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Guitard J, Bellanger AP, Dorin J, Cassaing S, Capitaine A, Gabriel F, Nicolas M, Coron N, Penn P, Moniot M, Quinio D, Ranque S, Sasso M, Lepape P, Dannaoui E, Brun S, Lacroix C, Cornu M, Debourgogne A, Durieux MF, Laurent G, Bru V, Bourgeois N, Brunet K, Chouaki T, Huguenin A, Hasseine L, Maubon D, Gangneux JP, Desbois-Nogard N, Houze S, Dalle F, Bougnoux ME, Alanio A, Costa D, Botterel F, Hennequin C. Current knowledge and practice of Candida auris screening in France: A nationwide survey from the French Society of Medical Mycology (SFMM). J Mycol Med 2024; 34:101490. [PMID: 38852225 DOI: 10.1016/j.mycmed.2024.101490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/27/2024] [Accepted: 06/03/2024] [Indexed: 06/11/2024]
Abstract
Due to large outbreaks observed worldwide, Candida auris has emerged as a major threat to healthcare facilities. To prevent these phenomena, a systematic screening should be performed in patients transferred from regions where the pathogen is highly endemic. In this study, we recorded and analyzed French mycologists' current knowledge and practice regarding C. auris screening and diagnosis. Thirty-six centers answered an online questionnaire. Only 11 (30.6 %) participants were aware of any systematic screening for C. auris for patients admitted to their hospital. In the case of post-admission screening, axillae/groins (n = 21), nares (n = 7), rectum (n = 9), and mouth (n = 6) alone or various combinations were the body sites the most frequently sampled. Only six centers (8.3 %) reported using a commercially available plate allowing the differentiation of C. auris colonies from that of other Candida species, while five laboratories (13.8 %) had implemented a C. auris-specific qPCR. Considering the potential impact on infected patients and the risk of disorganization in the care of patients, it is crucial to remember to biologists and clinicians the utmost importance of systematic screening on admission.
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Affiliation(s)
- J Guitard
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, F-75012 Paris, France
| | - A P Bellanger
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, F-25000 Besançon, France
| | - J Dorin
- Centre Hospitalier d'Antibes-Juan-Les-Pins, Service de Biologie, 06600 Antibes, France
| | - S Cassaing
- Laboratoire de Parasitologie-Mycologie, Hôpital Purpan, 31059 Toulouse, France
| | - A Capitaine
- Laboratoire de Parasitologie-Mycologie, CHU Caen, 14000 Caen, France
| | - F Gabriel
- Laboratoire de Parasitologie-Mycologie, CHRU Bordeaux, 33000 Bordeaux, France
| | - M Nicolas
- Laboratoire de Parasitologie-Mycologie, CHU Guadeloupe, Pointe-à-Pitre/Abymes 97159 Pointe-à-Pitre, France
| | - N Coron
- Laboratoire Bioesterel-Biogroup - Secteur de Parasitologie-Mycologie - Plateau technique de Mouans-Sartoux, 130 impasse des Bruyères, ZI Argile, 06370 Mouans-Sartoux, France
| | - P Penn
- Laboratoire de Microbiologie, Centre Hospitalier Le Mans, F-72034 Le Mans, France
| | - M Moniot
- Service de Parasitologie-Mycologie, CHU Clermont-Ferrand, 3IHP, Clermont-Ferrand, France
| | - D Quinio
- Laboratoire de Parasitologie-Mycologie, CHU Brest, Hôpital de la Cavale Blanche, 29200 Brest, France
| | - S Ranque
- Aix-Marseille Université, IHU Méditerranée Infection, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France
| | - M Sasso
- Laboratoire de Parasitologie-Mycologie, CHU Nîmes & Université de Montpellier, CNRS, IRD, MiVEGEC, 33000 Montpellier, France
| | - P Lepape
- Laboratoire de Parasitologie-Mycologie et immunologie parasitaire, Institut de Biologie- CHU de Nantes, Nantes, France
| | - E Dannaoui
- Unité de Parasitologie-Mycologie, Hôpital Necker Enfants Malades, AP-HP, 75015 Paris, France
| | - S Brun
- Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93009 Bobigny, France
| | - C Lacroix
- Laboratoire Inovie Gen-Bio, Sites de Thiers et Ambert, 63300 Thiers, France
| | - M Cornu
- Service de Parasitologie-Mycologie, CHU Lille, 59000 Lille, France
| | - A Debourgogne
- Laboratoire de Microbiologie, CHRU de Nancy, 54500 Vandoeuvre les Nancy, France
| | - M F Durieux
- Laboratoire de parasitologie-mycologie, Centre de Biologie et de Recherche en Santé, Centre Hospitalier Universitaire de Limoges, 87000 Limoges, France
| | - G Laurent
- Laboratoire de biologie médicale, GCS Loire et Sologne, Centre hospitalier Simone Veil de Blois, 41000 Blois, France
| | - V Bru
- Laboratoire de Parasitologie et Mycologie Médicale, Les Hôpitaux Universitaires de Strasbourg, Institut de Parasitologie et Pathologie Tropicale, UR7292 Dynamique des interactions hôte pathogène, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France
| | - N Bourgeois
