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Ciesielska A, Kowalczyk A, Paneth A, Stączek P. Evaluation of the antidermatophytic activity of potassium salts of N-acylhydrazinecarbodithioates and their aminotriazole-thione derivatives. Sci Rep 2024; 14:3521. [PMID: 38347115 PMCID: PMC10861498 DOI: 10.1038/s41598-024-54025-9] [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: 02/07/2023] [Accepted: 02/07/2024] [Indexed: 02/15/2024] Open
Abstract
Nowadays, dermatophyte infections are relatively easy to cure, especially since the introduction of orally administered antifungals such as terbinafine and itraconazole. However, these drugs may cause side effects due to liver damage or their interactions with other therapeutics. Hence, the search for new effective chemotherapeutics showing antidermatophyte activity seems to be the urge of the moment. Potassium salts of N-acylhydrazinecarbodithioates are used commonly as precursors for the synthesis of biologically active compounds. Keeping that in mind, the activity of a series of five potassium N-acylhydrazinecarbodithioates (1a-e) and their aminotriazole-thione derivatives (2a-e) was evaluated against a set of pathogenic, keratinolytic fungi, such as Trichophyton ssp., Microsporum ssp. and Chrysosporium keratinophilum, but also against some Gram-positive and Gram-negative bacteria. All tested compounds were found non-toxic for L-929 and HeLa cells, with the IC30 and IC50 values assessed in the MTT assay above 128 mg/L. The compound 5-amino-3-(naphtalene-1-yl)-4,5-dihydro-1H-1,2,4-triazole-5-thione (2d) was found active against all fungal strains tested. Scanning Electron Microscopy (SEM) revealed inhibition of mycelium development of Trichophyton rubrum cultivated on nail fragments and treated with 2d 24 h after infection with fungal spores. Transmission Electron Microscopy (TEM) observation of mycelium treated with 2d showed ultrastructural changes in the morphology of germinated spores. Finally, the RNA-seq analysis indicated that a broad spectrum of genes responded to stress induced by the 2d compound. In conclusion, the results confirm the potential of N-acylhydrazinecarbodithioate derivatives for future use as promising leads for new antidermatophyte agents development.
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Affiliation(s)
- Anita Ciesielska
- Department of Molecular Microbiology, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland.
| | - Aleksandra Kowalczyk
- Department of Molecular Microbiology, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland
| | - Agata Paneth
- Department of Organic Chemistry, Faculty of Pharmacy with Medical Analytics Division, Medical University of Lublin, Chodźki 4a, 20-093, Lublin, Poland
| | - Paweł Stączek
- Department of Molecular Microbiology, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland
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Anaya EU, Amin AE, Wester MJ, Danielson ME, Michel KS, Neumann AK. Dectin-1 multimerization and signaling depends on fungal β-glucan structure and exposure. Biophys J 2023; 122:3749-3767. [PMID: 37515324 PMCID: PMC10541497 DOI: 10.1016/j.bpj.2023.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/30/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023] Open
Abstract
Dectin-1A is a C-type lectin innate immunoreceptor that recognizes β-(1,3;1,6)-glucan, a structural component of Candida species cell walls. β-Glucans can adopt solution structures ranging from random coil to insoluble fiber due to tertiary (helical) and quaternary structure. Fungal β-glucans of medium and high molecular weight are highly structured, but low molecular weight glucan is much less structured. Despite similar affinity for Dectin-1, the ability of glucans to induce Dectin-1A-mediated signaling correlates with degree of structure. Glucan denaturation experiments showed that glucan structure determines agonistic potential, but not receptor binding affinity. We explored the impact of glucan structure on molecular aggregation of Dectin-1A. Stimulation with glucan signaling decreased Dectin-1A diffusion coefficient. Fluorescence measurements provided direct evidence of ligation-induced Dectin-1A aggregation, which positively correlated with increasing glucan structure content. In contrast, Dectin-1A is predominantly in a low aggregation state in resting cells. Molecular aggregates formed during interaction with highly structured, agonistic glucans did not exceed relatively small (<15 nm) clusters of a few engaged receptors. Finally, we observed increased molecular aggregation of Dectin-1A at fungal particle contact sites in a manner that positively correlated with the degree of exposed glucan on the particle surface. These results indicate that Dectin-1A senses the solution conformation of β-glucans through their varying ability to drive receptor dimer/oligomer formation and activation of membrane proximal signaling events.
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Affiliation(s)
- Eduardo U Anaya
- Department of Pathology, University of New Mexico, School of Medicine, Albuquerque, New Mexico
| | - Akram Etemadi Amin
- Department of Pathology, University of New Mexico, School of Medicine, Albuquerque, New Mexico; Department of Physics and Astronomy, University of New Mexico, Albuquerque, New Mexico
| | - Michael J Wester
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, New Mexico
| | | | | | - Aaron K Neumann
- Department of Pathology, University of New Mexico, School of Medicine, Albuquerque, New Mexico.
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Jahanshahi A, Nami S, Hosein Pour Feizi AA, Alihosseini S, Jaberinezhad M, Abdollahi M, Rahimi F, Falahatian M. Muscular and hepatosplenic candidiasis in a patient with acute myeloblastic leukemia: A case report and literature review. Clin Case Rep 2023; 11:e7700. [PMID: 37476594 PMCID: PMC10354359 DOI: 10.1002/ccr3.7700] [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: 01/18/2023] [Revised: 06/24/2023] [Accepted: 06/29/2023] [Indexed: 07/22/2023] Open
Abstract
Key Clinical Message Muscular and subcutaneous candidiasis is a rare entity in immunocompromised patients, but it should be kept in mind when we see multiple cystic soft tissue masses in addition to target-shaped hepatosplenic lesions in neutropenic patients. US and MRI are useful imaging modalities for the diagnosis and follow-up of these patients. Abstract Soft tissue candidiasis is an opportunistic infection in immunocompromised patients and must always be diagnosed and treated as soon as possible. In this case report, the patient is a 14-year-old boy with acute myeloid leukemia M3-type who presented with numerous soft tissue and hepatosplenic candidal abscesses.
