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Kim YH, Kim JH, Kim DH, Kim SH, Kim HR, Kim YM. Synergistic Antimicrobial Effect of Sargassum serratifolium (C. Agardh) C. Agardh Extract against Human Skin Pathogens. ACTA ACUST UNITED AC 2016. [DOI: 10.9721/kjfst.2016.48.3.241] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Shokohi T, Badali H, Amirrajab N, Ataollahi MR, Kouhpayeh SA, Afsarian MH. In vitro activity of five antifungal agents against Candida albicans isolates, Sari, Iran. Curr Med Mycol 2016; 2:34-39. [PMID: 28681018 PMCID: PMC5490303 DOI: 10.18869/acadpub.cmm.2.2.8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background and Purpose: Candidaalbicans is the most common causative agent of candidiasis. Candidiasis management is dependent on the immune status of the host, severity of disease, and the choice of antifungal drug. Antifungals, specifically triazoles, are widely administered for the treatment of invasive fungal infections. Herein, we aimed to evaluate the invitro susceptibility of C. albicans isolates to fluconazole (FLZ), itraconazole (ITZ), voriconazole (VRZ), amphotericin B (AMB), and Caspofungin (CAS). Materials and Methods: A total of 44 clinical strains of C. albicans were collected from 36 patients admitted to four hospitals in Mazandaran Province, Iran. The invitro antifungal susceptibility testing was performed based on the Clinical and Laboratory Standards Institute methods. Results : Generally, 34 isolates were susceptible to all the five antifungal drugs, while four isolates were susceptible or susceptible dose-dependent (SDD) and six isolates were SDD or resistant to these antifungals. The lowest minimum inhibitory concentration (MIC; 0.016 µg/ml) belonged to AMB and the highest MIC was for FLZ )16 µg/ml). The lowest MIC (50 0.063 µg/ml) was related to ITZ and the lowest MIC (90 0.25 µg/ml) pertained to CAS, in addition , the highest MIC (50 1 µg/ml) and MIC (90 4 µg/ml) were for FLZ. Four of the isolates showed resistance to both FLZ and VRZ, separately, and five isolates were resistant to ITZ. Caspofungin showed potent activity against more than %95 of the C. albicans isolates. Conclusion: Overall, we reported %9.1 resistance to FLZ and VRZ ,%11.3 resistance to ITZ and AMB, and %4.6 resistance to caspofungin .Our finding is in agreement with previous observations proposing that C. albicans isolates develop resistance to some antifungal drugs such as FLZ since they are widely used as prophylaxis.
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Affiliation(s)
- T Shokohi
- Invasive Fungal Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - H Badali
- Invasive Fungal Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - N Amirrajab
- Department of Medical Laboratory Sciences, School of Paramedicine/Infectious & Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - M R Ataollahi
- Department of Medical Microbiology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - S A Kouhpayeh
- Department of Pharmacology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - M H Afsarian
- Department of Medical Microbiology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
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53
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Dagi HT, Findik D, Senkeles C, Arslan U. Identification and antifungal susceptibility of Candida species isolated from bloodstream infections in Konya, Turkey. Ann Clin Microbiol Antimicrob 2016; 15:36. [PMID: 27245756 PMCID: PMC4888423 DOI: 10.1186/s12941-016-0153-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 05/23/2016] [Indexed: 12/12/2022] Open
Abstract
Background In this study, our aim was to identify Candida species isolated from bloodstream infections and to determine their susceptibilities to various antifungal agents to demonstrate the local resistance profiles and to guide empirical treatment for clinicians. Methods Two hundred Candida isolates (95 Candida albicans, 105 non-albicans Candida strains) were included in the study. Candida species were identified by conventional, biochemical and molecular methods. Antifungal susceptibility tests for amphotericin B, fluconazole, voriconazole, posaconazole, caspofungin and anidulafungin were performed with broth microdilution method according to the Clinical and Laboratory Standards Institute M27-A3 document. Results Of the 200 Candida strains, the most prevalent species were C. albicans (47.5 %), Candida glabrata (18.0 %) and Candida parapsilosis complex (14.0 %). All Candida species except for three (1.5 %) Candida kefyr strains were susceptible to amphotericin B. Only one (2.8 %) C. glabrata was resistant to fluconazole (MIC ≥ 64 μg/ml), and the others (97.2 %) exhibited dose-dependent susceptibility. All species, but C. glabrata strains, were susceptible to fluconazole. Resistance to voriconazole, posaconazole, caspofungin and anidulafungin was not detected in any strain. Conclusion Candida albicans were susceptible to all antifungal drugs. Three C. kefyr strains were resistant to amphotericin B. Only one C. glabrata was resistant to fluconazole. All the strains were susceptible to voriconazole, posaconazole, caspofungin and anidulafungin. In vitro antifungal susceptibility tests should be performed to select of appropriate and effective antifungal therapy, and monitor the development of resistance.
