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Ton Nu PA, Ngo TMC, Le Chi C, Do TBT, Tran Thi G, Ha TNT, Nguyen PV, Le MT. Three cases of vulvovaginal candidiasis due to Candida nivariensis. Med Mycol Case Rep 2024; 43:100640. [PMID: 38444800 PMCID: PMC10914576 DOI: 10.1016/j.mmcr.2024.100640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/16/2024] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
Candida nivariensis is emerging as a highly resistant species of the Candida glabrata complex causing invasive and mucocutaneous infections. In this study, three cases of vulvovaginal candidiasis caused by C. nivariensis are described and identified by Internal Transcribed Spacer 1-2 sequencing. All isolates were susceptible in vitro to anidulafungin, micafungin, caspofungin, 5-flucytosine, posaconazole, voriconazole, itraconazole, amphotericin B, and showed dose-dependent susceptibility to fluconazole. In two patients, three doses of oral fluconazole were effective, while one patient developed clinical fluconazole resistance with a new relapse after 6 months. Increasing the weekly dose of fluconazole showed to be effective in this patient.
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Affiliation(s)
- Phuong Anh Ton Nu
- Department of Parasitology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Hue City, 49000, Viet Nam
| | - Thi Minh Chau Ngo
- Department of Parasitology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Hue City, 49000, Viet Nam
| | - Cao Le Chi
- Department of Parasitology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Hue City, 49000, Viet Nam
| | - Thị Bich Thao Do
- Department of Parasitology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Hue City, 49000, Viet Nam
| | - Giang Tran Thi
- Department of Parasitology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Hue City, 49000, Viet Nam
| | - Thị Ngoc Thuy Ha
- Department of Parasitology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Hue City, 49000, Viet Nam
| | - Phuoc Vinh Nguyen
- Department of Parasitology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Hue City, 49000, Viet Nam
| | - Minh Tam Le
- Hue Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy Hospital, 41 Nguyen Hue Street, Hue City, 4900, Viet Nam
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Chamroensakchai T, Sanaklang N, Hurdeal VG, Banjongjit A, Hyde KD, Kanjanabuch T. Candida nivariensis, an emerging fungus causing peritonitis in a patient receiving peritoneal dialysis. Med Mycol Case Rep 2022; 39:5-7. [PMID: 36568645 PMCID: PMC9772606 DOI: 10.1016/j.mmcr.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/20/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022] Open
Abstract
Fungal peritonitis (FP) is usually associated with poor patient outcomes and is mostly caused by non-albicans Candida species. We present a Candida nivariensis-associated peritonitis in a 68-year-old woman with end-stage kidney disease on peritoneal dialysis (PD). Biochemical profiling of the cultured yeast of the effluent sample did not adequately identify the yeast. Hence, molecular phylogeny and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF) mass spectroscopy were employed which correctly identified the causative species, C. nivariensis. PD catheter was removed and oral fluconazole was promptly started according to the 2022 International Society for PD (ISPD) Peritonitis Guidelines. However, the patient achieved only a partial clinical response and eventually died. The susceptibility test showed that the pathogen was susceptible to amphotericin B and voriconazole but resistant to other triazoles. This report underlines the importance of identifying the species, though rarely reported, and the drug susceptibility of the organism.
