteins extracted from C. parapsilosis were resolved by two-dimensional electrophoresis followed by immunoblotting using antisera from experimentally infected mice. Mass spectrometry analysis of the 32 immunoreactive protein spots resulted in the identification of 12 distinct proteins. Among them, 11 proteins were known antigens of Candida albicans, whereas Idh2p was identified for the first time as an immunogenic protein of Candida species. Recombinant Idh2p was expressed in Escherichia coli, and its antigenicity was verified by immunoblot analysis. CONCLUSIONS An immunoproteomic approach was successfully applied to identify immunogenic proteins of C. parapsilosis, with Idh2p as a novel candidate antigen. The identified antigens may serve as potential biomarkers for development of diagnostic assay and/or vaccine for C. parapsilosis. SIGNIFICANCE AND IMPACT OF THE STUDY This work represents the first immunoproteomic analysis of C. parapsilosis, which provides new insights into host-pathogen interactions and pathogenesis of C. parapsilosis. The immunogenic proteins could be studied as biomarker candidates for C. parapsilosis.
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Affiliation(s)
- P Y Lee
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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93
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Katsuragi S, Sata M, Kobayashi Y, Miyoshi T, Yamashita Y, Neki R, Horiuchi C, Yamanaka K, Kamiya C, Iwanaga N, Tanaka H, Ikeda T, Yoshimatsu J. Antifungal Susceptibility of Candida Isolates at One Institution. Med Mycol J 2014; 55:E1-7. [DOI: 10.3314/mmj.55.e1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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94
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Candida identification: a journey from conventional to molecular methods in medical mycology. World J Microbiol Biotechnol 2014; 30:1437-51. [PMID: 24379160 DOI: 10.1007/s11274-013-1574-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 12/02/2013] [Indexed: 12/17/2022]
Abstract
The incidence of Candida infections have increased substantially in recent years due to aggressive use of immunosuppressants among patients. Use of broad-spectrum antibiotics and intravascular catheters in the intensive care unit have also attributed with high risks of candidiasis among immunocompromised patients. Among Candida species, C. albicans accounts for the majority of superficial and systemic infections, usually associated with high morbidity and mortality often caused due to increase in antimicrobial resistance and restricted number of antifungal drugs. Therefore, early detection of candidemia and correct identification of Candida species are indispensable pre-requisites for appropriate therapeutic intervention. Since blood culture based methods lack sensitivity, and species-specific identification by conventional method is time-consuming and often leads to misdiagnosis within closely related species, hence, molecular methods may provide alternative for accurate and rapid identification of Candida species. Although, several molecular approaches have been developed for accurate identification of Candida species but the internal transcribed spacer 1 and 2 (ITS1 and ITS2) regions of the rRNA gene are being used extensively in a variety of formats. Of note, ITS sequencing and PCR-RFLP analysis of ITS region seems to be promising as a rapid, easy, and cost-effective method for identification of Candida species. Here, we review a number of existing techniques ranging from conventional to molecular approaches currently in use for the identification of Candida species. Further, advantages and limitations of these methods are also discussed with respect to their discriminatory power, reproducibility, and ease of performance.
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95
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Saha K, Sit NK, Maji A, Jash D. Recovery of fluconazole sensitive Candida ciferrii in a diabetic chronic obstructive pulmonary disease patient presenting with pneumonia. Lung India 2013; 30:338-40. [PMID: 24339494 PMCID: PMC3841693 DOI: 10.4103/0970-2113.120614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) exacerbations admitted in intensive care units (ICUs) occur rarely due to fungal respiratory tract infections, but may occur when associated co-morbidities like diabetes mellitus coexist. Candida ciferrii is a new agent, recently was isolated from lung infections but usually resistant to fluconazole. Here, we report a rare case of pneumonia due to fluconazole sensitive Candida ciferrii in a COPD patient with known diabetes, admitted in our ICU.