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Affiliation(s)
- Hatice Turk Dagi
- Department of Microbiology, Faculty of Medicine, Selcuk University, Alaeddin Keykubat Campus, 42131, Konya, Selcuklu, Turkey.
| | - Duygu Findik
- Department of Microbiology, Faculty of Medicine, Selcuk University, Alaeddin Keykubat Campus, 42131, Konya, Selcuklu, Turkey
| | - Cigdem Senkeles
- Department of Microbiology, Faculty of Medicine, Selcuk University, Alaeddin Keykubat Campus, 42131, Konya, Selcuklu, Turkey
| | - Ugur Arslan
- Department of Microbiology, Faculty of Medicine, Selcuk University, Alaeddin Keykubat Campus, 42131, Konya, Selcuklu, Turkey
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54
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Sanglard D. Emerging Threats in Antifungal-Resistant Fungal Pathogens. Front Med (Lausanne) 2016; 3:11. [PMID: 27014694 PMCID: PMC4791369 DOI: 10.3389/fmed.2016.00011] [Citation(s) in RCA: 233] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 03/03/2016] [Indexed: 12/15/2022] Open
Abstract
The use of antifungal drugs in the therapy of fungal diseases can lead to the development of antifungal resistance. Resistance has been described for virtually all antifungal agents in diverse pathogens, including Candida and Aspergillus species. The majority of resistance mechanisms have also been elucidated at the molecular level in these pathogens. Drug resistance genes and genome mutations have been identified. Therapeutic choices are limited for the control of fungal diseases, and it is tempting to combine several drugs to achieve better therapeutic efficacy. In the recent years, several novel resistance patterns have been observed, including antifungal resistance originating from environmental sources in Aspergillus fumigatus and the emergence of simultaneous resistance to different antifungal classes (multidrug resistance) in different Candida species. This review will summarize these current trends.
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Affiliation(s)
- Dominique Sanglard
- Institute of Microbiology, University Hospital Center, University of Lausanne , Lausanne , Switzerland
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55
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Katiraee F, Ashrafai Helan J, Emami SJ, Hamidian G, Babaei E. An investigation of the inhibitory effects of dendrosomal nanocurcumin on Candida albicans and systemic candidiasis in BALB/c mice. Curr Med Mycol 2016; 2:7-12. [PMID: 28681006 PMCID: PMC5490291 DOI: 10.18869/acadpub.cmm.2.1.7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and Purpose: Use of curcumin, as a promising antifungal agent, is considered an alternative treatment for fungal infections; however, the low solubility of this agent limits its efficacy. Accordingly, in this study, we aimed to evaluate the in vitro and in vivo antifungal activities of dendrosomal nanocurcumin with improved solubility and bioavailability. Materials and Methods: The in vitro antifungal activities of several Candida species, including C. albicans, C. tropicalis, C. krusei, C. parapsilosis , and C. dubliniensis, were evaluated, using the broth microdilution method. In the in vivo study, different doses of nanocurcumin (5, 10, 20, and 40 mg/kg) were administered to mice with systemic C. albicans infection via intraperitoneal injection. All mice were euthanized at 20 days following the administration of different doses of nanocurcumin. Different organs were extracted for organ culture and histopathological investigation. Results: Based on the findings, 40 mg/kg of nanocurcumin significantly decreased the fungal load in the evaluated organs; the results were confirmed with histopathological examination. The kidney was found to be the most affected organ with the highest number of severe lesions. Yeasts and pseudohyphae were observed in the blood vessels, kidney, and brain. Also, yeasts were present in the liver, brain, lungs, and heart of the control group. Conclusion: Although curcumin is generally an excellent antifungal component, its nano-sized form showed more potent properties. Based on the gathered data, dendrosomal nanocurcumin is an effective antifungal agent with good efficacy against disseminated candidiasis. However, further studies are required to evaluate the effects of dendrosomal nanocurcumin on other fungal infections. Also, this agent could be useful for the prevention of fungal infections, such as candidiasis, particularly in high-risk patients.