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Key Words
- CAPD, Continuous ambulatory peritoneal dialysis
- CLSI, Clinical and Laboratory Standards Institute
- Candida nivariensis
- ESKD, End-stage kidney disease
- Fungal peritonitis
- IP, Intraperitoneal
- ISPD, International Society for Peritoneal Dialysis
- ITS, Internal transcribed space
- KCMH, King Chulalongkorn Memorial Hospital
- MIC, Minimum inhibitory concentration
- PD, Peritoneal dialysis
- PDE, Peritoneal dialysis effluent
- Peritoneal dialysis
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Affiliation(s)
- Tamonwan Chamroensakchai
- Center of Excellence in Kidney Metabolic Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | | | - Vedprakash G. Hurdeal
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai, 57100, Thailand,School of Science, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Athiphat Banjongjit
- Nephrology Unit, Department of Medicine, Vichaiyut Hospital, Bangkok, 10400, Thailand
| | - Kevin D. Hyde
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Talerngsak Kanjanabuch
- Center of Excellence in Kidney Metabolic Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand,Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand,CAPD Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, 10330, Thailand,Corresponding author. Center of Excellence in Kidney Metabolic Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
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3
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High diversity of yeast species and strains responsible for vulvovaginal candidiasis in South-East Gabon. J Mycol Med 2022; 33:101354. [PMID: 36473325 DOI: 10.1016/j.mycmed.2022.101354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/10/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Candida albicans generally remains the principal pathogenic yeast responsible for vulvovaginal candidiasis (VVC), although with variable prevalence. In this study, we evaluated the evolution of the prevalence of the non-Candida albicans Candida (NCAC) species and investigated the genotypic diversity and the population genetic structure of the circulating C. albicans strains associated with VVC in the vicinity of Franceville (Gabon). METHODS A total of 110 independent isolates were identified using both MALDI-TOF MS and conventional techniques. The population genetic structure of the C. albicans strains was determined by multiple locus variable-number tandem repeat analysis using 4 microsatellite markers. RESULTS The mean and median age of the patients was 31 years. Seven patients had a mixed infection. C. albicans accounted for 62 % (n=68) of the total isolates. NCAC were dominated by C. glabrata, followed by P. kudriavzevii, C. parapsilosis, C. tropicalis, M. guilliermondii, and C. nivariensis. The cluster analysis revealed a high diversity, with a total of 50 different genotypes. The most represented genotype was shared by only four strains, while the vast majority (39 strains) had a unique MLVA pattern. Geographic clusters were not detected. CONCLUSION The study provides information on species distribution and possible changing epidemiology while reporting for the first time C. nivariensis in VVC in Africa. This study is also the first to investigate the genotypic diversity of the circulating C. albicans strains associated with VVC in Central Africa. Such analyses would help understand the molecular epidemiology of C. albicans.
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Sousa BR, Freitas JF, Valeriano CA, Neto LN, Neves RP, Gambarra FF, Gomes TM, da Silva Acioly JC, Lima-Neto RG. Refractory esophagitis caused by Candida nivariensis: second description of this yeast in Brazil and a literature review. Future Microbiol 2022; 17:903-915. [PMID: 35748170 DOI: 10.2217/fmb-2021-0109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Candida nivariensis caused refractory esophagitis in a 36-year-old Brazilian man coinfected with HIV and Leishmania. A literature review on this rare fungal pathogen is also presented. The diagnosis was made, and pathogen identification was performed using matrix-assisted laser desorption ionization-time of flight mass spectrometry and sequencing of the LSU/26S region. An antifungigram was performed using broth microdilution. A literature search of PubMed was performed. The causative agent, C. nivariensis, was resistant to fluconazole and voriconazole. The patient's condition worsened considerably, and he passed away. This is the second report of this Candida species in Brazil and the first case reported worldwide of refractory esophagitis in a patient coinfected with HIV and Leishmania. The case illustrates the importance of precise identification and antifungal susceptibility testing when isolating this emerging pathogen.
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Affiliation(s)
- Bruna R Sousa
- Department of Mycology, Postgraduate Program in Fungal Biology, Federal University of Pernambuco, Recife, Pernambuco, Av Professor Moraes Rêgo, s/n, 50670-901, Brazil
| | - Jucieli F Freitas
- Department of Mycology, Postgraduate Program in Fungal Biology, Federal University of Pernambuco, Recife, Pernambuco, Av Professor Moraes Rêgo, s/n, 50670-901, Brazil
| | - Carlos At Valeriano
- Department of Mycology, Postgraduate Program in Fungal Biology, Federal University of Pernambuco, Recife, Pernambuco, Av Professor Moraes Rêgo, s/n, 50670-901, Brazil
| | - Luiz Na Neto
- Department of Mycology, Postgraduate Program in Fungal Biology, Federal University of Pernambuco, Recife, Pernambuco, Av Professor Moraes Rêgo, s/n, 50670-901, Brazil
| | - Rejane P Neves
- Department of Mycology, Postgraduate Program in Fungal Biology, Federal University of Pernambuco, Recife, Pernambuco, Av Professor Moraes Rêgo, s/n, 50670-901, Brazil
| | - Fernanda F Gambarra
- Department of Health, Infectious Diseases Hospital Dr Clementino Fraga, State of Paraíba, Rua Estér Borges Bastos, s/n, Jaguaribe, João Pessoa, 58015-270, Brazil
| | - Tiago M Gomes
- Department of Health, Infectious Diseases Hospital Dr Clementino Fraga, State of Paraíba, Rua Estér Borges Bastos, s/n, Jaguaribe, João Pessoa, 58015-270, Brazil
| | - Jack C da Silva Acioly
- Department of Health, Infectious Diseases Hospital Dr Clementino Fraga, State of Paraíba, Rua Estér Borges Bastos, s/n, Jaguaribe, João Pessoa, 58015-270, Brazil
| | - Reginaldo G Lima-Neto