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Montpellier, UMR MiVEGEC, 34090 Montpellier, France
| | - K Brunet
- Université de Poitiers, INSERM U1070 PHAR2, CHU de Poitiers, Service de parasitologie et mycologie médicale, 86000 Poitiers, France
| | - T Chouaki
- Service de Parasitologie-Mycologie Médicales, CHU Amiens-Picardie, 80054 Amiens, France
| | - A Huguenin
- Université de Reims Champagne Ardenne, ESCAPE EA7510, F-51097 Reims, France
| | - L Hasseine
- Service de Parasitologie Mycologie, CHU de Nice, Hôpital de l'Archet, 06202 Nice, France
| | - D Maubon
- Laboratoire de Parasitologie-Mycologie, CHU Grenoble Alpes, 38706 La Tronche, France
| | - J P Gangneux
- Laboratoire de Parasitologie et Mycologie, ECMM Excellence Center, CHU de Rennes, 35000 Rennes, France
| | - N Desbois-Nogard
- Laboratoire de Parasitologie-Mycologie, CHU Martinique, 97200 Fort de France, France
| | - S Houze
- Laboratoire de Parasitologie-Mycologie, Hôpital Bichat, 75018 Paris, France
| | - F Dalle
- Laboratoire de Parasitologie-Mycologie, CHU Dijon-Bourgogne, 21000 Dijon, France
| | - M E Bougnoux
- APHP, Hôpital Necker-Enfants-Malades, Service de Microbiologie Clinique, Unité de Parasitologie-Mycologie, 75012 Paris, France
| | - A Alanio
- Laboratoire de Parasitologie-Mycologie, Hopital St Louis, 75010 Paris, France
| | - D Costa
- Université de Rouen Normandie, Laboratory of Parasitology-Mycology, EA7510 ESCAPE, University hospital of Normandy F-76000 Rouen, France
| | - F Botterel
- Unité de Parasitologie-Mycologie, Hôpitaux Universitaires Henri-Mondor, 94010 Créteil, France
| | - C Hennequin
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, F-75012 Paris, France.
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Dakalbab S, Hamdy R, Holigová P, Abuzaid EJ, Abu-Qiyas A, Lashine Y, Mohammad MG, Soliman SSM. Uniqueness of Candida auris cell wall in morphogenesis, virulence, resistance, and immune evasion. Microbiol Res 2024; 286:127797. [PMID: 38851008 DOI: 10.1016/j.micres.2024.127797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/02/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024]
Abstract
Candida auris has drawn global attention due to its alarming multidrug resistance and the emergence of pan resistant strains. C. auris poses a significant risk in nosocomial candidemia especially among immunocompromised patients. C. auris showed unique virulence characteristics associated with cell wall including cell polymorphism, adaptation, endurance on inanimate surfaces, tolerance to external conditions, and immune evasion. Notably, it possesses a distinctive cell wall composition, with an outer mannan layer shielding the inner 1,3-β glucan from immune recognition, thereby enabling immune evasion and drug resistance. This review aimed to comprehend the association between unique characteristics of C. auris's cell wall and virulence, resistance mechanisms, and immune evasion. This is particularly relevant since the fungal cell wall has no human homology, providing a potential therapeutic target. Understanding the complex interactions between the cell wall and the host immune system is essential for devising effective treatment strategies, such as the use of repurposed medications, novel therapeutic agents, and immunotherapy like monoclonal antibodies. This therapeutic targeting strategy of C. auris holds promise for effective eradication of this resilient pathogen.
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Affiliation(s)
- Salam Dakalbab
- Research Institute for Medical and Health sciences, University of Sharjah, P.O. Box, Sharjah 27272, United Arab Emirates; College of Medicine, University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates
| | - Rania Hamdy
- Research Institute for Science and Engineering (RISE), University of Sharjah, Sharjah 27272, United Arab Emirates; Faculty of Pharmacy, Zagazig University, P.O. Box 44519, Egypt
| | | | - Eman J Abuzaid
- Research Institute for Medical and Health sciences, University of Sharjah, P.O. Box, Sharjah 27272, United Arab Emirates
| | - Ameera Abu-Qiyas
- Research Institute for Medical and Health sciences, University of Sharjah, P.O. Box, Sharjah 27272, United Arab Emirates
| | - Yasmina Lashine
- Research Institute for Medical and Health sciences, University of Sharjah, P.O. Box, Sharjah 27272, United Arab Emirates; Faculty of Pharmacy, Zagazig University, P.O. Box 44519, Egypt
| | - Mohammad G Mohammad
- Research Institute for Medical and Health sciences, University of Sharjah, P.O. Box, Sharjah 27272, United Arab Emirates; Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates
| | - Sameh S M Soliman
- Research Institute for Medical and Health sciences, University of Sharjah, P.O. Box, Sharjah 27272, United Arab Emirates; Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates.