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Affiliation(s)
- F Katiraee
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - J Ashrafai Helan
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - S J Emami
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Gh Hamidian
- Department of Basic Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - E Babaei
- Department of Genetics, Faculty of Basic Sciences, University of Tabriz, Tabriz, Iran
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Tan TY, Hsu LY, Alejandria MM, Chaiwarith R, Chinniah T, Chayakulkeeree M, Choudhury S, Chen YH, Shin JH, Kiratisin P, Mendoza M, Prabhu K, Supparatpinyo K, Tan AL, Phan XT, Tran TTN, Nguyen GB, Doan MP, Huynh VA, Nguyen SMT, Tran TB, Van Pham H. Antifungal susceptibility of invasive Candida bloodstream isolates from the Asia-Pacific region. Med Mycol 2016; 54:471-7. [PMID: 26868904 DOI: 10.1093/mmy/myv114] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/09/2015] [Indexed: 11/14/2022] Open
Abstract
Bloodstream infections caused by Candida species are of increasing importance and associated with significant mortality. We performed a multi-centre prospective observational study to identify the species and antifungal susceptibilities of invasive bloodstream isolates of Candida species in the Asia-Pacific region. The study was carried out over a two year period, involving 13 centers from Brunei, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Identification of Candida species was performed at each study center, and reconfirmed at a central laboratory. Susceptibility testing was performed using a commercial broth dilution panel (Sensititre YeastOne YST-010, Thermofisher, United Kingdom) with susceptibility categorisation (S = susceptible, S-DD = susceptible dose-dependent) applied using breakpoints from the Clinical Laboratory Standards Institute. Eight hundred and sixty-one Candida isolates were included in the study. The most common species were C. albicans (35.9%), C. tropicalis (30.7%), C. parapsilosis (15.7%), and C. glabrata (13.6%). Non-albicans species exceeded C. albicans species in centers from all countries except Taiwan. Fluconazole susceptibility was almost universal for C. albicans (S = 99.7%) but lower for C. tropicalis (S = 75.8%, S-DD = 6.1%), C. glabrata (S-DD = 94.9%), and C. parapsilosis (S = 94.8%). Echinocandins demonstrated high rates of in vitro susceptibility (S>99%) against C. albicans, C. tropicalis, and C. parapsilosis This study demonstrates that non-albicans species are the most common isolates from bloodstream infections in most countries in the Asia-Pacific region, with C. tropicalis as the predominant species. Because of the prevalence of reduced susceptibility to fluconazole in non-albicans species, the study indicates that echinocandins should be the antifungal of choice in clinically unstable or high-risk patients with documented candidemia.