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Affiliation(s)
- Amirreza Jahanshahi
- Medical Radiation Sciences Research GroupTabriz University of Medical SciencesTabrizIran
- Department of RadiologyTabriz University of Medical SciencesTabrizIran
| | - Sanam Nami
- Department of Parasitology and MycologySchool of MedicineTabriz University of Medical SciencesTabrizIran
| | | | - Samin Alihosseini
- Medical Radiation Sciences Research GroupTabriz University of Medical SciencesTabrizIran
- Department of RadiologyTabriz University of Medical SciencesTabrizIran
| | | | - Mirsaeed Abdollahi
- Cardiovascular Research CenterTabriz University of Medical SciencesTabrizIran
| | - Faezeh Rahimi
- Department of RadiologyZanjan University of Medical SciencesZanjanIran
| | - Masih Falahatian
- Medical Radiation Sciences Research GroupTabriz University of Medical SciencesTabrizIran
- Department of RadiologyTabriz University of Medical SciencesTabrizIran
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Nouri N, Mohammadi SR, Beardsley J, Aslani P, Ghaffarifar F, Roudbary M, Rodrigues CF. Thymoquinone Antifungal Activity against Candida glabrata Oral Isolates from Patients in Intensive Care Units-An In Vitro Study. Metabolites 2023; 13:metabo13040580. [PMID: 37110238 PMCID: PMC10143056 DOI: 10.3390/metabo13040580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/17/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
The number of Candida spp. infections and drug resistance are dramatically increasing worldwide, particularly among immunosuppressed patients, and it is urgent to find novel compounds with antifungal activity. In this work, the antifungal and antibiofilm activity of thymoquinone (TQ), a key bioactive constituent of black cumin seed Nigella sativa L., was evaluated against Candida glabrata, a WHO 'high-priority' pathogen. Then, its effect on the expression of C. glabrata EPA6 and EPA7 genes (related to biofilm adhesion and development, respectively) were analyzed. Swab samples were taken from the oral cavity of 90 hospitalized patients in ICU wards, transferred to sterile falcon tubes, and cultured on Sabouraud Dextrose Agar (SDA) and Chromagar Candida for presumptive identification. Next, a 21-plex PCR was carried out for the confirmation of species level. C. glabrata isolates underwent antifungal drug susceptibility testing against fluconazole (FLZ), itraconazole (ITZ), amphotericin B (AMB), and TQ according to the CLSI microdilution method (M27, A3/S4). Biofilm formation was measured by an MTT assay. EPA6 and EPA7 gene expression was assessed by real-time PCR. From the 90 swab samples, 40 isolates were identified as C. glabrata with the 21-plex PCR. Most isolates were resistant to FLZ (n = 29, 72.5%), whereas 12.5% and 5% were ITZ and AMB resistant, respectively. The minimum inhibitory concentration (MIC50) of TQ against C. glabrata was 50 µg/mL. Importantly, TQ significantly inhibited the biofilm formation of C. glabrata isolates, and EPA6 gene expression was reduced significantly at MIC50 concentration of TQ. TQ seems to have some antifungal, antibiofilm (adhesion) effect on C. glabrata isolates, showing that this plant secondary metabolite is a promising agent to overcome Candida infections, especially oral candidiasis.
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Affiliation(s)
- Noura Nouri
- Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115111, Iran
| | - Shahla Roudbar Mohammadi
- Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115111, Iran
| | - Justin Beardsley
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW 2145, Australia
- Westmead Hospital, NSW Health, Sydney, NSW 2145, Australia
| | - Peyman Aslani
- Department of Parasitology and Mycology, Faculty of Medicine, Aja University of Medical Sciences, Tehran 1411718541, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115111, Iran
| | - Maryam Roudbary
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Célia Fortuna Rodrigues
- TOXRUN-Toxicology Research Unit, Cooperativa de Ensino Superior Politécnico e Universitário-CESPU, 4585-116 Gandra PRD, Portugal
- LEPABE-Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
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Epidemiology of Fungal Periprosthetic Joint Infection: A Systematic Review of the Literature. Microorganisms 2022; 11:microorganisms11010084. [PMID: 36677376 PMCID: PMC9864285 DOI: 10.3390/microorganisms11010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/15/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
Fungal prosthetic joint infection (fPJI) is a rare complication; nonetheless, it represents a significant diagnostic and therapeutic challenge. There are no official guidelines on the most effective approach to identify and treat fPJIs. This systematic review aims to review the current literature on fPJI management and provide a comprehensive overview of this topic, especially from an epidemiologic point of view. Studies eligible for this systematic review were identified through an electronic systematic search of PubMed, Scopus, and Web of Science until 30 September 2022. Further references were obtained by cross-referencing. Sixty-three studies met the inclusion criteria, reporting on 372 cases of fPJI; such cases were described mostly in case reports and small case series with only a few larger cohort studies. Diagnosis of fPJI is challenging because of its chronic and indolent clinical course; it is further complicated by the technical difficulty of harvesting fungal cultures. A two-stage revision was the primary procedure in 239 (64.2%) patients whereas DAIR and one-stage approaches were reported in 30 (8.0%) and 18 (4.8 %) cases. In conclusion, our study highlights the heterogeneity of the reported treatments of fPJI, particularly in terms of medical management. With concern to a surgical approach, a two-stage revision arthroplasty is generally suggested, considering fPJI a delayed or late infection. The need for multicenter, prospective studies to provide standardized protocols and improve the treatment of fungal PJI clearly emerges.
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Choi JE, Jeon JS, Kim JK. Distribution Analysis of Candida albicans according to Sex and Age in Clinical Specimen Testing for Sexually Transmitted Diseases. J Microbiol Biotechnol 2022; 33:1-4. [PMID: 36457183 PMCID: PMC9895988 DOI: 10.4014/jmb.2208.08029] [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: 08/17/2022] [Revised: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 01/31/2023]
Abstract
The prevalence of candidiasis, a contagious disease with high morbidity and mortality, has sharply increased globally over the last two decades. Candida albicans can cause serious infections in patients with weak immunity and in recipients of prolonged antibiotic treatment. Consequently, rapid and accurate identification of species can play an important role in the treatment of candidiasis. Here, we investigated the positive rate and infection trend of Candida albicans according to age, specimen type, and sex using multiplex real-time polymerase chain reactionbased testing of samples collected for the diagnosis of sexually transmitted diseases in Korea between 2018 and 2020. When the type of specimen collected was a swab, the positive rate of Candida albicans was higher among younger women, and tended to decrease with age. Analysis of swab samples revealed higher positive rates than urinalysis. The reduction trend in positive rates by age was comparable between the overall samples and urine specimens. Among male patients, the positive rate did not differ substantially across the various types of specimens collected. Previous studies have shown a higher prevalence of non-albicans Candida species than Candida albicans in clinical specimens, and exclusion of the former from our analysis may be a limitation of this study. However, our findings contribute significantly to the literature because globally, there is a paucity of epidemiological studies using molecular techniques to detect Candida albicans in sexually transmitted disease test samples.
