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Adam RD, Revathi G, Okinda N, Fontaine M, Shah J, Kagotho E, Castanheira M, Pfaller MA, Maina D. Analysis of Candida auris fungemia at a single facility in Kenya. Int J Infect Dis 2019; 85:182-187. [PMID: 31185293 DOI: 10.1016/j.ijid.2019.06.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/31/2019] [Accepted: 06/04/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Candida auris emerged as a human pathogen in 2009 and has subsequently been identified around the world as a cause of invasive candidiasis. We did an analysis from a single institution in order to analyze risk factors and outcomes for C. auris candidemia. METHODS Patients with candidemia were identified by the electronic medical record and reviewed for risk factors and outcome. Candida isolates were identified by Vitek2 as Candida haemulonii, but species determinations for 21 of the isolates using published molecular and proteomic methods identified all as C. auris. FINDINGS From September 2010 to December 2016, C. auris accounted for 38% of 201 patients with candidemia, while C. albicans contributed 25%. C. auris patients had been hospitalized longer (mean 32 days vs. 13 days; p<0.001), were more likely to have central lines preceding candidemia than C. albicans patients (84% vs. 54%; p=<0.001) and had more commonly been treated with carbapenems (83% vs 61% for C. albicans [p=0.01]). The crude mortality was 29%, compared to 36% for C. albicans. CONCLUSIONS These findings suggest an opportunistic pathogen that may be less virulent, but difficult to eradicate and that control efforts should focus on antimicrobial usage.
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Affiliation(s)
- Rodney D Adam
- Departments of Pathology and Medicine, Aga Khan University, Third Parklands Rd., Nairobi, Kenya.
| | - Gunturu Revathi
- Department of Pathology, Aga Khan University, Third Parklands Rd., Nairobi, Kenya
| | - Nancy Okinda
- Department of Pathology, Aga Khan University, Third Parklands Rd., Nairobi, Kenya
| | - Melanie Fontaine
- Department of Pathology, Aga Khan University, Third Parklands Rd., Nairobi, Kenya
| | - Jasmit Shah
- Departments of Population Health and Medicine, Aga Khan University, Third Parklands Rd., Nairobi, Kenya
| | - Elizabeth Kagotho
- Department of Pathology, Aga Khan University, Third Parklands Rd., Nairobi, Kenya
| | | | | | - Daniel Maina
- Department of Pathology, Aga Khan University, Third Parklands Rd., Nairobi, Kenya
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53
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Mahmoudi S, Agha Kuchak Afshari S, Aghaei Gharehbolagh S, Mirhendi H, Makimura K. Methods for identification of Candida auris, the yeast of global public health concern: A review. J Mycol Med 2019; 29:174-179. [DOI: 10.1016/j.mycmed.2019.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/05/2019] [Accepted: 04/11/2019] [Indexed: 12/23/2022]
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Ahmad A, Spencer JE, Lockhart SR, Singleton S, Petway DJ, Bagarozzi DA, Herzegh OT. A high-throughput and rapid method for accurate identification of emerging multidrug-resistant Candida auris. Mycoses 2019; 62:513-518. [PMID: 30801778 PMCID: PMC10888143 DOI: 10.1111/myc.12907] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 02/07/2019] [Accepted: 02/08/2019] [Indexed: 02/06/2023]
Abstract
Candida auris is an emerging multidrug-resistant yeast associated with invasive infection in healthcare settings. Recently, C auris cases in the United States have been detected in 11 states with the majority of cases in New York, New Jersey and Illinois. Rapid and accurate identification of C auris is critical for patient care and the implementation of public health measures to control the spread of infection. Our aim was to develop and validate a rapid DNA extraction method using the Roche MagNA Pure 96 instrument and a TaqMan real-time PCR assay for reliable, high-throughput identification of C auris. We evaluated 247 patient dermal swab samples previously analysed by culture/MALDI-TOF. The diagnostic sensitivity and specificity were 93.6% and 97.2%, respectively. The assay was highly reproducible with a detection limit of 1 C auris CFU/10 μL. A receiver operating characteristic curve analysis of the real-time PCR data showed an area of 0.982 under the curve, with a CT cut-off value of ≤37.0. The turnaround time from DNA extraction to real-time PCR results was approximately 200 samples/day. In conclusion, we successfully validated a rapid and high-throughput method for accurate and reproducible identification of C auris with a significantly reduced turnaround time compared to culture/MALDI-TOF based methods.