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Affiliation(s)
- Thean Yen Tan
- Changi General Hospital, 2 Simei Street 3, Singapore 529889
| | - Li Yang Hsu
- National University Health System, 1E Kent Ridge Road, Singapore 119228
| | - Marissa M Alejandria
- University of the Philippines - Philippine General Hospital, Taft Avenue, Ermita, Manila 1000, Metro Manila, Philippines
| | - Romanee Chaiwarith
- Maharaj Nakorn Chiang Mai Hospital, 110 Intavaroros Road, Sribhoom, Muang District, Chiang Mai, Thailand
| | - Terrence Chinniah
- Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Jalan Putera Al-Muhtadee Billah / Jalan Tutong Brunei Darussalam BA1710
| | | | | | - Yen Hsu Chen
- Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan National Chiao Tung University, HsinChu City, Taiwan Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Jong Hee Shin
- Chonnam National University Hospital, 42 Jebongro, Dongku, Gwangju, Korea 501-575
| | | | - Myrna Mendoza
- National Kidney and Transplant Institute Hospital, East Ave, Diliman, Quezon City, Metro Manila, Philippines
| | - Kavitha Prabhu
- Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Jalan Putera Al-Muhtadee Billah / Jalan Tutong Brunei Darussalam BA1710
| | - Khuanchai Supparatpinyo
- Maharaj Nakorn Chiang Mai Hospital, 110 Intavaroros Road, Sribhoom, Muang District, Chiang Mai, Thailand
| | - Ai Ling Tan
- Singapore General Hospital, Outram Rd, Singapore 169608
| | - Xuan Thi Phan
- Cho Ray Hospital, 201B Nguyen Chi Thanh, District 5, Ho Chi Minh City, Vietnam
| | - Thi Thanh Nga Tran
- Cho Ray Hospital, 201B Nguyen Chi Thanh, District 5, Ho Chi Minh City, Vietnam
| | - Gia Binh Nguyen
- Bach Mai Hospital, 78 Giai Phong, Phuong Mai, Dong Da, Hanoi, Vietnam
| | - Mai Phuong Doan
- Bach Mai Hospital, 78 Giai Phong, Phuong Mai, Dong Da, Hanoi, Vietnam
| | - Van An Huynh
- Nhan Dan Gia Dinh Hospital, 01 No Trang Long, Binh Thanh District, Ho Chi Minh City, Vietnam
| | - Su Minh Tuyet Nguyen
- Nhan Dan Gia Dinh Hospital, 01 No Trang Long, Binh Thanh District, Ho Chi Minh City, Vietnam
| | - Thanh Binh Tran
- Nguyen Tri Phuong Hospital, 468 Nguyen Trai Street, Ward 8, District 5, Ho Chi Minh City, Vietnam
| | - Hung Van Pham
- Nguyen Tri Phuong Hospital, 468 Nguyen Trai Street, Ward 8, District 5, Ho Chi Minh City, Vietnam
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Acquired Multidrug Antifungal Resistance in Candida lusitaniae during Therapy. Antimicrob Agents Chemother 2015; 59:7715-22. [PMID: 26438490 DOI: 10.1128/aac.02204-15] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 09/26/2015] [Indexed: 12/20/2022] Open
Abstract
Candida lusitaniae is usually susceptible to echinocandins. Beta-1,3-glucan synthase encoded by FKS genes is the target of echinocandins. A few missense mutations in the C. lusitaniae FKS1 hot spot 1 (HS1) have been reported. We report here the rapid emergence of antifungal resistance in C. lusitaniae isolated during therapy with amphotericin B (AMB), caspofungin (CAS), and azoles for treatment of persistent candidemia in an immunocompromised child with severe enterocolitis and visceral adenoviral disease. As documented from restriction fragment length polymorphism (RFLP) and random amplified polymorphic DNA (RAPD) analysis, the five C. lusitaniae isolates examined were related to each other. From antifungal susceptibility and molecular analyses, 5 different profiles (P) were obtained. These profiles included the following: profile 1 (P1) (CAS MIC [μg/ml], 0.5; fluconazole [FLC] MIC, 0.25), determined while the patient was being treated with liposomal AMB for 3 months; P2 (FLC MIC [μg/ml], 0.25; CAS MIC, 4), while the patient was being treated with CAS for 2 weeks; P3 (CAS MIC [μg/ml], 0.5; FLC MIC, 32), while the patient was being treated with azoles and CAS initially followed by azoles alone for a week; P4 (CAS MIC [μg/ml], 8; FLC MIC, 8), while the patient was being treated with both drugs for 3 weeks; and P5 (AMB MIC [μg/ml], 0.125; CAS MIC, 8), while the patient was being treated with AMB and FLC for 2 weeks. CAS resistance was associated with resistance not only to micafungin and anidulafungin but also to AMB. Analysis of CAS resistance revealed 3 novel FKS1 mutations in CAS-resistant isolates (S638Y in P2; S631Y in P4; S638P in P5). While S638Y and -P are within HS1, S631Y is in close proximity to this domain but was confirmed to confer candin resistance using a site-directed mutagenesis approach. FLC resistance could be linked with overexpression of major facilitator gene 7 (MFS7) in C. lusitaniae P2 and P4 and was associated with resistance to 5-flurocytosine. This clinical report describes resistance of C. lusitaniae to all common antifungals. While candins or azole resistance followed monotherapy, multidrug antifungal resistance emerged during combined therapy.