- Department of Mycology, Postgraduate Program in Fungal Biology, Federal University of Pernambuco, Recife, Pernambuco, Av Professor Moraes Rêgo, s/n, 50670-901, Brazil.,Department of Tropical Medicine, Center for Medical Sciences, Federal University of Pernambuco, Recife, Pernambuco, Av Professor Moraes Rêgo, s/n, 50670-901, Brazil
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5
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Fan Y, Gale AN, Bailey A, Barnes K, Colotti K, Mass M, Morina LB, Robertson B, Schwab R, Tselepidakis N, Timp W. Genome and transcriptome of a pathogenic yeast, Candida nivariensis. G3 (BETHESDA, MD.) 2021; 11:jkab137. [PMID: 33890630 PMCID: PMC8496292 DOI: 10.1093/g3journal/jkab137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/11/2021] [Indexed: 11/14/2022]
Abstract
We present a highly contiguous genome and transcriptome of the pathogenic yeast, Candida nivariensis. We sequenced both the DNA and RNA of this species using both the Oxford Nanopore Technologies and Illumina platforms. We assembled the genome into an 11.8 Mb draft composed of 16 contigs with an N50 of 886 Kb, including a circular mitochondrial sequence of 28 Kb. Using direct RNA nanopore sequencing and Illumina cDNA sequencing, we constructed an annotation of our new assembly, supplemented by lifting over genes from Saccharomyces cerevisiae and Candida glabrata.
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Affiliation(s)
- Yunfan Fan
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Andrew N Gale
- Department of Biology, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Anna Bailey
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Kali Barnes
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Kiersten Colotti
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Michal Mass
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Luke B Morina
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Bailey Robertson
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Remy Schwab
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Niki Tselepidakis
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Winston Timp
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Molecular Biology and Genetics, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Division of Infectious Disease, Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
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6
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Lotfali E, Fattahi A, Sayyahfar S, Ghasemi R, Rabiei MM, Fathi M, Vakili K, Deravi N, Soheili A, Toreyhi H, Shirvani F. A Review on Molecular Mechanisms of Antifungal Resistance in Candida glabrata: Update and Recent Advances. Microb Drug Resist 2021; 27:1371-1388. [PMID: 33956513 DOI: 10.1089/mdr.2020.0235] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Candida glabrata is the second frequent etiologic agent of mucosal and invasive candidiasis. Based on the recent developments in molecular methods, C. glabrata has been introduced as a complex composed of C. glabrata, Candida nivariensis, and Candida bracarensis. The four main classes of antifungal drugs effective against C. glabrata are pyrimidine analogs (flucytosine), azoles, echinocandins, and polyenes. Although the use of antifungal drugs is related to the predictable development of drug resistance, it is not clear why C. glabrata is able to rapidly resist against multiple antifungals in clinics. The enhanced incidence and antifungal resistance of C. glabrata and the high mortality and morbidity need more investigation regarding the resistance mechanisms and virulence associated with C. glabrata; additional progress concerning the drug resistance of C. glabrata has to be further prevented. The present review highlights the mechanism of resistance to antifungal drugs in C. glabrata.
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Affiliation(s)
- Ensieh Lotfali
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azam Fattahi
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Sayyahfar
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Ghasemi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Mahdi Rabiei
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mobina Fathi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kimia Vakili
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirali Soheili
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Toreyhi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Shirvani
- Pediatric Infections Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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7
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Alobaid K, Asadzadeh M, Bafna R, Ahmad S. First Isolation of Candida nivariensis, an Emerging Fungal Pathogen, in Kuwait. Med Princ Pract 2021; 30:80-84. [PMID: 32927454 PMCID: PMC7923905 DOI: 10.1159/000511553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/11/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE C. nivariensis is a rare Candida species which is phenotypically closely related to Candida glabrata and Candida bracarensis. The 3 species form the C. glabrata sensu lato complex. Here, we describe the first isolation and characterization of a C. nivariensis isolate cultured from the tracheal aspirate obtained from a young man in Kuwait. MATERIALS AND METHODS The yeast isolate was initially tested by VITEK 2 followed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and multiplex PCR. The identification was confirmed by sequencing of internal transcribed spacer (ITS) region of rDNA. Antifungal susceptibility testing was performed by Etest, and phylogenetic comparison with other international strains was carried out by using MEGA version 7 software. RESULTS The C. nivariensis isolate was misidentified by VITEK 2, but correctly identified by MALDI-TOF MS with updated software and multiplex PCR. The identity was confirmed by sequence comparisons of ITS region of rDNA. Antifungal susceptibility testing revealed high minimum inhibitory concentration (MIC) against fluconazole, but low MICs against amphotericin B and echinocandins. Phylogenetically, our isolate was closely related to Indian isolates. CONCLUSIONS This report extends the geographic distribution of C. nivariensis to the Arabian Peninsula. MALDI-TOF MS with updated software and molecular tests are needed to correctly identify C. nivariensis. Since C. nivariensis may exhibit reduced susceptibility to antifungal agents, accurate identification and antifungal susceptibility testing are essential, particularly for isolates from sterile sites, for optimal patient management.