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Affiliation(s)
- Ausaf Ahmad
- Enhanced Capacity Surge Laboratory, Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Centers for Disease Control & Prevention (CDC), Atlanta, Georgia
| | - Jonathan E Spencer
- Enhanced Capacity Surge Laboratory, Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Centers for Disease Control & Prevention (CDC), Atlanta, Georgia
| | - Shawn R Lockhart
- Mycotic Diseases Branch, Division of Foodborne Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Centers for Disease Control & Prevention (CDC), Atlanta, Georgia
| | - Sabrina Singleton
- Mycotic Diseases Branch, Division of Foodborne Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Centers for Disease Control & Prevention (CDC), Atlanta, Georgia
| | - David J Petway
- Enhanced Capacity Surge Laboratory, Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Centers for Disease Control & Prevention (CDC), Atlanta, Georgia
| | - Dennis A Bagarozzi
- Enhanced Capacity Surge Laboratory, Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Centers for Disease Control & Prevention (CDC), Atlanta, Georgia
| | - Owen T Herzegh
- Enhanced Capacity Surge Laboratory, Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Centers for Disease Control & Prevention (CDC), Atlanta, Georgia
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55
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Weber DJ, Sickbert-Bennett EE, Kanamori H, Rutala WA. New and emerging infectious diseases (Ebola, Middle Eastern respiratory syndrome coronavirus, carbapenem-resistant Enterobacteriaceae, Candida auris): Focus on environmental survival and germicide susceptibility. Am J Infect Control 2019; 47S:A29-A38. [PMID: 31146847 PMCID: PMC7132701 DOI: 10.1016/j.ajic.2019.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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56
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Nath A. Prediction and molecular insights into fungal adhesins and adhesin like proteins. Comput Biol Chem 2019; 80:333-340. [PMID: 31078912 DOI: 10.1016/j.compbiolchem.2019.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 04/02/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
Adhesion is the foremost step in pathogenesis and biofilm formation and is facilitated by a special class of cell wall proteins known as adhesins. Formation of biofilms in catheters and other medical devices subsequently leads to infections. As compared to bacterial adhesins, there is relatively less work for the characterization and identification of fungal adhesins. Understanding the sequence characterization of fungal adhesins may facilitate a better understanding of its role in pathogenesis. Experimental methods for investigation and characterization of fungal adhesins are labor intensive and expensive. Therefore, there is a need for fast and efficient computational methods for the identification and characterization of fungal adhesins. The aim of the current study is twofold: (i) to develop an accurate predictor for fungal adhesins, (ii) to sieve out the prominent molecular signatures present in fungal adhesins. Of the many supervised learning algorithms implemented in the current study, voting ensembles resulted in enhanced prediction accuracy. The best voting-ensemble consisting of three support vector machines with three different kernels (PolyK, RBF, PuK) achieved an accuracy of 94.9% on leave one out cross validation and 98.0% accuracy on blind testing set. A preference/avoidance list of molecular features as well as human interpretable rules are also extracted giving insights into the general sequence features of fungal adhesins. Fungal adhesins are characterized by high Threonine and Cysteine and avoidance for Phenylalanine and Methionine. They also have avoidance for average hydrophilicity. The current analysis possibly will facilitate the understanding of the mechanism of fungal adhesin function which may further help in designing methods for restricting adhesin mediated pathogenesis.