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58
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Yenisehirli G, Bulut N, Yenisehirli A, Bulut Y. In Vitro Susceptibilities of Candida albicans Isolates to Antifungal Agents in Tokat, Turkey. Jundishapur J Microbiol 2015; 8:e28057. [PMID: 26495115 PMCID: PMC4609313 DOI: 10.5812/jjm.28057] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 06/09/2015] [Accepted: 06/16/2015] [Indexed: 12/02/2022] Open
Abstract
Background: Candida albicans is the pathogenic species most commonly isolated from fungal infections. Management of these infections depends on the immune status of the host, severity of disease, and the choice of antifungal drug. In spite of the development of new antifungal drugs, epidemiological studies have shown that resistance to antifungal drugs in C. albicans strains is becoming a serious problem. Objectives: The aim of this study was to evaluate the in vitro susceptibility of C. albicans isolates to ketoconazole, fluconazole, itraconazole, voriconazole, posaconazole, amphotericin B, caspofungin, and anidulafungin. Materials and Methods: A total of 201 C. albicans isolates were collected from clinical specimens. Antifungal susceptibility tests were performed using the Etest. Results: All the tested C. albicans isolates were found to be susceptible to amphotericin B and anidulafungin. Although none of the isolates showed resistance to caspofungin, 15% of the isolates were classified as showing intermediate resistance. The resistance rates of C. albicans isolates to ketoconazole, fluconazole, itraconazole, voriconazole and posaconazole were 32%, 34%, 21%, 14% and 14%, respectively. Conclusions: Our findings indicate that resistance of C. albicans strains to azoles is more common in Tokat, Turkey. Therefore, a strategy to control the inappropriate and widespread use of antifungal drugs is urgently needed. Fungal culturing and antifungal susceptibility testing will be useful in patient management as well as resistance surveillance.
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Affiliation(s)
- Gulgun Yenisehirli
- Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
- Corresponding author: Gulgun Yenisehirli, Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey. Tel: +90-3562129500; +90-3562127209, Fax: +90-3562133176, E-mail:
| | - Nermin Bulut
- Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Aydan Yenisehirli
- Department of Pharmacology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Yunus Bulut
- Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
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59
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Katiraee F, Teifoori F, Soltani M. Emergence of azole-resistant Candida species in AIDS patients with oropharyngeal candidiasis in Iran. Curr Med Mycol 2015; 1:11-16. [PMID: 28680991 PMCID: PMC5490324 DOI: 10.18869/acadpub.cmm.1.3.11] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background and Purpose: Oropharyngeal candidiasis (OPC) and antifungal drug resistance are major health concerns in patients with human immunodeficiency virus (HIV). The increased reports of antifungal resistance and expanding drug therapy options prompted the determination of antifungal susceptibility profile. The present study was performed to determine the antifungal susceptibility of Candida species isolated from AIDS patients with OPC in Iran. Materials and Methods: In total, 100 Candida isolates from the oral cavity of patients with OPC (TCD4 < 200 cells/μL) were obtained and cultured on CHROMagar and Sabouraud’s dextrose agar. All isolates were identified according to the assimilation profile, colony color and other conventional methods. Broth microdilution of antifungal drugs was carried out, according to the methods described in M27-S4 and M44-A guidelines by the Clinical and Laboratory Standards Institute (CLSI). Results: Among 60 Candida albicans (C. albicans) strains, 56.7% were resistant to fluconazole, while 38.3% were resistant to ketoconazole and clotrimazole. The resistance of C. albicans isolates against polyene antifungals including amphotericin B was scarce (1.7%). Based on the results, 52.2% of C.glabrata strains were resistant to fluconazole, while 47.8% and 30.4% of these isolates were resistant to ketoconazole and clotrimazole, respectively. All Candida isolates were susceptible to nystatin and caspofungin. Conclusion: Based on the findings, it can be concluded that screening of resistant Candida isolates by disk diffusion or broth dilution method is essential for the surveillance and prevention of antifungal resistance in patient management. Although nystatin is widely used in clinical practice for HIV patients in Iran, no evidence of enhanced resistance against this agent was found; on the other hand, resistance to azole antifungals, particularly fluconazole, increased. Considering the lack of resistance to caspofungin, administration of this agent is suggested for the treatment of OPC in AIDS patients.