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Affiliation(s)
- Khaled Alobaid
- Mycology Laboratory, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait,
| | - Mohammad Asadzadeh
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Ritu Bafna
- Microbiology Unit, Medical Laboratory Department, Sabah Hospital, Shuwaikh, Kuwait
| | - Suhail Ahmad
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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8
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Rodríguez-Cerdeira C, Martínez-Herrera E, Carnero-Gregorio M, López-Barcenas A, Fabbrocini G, Fida M, El-Samahy M, González-Cespón JL. Pathogenesis and Clinical Relevance of Candida Biofilms in Vulvovaginal Candidiasis. Front Microbiol 2020; 11:544480. [PMID: 33262741 PMCID: PMC7686049 DOI: 10.3389/fmicb.2020.544480] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 10/23/2020] [Indexed: 12/30/2022] Open
Abstract
The ability of Candida spp. to form biofilms is crucial for its pathogenicity, and thus, it should be considered an important virulence factor in vulvovaginal candidiasis (VVC) and recurrent VVC (RVVC). Its ability to generate biofilms is multifactorial and is generally believed to depend on the site of infection, species and strain involved, and the microenvironment in which the infection develops. Therefore, both cell surface proteins, such as Hwp1, Als1, and Als2, and the cell wall-related protein, Sun41, play a critical role in the adhesion and virulence of the biofilm. Immunological and pharmacological approaches have identified the NLRP3 inflammasome as a crucial molecular factor contributing to host immunopathology. In this context, we have earlier shown that Candida albicans associated with hyphae-secreted aspartyl proteinases (specifically SAP4-6) contribute to the immunopathology of the disease. Transcriptome profiling has revealed that non-coding transcripts regulate protein synthesis post-transcriptionally, which is important for the growth of Candida spp. Other studies have employed RNA sequencing to identify differences in the 1,245 Candida genes involved in surface and invasive cellular metabolism regulation. In vitro systems allow the simultaneous processing of a large number of samples, making them an ideal screening technique for estimating various physicochemical parameters, testing the activity of antimicrobial agents, and analyzing genes involved in biofilm formation and regulation (in situ) in specific strains. Murine VVC models are used to study C. albicans infection, especially in trials of novel treatments and to understand the cause(s) for resistance to conventional therapeutics. This review on the clinical relevance of Candida biofilms in VVC focuses on important advances in its genomics, transcriptomics, and proteomics. Moreover, recent experiments on the influence of biofilm formation on VVC or RVVC pathogenesis in laboratory animals have been discussed. A clear elucidation of one of the pathogenesis mechanisms employed by Candida biofilms in vulvovaginal candidiasis and its applications in clinical practice represents the most significant contribution of this manuscript.