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Hamburger FG, Gales AC, Colombo AL. Systematic Review of Candidemia in Brazil: Unlocking Historical Trends and Challenges in Conducting Surveys in Middle-Income Countries. Mycopathologia 2024; 189:60. [PMID: 38940953 DOI: 10.1007/s11046-024-00867-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/06/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION Candidemia, a bloodstream infection predominantly affecting critically ill patients, poses a significant global health threat especially with the emergence of non-albicans Candida species, including drug-resistant strains. In Brazil, limited access to advanced diagnostic tools and trained microbiologists hampers accurate identification of Candida species and susceptibility to antifungals testing hindering surveillance efforts. METHODS We conducted a systematic review spanning publications from 2017 to 2023 addressing Candida species distribution and antifungal susceptibility among Brazilian patients with candidemia. RESULTS Despite initially identifying 7075 records, only 16 met inclusion criteria providing accurate information of 2305 episodes of candidemia. The predominant species were C. albicans, C. parapsilosis, and C. tropicalis, followed by notable proportions of Nakaseomyces glabratus. Limited access to diagnostic tests was evident as only 5 out of 16 studies on candidemia were able to report antifungal susceptibility testing results. In vitro resistance to echinocandins was rare (only 6/396 isolates, 1,5%). In counterpart, fluconazole exhibited resistance rates ranging from 0 to 43%, with great heterogeneity among different studies and species of Candida considered. CONCLUSION Our review underscores the critical need for enhanced surveillance and research efforts to address the evolving landscape of candidemia and antifungal resistance in Brazil. Despite some limitations, available data suggest that while resistance to echinocandins and amphotericin B remains rare, there is a growing concern regarding resistance to fluconazole among Candida species.
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Affiliation(s)
- Flávio Guinsburg Hamburger
- Division of Infectious Diseases, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ana Cristina Gales
- Division of Infectious Diseases, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Antimicrobial Resistance Institute of São Paulo (Aries), São Paulo, Brazil
| | - Arnaldo Lopes Colombo
- Division of Infectious Diseases, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
- Antimicrobial Resistance Institute of São Paulo (Aries), São Paulo, Brazil.
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Erkose Genc G, Caklovica Kucukkaya I, Komec S, Toker Onder I, Toptas O, Teke L, Turan D, Aygun G, Gulmez D, Arikan Akdagli S, Erturan Z. Evaluation of the first Candida auris isolates reported from Türkiye in terms of identification by various methods and susceptibility to antifungal drugs. Indian J Med Microbiol 2024; 49:100594. [PMID: 38636843 DOI: 10.1016/j.ijmmb.2024.100594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE Candida auris is increasingly being isolated from patients all over the world. It has five clades. In this study, it was aimed to compare the results of biochemical tests obtained using different methods and the antifungal susceptibility profiles of C. auris strains isolated from the first seven cases reported in Türkiye, and evaluate whether this information could be useful as preliminary data in determining the clade of strains in centers that lack the opportunity to apply molecular methods. METHODS Identification test results obtained using API ID 32 C, API 20 C AUX, VITEK-2 YST, and MALDI-TOF MS; colony color and morphology on Chromagar Candida, CHROMagar Candida Plus media, and cornmeal-Tween 80 agar; susceptibility to antifungals were tested and compared. Antifungal susceptibility test was studied using microdilution method according to the recommendations of EUCAST. Additionally, a pilot study was conducted to investigate the value of CHROMagar Candida Plus. RESULTS All seven strains were identified as Lachancea kluyveri with API ID 32 C, Rhodotorula glutinis; Cryptococcus neoformans with API 20 C AUX, and C. auris with both VITEK-2 YST and MALDI-TOF MS. MIC values for fluconazole were very high (≥64 mg/L) for all seven strains. It was observed that 11 (37.9%) of 29 Candida parapsilosis strains formed colonies with morphology similar to C. auris on CHROMagar Candida Plus medium, leading to false positivity. CONCLUSIONS Although there have been many isolations of C. auris in our country in recent years, clade distribution of only a small number of strains is known yet. In this study, when the biochemical properties and antifungal susceptibility profiles of the seven strains were evaluated, it was concluded that they exhibited some characteristics compatible with clade I. It was also observed that strains 1 and 2 may belong to a different clade.
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Affiliation(s)
- Gonca Erkose Genc
- Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkiye.
| | - Ilvana Caklovica Kucukkaya
- Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkiye.
| | - Selda Komec
- Basaksehir Cam and Sakura City Hospital, Laboratory of Medical Microbiology, Istanbul, Turkiye.
| | - Ilke Toker Onder
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkiye.
| | - Oyku Toptas
- Altinbas University Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkiye.
| | - Leyla Teke
- University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, Laboratory of Medical Microbiology, Istanbul, Turkiye.
| | - Deniz Turan
- University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Laboratory of Medical Microbiology, Istanbul, Turkiye.
| | - Gokhan Aygun
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkiye.
| | - Dolunay Gulmez
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkiye.
| | - Sevtap Arikan Akdagli
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkiye.
| | - Zayre Erturan
- Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkiye.