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Affiliation(s)
- Kaushik Saha
- Department of Pulmonary Medicine, Burdwan Medical College and Hospital, Burdwan, West Bengal, India
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96
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Vázquez-González D, Perusquía-Ortiz AM, Hundeiker M, Bonifaz A. Opportunistic yeast infections: candidiasis, cryptococcosis, trichosporonosis and geotrichosis. J Dtsch Dermatol Ges 2013; 11:381-93; quiz 394. [PMID: 23621330 DOI: 10.1111/ddg.12097] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Accepted: 02/19/2013] [Indexed: 11/28/2022]
Abstract
Opportunistic yeast infections are diseases caused by fungi which normally are saprophytic and do not cause disease in humans or animals. The prevalence of these diseases has been increasing due to immunosuppressive, corticosteroid, and long-term antibiotic treatment following organ transplantation or after serious metabolic, hematological, or immunological diseases. We review epidemiological, clinical, diagnostic, and therapeutic aspects of the four "big" opportunistic yeast infections: candidiasis, cryptococcosis, trichosporonosis, and geotrichosis.
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Affiliation(s)
- Denisse Vázquez-González
- Departamento de Micología, Servicio de Dermatología, Hospital General de Mexico, Mexico City, Mexico
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97
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Development of vaccines for Candida albicans: fighting a skilled transformer. Nat Rev Microbiol 2013; 11:884-91. [DOI: 10.1038/nrmicro3156] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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98
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Lionakis MS, Swamydas M, Fischer BG, Plantinga TS, Johnson MD, Jaeger M, Green NM, Masedunskas A, Weigert R, Mikelis C, Wan W, Lee CCR, Lim JK, Rivollier A, Yang JC, Laird GM, Wheeler RT, Alexander BD, Perfect JR, Gao JL, Kullberg BJ, Netea MG, Murphy PM. CX3CR1-dependent renal macrophage survival promotes Candida control and host survival. J Clin Invest 2013; 123:5035-51. [PMID: 24177428 DOI: 10.1172/jci71307] [Citation(s) in RCA: 170] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 08/27/2013] [Indexed: 12/19/2022] Open
Abstract
Systemic Candida albicans infection causes high morbidity and mortality and is associated with neutropenia; however, the roles of other innate immune cells in pathogenesis are poorly defined. Here, using a mouse model of systemic candidiasis, we found that resident macrophages accumulated in the kidney, the main target organ of infection, and formed direct contacts with the fungus in vivo mainly within the first few hours after infection. Macrophage accumulation and contact with Candida were both markedly reduced in mice lacking chemokine receptor CX3CR1, which was found almost exclusively on resident macrophages in uninfected kidneys. Infected Cx3cr1-/- mice uniformly succumbed to Candida-induced renal failure, but exhibited clearance of the fungus in all other organs tested. Renal macrophage deficiency in infected Cx3cr1-/- mice was due to reduced macrophage survival, not impaired proliferation, trafficking, or differentiation. In humans, the dysfunctional CX3CR1 allele CX3CR1-M280 was associated with increased risk of systemic candidiasis. Together, these data indicate that CX3CR1-mediated renal resident macrophage survival is a critical innate mechanism of early fungal control that influences host survival in systemic candidiasis.