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Affiliation(s)
- Carmen Rodríguez-Cerdeira
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Health Research Institute, SERGAS-UVIGO, Vigo, Spain.,Department of Dermatology, Hospital do Meixoeiro and University of Vigo, Vigo, Spain.,European Women's Dermatologic and Venereologic Society, Tui, Spain.,Psychodermatology Task Force of the Ibero-Latin American College of Dermatology (CILAD), Buenos Aires, Argentina
| | - Erick Martínez-Herrera
- Psychodermatology Task Force of the Ibero-Latin American College of Dermatology (CILAD), Buenos Aires, Argentina.,Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, Mexico
| | - Miguel Carnero-Gregorio
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Health Research Institute, SERGAS-UVIGO, Vigo, Spain.,Department of Molecular Diagnosis (Array & NGS Division), Institute of Cellular and Molecular Studies, Lugo, Spain
| | - Adriana López-Barcenas
- European Women's Dermatologic and Venereologic Society, Tui, Spain.,Psychodermatology Task Force of the Ibero-Latin American College of Dermatology (CILAD), Buenos Aires, Argentina.,Section of Mycology, Department of Dermatology, Manuel Gea González hospital, Mexico City, Mexico
| | - Gabriella Fabbrocini
- European Women's Dermatologic and Venereologic Society, Tui, Spain.,Department of Dermatology, University of Naples Federico II, Naples, Italy
| | - Monika Fida
- European Women's Dermatologic and Venereologic Society, Tui, Spain.,Department of Dermatology, University of Medicine, Tirana, Tirana, Albania
| | - May El-Samahy
- European Women's Dermatologic and Venereologic Society, Tui, Spain.,Department of Dermatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - José Luís González-Cespón
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Health Research Institute, SERGAS-UVIGO, Vigo, Spain
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9
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Caenorhabditis elegans as a Model System To Assess Candida glabrata, Candida nivariensis, and Candida bracarensis Virulence and Antifungal Efficacy. Antimicrob Agents Chemother 2020; 64:AAC.00824-20. [PMID: 32718968 DOI: 10.1128/aac.00824-20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/19/2020] [Indexed: 12/18/2022] Open
Abstract
Although Candida albicans remains the major etiological agent of invasive candidiasis, Candida glabrata and other emerging species of Candida are increasingly isolated. This species is the second most prevalent cause of candidiasis in many regions of the world. However, clinical isolates of Candida nivariensis and Candida bracarensis can be misidentified and are underdiagnosed due to phenotypic traits shared with C. glabrata Little is known about the two cryptic species. Therefore, pathogenesis studies are needed to understand their virulence traits and their susceptibility to antifungal drugs. The susceptibility of Caenorhabditis elegans to different Candida species makes this nematode an excellent model for assessing host-fungus interactions. We evaluated the usefulness of C. elegans as a nonconventional host model to analyze the virulence of C. glabrata, C. nivariensis, and C. bracarensis The three species caused candidiasis, and the highest virulence of C. glabrata was confirmed. Furthermore, we determined the efficacy of current antifungal drugs against the infection caused by these species in the C. elegans model. Amphotericin B and azoles showed the highest activity against C. glabrata and C. bracarensis infections, while echinocandins were more active for treating those caused by C. nivariensis C. elegans proved to be a useful model system for assessing the pathogenicity of these closely related species.
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10
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Cartier N, Chesnay A, N'diaye D, Thorey C, Ferreira M, Haillot O, Bailly É, Desoubeaux G. Candida nivariensis: Identification strategy in mycological laboratories. J Mycol Med 2020; 30:101042. [PMID: 32919860 DOI: 10.1016/j.mycmed.2020.101042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
Candida nivariensis is a cryptic fungal species classified within the Candida glabrata complex. It was described for the first time in 2005 by the means of DNA sequencing. We report a rare case of C. nivariensis deep-seated infection occurring in a 77-year-old man hospitalized for cysto-prostatectomy. Phenotypic testing based on the direct examination and the macroscopic features of the in vitro culture initially suggested C. glabrata species, while MALDI-TOF mass spectrometry enables correct identification. The isolate was found resistant to fluconazole, like in almost 20% of the reported cases. Herein, we present our practical strategy to reliably characterize this rare cryptic species. To date, MALDI-TOF mass spectrometry-based analysis showed very good results for such a purpose.
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Affiliation(s)
- N Cartier
- Parasitologie - mycologie - médecine tropicale, CHRU de Tours, 37044 Tours, France
| | - A Chesnay
- Parasitologie - mycologie - médecine tropicale, CHRU de Tours, 37044 Tours, France; CEPR - Inserm U1100/équipe 3, faculté de médecine, université de Tours, 37032 Tours, France
| | - D N'diaye
- Médecine interne et maladies infectieuses, CHRU de Tours, 37044 Tours, France
| | - C Thorey
- Médecine interne et maladies infectieuses, CHRU de Tours, 37044 Tours, France
| | - M Ferreira
- CEPR - Inserm U1100/équipe 3, faculté de médecine, université de Tours, 37032 Tours, France; Pneumologie, CHRU de Tours, 37044 Tours, France
| | - O Haillot
- Urologie, CHRU de Tours, 37044 Tours, France
| | - É Bailly
- Parasitologie - mycologie - médecine tropicale, CHRU de Tours, 37044 Tours, France
| | - G Desoubeaux
- Parasitologie - mycologie - médecine tropicale, CHRU de Tours, 37044 Tours, France; CEPR - Inserm U1100/équipe 3, faculté de médecine, université de Tours, 37032 Tours, France.