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Hefny ZA, Ji B, Elsemman IE, Nielsen J, Van Dijck P. Transcriptomic meta-analysis to identify potential antifungal targets in Candida albicans. BMC Microbiol 2024; 24:66. [PMID: 38413885 PMCID: PMC10898158 DOI: 10.1186/s12866-024-03213-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Candida albicans is a fungal pathogen causing human infections. Here we investigated differential gene expression patterns and functional enrichment in C. albicans strains grown under different conditions. METHODS A systematic GEO database search identified 239 "Candida albicans" datasets, of which 14 were selected after rigorous criteria application. Retrieval of raw sequencing data from the ENA database was accompanied by essential metadata extraction from dataset descriptions and original articles. Pre-processing via the tailored nf-core pipeline for C. albicans involved alignment, gene/transcript quantification, and diverse quality control measures. Quality assessment via PCA and DESeq2 identified significant genes (FDR < = 0.05, log2-fold change > = 1 or <= -1), while topGO conducted GO term enrichment analysis. Exclusions were made based on data quality and strain relevance, resulting in the selection of seven datasets from the SC5314 strain background for in-depth investigation. RESULTS The meta-analysis of seven selected studies unveiled a substantial number of genes exhibiting significant up-regulation (24,689) and down-regulation (18,074). These differentially expressed genes were further categorized into 2,497 significantly up-regulated and 2,573 significantly down-regulated Gene Ontology (GO) IDs. GO term enrichment analysis clustered these terms into distinct groups, providing insights into the functional implications. Three target gene lists were compiled based on previous studies, focusing on central metabolism, ion homeostasis, and pathogenicity. Frequency analysis revealed genes with higher occurrence within the identified GO clusters, suggesting their potential as antifungal targets. Notably, the genes TPS2, TPS1, RIM21, PRA1, SAP4, and SAP6 exhibited higher frequencies within the clusters. Through frequency analysis within the GO clusters, several key genes emerged as potential targets for antifungal therapies. These include RSP5, GLC7, SOD2, SOD5, SOD1, SOD6, SOD4, SOD3, and RIM101 which exhibited higher occurrence within the identified clusters. CONCLUSION This comprehensive study significantly advances our understanding of the dynamic nature of gene expression in C. albicans. The identification of genes with enhanced potential as antifungal drug targets underpins their value for future interventions. The highlighted genes, including TPS2, TPS1, RIM21, PRA1, SAP4, SAP6, RSP5, GLC7, SOD2, SOD5, SOD1, SOD6, SOD4, SOD3, and RIM101, hold promise for the development of targeted antifungal therapies.
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Affiliation(s)
- Zeinab Abdelmoghis Hefny
- Laboratory of Molecular Cell Biology, Department of Biology, Katholieke Universiteit Leuven, Kasteelpark Arenberg 31, Leuven, B-3001, Belgium
| | - Boyang Ji
- BioInnovation Institute, Ole Maaløes Vej 3, Copenhagen, DK2200, Denmark
| | - Ibrahim E Elsemman
- Department of Information Systems, Faculty of Computers and Information, Assiut University, Assiut, 2071515, Egypt
| | - Jens Nielsen
- BioInnovation Institute, Ole Maaløes Vej 3, Copenhagen, DK2200, Denmark.
- Department of Life Sciences, Chalmers University of Technology, Kemivägen 10, SE41296, Gothenburg, SE41296, Sweden.
| | - Patrick Van Dijck
- Laboratory of Molecular Cell Biology, Department of Biology, Katholieke Universiteit Leuven, Kasteelpark Arenberg 31, Leuven, B-3001, Belgium.
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Abstract
PURPOSE OF REVIEW The increasing incidence of drug-resistant Candida brings a new challenge to the treatment of invasive candidiasis. Although cross-resistance among azoles and echinocandins was generally uncommon, reports of multidrug-resistant (MDR) Candida markedly increased in the last decade. The purpose of this review is to understand mechanisms and risk factors for resistance and how to tackle antifungal resistance. RECENT FINDINGS The paper describes the action of the three main classes of antifungals - azoles, echinocandins and polyenes - and Candida's mechanisms of resistance. The current evolution from cross-resistance to multiresistance among Candida explains the modern glossary - multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) - imported from bacteria. MDR Candida most commonly involves acquired resistance in species with intrinsic resistance, therefore it mostly involves C. glabrata, C. parapsilosis, C. krusei, C guilliermondii or C. auris , which is intrinsically multidrug resistant. Finally, strategies to tackle antifungal resistance became clearer, ideally implemented through antifungal stewardship. SUMMARY Avoiding antifungal's overuse and selecting the best drug, dose and duration, when they are needed, is fundamental. Knowledge of risk factors for resistance, microbiological diagnosis to the species, use of susceptibility test supported by antifungal stewardship programs help attaining effective therapy and sustaining the effectiveness of the current antifungal armamentarium.