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Affiliation(s)
- Jae Eun Choi
- Department of Public Health Science, Dankook University Graduate School, Chungnam 31116, Republic of Korea
| | - Jae-Sik Jeon
- Department of Biomedical Laboratory Science, Dankook University College of Health Sciences, Chungnam 31116, Republic of Korea
| | - Jae Kyung Kim
- Department of Biomedical Laboratory Science, Dankook University College of Health Sciences, Chungnam 31116, Republic of Korea
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Sanderford J, Krumrey J, Campaigniac E, Lin J, Tsai P, Pipitone O. The Utility of Acid-Fast Bacillus (AFB) and Fungal Cultures in Orthopaedic Infections. Cureus 2022; 14:e26639. [PMID: 35949753 PMCID: PMC9357251 DOI: 10.7759/cureus.26639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction When diagnosing suspected orthopaedic-related infections, fungal and acid-fast bacilli (AFB) cultures are often obtained intraoperatively. These cultures are difficult and time-consuming to grow and increase healthcare costs. This study aimed to quantify the rate of positive AFB and fungal cultures in orthopaedic infections and to compare potential risk factors for a positive result. Methods Orthopaedic surgical cases for suspected infection at one institution from March 2013 through December 2019 were included. Data were collected on patient demographics and procedure characteristics for patients with surgical AFB or fungal lab tests ordered on the day of surgery. Results Of the 813 patients for whom intraoperative AFB or fungal cultures were ordered, 3.8% (N=31) had a positive result. Of the 31 positive results, 30 were from fungal cultures and one was from AFB cultures. Patients with a positive versus negative culture result did not differ significantly by age, sex, American Society of Anesthesiologists (ASA) score, diabetes, obesity, or HIV/AIDS. In both unadjusted and adjusted analyses, peripheral vascular disease (PVD) was associated with higher odds of a positive fungal culture result (adjusted OR (aOR)=3.5, 95%CI=1.3-8.4). Likewise, in both unadjusted and adjusted models, a hand/foot operating region was associated with higher odds of a positive fungal culture result compared with all other regions (aOR=4.2, 95%CI=1.9-9.8). Conclusion Intraoperative fungal and AFB cultures may not need to be obtained except in orthopaedic surgical cases for hand or foot infections or in patients with PVD.
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Parslow BY, Thornton CR. Continuing Shifts in Epidemiology and Antifungal Susceptibility Highlight the Need for Improved Disease Management of Invasive Candidiasis. Microorganisms 2022; 10:microorganisms10061208. [PMID: 35744725 PMCID: PMC9228503 DOI: 10.3390/microorganisms10061208] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 12/07/2022] Open
Abstract
Invasive candidiasis (IC) is a systemic life-threatening infection of immunocompromised humans, but remains a relatively neglected disease among public health authorities. Ongoing assessments of disease epidemiology are needed to identify and map trends of importance that may necessitate improvements in disease management and patient care. Well-established incidence increases, largely due to expanding populations of patients with pre-disposing risk factors, has led to increased clinical use and pressures on antifungal drugs. This has been exacerbated by a lack of fast, accurate diagnostics that have led treatment guidelines to often recommend preventative strategies in the absence of proven infection, resulting in unnecessary antifungal use in many instances. The consequences of this are multifactorial, but a contribution to emerging drug resistance is of primary concern, with high levels of antifungal use heavily implicated in global shifts to more resistant Candida strains. Preserving and expanding the utility and number of antifungals should therefore be of the highest priority. This may be achievable through the development and use of biomarker tests, bringing about a new era in improved antifungal stewardship, as well as novel antifungals that offer favorable profiles by targeting Candida pathogenesis mechanisms over cell viability.
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Affiliation(s)
- Ben Y. Parslow
- Biosciences, College of Life and Environmental Sciences, Geoffrey Pope Building, University of Exeter, Stocker Road, Exeter EX4 4QD, UK;
| | - Christopher R. Thornton
- Medical Research Council Centre for Medical Mycology, Geoffrey Pope Building, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
- Correspondence:
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de Azevedo Pereira FG, Milagres A, Werneck JT, Marques LC, Picciani BLS, Junior AS. Oral candidiasis in patients with hematological diseases: Diagnosis through clinical and cytopathological examinations. Cytopathology 2022; 33:611-617. [PMID: 35603463 DOI: 10.1111/cyt.13151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study is the first to analyze the prevalence of oral candidiasis in onco-hematological patients by physical and oral cytopathological examinations. METHODS This is a cross-sectional and observational study with a retrospective sample composed of participants hospitalized in the hematology clinic, diagnosed with hematological diseases. All participants were submitted to an oral mucosal examination and scraping from oral mucosa. RESULTS Of the 62 participants, 56.5% were male, 82.3% were white, with mean age of 57 years. Lymphoma was the most common hematological disease (24.2%). In total, 48.4% of the sample was diagnosed with oral candidiasis. Of these participants with oral candidiasis, 13 (21.0%) had clinical diagnosis. Cytopathological analysis revealed more 17 (27.4%) cases, without oral lesion indicative of candidiasis. Erythematous candidiasis (p=0.02), pseudomembranous candidiasis (p<0,001), clinical candidiasis (p<0,001), fibrous hyperplasia (p=0,032), and coated tongue (p=0,012) showed correlation to candidiasis cytopathologic diagnosis. CONCLUSIONS Oral candidiasis is common among patients with hematological disease, and the cytopathological examination proved to be a useful tool, confirming clinical diagnosis of candidiasis and identifying subclinical cases. These data are of great relevance considering the possible complications that these patients may develop such as longer hospitalizations, worsening of the general condition or even death due to candidemia.