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Affiliation(s)
- Abhigyan Nath
- Department of Biochemistry, Pt. Jawahar Lal Nehru Memorial Medical College, Raipur, 492001, India.
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57
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Navarro-Arias MJ, Hernández-Chávez MJ, García-Carnero LC, Amezcua-Hernández DG, Lozoya-Pérez NE, Estrada-Mata E, Martínez-Duncker I, Franco B, Mora-Montes HM. Differential recognition of Candida tropicalis, Candida guilliermondii, Candida krusei, and Candida auris by human innate immune cells. Infect Drug Resist 2019; 12:783-794. [PMID: 31040708 PMCID: PMC6459152 DOI: 10.2147/idr.s197531] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background The deep-seated infections caused by the Candida genus are associated with a high mortality rate, and Candida albicans is the most frequent species associated with these diseases. The fungal wall is composed of macromolecules not synthesized by the host, and therefore is a source of ligands recognized by innate immune cells. Methods We performed a comparative study analyzing the cell wall composition and organization of Candida tropicalis, Candida guilliermondii, Candida krusei, and Candida auris, along with their ability to stimulate cytokine production and phagocytosis by human innate immune cells. Results We found that the wall of these species had the basic components already described in C. albicans, with most of the chitin and b1,3-glucan located underneath the mannan layer. However, the walls of C. krusei and C. auris were rich in chitin and the former had a lower content of mannans. C. guilliermondii contained changes in the mannan and the b1,3-glucan levels. These species were differentially phagocytosed by human macrophages and stimulated cytokine production in a dectin-1-dependent pathway. C. krusei showed the most significant changes in the tested parameters, whereas C. auris behaved like C. albicans. Conclusion Our results suggest that the cell wall and innate immune recognition of C. tropicalis, C. guilliermondii, C. krusei, and Candida auris is different from that reported for C. albicans.
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Affiliation(s)
- María J Navarro-Arias
- Department of Biology, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, 36050, Guanajuato, Gto, México,
| | - Marco J Hernández-Chávez
- Department of Biology, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, 36050, Guanajuato, Gto, México,
| | - Laura C García-Carnero
- Department of Biology, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, 36050, Guanajuato, Gto, México,
| | - Diana G Amezcua-Hernández
- Department of Biology, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, 36050, Guanajuato, Gto, México,
| | - Nancy E Lozoya-Pérez
- Department of Biology, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, 36050, Guanajuato, Gto, México,
| | - Eine Estrada-Mata
- Department of Biology, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, 36050, Guanajuato, Gto, México,
| | - Iván Martínez-Duncker
- Laboratory of Human Glycobiology and Molecular Diagnostics, Centro de Investigación en Dinámica Celular, Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Cuernavaca, 62209, Morelos, México
| | - Bernardo Franco
- Department of Biology, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, 36050, Guanajuato, Gto, México,
| | - Héctor M Mora-Montes
- Department of Biology, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, 36050, Guanajuato, Gto, México,
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58
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de Oliveira HC, Monteiro MC, Rossi SA, Pemán J, Ruiz-Gaitán A, Mendes-Giannini MJS, Mellado E, Zaragoza O. Identification of Off-Patent Compounds That Present Antifungal Activity Against the Emerging Fungal Pathogen Candida auris. Front Cell Infect Microbiol 2019; 9:83. [PMID: 31001487 PMCID: PMC6454888 DOI: 10.3389/fcimb.2019.00083] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/11/2019] [Indexed: 12/16/2022] Open
Abstract
Candida auris is an emerging fungal pathogen of great concern among the scientific community because it is causing an increasing number of hospital outbreaks of difficult management worldwide. In addition, isolates from this species frequently present reduced susceptibility to azole and echinocandin drugs. For this reason, it is necessary to develop new antifungal strategies to better control the disease caused by this yeast. In this work, we screened drugs from the Prestwick chemical library, which contains 1,280 off-patent compounds that are already approved by the Food and Drug Administration, with the aim of identifying molecules with antifungal activity against C. auris. In an initial screening, we looked for drugs that inhibited the growth of three different C. auris strains and found 27 of them which it did so. Ten active compounds were selected to test the susceptibility profile by using the EUCAST protocol. Antifungal activity was confirmed for seven drugs with MICs ranging from 0.5 to 64 mg/L. Some of these drugs were also tested in combination with voriconazole and anidulafungin at sub-inhibitory concentrations. Our results suggest synergistic interactions between suloctidil and voriconazole with fractional inhibitory concentration index (FICI) values of 0.11 to 0.5 and between ebselen and anidulafungin (FICI, 0.12 to 0.44). Our findings indicate that drug repurposing could be a viable alternative to managing infections by C. auris.