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Affiliation(s)
- José-Artur Paiva
- Intensive Care Medicine Department, Centro Hospitalar Universitário S. João, Porto, Portugal
- Department of Medicine, Faculty of Medicine of University of Porto, Porto, Portugal
- Grupo de Infeção e Sepsis, Porto, Portugal
| | - José Manuel Pereira
- Intensive Care Medicine Department, Centro Hospitalar Universitário S. João, Porto, Portugal
- Department of Medicine, Faculty of Medicine of University of Porto, Porto, Portugal
- Grupo de Infeção e Sepsis, Porto, Portugal
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Coste AT, Egli A, Schrenzel J, Nickel B, Zbinden A, Lienhard R, Dumoulin A, Risch M, Greub G. IVDR: Analysis of the Social, Economic, and Practical Consequences of the Application of an Ordinance of the In Vitro Diagnostic Ordinance in Switzerland. Diagnostics (Basel) 2023; 13:2910. [PMID: 37761277 PMCID: PMC10529212 DOI: 10.3390/diagnostics13182910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/04/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
IVDR regulation represents a major challenge for diagnostic microbiology laboratories. IVDR complicates a broad range of aspects and poses a risk given the high diversity of pathogens (including rare but highly virulent microbes) and the large variety of samples submitted for analysis. The regular emergence of new pathogens (including Echovirus E-11, Adenovirus 41, Monkeypox virus, Alongshan virus, and Enterovirus D68, as recent examples in Europe in the post SARS-CoV-2 era) is another factor that makes IVDR regulation risky, because its detrimental effect on production of in-house tests will negatively impact knowledge and expertise in the development of new diagnostic tests. Moreover, such regulations negatively impact the availability of diagnostic tests, especially for neglected pathogens, and has a detrimental effect on the overall costs of the tests. The increased regulatory burden of IVDR may thereby pose an important risk for public health. Taken together, it will have a negative impact on the financial balance of diagnostic microbiology laboratories (especially small ones). The already-high standards of quality management of all ISO-accredited and Swissmedic-authorized laboratories render IVDR law of little value, at least in Switzerland, while tremendously increasing the regulatory burden and associated costs. Eventually, patients will need to pay for diagnostic assays outside of the framework of their insurance in order to obtain a proper diagnostic assessment, which may result in social inequity. Thus, based on the risk assessment outlined above, the coordinated commission for clinical microbiology proposes adjusting the IvDO ordinance by (i) introducing an obligation to be ISO 15189 accredited and (ii) not implementing the IvDO 2028 milestone.
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Affiliation(s)
- Alix T. Coste
- Institute of Microbiology, University of Lausanne & University Hospital Center, 1011 Lausanne, Switzerland;
| | - Adrian Egli
- Institute of Medical Microbiology, University of Zurich, 8006 Zurich, Switzerland; (A.E.); (A.Z.)
| | - Jacques Schrenzel
- Bacteriology Laboratory, Service of Laboratory Medicine, Department of Diagnostic, Geneva University Hospitals, 1211 Geneva, Switzerland;
| | - Beatrice Nickel
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland;
- University of Basel, 4002 Basel, Switzerland
| | - Andrea Zbinden
- Institute of Medical Microbiology, University of Zurich, 8006 Zurich, Switzerland; (A.E.); (A.Z.)
| | - Reto Lienhard
- ADMed Microbiologie Laboratory, 2300 La Chaux-de-Fonds, Switzerland;
| | - Alexis Dumoulin
- Department of Infectious Diseases, Institut Central des Hôpitaux, Hôpital du Valais, 1950 Sion, Switzerland;
| | - Martin Risch
- Dr Risch Medical Laboratory, Wuhrstrasse 14, 9490 Vaduz, Switzerland;
| | - Gilbert Greub
- Institute of Microbiology, University of Lausanne & University Hospital Center, 1011 Lausanne, Switzerland;
- Infectious Disease Service, University of Lausanne & University Hospital Center, 1011 Lausanne, Switzerland
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Aldejohann AM, Martin R, Hecht J, Haller S, Rickerts V, Walther G, Eckmanns T, Kurzai O. Rise in Candida Auris Cases and First Nosocomial Transmissions in Germany. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:447-478. [PMID: 37661316 DOI: 10.3238/arztebl.m2023.0047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 11/18/2022] [Accepted: 02/09/2023] [Indexed: 09/05/2023]
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Oliva A, De Rosa FG, Mikulska M, Pea F, Sanguinetti M, Tascini C, Venditti M. Invasive Candida infection: epidemiology, clinical and therapeutic aspects of an evolving disease and the role of rezafungin. Expert Rev Anti Infect Ther 2023; 21:957-975. [PMID: 37494128 DOI: 10.1080/14787210.2023.2240956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION Invasive Candida Infections (ICIs) have undergone a series of significant epidemiological, pathophysiological, and clinical changes during the last decades, with a shift toward non-albicans species, an increase in the rate of exogenous infections and clinical manifestations ranging from candidemia to an array of highly invasive and life-threatening clinical syndromes. The long-acting echinocandin rezafungin exhibits potent in-vitro activity against most wild-type and azole-resistant Candida spp. including C.auris. AREAS COVERED The following topics regarding candidemia only and ICIs were reviewed and addressed: i) pathogenesis; ii) epidemiology and temporal evolution of Candida species; iii) clinical approach; iv) potential role of the novel long-acting rezafungin in the treatment of ICIs. EXPERT OPINION Authors' expert opinion focused on considering the potential role of rezafungin in the evolving context of ICIs. Rezafungin, which combines a potent in-vitro activity against Candida species, including azole-resistant strains and C.auris, with a low likelihood of drug-drug interactions and a good safety profile, may revolutionize the treatment of candidemia/ICI. Indeed, it may shorten the length of hospital stays when clinical conditions allow and extend outpatient access to treatment of invasive candidiasis, especially when prolonged treatment duration is expected.