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Affiliation(s)
| | - Adrianna Milagres
- Department of Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | - Juliana Tristão Werneck
- Department of Specific Formation, School of Dentistry, Universidade Federal Fluminense, Nova Friburgo, Rio de Janeiro, Brazil
| | - Letícia Côgo Marques
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | - Bruna Lavinas Sayed Picciani
- Department of Specific Formation, School of Dentistry, Universidade Federal Fluminense, Nova Friburgo, Rio de Janeiro, Brazil
| | - Arley Silva Junior
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
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Thrombin-Derived C-Terminal Peptide Reduces Candida-Induced Inflammation and Infection In Vitro and In Vivo. Antimicrob Agents Chemother 2021; 65:e0103221. [PMID: 34424043 PMCID: PMC8522777 DOI: 10.1128/aac.01032-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Infections due to the opportunistic fungus Candida have been on the rise in the last decades, especially in immunocompromised individuals and hospital settings. Unfortunately, the treatments available today are limited. Thrombin-derived C-terminal peptide (TCP-25) is an antimicrobial peptide (AMP) with antibacterial and immunomodulatory effects. In this work, we, for the first time, demonstrate the ability of TCP-25 ability to counteract Candidain vitro and in vivo. Using a combination of viable count assay (VCA), radial diffusion assay (RDA), and fluorescence and transmission electron microscopy analyses, TCP-25 was found to exert a direct fungicidal activity. An inhibitory activity of TCP-25 on NF-κB activation induced by both zymosan alone and heat-killed C. albicans was demonstrated in vitro using THP-1 cells, and in vivo using NF-κB reporter mice. Moreover, the immunomodulatory property of TCP-25 was further substantiated in vitro by analyzing cytokine responses in human blood stimulated with zymosan, and in vivo employing a zymosan-induced peritonitis model in C57BL/6 mice. The therapeutic potential of TCP-25 was demonstrated in mice infected with luminescent C. albicans. Finally, the binding between TCP-25 and zymosan was investigated using circular dichroism spectroscopy and intrinsic fluorescence analysis. Taken together, our results show that TCP-25 has a dual function by inhibiting Candida as well as the associated zymosan-induced inflammation. The latter function is accompanied by a change in secondary structure upon binding to zymosan. TCP-25, therefore, shows promise as a novel drug candidate against Candida infections.
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A New Antifungal-Loaded Sol-Gel Can Prevent Candida albicans Prosthetic Joint Infection. Antibiotics (Basel) 2021; 10:antibiotics10060711. [PMID: 34204833 PMCID: PMC8231561 DOI: 10.3390/antibiotics10060711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 12/12/2022] Open
Abstract
Fungal PJI is one of the most feared complications after arthroplasty. Although a rare finding, its high associated morbidity and mortality makes it an important object of study. The most frequent species causing fungal PJI is C. albicans. New technology to treat this type of PJI involves organic-inorganic sol-gels loaded with antifungals, as proposed in this study, in which anidulafungin is associated with organophosphates. This study aimed to evaluate the efficacy of an anidulafungin-loaded organic-inorganic sol-gel in preventing prosthetic joint infection (PJI), caused by Candida albicans using an in vivo murine model that evaluates many different variables. Fifty percent (3/6) of mice in the C. albicans-infected, non-coated, chemical-polished (CP)-implant group had positive culture and 100% of the animals in the C. albicans-infected, anidulafungin-loaded, sol-gel coated (CP + A)-implant group had a negative culture (0/6) (p = 0.023). Taking the microbiology and pathology results into account, 54.5% (6/11) of C. albicans-infected CP-implant mice were diagnosed with a PJI, whilst only 9.1% (1/11) of C. albicans-infected CP + A-implant mice were PJI-positive (p = 0.011). No differences were observed between the bone mineral content and bone mineral density of noninfected CP and noninfected CP + A (p = 0.835, and p = 0.181, respectively). No histological or histochemical differences were found in the tissue area occupied by the implant among CP and CP + A. Only 2 of the 6 behavioural variables evaluated exhibited changes during the study: limping and piloerection. In conclusion, the anidulafungin-loaded sol-gel coating showed an excellent antifungal response in vivo and can prevent PJI due to C. albicans in this experimental model.
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Singh A, Singh PK, de Groot T, Kumar A, Mathur P, Tarai B, Sachdeva N, Upadhyaya G, Sarma S, Meis JF, Chowdhary A. Emergence of clonal fluconazole-resistant Candida parapsilosis clinical isolates in a multicentre laboratory-based surveillance study in India. J Antimicrob Chemother 2021; 74:1260-1268. [PMID: 30753525 DOI: 10.1093/jac/dkz029] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/17/2018] [Accepted: 01/04/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The emergence of fluconazole resistance in Candida parapsilosis healthcare-associated infections has recently been increasingly reported. Antifungal susceptibility profiles and mechanisms of fluconazole resistance in C. parapsilosis (n = 199) from nine hospitals in India collected over a period of 3 years were studied. Further, clonal transmission of fluconazole-resistant isolates in different hospitals was investigated. METHODS Antifungal susceptibility testing of five azoles, amphotericin B and 5-flucytosine was performed by the CLSI microbroth dilution method. The azole target ERG11 gene was sequenced, and the significance of a novel ERG11 mutation in C. parapsilosis was determined using a gap-repair cloning approach in Saccharomyces cerevisiae. In addition, microsatellite analysis was performed to determine the clonal lineage of C. parapsilosis-resistant strains circulating among different hospitals. RESULTS A total of 64 (32%) C. parapsilosis isolates were non-susceptible to fluconazole, which included resistant (n = 55; MIC >4 mg/L) and susceptible dose-dependent (n = 9) isolates. Of these 64 non-susceptible isolates, a novel K143R amino acid substitution was noted in 92%, and the remaining five isolates had the Y132F substitution. Elevated azole MICs (≥16-fold) were detected in S. cerevisiae upon expression of C. parapsilosis ERG11 alleles carrying Y132F or K143R substitutions. Two major clusters of non-susceptible isolates were circulating in seven Indian hospitals. CONCLUSIONS We report a novel K143R amino acid substitution in ERG11p causing fluconazole resistance in C. parapsilosis. Fluconazole-non-susceptible C. parapsilosis isolates carrying the novel K143R amino acid substitution should be identified in clinical microbiology laboratories to prevent further clonal transmission.