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11
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Asadzadeh M, Alanazi AF, Ahmad S, Al-Sweih N, Khan Z. Lack of detection of Candida nivariensis and Candida bracarensis among 440 clinical Candida glabrata sensu lato isolates in Kuwait. PLoS One 2019; 14:e0223920. [PMID: 31618264 PMCID: PMC6795469 DOI: 10.1371/journal.pone.0223920] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 10/01/2019] [Indexed: 12/12/2022] Open
Abstract
Occurrence of Candida nivariensis and Candida bracarensis, two species phenotypically similar to Candida glabrata sensu stricto, in human clinical samples from different geographical settings remains unknown. This study developed a low-cost multiplex PCR (mPCR) and three species-specific singleplex PCR assays. Reference strains of common Candida species were used during development and the performance of mPCR and singleplex PCR assays was evaluated with 440 clinical C. glabrata sensu lato isolates. The internal transcribed spacer (ITS) region of rDNA was also sequenced from 85 selected isolates and rDNA sequence variations were used for determining genetic relatedness among the isolates by using MEGA X software. Species-specific amplicons for C. glabrata (~360 bp), C. nivariensis (~250 bp) and C. bracarensis (~180 bp) were obtained in mPCR while no amplicon was obtained from other Candida species. The three singleplex PCR assays also yielded expected results with reference strains of Candida species. The mPCR amplified ~360 bp amplicon from all 440 C. glabrata sensu lato isolates thus identifying all clinical isolates in Kuwait as C. glabrata sensu stricto. The results of mPCR were confirmed for all 440 isolates as they yielded an amplicon only in C. glabrata sensu stricto-specific singleplex PCR assay. The rDNA sequence data identified 28 ITS haplotypes among 85 isolates with 18 isolates belonging to unique haplotypes and 67 isolates belonging to 10 cluster haplotypes. In conclusion, we have developed a simple, low-cost mPCR assay for rapid differentiation of C. glabrata sensu stricto from C. nivariensis and C. bracarensis. Our data obtained from a large collection of clinical C. glabrata sensu lato isolates show that C. nivariensis and C. bracarensis are rare pathogens in Kuwait. Considerable genetic diversity among C. glabrata sensu stricto isolates was also indicated by rDNA sequence analyses.
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Affiliation(s)
- Mohammad Asadzadeh
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Ahlam F. Alanazi
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Suhail Ahmad
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
- * E-mail: ,
| | - Noura Al-Sweih
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Ziauddin Khan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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12
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Fuchs S, Lass-Flörl C, Posch W. Diagnostic Performance of a Novel Multiplex PCR Assay for Candidemia among ICU Patients. J Fungi (Basel) 2019; 5:jof5030086. [PMID: 31533333 PMCID: PMC6787705 DOI: 10.3390/jof5030086] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/11/2019] [Accepted: 09/13/2019] [Indexed: 12/16/2022] Open
Abstract
Candidemia poses a major threat to ICU patients and is routinely diagnosed by blood culture, which is known for its low sensitivity and long turnaround times. We compared the performance of a novel, Candida-specific multiplex real-time PCR assay (Fungiplex® Candida IVD Real-Time PCR Kit) with blood culture and another established diagnostic real-time PCR assay (LightCycler SeptiFast Test) with respect to Candida detection from whole blood samples. Clinical samples from 58 patients were analyzed by standard blood culture (BC) and simultaneously tested with the Fungiplex Candida PCR (FP) and the SeptiFast test (SF) for molecular detection of Candida spp. Compared to BC, the FP test showed high diagnostic power, with a sensitivity of 100% and a specificity of 94.1%. Overall diagnostic accuracy reached 94.6%. Using SF, we found a sensitivity of 60%, a specificity of 96.1%, and an overall diagnostic accuracy of 92.9%. The Fungiplex Candida PCR has shown good sensitivity and specificity on clinical samples of high-risk patients for direct detection of Candida species in whole blood samples. Together with conventional diagnostics (BC and antigen testing), this new multiplex PCR assay may contribute to a rapid and accurate diagnosis of candidiasis.