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Affiliation(s)
- F Katiraee
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - F Teifoori
- Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy and laboratory of Parasitology and Allergy, Lascaray Research Center, University of the Basque Country, Vitoria, Spain
| | - M Soltani
- Mycology Research Center, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
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60
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Yenisehirli G, Bulut N, Yenisehirli A, Bulut Y. In Vitro Susceptibilities of Candida albicans Isolates to Antifungal Agents in Tokat, Turkey. Jundishapur J Microbiol 2015. [PMID: 26495115 DOI: 10.5812/2fjjm.28057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Candida albicans is the pathogenic species most commonly isolated from fungal infections. Management of these infections depends on the immune status of the host, severity of disease, and the choice of antifungal drug. In spite of the development of new antifungal drugs, epidemiological studies have shown that resistance to antifungal drugs in C. albicans strains is becoming a serious problem. OBJECTIVES The aim of this study was to evaluate the in vitro susceptibility of C. albicans isolates to ketoconazole, fluconazole, itraconazole, voriconazole, posaconazole, amphotericin B, caspofungin, and anidulafungin. MATERIALS AND METHODS A total of 201 C. albicans isolates were collected from clinical specimens. Antifungal susceptibility tests were performed using the Etest. RESULTS All the tested C. albicans isolates were found to be susceptible to amphotericin B and anidulafungin. Although none of the isolates showed resistance to caspofungin, 15% of the isolates were classified as showing intermediate resistance. The resistance rates of C. albicans isolates to ketoconazole, fluconazole, itraconazole, voriconazole and posaconazole were 32%, 34%, 21%, 14% and 14%, respectively. CONCLUSIONS Our findings indicate that resistance of C. albicans strains to azoles is more common in Tokat, Turkey. Therefore, a strategy to control the inappropriate and widespread use of antifungal drugs is urgently needed. Fungal culturing and antifungal susceptibility testing will be useful in patient management as well as resistance surveillance.
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Affiliation(s)
- Gulgun Yenisehirli
- Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Nermin Bulut
- Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Aydan Yenisehirli
- Department of Pharmacology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Yunus Bulut
- Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
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61
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Quantitative Microplate-Based Growth Assay for Determination of Antifungal Susceptibility of Histoplasma capsulatum Yeasts. J Clin Microbiol 2015; 53:3286-95. [PMID: 26246483 DOI: 10.1128/jcm.00795-15] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 07/29/2015] [Indexed: 11/20/2022] Open
Abstract
Standardized methodologies for determining the antifungal susceptibility of fungal pathogens is central to the clinical management of invasive fungal disease. Yeast-form fungi can be tested using broth macrodilution and microdilution assays. Reference procedures exist for Candida species and Cryptococcus yeasts; however, no standardized methods have been developed for testing the antifungal susceptibility of yeast forms of the dimorphic systemic fungal pathogens. For the dimorphic fungal pathogen Histoplasma capsulatum, susceptibility to echinocandins differs for the yeast and the filamentous forms, which highlights the need to employ Histoplasma yeasts, not hyphae, in antifungal susceptibility tests. To address this, we developed and optimized methodology for the 96-well microtiter plate-based measurement of Histoplasma yeast growth in vitro. Using optical density, the assay is quantitative for fungal growth with a dynamic range greater than 30-fold. Concentration and assay reaction time parameters were also optimized for colorimetric (MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] reduction) and fluorescent (resazurin reduction) indicators of fungal vitality. We employed this microtiter-based assay to determine the antifungal susceptibility patterns of multiple clinical isolates of Histoplasma representing different phylogenetic groups. This methodology fulfills a critical need for the ability to monitor the effectiveness of antifungals on Histoplasma yeasts, the morphological form present in mammalian hosts and, thus, the form most relevant to disease.