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Affiliation(s)
- Ashutosh Singh
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Pradeep K Singh
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Theun de Groot
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
| | - Anil Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences and Research Center, Vishwa Vidyapeetham, Ponekkara, Cochin, India
| | - Purva Mathur
- Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | | | - Neelam Sachdeva
- Department of Microbiology, Rajiv Gandhi Cancer Institute & Research Center, Delhi, India
| | - Gargi Upadhyaya
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Smita Sarma
- Department of Microbiology, Medanta-The Medcity, Gurgaon, Haryana, India
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands.,Centre of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
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Cuéllar-Cruz M. The histo-blood group antigens of the host cell may determine the binding of different viruses such as SARS-CoV-2. Future Microbiol 2021; 16:107-118. [PMID: 33459559 PMCID: PMC7842250 DOI: 10.2217/fmb-2020-0158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Viruses have caused the death of millions of people worldwide. Specifically, human viruses are grouped into 21 families, including the family of coronaviruses (CoVs). In December 2019, in Wuhan, China, a new human CoV was identified, SARS-CoV-2. The first step of the infection mechanism of the SARS-CoV-2 in the human host is adhesion, which occurs through the S glycoprotein that is found in diverse human organs. Another way through which SARS-CoV-2 could possibly attach to the host's cells is by means of the histo-blood group antigens. In this work, we have reviewed the mechanisms by which some viruses bind to the histo-blood group antigens, which could be related to the susceptibility of the individual and are dependent on the histo-blood group.
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Affiliation(s)
- Mayra Cuéllar-Cruz
- Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Noria Alta S/N, Col. Noria Alta, C.P. 36050, Guanajuato, Guanajuato, México
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Shah S, Haq S, Antony SJ. Coccidiomycosis immitis Resulting in a Prosthetic Joint Infection in an Immunocompetent Patient after a Total Hip Arthroplasty: A Case Report and Review of the Literature. Infect Disord Drug Targets 2020; 22:e170322188282. [PMID: 33231149 DOI: 10.2174/1871526520999201123205249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/06/2020] [Accepted: 10/20/2020] [Indexed: 11/22/2022]
Abstract
Coccidiomycosis immitis is a fungal infection that is a rare cause of prosthetic joint infection (PJI) in patients. This case report describes an immunocompetent patient who had a right total hip arthroplasty (THA) complicated with Coccidiomycosis immitis. This patient is the 9th reported case of Coccidiomycosis immitis causing a PJI and only the second case to be reported in a THA. Once progressed, it can be difficult to treat, often reoccurring and requiring repeat sur-gical and prolonged therapy. We discuss the clinical presentation in this patient and review the literature on the current pub-lished cases.
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Affiliation(s)
- Sidra Shah
- Department of Medicine, Section of Infectious Disease, Burrell College of Osteopathic Medicine, Las Cruces, New Mexico,. United States
| | - Syed Haq
- Department of Medicine, Section of Infectious Disease, Burrell College of Osteopathic Medicine, Las Cruces, New Mexico,. United States
| | - Suresh J Antony
- Texas Tech University Health Sciences Center, El Paso, Texas,. United States
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15
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Camp I, Spettel K, Willinger B. Molecular Methods for the Diagnosis of Invasive Candidiasis. J Fungi (Basel) 2020; 6:jof6030101. [PMID: 32640656 PMCID: PMC7558065 DOI: 10.3390/jof6030101] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/03/2020] [Accepted: 07/04/2020] [Indexed: 12/19/2022] Open
Abstract
Invasive infections caused by members of the genus Candida are on the rise. Especially patients in intensive care units, immunocompromised patients, and those recovering from abdominal surgery are at risk for the development of candidemia or deep-seated candidiasis. Rapid initiation of appropriate antifungal therapy can increase survival rates significantly. In the past, most of these infections were caused by C. albicans, a species that typically is very susceptible to antifungals. However, in recent years a shift towards infections caused by non-albicans species displaying various susceptibly patterns has been observed and the prompt diagnosis of the underlying species has become an essential factor determining the therapeutic outcome. The gold standard for diagnosing invasive candidiasis is blood culture, even though its sensitivity is low and the time required for species identification usually exceeds 48 h. To overcome these issues, blood culture can be combined with other methods, and a large number of tests have been developed for this purpose. The aim of this review was to give an overview on strengths and limitations of currently available molecular methods for the diagnosis of invasive candidiasis.