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Affiliation(s)
- Stefan Fuchs
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Cornelia Lass-Flörl
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Wilfried Posch
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
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13
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Reyes-Montes MDR, Acosta-Altamirano G, Duarte-Escalante E, Salazar EG, Martínez-Herrera E, Arenas R, González G, Frías-De-León MG. Usefulness of a multiplex PCR for the rapid identification of Candida glabrata species complex in Mexican clinical isolates. Rev Inst Med Trop Sao Paulo 2019; 61:e37. [PMID: 31411267 PMCID: PMC6690577 DOI: 10.1590/s1678-9946201961037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/25/2019] [Indexed: 01/12/2023] Open
Abstract
Candida glabrata complex includes three species identified
through molecular biology methods: C. glabrata sensu stricto ,
C. nivariensis and C. bracarensis . In
Mexico, the phenotypic methods are still used in the diagnosis; therefore, the
presence of C. nivariensis and C. bracarensis
among clinical isolates is still unknown. The aim of this study was to evaluate
the utility of a multiplex PCR for the identification of the C.
glabrata species complex. DNA samples from 92 clinical isolates
that were previously identified through phenotypic characteristics as C.
glabrata were amplified by four oligonucleotides (UNI-5.8S, GLA-f,
BRA-f, and NIV-f) that generate amplicons of 397, 293 and 223-bp corresponding
to C. glabrata sensu stricto , C. nivariensis
, and C. bracarensis , respectively. The amplicon sequences
were used to perform a phylogenetic analysis through the Maximum Likelihood
method (MEGA6), including strains and reference sequences of species belonging
to C. glabrata complex. In addition, recombination and linkage
disequilibrium were estimated (DnaSP version 5.0) for C. glabrata sensu
stricto isolate s . Eighty-eight isolates
generated a 397-bp fragment and only in one isolate a 223-bp amplicon was
observed. In the phylogenetic tree, the sequences of 397-bp were grouped with
C. glabrata reference sequences , and the
sequence of 223-bp was grouped with C. bracarensis reference
sequences, corroborating the PCR identification. The number of recombination
events for the isolates of C. glabrata sensu stricto was zero,
suggesting a clonal population structure. Three isolates that did not amplify
any of the expected fragments were identified as Saccharomyces
cerevisiae through the sequencing of the D1/D2 domain region within
the 28S rDNA gene. The multiplex PCR is a fast, cost-effective and reliable tool
that can be used in clinical laboratories to identify C.
glabrata complex species.
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Affiliation(s)
- María Del Rocío Reyes-Montes
- Universidad Nacional Autónoma de México, Facultad de Medicina, Departamento de Microbiología y Parasitología, Ciudad de México, México
| | | | - Esperanza Duarte-Escalante
- Universidad Nacional Autónoma de México, Facultad de Medicina, Departamento de Microbiología y Parasitología, Ciudad de México, México
| | - Eduardo García Salazar
- Hospital Regional de Alta Especialidad de Ixtapaluca, Unidad de Investigación, Ixtapaluca, México
| | - Erick Martínez-Herrera
- Hospital Regional de Alta Especialidad de Ixtapaluca, Unidad de Investigación, Ixtapaluca, México
| | - Roberto Arenas
- Hospital General "Dr. Manuel Gea González, Sección de Micología, Ciudad de México, México
| | - Gloria González
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Departamento de Microbiología, Monterrey, México
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14
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Małek M, Mrowiec P, Klesiewicz K, Skiba-Kurek I, Szczepański A, Białecka J, Żak I, Bogusz B, Kędzierska J, Budak A, Karczewska E. Prevalence of human pathogens of the clade Nakaseomyces in a culture collection-the first report on Candida bracarensis in Poland. Folia Microbiol (Praha) 2018; 64:307-312. [PMID: 30361876 PMCID: PMC6529382 DOI: 10.1007/s12223-018-0655-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 10/08/2018] [Indexed: 12/11/2022]
Abstract
Human pathogens belonging to the Nakaseomyces clade include Candida glabrata sensu stricto, Candida nivariensis and Candida bracarensis. Their highly similar phenotypic characteristics often lead to misidentification by conventional laboratory methods. Therefore, limited information on the true epidemiology of the Candida glabrata species complex is available. Due to life-threatening infections caused by these species, it is crucial to supplement this knowledge. The aim of the study was to estimate the prevalence of C. bracarensis and C. nivariensis in a culture collection of C. glabrata complex isolates. The study covered 353 isolates identified by biochemical methods as C. glabrata, collected from paediatric and adult patients hospitalised at four medical centres in Southern Poland. The multiplex PCR was used to identify the strains. Further species confirmation was performed via sequencing and matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) analysis. One isolate was recognised as C. bracarensis (0.28%). To our knowledge, it is the first isolate in Poland. C. glabrata sensu stricto species has been confirmed for all the remaining isolates. No C. nivariensis was found. Our study has shown that the prevalence of C. nivariensis and C. bracarensis strains is infrequent. However, it should be emphasised that the incidence of these strains may differ locally and depend on environmental factors and the population.