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Affiliation(s)
- Haroldo Cesar de Oliveira
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain.,Laboratório de Micologia Clínica, Departamento de Análises Clínicas, Faculdade de Ciências Farmacêuticas, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Maria Candida Monteiro
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Suélen Andreia Rossi
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Pemán
- Hospital Universitari i Politécnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | | | - Maria José Soares Mendes-Giannini
- Laboratório de Micologia Clínica, Departamento de Análises Clínicas, Faculdade de Ciências Farmacêuticas, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Emilia Mellado
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Oscar Zaragoza
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
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Arastehfar A, Bakhtiari M, Daneshnia F, Fang W, Sadati SK, Al-Hatmi AM, Groenewald M, Sharifi-Mehr H, Liao W, Pan W, Zomorodian K, Hagen F, Boekhout T. First fungemia case due to environmental yeast Wickerhamomyces myanmarensis: detection by multiplex qPCR and antifungal susceptibility. Future Microbiol 2019; 14:267-274. [PMID: 30859860 PMCID: PMC6482385 DOI: 10.2217/fmb-2018-0253] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Presenting the first clinical case of Wickerhamomyces myanmarensis. PATIENTS & METHODS Yeast cells were isolated from blood and central venous catheter of a 5.5-year-old male subject. API 20C AUX, MALDI-TOF MS, ITS and LSU rDNA sequencing, and our qPCR assay were used for identification and the MIC values were determined by CLSI M27-A3. RESULTS ITS and LSU rDNA sequencing identified both isolates as W. myanmarensis, while API 20C AUX and MALDI-TOF MS did not identify them correctly. Our qPCR specifically distinguished W. myanmarensis from W. anomalus. Isolate obtained from blood showed a higher MIC value for fluconazole, voriconazole and posaconazole. CONCLUSION Utilization of reliable identification tools might reveal the genuine spectrum of opportunistic yeast species.
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Affiliation(s)
- Amir Arastehfar
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Mina Bakhtiari
- Basic Sciences in Infectious Diseases Research Center, & Department of Medical Mycology & Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farnaz Daneshnia
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Wenjie Fang
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Sara Khanjari Sadati
- Basic Sciences in Infectious Diseases Research Center, & Department of Medical Mycology & Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdullah Ms Al-Hatmi
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Ministry of Health, Directorate General of Health Services, Ibri, Oman
| | | | - Hamid Sharifi-Mehr
- Biology Department, Faculty of Science, Sahid Bahonar University of Kerman, Kerman, Iran
| | - Wanqing Liao
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Weihua Pan
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Kamiar Zomorodian
- Basic Sciences in Infectious Diseases Research Center, & Department of Medical Mycology & Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Basic Sciences in Infectious Diseases Research Center, & Department of Medical Mycology & Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Institute of Biodiversity & Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
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60
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Boyce K, Morrissey O, Idnurm A, Macreadie I. Insights into the global emergence of antifungal drug resistance. MICROBIOLOGY AUSTRALIA 2019. [DOI: 10.1071/ma19024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The global prevalence of fungal diseases has escalated in the last several decades. Currently, it is estimated that fungi infect 1.7 billion people annually and result in 1.5 million deaths every year1. Deaths due to fungal infections are increasing, with mortality often exceeding 50%, further increasing to 100% if treatment is delayed1. Despite these staggering figures, the contribution of fungal infections to the global burden of disease remains under-recognised. In Australia, over a 5-year period fungal infections cost Australia an estimated $583 million2. The median cost for one invasive fungal disease (IFD) is AU$30957, increasing to AU$80291 if the patient is admitted to an intensive care unit3. Treatment of fungal infections poses significant challenges due to the small number of safe and effective antifungal drugs available and emerging antifungal drug resistance. Resistance to every class of antifungal drugs has been described and for some drug classes is extremely common4,5.