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Morbidity and mortality of candidaemia in Europe: an epidemiologic meta-analysis. Clin Microbiol Infect 2019; 25:1200-1212. [DOI: 10.1016/j.cmi.2019.04.024] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 01/30/2023]
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17
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Toda M, Williams SR, Berkow EL, Farley MM, Harrison LH, Bonner L, Marceaux KM, Hollick R, Zhang AY, Schaffner W, Lockhart SR, Jackson BR, Vallabhaneni S. Population-Based Active Surveillance for Culture-Confirmed Candidemia - Four Sites, United States, 2012-2016. MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES (WASHINGTON, D.C. : 2002) 2019; 68:1-15. [PMID: 31557145 PMCID: PMC6772189 DOI: 10.15585/mmwr.ss6808a1] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PROBLEM/CONDITION Candidemia is a bloodstream infection (BSI) caused by yeasts in the genus Candida. Candidemia is one of the most common health care-associated BSIs in the United States, with all-cause in-hospital mortality of up to 30%. PERIOD COVERED 2012-2016. DESCRIPTION OF SYSTEM CDC's Emerging Infections Program (EIP), a collaboration among CDC, state health departments, and academic partners that was established in 1995, was used to conduct active, population-based laboratory surveillance for candidemia in 22 counties in four states (Georgia, Maryland, Oregon, and Tennessee) with a combined population of approximately 8 million persons. Laboratories serving the catchment areas were recruited to report candidemia cases to the local EIP program staff. A case was defined as a blood culture that was positive for a Candida species collected from a surveillance area resident during 2012-2016. Isolates were sent to CDC for species confirmation and antifungal susceptibility testing. Any subsequent blood cultures with Candida within 30 days of the initial positive culture in the same patient were considered part of the same case. Trained surveillance officers collected clinical information from the medical chart for all cases, and isolates were sent to CDC for species confirmation and antifungal susceptibility testing. RESULTS Across all sites and surveillance years (2012-2016), 3,492 cases of candidemia were identified. The crude candidemia incidence averaged across sites and years during 2012-2016 was 8.7 per 100,000 population; important differences in incidence were found by site, age group, sex, and race. The crude annual incidence was the highest in Maryland (14.1 per 100,000 population) and lowest in Oregon (4.0 per 100,000 population). The crude annual incidence of candidemia was highest among adults aged ≥65 years (25.5 per 100,000 population) followed by infants aged <1 year (15.8). The crude annual incidence was higher among males (9.4) than among females (8.0) and was approximately 2 times greater among blacks than among nonblacks (13.7 versus 5.8). Ninety-six percent of cases occurred in patients who were hospitalized at the time of or during the week after having a positive culture. One third of cases occurred in patients who had undergone a surgical procedure in the 90 days before the candidemia diagnosis, 77% occurred in patients who had received systemic antibiotics in the 14 days before the diagnosis, and 73% occurred in patients who had had a central venous catheter (CVC) in place within 2 days before the diagnosis. Ten percent were in patients who had used injection drugs in the past 12 months. The median time from admission to candidemia diagnosis was 5 days (interquartile range [IQR]: 0-16 days). Among 2,662 cases that were treated in adults aged >18 years, 34% were treated with fluconazole alone, 30% with echinocandins alone, and 34% with both. The all-cause, in-hospital case-fatality ratio was 25% for any time after admission; the all-cause in-hospital case-fatality ratio was 8% for <48 hours after a positive culture for Candida species. Candida albicans accounted for 39% of cases, followed by Candida glabrata (28%) and Candida parapsilosis (15%). Overall, 7% of isolates were resistant to fluconazole and 1.6% were resistant to echinocandins, with no clear trends in resistance over the 5-year surveillance period. INTERPRETATION Approximately nine out of 100,000 persons developed culture-positive candidemia annually in four U.S. sites. The youngest and oldest persons, men, and blacks had the highest incidences of candidemia. Patients with candidemia identified in the surveillance program had many of the typical risk factors for candidemia, including recent surgery, exposure to broad-spectrum antibiotics, and presence of a CVC. However, an unexpectedly high proportion of candidemia cases (10%) occurred in patients with a history of injection drug use (IDU), suggesting that IDU has become a common risk factor for candidemia. Deaths associated with candidemia remain high, with one in four cases resulting in death during hospitalization. PUBLIC HEALTH ACTION Active surveillance for candidemia yielded important information about the disease incidence and death rate and persons at greatest risk. The surveillance was expanded to nine sites in 2017, which will improve understanding of the geographic variability in candidemia incidence and associated clinical and demographic features. This surveillance will help monitor incidence trends, track emergence of resistance and species distribution, monitor changes in underlying conditions and predisposing factors, assess trends in antifungal treatment and outcomes, and be helpful for those developing prevention efforts. IDU has emerged as an important risk factor for candidemia, and interventions to prevent invasive fungal infections in this population are needed. Surveillance data documenting that approximately two thirds of candidemia cases were caused by species other than C. albicans, which are generally associated with greater antifungal resistance than C. albicans, and the presence of substantial fluconazole resistance supports 2016 clinical guidelines recommending a switch from fluconazole to echinocandins as the initial treatment for candidemia in most patients.
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Egue LAN, N'guessan FK, Aka-Gbezo S, Bouatenin JPKM, Koussemon-Camara M. Candida species in tchapalo and bangui, two traditional alcoholic beverages from Côte d'Ivoire. Fungal Biol 2018; 122:283-292. [PMID: 29665954 DOI: 10.1016/j.funbio.2018.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 01/05/2023]
Abstract
The increase of infections due to non-Candida albicans species made it very necessary to conduct adequate characterization to be able to identify the species of Candida isolated from traditional fermented foods. In this study, based on their hue on Candida Chromogenic Agar medium, a total of 136 yeast strains were isolated from tchapalo and bangui. Molecular identification based on PCR-RFLP of internal transcribed spacers of rDNA (ITS) and sequencing of the ITS and the D1/D2 regions allowed us to assign these isolates to seven species: Candida tropicalis, Candida inconspicua, Candida rugosa, Saccharomyces cerevisiae, Kluyveromyces marxianus, Hanseniaspora guilliermondii, Trichosporon asahii. With the respect to each beverage, six species were found among with four species are regarded as opportunistic pathogens. From these, C. tropicalis, C. inconspicua and K. marxianus were the most commonly encountered. The enzyme activities of the potential pathogens assessed using API ZYM system showed that almost strains had esterase, esterase lipase, valine and cystine arylamidase, alpha chymotrypsin, alkaline phosphatase and naphthol phosphohydrolase activities. The activity of α-glucosidase was found only in C. tropicalis and C. inconspicua strains isolated from tchapalo while β-glucosidase activity was found in all strains from tchapalo and only in C. inconspicua isolated from bangui.