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MESH Headings
- Adaptor Proteins, Signal Transducing/physiology
- Adoptive Transfer
- Animals
- Apoptosis
- CX3C Chemokine Receptor 1
- Candida albicans/immunology
- Candida albicans/physiology
- Candida albicans/ultrastructure
- Candidiasis, Invasive/immunology
- Candidiasis, Invasive/pathology
- Cell Movement
- Chemokine CCL2/physiology
- Chemokine CX3CL1/physiology
- Female
- Genetic Predisposition to Disease
- Host-Pathogen Interactions/immunology
- Humans
- Hyphae/ultrastructure
- Kidney/immunology
- Kidney/microbiology
- Kidney/pathology
- Macrophage Activation
- Macrophages/microbiology
- Macrophages/physiology
- Male
- Mice
- Mice, Inbred C57BL
- Models, Animal
- Monocytes/microbiology
- Monocytes/physiology
- Netherlands
- Organ Specificity
- Polymorphism, Single Nucleotide
- Radiation Chimera
- Receptors, CCR2/physiology
- Receptors, Chemokine/deficiency
- Receptors, Chemokine/genetics
- Receptors, Chemokine/physiology
- Risk Factors
- Specific Pathogen-Free Organisms
- United States
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99
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Nunes CZ, Marra AR, Edmond MB, da Silva Victor E, Pereira CAP. Time to blood culture positivity as a predictor of clinical outcome in patients with Candida albicans bloodstream infection. BMC Infect Dis 2013; 13:486. [PMID: 24138760 PMCID: PMC3854507 DOI: 10.1186/1471-2334-13-486] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 10/17/2013] [Indexed: 01/31/2023] Open
Abstract
Background Few studies have assessed the time to blood culture positivity as a predictor of clinical outcome in fungal bloodstream infections (BSIs). The purpose of this study was to evaluate the time to positivity (TTP) of blood cultures in patients with Candida albicans BSIs and to assess its impact on clinical outcome. Methods A historical cohort study with 89 adults patients with C. albicans BSIs. TTP was defined as the time between the start of incubation and the time that the automated alert signal indicating growth in the culture bottle sounded. Results Patients with BSIs and TTPs of culture of ≤36 h (n=39) and >36 h (n=50) were compared. Septic shock occurred in 46.2% of patients with TTPs of ≤36 h and in 40.0% of patients with TTP of >36 h (p=0.56). A central venous catheter source was more common with a BSI TTP of ≤36 h (p=0.04). Univariate analyis revealed that APACHE II score≥20 at BSI onset, the development of at least one organ system failure (respiratory, cardiovascular, renal, hematologic, or hepatic), SOFA at BSI onset, SAPS II at BSI onset, and time to positivity were associated with death. By using logistic regression analysis, the only independent predictor of death was time to positivity (1.04; 95% CI, 1.0-1.1, p=0.035), with the chance of the patient with C. albicans BSI dying increasing 4.0% every hour prior to culture positivity. Conclusion A longer time to positivity was associated with a higher mortality for Candida albicans BSIs; therefore, initiating empiric treatment with antifungals may improve outcomes.
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Affiliation(s)
| | - Alexandre R Marra
- Infectious Diseases Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
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100
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Cheng S, Clancy CJ, Xu W, Schneider F, Hao B, Mitchell AP, Nguyen MH. Profiling of Candida albicans gene expression during intra-abdominal candidiasis identifies biologic processes involved in pathogenesis. J Infect Dis 2013; 208:1529-37. [PMID: 24006479 DOI: 10.1093/infdis/jit335] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The pathogenesis of intra-abdominal candidiasis is poorly understood. METHODS Mice were intraperitoneally infected with Candida albicans (1 × 10(6) colony-forming units) and sterile stool. nanoString assays were used to quantitate messenger RNA for 145 C. albicans genes within the peritoneal cavity at 48 hours. RESULTS Within 6 hours after infection, mice developed peritonitis, characterized by high yeast burdens, neutrophil influx, and a pH of 7.9 within peritoneal fluid. Organ invasion by hyphae and early abscess formation were evident 6 and 24 hours after infection, respectively; abscesses resolved by day 14. nanoString assays revealed adhesion and responses to alkaline pH, osmolarity, and stress as biologic processes activated in the peritoneal cavity. Disruption of the highly-expressed gene RIM101, which encodes an alkaline-regulated transcription factor, did not impact cellular morphology but reduced both C. albicans burden during early peritonitis and C. albicans persistence within abscesses. RIM101 influenced expression of 49 genes during intra-abdominal candidiasis, including previously unidentified Rim101 targets. Overexpression of the RIM101-dependent gene SAP5, which encodes a secreted protease, restored the ability of a rim101 mutant to persist within abscesses. CONCLUSIONS A mouse model of intra-abdominal candidiasis is valuable for studying pathogenesis and C. albicans gene expression. RIM101 contributes to persistence within intra-abdominal abscesses, at least in part through activation of SAP5.
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