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Affiliation(s)
- Marianna Małek
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland.
| | - Paulina Mrowiec
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland.
| | - Karolina Klesiewicz
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Iwona Skiba-Kurek
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Adrian Szczepański
- Department of Microbiology, University Hospital in Kraków, Kraków, Poland
| | - Joanna Białecka
- Centre for Microbiological Research and Autovaccines, Kraków, Poland
| | - Iwona Żak
- Department of Microbiology, University Children's Hospital of Kraków, Kraków, Poland
| | - Bożena Bogusz
- Department of Microbiology, Ludwik Rydygier Memorial Hospital in Kraków, Kraków, Poland
| | - Jolanta Kędzierska
- Department of Microbiology, University Hospital in Kraków, Kraków, Poland
| | - Alicja Budak
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Elżbieta Karczewska
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
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15
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Hou X, Xiao M, Chen SCA, Wang H, Yu SY, Fan X, Kong F, Xu YC. Identification and Antifungal Susceptibility Profiles of Candida nivariensis and Candida bracarensis in a Multi-Center Chinese Collection of Yeasts. Front Microbiol 2017; 8:5. [PMID: 28154553 PMCID: PMC5243801 DOI: 10.3389/fmicb.2017.00005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/03/2017] [Indexed: 12/18/2022] Open
Abstract
Candida nivariensis and C. bracarensis are two emerging cryptic species within the C. glabrata complex. Thirteen of these isolates from 10 hospitals in China were studied for their species identification and antifungal susceptibilities. Phenotypic and molecular [rDNA ITS sequencing, D1/D2 sequencing and ITS sequencer-based capillary gel electrophoresis (SCGE)] and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) MS identification methods were compared for their performance in species identification. Twelve of 13 (92.3%) isolates were identified as C. nivariensis and one as C. bracarensis using ITS sequencing as the reference method. Results obtained by D1/D2 sequencing and ITS SCGE were concordant with ITS sequencing results for all (100%) isolates. SCGE was able to subtype 12 C. nivariensis into four ITS SCGE length types. All isolates failed to be identified by the Vitek MALDI-TOF MS system (bioMérieux), whilst the Bruker MS system (Bruker Daltoniks) correctly identified all C. nivariensis isolates but using a lowered (≥1.700) cut-off score for species assignment; the C. bracarensis isolate was identified but with score <1.700. The Vitek 2 Compact system could not identify 11 C. nivariensis and one C. bracarensis isolate and misidentified the remaining C. nivarensis strain as “C. glabrata.” All isolates were susceptible-dose dependent to fluconazole [minimum inhibitory concentration (MIC) range 0.5–4 μg/mL] and were classed as susceptible to echinocandins (MICs ≤ 0.06 μg/mL). All 13 isolates had low MICs for other azoles (MICs ≤ 0.5 μg/mL), amphotericin B (MICs ≤ 2 μg/mL) and 5-flucytosine (MICs ≤ 0.25 μg/mL). Our results reinforce the need for molecular differentiation of species of C. nivarensis and C. bracarensis. The performance of MALDI-TOF may be improved by adding mass spectral profiles (MSPs) into the current databases. The antifungal susceptibility profile of isolates should be monitored.
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Affiliation(s)
- Xin Hou
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesBeijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical SciencesBeijing, China
| | - Meng Xiao
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing, China
| | - Sharon C-A Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research-Pathology West, Westmead Hospital, University of Sydney, Sydney NSW, Australia
| | - He Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing, China
| | - Shu-Ying Yu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesBeijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical SciencesBeijing, China
| | - Xin Fan
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesBeijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical SciencesBeijing, China
| | - Fanrong Kong
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research-Pathology West, Westmead Hospital, University of Sydney, Sydney NSW, Australia
| | - Ying-Chun Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing, China
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