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Affiliation(s)
- Laurence A N Egue
- Nangui Abrogoua University, Laboratory of Biotechnology and Food Microbiology, Department of Food Science and Technology (UFR-STA), 02 BP 801 Abidjan 02, Cote d'Ivoire.
| | - Florent K N'guessan
- Nangui Abrogoua University, Laboratory of Biotechnology and Food Microbiology, Department of Food Science and Technology (UFR-STA), 02 BP 801 Abidjan 02, Cote d'Ivoire
| | - Solange Aka-Gbezo
- Nangui Abrogoua University, Laboratory of Biotechnology and Food Microbiology, Department of Food Science and Technology (UFR-STA), 02 BP 801 Abidjan 02, Cote d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire (CSRS), 01 BP 1303 Abidjan 01, Cote d'Ivoire
| | - Jean-Paul K M Bouatenin
- Nangui Abrogoua University, Laboratory of Biotechnology and Food Microbiology, Department of Food Science and Technology (UFR-STA), 02 BP 801 Abidjan 02, Cote d'Ivoire
| | - Marina Koussemon-Camara
- Nangui Abrogoua University, Laboratory of Biotechnology and Food Microbiology, Department of Food Science and Technology (UFR-STA), 02 BP 801 Abidjan 02, Cote d'Ivoire
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Inhibitory effect of probiotic lactobacilli supernatants on single and mixed non-albicans Candida species biofilm. Arch Oral Biol 2017; 85:40-45. [PMID: 29031236 DOI: 10.1016/j.archoralbio.2017.10.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/02/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Oral candidiasis is one of the most common human fungal infections. While most cases of the Candida species isolated from the oral cavity are Candida albicans, a large number of candidiasis is attributed to non-albicans Candida species. In this study, we aim to evaluate the in vitro inhibition of supernatants of Lactobacillus gasseri and Lactobacillus rhamnosus on the single and mixed species biofilm of non-albicans Candida species, including Candida tropicalis, Candida krusei and Candida parapsilosis. DESIGN Cell-free supernatants of Lactobacillus gasseri and Lactobacillus rhamnosus were prepared. Single and mixed non-albicans Candida species biofilm were formed in the 96-well microplate and on the surfaces of medical grade silicone. Biomass and cell viability were tested with crystal violet and cell counting kit-8. In order to examine the ability of the supernatant to disrupt pre-formed biofilm, supernatant was added to 24h-old biofilms. Biofilm architecture on silicone was investigated by scanning electron microscopy and confocal laser scanning microscopy was used to examine live/dead organisms within biofilm. RESULTS Single and mixed species biofilms and cell viability of non-albicans Candida biofilms were inhibited by probiotic lactobacilli supernatants. Matrue biofilm formation was disrupted by lactobacilli supernatants added at 24h after biofilm initiation. Examination with confocal laser scanning microscopy and scanning electron microscopy confirmed that lactobacilli supernatants inhibited the mixed biofilms and damaged the cells. CONCLUSIONS Our data elucidate the inhibitory activity of probiotic lactobacilli on non-albicans Candida biofilm, so as to support their utility as an adjunctive therapeutic mode against oral candida infections.
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Thinking beyond the Common Candida Species: Need for Species-Level Identification of Candida Due to the Emergence of Multidrug-Resistant Candida auris. J Clin Microbiol 2017; 55:3324-3327. [PMID: 28904185 DOI: 10.1128/jcm.01355-17] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Candida species are one of the leading causes of nosocomial infections. Because much of the treatment for Candida infections is empirical, some institutions do not identify Candida to species level. With the worldwide emergence of the multidrug-resistant species Candida auris, identification of Candida to species level has new clinical relevance. Species should be identified for invasive candidiasis isolates, and species-level identification can be considered for selected noninvasive isolates to improve detection of C. auris.
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Genetics, Molecular, and Proteomics Advances in Filamentous Fungi. Curr Microbiol 2017; 74:1226-1236. [PMID: 28733909 DOI: 10.1007/s00284-017-1308-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 07/13/2017] [Indexed: 10/19/2022]
Abstract
Filamentous fungi play a dynamic role in health and the environment. In addition, their unique and complex hyphal structures are involved in their morphogenesis, integrity, synthesis, and degradation, according to environmental and physiological conditions and resource availability. However, in biotechnology, it has a great value in the production of enzymes, pharmaceuticals, and food ingredients. The beginning of nomenclature of overall fungi started in early 1990 after which the categorization, interior and exterior mechanism, function, molecular and genetics study took pace. This mini-review has emphasized some of the important aspects of filamentous fungi, their pattern of life cycle, history, and development of different strategic methods applied to exploit this unique organism. New trends and concepts that have been applied to overcome obstacle because of their basic structure related to genomics and systems biology has been presented. Furthermore, the future aspects and challenges that need to be deciphered to get a bigger and better picture of filamentous fungi have been discussed.
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Rodrigues CF, Henriques M. Oral mucositis caused by Candida glabrata biofilms: failure of the concomitant use of fluconazole and ascorbic acid. Ther Adv Infect Dis 2017; 4:10-17. [PMID: 28357061 DOI: 10.1177/2049936116684477] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Candida glabrata is becoming one of the most prevalent pathogenic yeasts in cases of oral diseases. Mucositis is an recurrent oral infection in immunocompromised patients, and the actual guidelines recommend the use of fluconazole (Flu) for many cases. However, the azole resistance by C. glabrata is renowned, causing a reduced therapeutic response, especially when it occurs in biofilms. In this study, we performed an in vitro evaluation of an alternative pharmacotherapy for C. glabrata biofilm infections, combining ascorbic acid (AA) with Flu. AA is recognized for degrading β-glucans, an important compound of the biofilm matrices, which prevent drug diffusion. MATERIALS AND METHODS Routine clinical 30 or 40 mg/l doses of Flu were applied to C. glabrata biofilms simultaneously with 200 or 300 mg/l of AA. RESULTS The results showed that this combination effectively promoted the degradation of the biofilm network, but unfortunately, also stimulated the growth of the yeasts population due to release of several glucose monomers during β-glucans hydrolysis. DISCUSSION AA lead to the hydrolysis of the β-glucans of the matrix, liberating glucose molecules which are used as carbon souce by the yeasts, thus suppressing the desired antifungal effect of the drug combination with Flu. CONCLUSIONS Unlike to what happens in treatment of bacterial infection, AA should not be used together with Flu in the treating oral mucositis caused by Candida.