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Farmakiotis D, Tarrand JJ, Kontoyiannis DP. Drug-resistant Candida glabrata infection in cancer patients. Emerg Infect Dis 2015; 20:1833-40. [PMID: 25340258 PMCID: PMC4214312 DOI: 10.3201/eid2011.140685] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
High rates of resistance to azoles and echinocandins emphasize the need for good antifungal stewardship. Drug-Resistant C. glabrata Infection in Cancer Patients Cancer patients are at risk for candidemia, and increasing Candida spp. resistance poses an emerging threat. We determined rates of antifungal drug resistance, identified factors associated with resistance, and investigated the correlation between resistance and all-cause mortality rates among cancer patients with ≥1 C. glabrata–positive blood culture at MD Anderson Cancer Center, Houston, Texas, USA, during March 2005–September 2013. Of 146 isolates, 30 (20.5%) were resistant to fluconazole, 15 (10.3%) to caspofungin, and 10 (6.8%) to multiple drugs (9 caspofungin-resistant isolates were also resistant to fluconazole, 1 to amphotericin B). Independently associated with fluconazole resistance were azole preexposure, hematologic malignancy, and mechanical ventilation. Independently associated with caspofungin resistance were echinocandin preexposure, monocytopenia, and total parenteral nutrition. Fluconazole resistance was highly associated with caspofungin resistance, independent of prior azole or echinocandin use. Caspofungin resistance was associated with increased 28-day all-cause mortality rates. These findings highlight the need for good stewardship of antifungal drugs.
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Antifungal susceptibilities of bloodstream isolates of Candida species from nine hospitals in Korea: application of new antifungal breakpoints and relationship to antifungal usage. PLoS One 2015; 10:e0118770. [PMID: 25706866 PMCID: PMC4338005 DOI: 10.1371/journal.pone.0118770] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/06/2015] [Indexed: 11/19/2022] Open
Abstract
We applied the new clinical breakpoints (CBPs) of the Clinical and Laboratory Standards Institute (CLSI) to a multicenter study to determine the antifungal susceptibility of bloodstream infection (BSI) isolates of Candida species in Korea, and determined the relationship between the frequency of antifungal-resistant Candida BSI isolates and antifungal use at hospitals. Four hundred and fifty BSI isolates of Candida species were collected over a 1-year period in 2011 from nine hospitals. The susceptibilities of the isolates to four antifungal agents were determined using the CLSI M27 broth microdilution method. By applying the species-specific CBPs, non-susceptibility to fluconazole was found in 16.4% (70/428) of isolates, comprising 2.6% resistant and 13.8% susceptible-dose dependent isolates. However, non-susceptibility to voriconazole, caspofungin, or micafungin was found in 0% (0/370), 0% (0/437), or 0.5% (2/437) of the Candida BSI isolates, respectively. Of the 450 isolates, 72 (16.0%) showed decreased susceptibility to fluconazole [minimum inhibitory concentration (MIC) ≥4 μg/ml]. The total usage of systemic antifungals varied considerably among the hospitals, ranging from 190.0 to 7.7 defined daily dose per 1,000 patient days, and fluconazole was the most commonly prescribed agent (46.3%). By Spearman’s correlation analysis, fluconazole usage did not show a significant correlation with the percentage of fluconazole resistant isolates at hospitals. However, fluconazole usage was significantly correlated with the percentage of fluconazole non-susceptible isolates (r = 0.733; P = 0.025) or the percentage of isolates with decreased susceptibility to fluconazole (MIC ≥4 μg/ml) (r = 0.700; P = 0.036) at hospitals. Our work represents the first South Korean multicenter study demonstrating an association between antifungal use and antifungal resistance among BSI isolates of Candida at hospitals using the new CBPs of the CLSI.