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Arikan-Akdagli S, Ghannoum M, Meis JF. Antifungal Resistance: Specific Focus on Multidrug Resistance in Candida auris and Secondary Azole Resistance in Aspergillus fumigatus. J Fungi (Basel) 2018; 4:jof4040129. [PMID: 30563053 PMCID: PMC6308933 DOI: 10.3390/jof4040129] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 11/29/2018] [Accepted: 12/03/2018] [Indexed: 12/20/2022] Open
Abstract
Antifungal resistance is a topic of concern, particularly for specific fungal species and drugs. Among these are the multidrug-resistant Candida auris and azole-resistant Aspergillus fumigatus. While the knowledge on molecular mechanisms of resistance is now accumulating, further data are also available for the clinical implications and the extent of correlation of in vitro resistance to clinical outcomes. This review article summarizes the epidemiology of C. auris infections, animal models focusing on the activity of novel antifungal compounds in C. auris infections, virulence factors, and the mechanisms of antifungal resistance for this multi-resistant Candida species. Regarding A. fumigatus, the significance of azoles in the treatment of A. fumigatus infections, reference methods available for the detection of resistance in vitro, molecular mechanisms of secondary azole resistance, routes of acquisition, and clinical implications of in vitro resistance are covered to provide guidance for the current status of azole resistance in A. fumigatus.
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Affiliation(s)
- Sevtap Arikan-Akdagli
- Department of Medical Microbiology, Mycology Laboratory, Hacettepe University Medical School, TR-06100 Ankara, Turkey.
| | - Mahmoud Ghannoum
- Center for Medical Mycology, Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA.
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), 6532 Nijmegen, The Netherlands.
- Centre of Expertise in Mycology Radboudumc/CWZ, 6532 Nijmegen, The Netherlands.
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62
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Willaert RG. Adhesins of Yeasts: Protein Structure and Interactions. J Fungi (Basel) 2018; 4:jof4040119. [PMID: 30373267 PMCID: PMC6308950 DOI: 10.3390/jof4040119] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 12/14/2022] Open
Abstract
The ability of yeast cells to adhere to other cells or substrates is crucial for many yeasts. The budding yeast Saccharomyces cerevisiae can switch from a unicellular lifestyle to a multicellular one. A crucial step in multicellular lifestyle adaptation is self-recognition, self-interaction, and adhesion to abiotic surfaces. Infectious yeast diseases such as candidiasis are initiated by the adhesion of the yeast cells to host cells. Adhesion is accomplished by adhesin proteins that are attached to the cell wall and stick out to interact with other cells or substrates. Protein structures give detailed insights into the molecular mechanism of adhesin-ligand interaction. Currently, only the structures of a very limited number of N-terminal adhesion domains of adhesins have been solved. Therefore, this review focuses on these adhesin protein families. The protein architectures, protein structures, and ligand interactions of the flocculation protein family of S. cerevisiae; the epithelial adhesion family of C. glabrata; and the agglutinin-like sequence protein family of C. albicans are reviewed and discussed.
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Affiliation(s)
- Ronnie G Willaert
- Alliance Research Group VUB-UGent NanoMicrobiology (NAMI), IJRG VUB-EPFL NanoBiotechnology & NanoMedicine (NANO), Research Group Structural Biology Brussels, Vrije Universiteit Brussel, 1050 Brussels, Belgium.