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Affiliation(s)
- Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Francesco Giuseppe De Rosa
- Department of Medical Sciences, University of Turin, Infectious Diseases, City of Health and Sciences, Turin, Italy
| | - Malgorzata Mikulska
- Division of Infectious Diseases Department of Health Sciences (DISSAL), University of Genoa IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Federico Pea
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Clinical Pharmacology Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Maurizio Sanguinetti
- Department of Laboratory Sciences and Infectious Diseases, Fondazione Policlinico Universitario "A. Gemelli"; IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Carlo Tascini
- Infectious Diseases Clinic: Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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10
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de Oliveira H, Bezerra BT, Rodrigues ML. Antifungal Development and the Urgency of Minimizing the Impact of Fungal Diseases on Public Health. ACS BIO & MED CHEM AU 2023; 3:137-146. [PMID: 37101810 PMCID: PMC10125384 DOI: 10.1021/acsbiomedchemau.2c00055] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 04/28/2023]
Abstract
Fungal infections are a major public health problem resulting from the lack of public policies addressing these diseases, toxic and/or expensive therapeutic tools, scarce diagnostic tests, and unavailable vaccines. In this Perspective, we discuss the need for novel antifungal alternatives, highlighting new initiatives based on drug repurposing and the development of novel antifungals.
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Affiliation(s)
| | - Bárbara T. Bezerra
- Instituto
Carlos Chagas, Fundação Oswaldo Cruz (Fiocruz), Curitiba81310-020, Brazil
| | - Marcio L. Rodrigues
- Instituto
Carlos Chagas, Fundação Oswaldo Cruz (Fiocruz), Curitiba81310-020, Brazil
- Instituto
de Microbiologia Paulo de Góes (IMPG), Universidade Federal do Rio de Janeiro, Rio de Janeiro21941-902, Brazil
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11
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Katsiari M, Mavroidi A, Kesesidis N, Palla E, Zourla K, Ntorlis K, Konstantinidis K, Laskou M, Strigklis K, Sakkalis A, Nikolaou C, Platsouka ED, Karakasiliotis I, Vrioni G, Tsakris A. Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit. J Fungi (Basel) 2023; 9:jof9020243. [PMID: 36836357 PMCID: PMC9964037 DOI: 10.3390/jof9020243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Candida auris has recently emerged as a multidrug-resistant yeast implicated in various healthcare-associated invasive infections and hospital outbreaks. In the current study, we report the first five intensive care unit (ICU) cases affected by C. auris isolates in Greece, during October 2020-January 2022. The ICU of the hospital was converted to a COVID-19 unit on 25 February 2021, during the third wave of COVID-19 in Greece. Identification of the isolates was confirmed by Matrix Assisted Laser Desorption Ionization Time of Flight mass spectroscopy (MALDI-TOF]. Antifungal susceptibility testing was performed by the EUCAST broth microdilution method. Based on the tentative CDC MIC breakpoints, all five C. auris isolates were resistant to fluconazole (≥32 μg/mL), while three of them exhibited resistance to amphotericin B (≥2 μg/mL). The environmental screening also revealed the dissemination of C. auris in the ICU. Molecular characterization of C. auris clinical and environmental isolates was performed by MultiLocus Sequence Typing (MLST) of a set of four genetic loci, namely ITS, D1/D2, RPB1 and RPB2, encoding for the internal transcribed spacer region (ITS) of the ribosomal subunit, the large ribosomal subunit region and the RNA polymerase II largest subunit, respectively. MLST analysis showed that all isolates possessed identical sequences in the four genetic loci and clustered with the South Asian clade I strains. Additionally, PCR amplification and sequencing of the CJJ09_001802 genetic locus, encoding for the "nucleolar protein 58" that contains clade-specific repeats was performed. Sanger sequence analysis of the TCCTTCTTC repeats within CJJ09_001802 locus also assigned the C. auris isolates to the South Asian clade I. Our study confirms that C. auris is an emerging yeast pathogen in our region, especially in the setting of the ongoing COVID-19 worldwide pandemic. Adherence to strict infection control is needed to restrain further spread of the pathogen.