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Hu L, Du X, Li T, Song Y, Zai S, Hu X, Zhang X, Li M. Genetic and phenotypic characterization of Candida albicans strains isolated from infectious disease patients in Shanghai. J Med Microbiol 2015; 64:74-83. [PMID: 25351710 DOI: 10.1099/jmm.0.080200-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Lvyin Hu
- Department of Clinical Laboratory, Shanghai Public Health Clinical Center, Fudan University, No. 2901 Cao Lang Rd, Shanghai, PR China
- Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Central Urumqi Road, Shanghai, PR China
| | - Xin Du
- Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Central Urumqi Road, Shanghai, PR China
| | - Tianming Li
- Department of Laboratory Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, PR China
| | - Yan Song
- Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Central Urumqi Road, Shanghai, PR China
| | - Shubei Zai
- Department of Clinical Laboratory, Shanghai Public Health Clinical Center, Fudan University, No. 2901 Cao Lang Rd, Shanghai, PR China
| | - Xiangnan Hu
- Department of Clinical Laboratory, Shanghai Public Health Clinical Center, Fudan University, No. 2901 Cao Lang Rd, Shanghai, PR China
| | - Xiaonan Zhang
- Research Unit, Shanghai Public Health Clinical Center, Fudan University, No. 2901 Cao Lang Rd, Shanghai, PR China
| | - Min Li
- Department of Laboratory Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, PR China
- Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Central Urumqi Road, Shanghai, PR China
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Bernardo SM, Allen CP, Waller A, Young SM, Oprea T, Sklar LA, Lee SA. An automated high-throughput cell-based multiplexed flow cytometry assay to identify novel compounds to target Candida albicans virulence-related proteins. PLoS One 2014; 9:e110354. [PMID: 25350399 PMCID: PMC4211665 DOI: 10.1371/journal.pone.0110354] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 09/18/2014] [Indexed: 11/19/2022] Open
Abstract
Although three major classes of systemic antifungal agents are clinically available, each is characterized by important limitations. Thus, there has been considerable ongoing effort to develop novel and repurposed agents for the therapy of invasive fungal infections. In an effort to address these needs, we developed a novel high-throughput, multiplexed screening method that utilizes small molecules to probe candidate drug targets in the opportunistic fungal pathogen Candida albicans. This method is amenable to high-throughput automated screening and is based upon detection of changes in GFP levels of individually tagged target proteins. We first selected four GFP-tagged membrane-bound proteins associated with virulence or antifungal drug resistance in C. albicans. We demonstrated proof-of-principle that modulation of fluorescence intensity can be used to assay the expression of specific GFP-tagged target proteins to inhibitors (and inducers), and this change is measurable within the HyperCyt automated flow cytometry sampling system. Next, we generated a multiplex of differentially color-coded C. albicans strains bearing C-terminal GFP-tags of each gene encoding candidate drug targets incubated in the presence of small molecules from the Prestwick Chemical Library in 384-well microtiter plate format. Following incubation, cells were sampled through the HyperCyt system and modulation of protein levels, as indicated by changes in GFP-levels of each strain, was used to identify compounds of interest. The hit rate for both inducers and inhibitors identified in the primary screen did not exceed 1% of the total number of compounds in the small-molecule library that was probed, as would be expected from a robust target-specific, high-throughput screening campaign. Secondary assays for virulence characteristics based on null mutant strains were then used to further validate specificity. In all, this study presents a method for the identification and verification of new antifungal drugs targeted to fungal virulence proteins using C. albicans as a model fungal pathogen.
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Affiliation(s)
- Stella M. Bernardo
- Section of Infectious Diseases, New Mexico Veterans Healthcare System, Albuquerque, NM, United States of America
- Division of Infectious Diseases, University of New Mexico Health Science Center, Albuquerque, NM, United States of America
| | - Christopher P. Allen
- Center for Molecular Discovery, University of New Mexico, Albuquerque, NM, United States of America
| | - Anna Waller
- Center for Molecular Discovery, University of New Mexico, Albuquerque, NM, United States of America
| | - Susan M. Young
- Center for Molecular Discovery, University of New Mexico, Albuquerque, NM, United States of America
| | - Tudor Oprea
- Center for Molecular Discovery, University of New Mexico, Albuquerque, NM, United States of America
| | - Larry A. Sklar
- Center for Molecular Discovery, University of New Mexico, Albuquerque, NM, United States of America
| | - Samuel A. Lee
- Section of Infectious Diseases, New Mexico Veterans Healthcare System, Albuquerque, NM, United States of America
- Division of Infectious Diseases, University of New Mexico Health Science Center, Albuquerque, NM, United States of America
- * E-mail:
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