- Department Bioscience Engineering, University Antwerp, 2020 Antwerp, Belgium.
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63
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Abstract
Fungal diseases became a major medical problem in the second half of the 20th century when advances in modern medicine together with the HIV epidemic resulted in large numbers of individuals with impaired immunity. Fungal diseases are difficult to manage because they tend to be chronic, hard to diagnose, and difficult to eradicate with antifungal drugs. This essay considers the future of medical mycology in the 21st century, extrapolating from current trends. In the near horizon, the prevalence of fungal diseases is likely to increase, as there will be more hosts with impaired immunity and drug resistance will inevitably increase after selection by antifungal drug use. We can expect progress in the development of new drugs, diagnostics, vaccines, and immunotherapies. In the far horizon, humanity may face new fungal diseases in association with climate change. Some current associations between chronic diseases and fungal infections could lead to the establishment of fungi as causative agents, which will greatly enhance their medical importance. All trends suggest that the importance of fungal diseases will increase in the 21st century, and enhanced human preparedness for this scourge will require more research investment in this group of infectious diseases.
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Affiliation(s)
- Arturo Casadevall
- Department of Molecular Microbiology and Immunology, The Johns Hopkins School of Public Health, Baltimore, Maryland
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64
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Eldesouky HE, Li X, Abutaleb NS, Mohammad H, Seleem MN. Synergistic interactions of sulfamethoxazole and azole antifungal drugs against emerging multidrug-resistant Candida auris. Int J Antimicrob Agents 2018; 52:754-761. [PMID: 30145250 DOI: 10.1016/j.ijantimicag.2018.08.016] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/15/2018] [Accepted: 08/18/2018] [Indexed: 01/05/2023]
Abstract
Candida auris is an emerging multidrug-resistant pathogen implicated in numerous outbreaks worldwide, with a notably high mortality rate (ca. 60%). A significant challenge with treatment of these infections is the resistance of C. auris to most antifungal drugs used clinically. Thus, finding co-drugs capable of overcoming resistance to frontline antifungals is of prime clinical importance. In this study, the ability of the combination of different sulfa drugs with azole antifungals to inhibit the growth of azole-resistant C. auris isolates was evaluated. Among the active sulfa drugs, sulfamethoxazole exhibited the most potent in vitro synergistic interactions with voriconazole and itraconazole. The sulfamethoxazole-voriconazole combination restored voriconazole's fungistatic activity against three of eight voriconazole-resistant clinical isolates. Similarly, the sulfamethoxazole-itraconazole combination restored itraconazole's fungistatic activity against three of four itraconazole-resistant clinical isolates. This activity was further confirmed in vivo in a Caenorhabditis elegans model of C. auris infection. The sulfamethoxazole-voriconazole combination enhanced survival of nematodes infected with C. auris by nearly 70%. Notably, these data indicate that the efficacy of this novel combination is dependent on the underlying mechanism of azole resistance. Mutant strains demonstrating azole resistance by either overproduction of or decreased affinity for the azole target (ERG11p) were found highly to be susceptible to the sulfamethoxazole-azole combination. However, this synergistic interaction was ineffective against mutant strains that demonstrated azole resistance via efflux pump hyperactivity. In conclusion, sulfamethoxazole represents a promising co-drug that can restore the efficacy of certain azole antifungal drugs against some azole-resistant isolates of C. auris.
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Affiliation(s)
- Hassan E Eldesouky
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Xiaoyan Li
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA; College of Life Sciences, Northeast Forestry University, Harbin, Heilongjiang, China
| | - Nader S Abutaleb
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Haroon Mohammad
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Mohamed N Seleem
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA; Purdue Institute of Inflammation, Immunology, and Infectious Disease, Purdue University, West Lafayette, IN 47907, USA.
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