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Affiliation(s)
- Maria Katsiari
- Intensive Care Unit, Konstantopouleio-Patission General Hospital, 14233 Athens, Greece
| | - Angeliki Mavroidi
- Department of Microbiology, Konstantopouleio-Patission General Hospital, 14233 Athens, Greece
| | - Nikolaos Kesesidis
- Laboratory of Biology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Eleftheria Palla
- Department of Microbiology, Konstantopouleio-Patission General Hospital, 14233 Athens, Greece
| | - Konstantina Zourla
- Department of Microbiology, Konstantopouleio-Patission General Hospital, 14233 Athens, Greece
| | - Kyriakos Ntorlis
- Intensive Care Unit, Konstantopouleio-Patission General Hospital, 14233 Athens, Greece
| | - Konstantinos Konstantinidis
- Laboratory of Biology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Maria Laskou
- Intensive Care Unit, Konstantopouleio-Patission General Hospital, 14233 Athens, Greece
| | | | - Anastasios Sakkalis
- Intensive Care Unit, Konstantopouleio-Patission General Hospital, 14233 Athens, Greece
| | - Charikleia Nikolaou
- Intensive Care Unit, Konstantopouleio-Patission General Hospital, 14233 Athens, Greece
| | - Evangelia D. Platsouka
- Department of Microbiology, Konstantopouleio-Patission General Hospital, 14233 Athens, Greece
| | - Ioannis Karakasiliotis
- Laboratory of Biology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Georgia Vrioni
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 MikrasAsias Street, 11527 Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 MikrasAsias Street, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-210-7462011
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12
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Giacobbe DR, Mikulska M, Vena A, Di Pilato V, Magnasco L, Marchese A, Bassetti M. Challenges in the diagnosis and treatment of candidemia due to multidrug-resistant Candida auris. FRONTIERS IN FUNGAL BIOLOGY 2023; 4:1061150. [PMID: 37746122 PMCID: PMC10512377 DOI: 10.3389/ffunb.2023.1061150] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/16/2023] [Indexed: 09/26/2023]
Affiliation(s)
- Daniele Roberto Giacobbe
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Malgorzata Mikulska
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Vena
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Vincenzo Di Pilato
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Laura Magnasco
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Anna Marchese
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
- Unità di Microbiologia, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Bassetti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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13
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Proactive infection control measures to prevent nosocomial transmission of Candida auris in Hong Kong. J Hosp Infect 2023; 134:166-168. [PMID: 36646138 DOI: 10.1016/j.jhin.2022.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/15/2023]
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14
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Boyanova L, Markovska R, Mitov I, Gergova R. Non-viral infections and antimicrobial resistance in the time of COVID-19: what to expect? Expert Rev Clin Pharmacol 2022; 15:907-909. [PMID: 35912839 DOI: 10.1080/17512433.2022.2108403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lyudmila Boyanova
- Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
| | - Rumyana Markovska
- Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
| | - Ivan Mitov
- Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
| | - Raina Gergova
- Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
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15
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Tsai YT, Lu PL, Tang HJ, Huang CH, Hung WC, Tseng YT, Lee KM, Lin SY. The First Invasive Candida auris Infection in Taiwan. Emerg Microbes Infect 2022; 11:1867-1875. [PMID: 35811508 PMCID: PMC9336481 DOI: 10.1080/22221751.2022.2100280] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Candida auris, a multidrug resistant pathogenic yeast, has spread worldwide and caused several outbreaks in healthcare settings. Here, we report the first case of C. auris candidemia in Taiwan in a patient with a two-month history of hospitalization in Vietnam. We performed further investigation on the isolate from the present case as well as the previously reported C. auris isolate identified from a wound in 2018 in Taiwan, which was the first case reported in Taiwan. Both C. auris isolates were found to be susceptible to fluconazole, amphotericin B, and echinocandins. Additionally, mutations in ERG11 or FKS1 were not detected in either isolate. Microsatellite genotyping revealed that both isolates belonged to the South Asian clade. In recent years, C. auris has emerged as a global concern, and differences in clades and susceptibility patterns mandate further awareness and systematic surveillance.
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Affiliation(s)
- Yu-Te Tsai
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Liang Lu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Jen Tang
- Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chung-Hao Huang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wei-Chun Hung
- Department of Microbiology and Immunology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Ting Tseng
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Mu Lee
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shang-Yi Lin
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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16
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Haro-Reyes T, Díaz-Peralta L, Galván-Hernández A, Rodríguez-López A, Rodríguez-Fragoso L, Ortega-Blake I. Polyene Antibiotics Physical Chemistry and Their Effect on Lipid Membranes; Impacting Biological Processes and Medical Applications. MEMBRANES 2022; 12:681. [PMID: 35877884 PMCID: PMC9316096 DOI: 10.3390/membranes12070681] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 01/27/2023]
Abstract
This review examined a collection of studies regarding the molecular properties of some polyene antibiotic molecules as well as their properties in solution and in particular environmental conditions. We also looked into the proposed mechanism of action of polyenes, where membrane properties play a crucial role. Given the interest in polyene antibiotics as therapeutic agents, we looked into alternative ways of reducing their collateral toxicity, including semi-synthesis of derivatives and new formulations. We follow with studies on the role of membrane structure and, finally, recent developments regarding the most important clinical applications of these compounds.
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Affiliation(s)
- Tammy Haro-Reyes
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Av. Universidad s/n, Col. Chamilpa, Cuernavaca 62210, Morelos, Mexico; (T.H.-R.); (L.D.-P.); (A.G.-H.)
| | - Lucero Díaz-Peralta
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Av. Universidad s/n, Col. Chamilpa, Cuernavaca 62210, Morelos, Mexico; (T.H.-R.); (L.D.-P.); (A.G.-H.)
| | - Arturo Galván-Hernández
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Av. Universidad s/n, Col. Chamilpa, Cuernavaca 62210, Morelos, Mexico; (T.H.-R.); (L.D.-P.); (A.G.-H.)
| | - Anahi Rodríguez-López
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Cuernavaca 62210, Morelos, Mexico; (A.R.-L.); (L.R.-F.)
| | - Lourdes Rodríguez-Fragoso
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Cuernavaca 62210, Morelos, Mexico; (A.R.-L.); (L.R.-F.)
| | - Iván Ortega-Blake
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Av. Universidad s/n, Col. Chamilpa, Cuernavaca 62210, Morelos, Mexico; (T.H.-R.); (L.D.-P.); (A.G.-H.)
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17
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Validation of the Colibrí Instrument for Automated Preparation of MALDI-TOF MS Targets for Yeast Identification. J Clin Microbiol 2022; 60:e0023722. [PMID: 35703578 PMCID: PMC9297811 DOI: 10.1128/jcm.00237-22] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Recently, Copan (Italy) introduced the Colibrí instrument for automated colony picking and preparation of matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) target plates. Our study aimed to validate this system for yeasts as such testing has not been performed yet and is a missing link needed to implement the system for routine use. Fifty-five Candida strains were selected to evaluate the accuracy of Colibrí. For each strain, a sheep blood agar plate supplemented with X and V factors (HEM) and a Sabouraud agar plate (SAB) were inoculated and incubated using the WASPlab specimen processing system (Copan). After 18 h and 36 h of incubation, the isolates were spotted in parallel using Colibrí and manually onto MALDI-TOF target plates with the addition of formic acid and identified using MALDI-TOF mass spectrometry. The reproducibility was evaluated using ATCC reference and clinical isolate-derived strains. The cumulative percentage of acceptable identification scores (IDs) after 36 h was 91% for strains cultured on HEM plates using both Colibrí and the manual method. The SAB plates showed inferior results for both Colibrí (76%) and the manual method (78%). We observed an overall agreement of 92% at 18 h for identification of the strains on the HEM plates between Colibrí and the manual method and 94% after 36 h. For the SAB plates, the agreement was 78% after 18 h and 84% after 36 h. Apart from Candida dubliniensis and Candida tropicalis, all Candida species were identified with 100% accuracy using Colibrí on HEM plates. We observed good agreement between Colibrí and the manual reference method. These results demonstrate that Colibrí is a reliable system for MALDI-TOF target preparation for yeast identification, allowing increased standardization and less hands-on time.
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18
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Sanyaolu A, Okorie C, Marinkovic A, Abbasi AF, Prakash S, Mangat J, Hosein Z, Haider N, Chan J. Candida auris: An Overview of the Emerging Drug-Resistant Fungal Infection. Infect Chemother 2022; 54:236-246. [PMID: 35794716 PMCID: PMC9259907 DOI: 10.3947/ic.2022.0008] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/11/2022] [Indexed: 12/12/2022] Open
Abstract
Candida auris is an invasive fungal pathogen that has been recognized globally as a serious health threat due to its extensive innate and acquired resistance to antifungal drugs. A growing number of emerging cases of C. auris have been reported with resistance to the standard antifungal treatments including azoles, echinocandins, and polyenes, making it difficult to treat. Unlike other Candida species, C. auris is challenging to diagnose using the standard laboratory methods and are typically prone to misidentification, resulting in inappropriate management. Consequently, C. auris infections have spread globally. The Centers for Disease Control and Prevention data showed that clinical cases of C. auris increased from 329 in 2018 to 1,012 in 2021. The incidence and prevalence of this invasive fungal infection are high in immunocompromised and hospitalized patients. Patients who had an organ transplant, are on immunosuppressive agents, are diabetic, recent antibiotic use, catheter use, and prolonged hospital or nursing homestays are vulnerable to C. auris infections. C. auris is rapidly spreading across healthcare settings globally and monitoring of its virulence as well as devising appropriate treatment approaches are thus highly required.
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Affiliation(s)
| | - Chuku Okorie
- Union County College, Plainfield Campus, Plainfield, NJ, USA
| | | | | | | | - Jasmine Mangat
- Caribbean Medical University School of Medicine, Willemstad, Curacao
| | - Zaheeda Hosein
- Caribbean Medical University School of Medicine, Willemstad, Curacao
| | - Nafees Haider
- All Saints University School of Medicine, Roseau, Dominica
| | - Jennifer Chan
- Medical University of the Americas, Nevis, Saint Kitts and Nevis
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