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Affiliation(s)
- Célia F Rodrigues
- Centre of Biological Engineering (CEB), Laboratório de Investigação em Biofilmes Rosário Oliveira (LIBRO), University of Minho, Braga, Portugal
| | - Mariana Henriques
- Centre of Biological Engineering (CEB), Laboratório de Investigação em Biofilmes Rosário Oliveira (LIBRO), University of Minho, 4710-057 Braga, Portugal
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Kim D, Hwang GY, Yoo G, Kim J, Uh Y. Trend of Prevalence and Antifungal Drug Resistance of Candida Species Isolated from Candidemia Patients at a Tertiary Care Hospital During Recent Two Decades. ANNALS OF CLINICAL MICROBIOLOGY 2017. [DOI: 10.5145/acm.2017.20.3.53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Dongkyun Kim
- Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Gyu Yel Hwang
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Gilsung Yoo
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Juwon Kim
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Ting SY, Ishola OA, Ahmed MA, Tabana YM, Dahham S, Agha MT, Musa SF, Muhammed R, Than LTL, Sandai D. Metabolic adaptation via regulated enzyme degradation in the pathogenic yeast Candida albicans. J Mycol Med 2016; 27:98-108. [PMID: 28041812 DOI: 10.1016/j.mycmed.2016.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 11/01/2016] [Accepted: 12/05/2016] [Indexed: 11/29/2022]
Abstract
The virulence of Candida albicans is dependent upon fitness attributes as well as virulence factors. These attributes include robust stress responses and metabolic flexibility. The assimilation of carbon sources is important for growth and essential for the establishment of infections by C. albicans. Previous studies showed that the C. albicans ICL1 genes, which encode the glyoxylate cycle enzymes isocitratelyase are required for growth on non-fermentable carbon sources such as lactate and oleic acid and were repressed by 2% glucose. In contrast to S. cerevsiae, the enzyme CaIcl1 was not destabilised by glucose, resulting with its metabolite remaining at high levels. Further glucose addition has caused CaIcl1 to lose its signal and mechanisms that trigger destabilization in response to glucose. Another purpose of this study was to test the stability of the Icl1 enzyme in response to the dietary sugars, fructose, and galactose. In the present study, the ICL1 mRNAs expression was quantified using Quantitative Real Time PCR, whereby the stability of protein was measured and quantified using Western blot and phosphoimager, and the replacing and cloning of ICL1 ORF by gene recombination and ubiquitin binding was conducted via co-immuno-precipitation. Following an analogous experimental approach, the analysis was repeated using S. cerevisiaeas a control. Both galactose and fructose were found to trigger the degradation of the ICL1 transcript in C. albicans. The Icl1 enzyme was stable following galactose addition but was degraded in response to fructose. C. albicans Icl1 (CaIcl1) was also subjected to fructose-accelerated degradation when expressed in S. cerevisiae, indicating that, although it lacks a ubiquitination site, CaIcl1 is sensitive to fructose-accelerated protein degradation. The addition of an ubiquitination site to CaIcl1 resulted in this enzyme becoming sensitive to galactose-accelerated degradation and increases its rate of degradation in the presence of fructose. It can be concluded that ubiquitin-independent pathways of fructose-accelerated enzyme degradation exist in C. albicans.
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Affiliation(s)
- S Y Ting
- Infectomics Cluster, advanced medical and dental institute, universiti Sains Malaysia, Jln Tun Hamdan Sheikh Tahir, 13200 Bertam Penang, Malaysia
| | - O A Ishola
- Infectomics Cluster, advanced medical and dental institute, universiti Sains Malaysia, Jln Tun Hamdan Sheikh Tahir, 13200 Bertam Penang, Malaysia
| | - M A Ahmed
- Infectomics Cluster, advanced medical and dental institute, universiti Sains Malaysia, Jln Tun Hamdan Sheikh Tahir, 13200 Bertam Penang, Malaysia
| | - Y M Tabana
- Infectomics Cluster, advanced medical and dental institute, universiti Sains Malaysia, Jln Tun Hamdan Sheikh Tahir, 13200 Bertam Penang, Malaysia
| | - S Dahham
- Infectomics Cluster, advanced medical and dental institute, universiti Sains Malaysia, Jln Tun Hamdan Sheikh Tahir, 13200 Bertam Penang, Malaysia
| | - M T Agha
- Infectomics Cluster, advanced medical and dental institute, universiti Sains Malaysia, Jln Tun Hamdan Sheikh Tahir, 13200 Bertam Penang, Malaysia
| | - S F Musa
- Infectomics Cluster, advanced medical and dental institute, universiti Sains Malaysia, Jln Tun Hamdan Sheikh Tahir, 13200 Bertam Penang, Malaysia
| | - R Muhammed
- Regenerative medicine cluster, advanced medical and dental institute, UniversitiSains Malaysia, 13200 Bertam Penang, Malaysia
| | - L T L Than
- Department of medical microbiology and parasitology, faculty of medicine and health sciences, universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - D Sandai
- Infectomics Cluster, advanced medical and dental institute, universiti Sains Malaysia, Jln Tun Hamdan Sheikh Tahir, 13200 Bertam Penang, Malaysia.
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Bandara HMHN, Matsubara VH, Samaranayake LP. Future therapies targeted towards eliminating Candida biofilms and associated infections. Expert Rev Anti Infect Ther 2016; 15:299-318. [PMID: 27927053 DOI: 10.1080/14787210.2017.1268530] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Candida species are common human commensals and cause either superficial or invasive opportunistic infections. The biofilm form of candida as opposed to its suspended, planktonic form, is predominantly associated with these infections. Alternative or adjunctive therapies are urgently needed to manage Candida infections as the currently available short arsenal of antifungal drugs has been compromised due to their systemic toxicity, cross-reactivity with other drugs, and above all, by the emergence of drug-resistant Candida species due to irrational drug use. Areas covered: Combination anti-Candida therapies, antifungal lock therapy, denture cleansers, and mouth rinses have all been proposed as alternatives for disrupting candidal biofilms on different substrates. Other suggested approaches for the management of candidiasis include the use of natural compounds, such as probiotics, plants extracts and oils, antifungal quorum sensing molecules, anti-Candida antibodies and vaccines, cytokine therapy, transfer of primed immune cells, photodynamic therapy, and nanoparticles. Expert commentary: The sparsity of currently available antifungals and the plethora of proposed anti-candidal therapies is a distinct indication of the urgent necessity to develop efficacious therapies for candidal infections. Alternative drug delivery approaches, such as probiotics, reviewed here is likely to be a reality in clinical settings in the not too distant future.
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Affiliation(s)
- H M H N Bandara
- a School of Dentistry , The University of Queensland , Herston , QLD , Australia
| | - V H Matsubara
- b School of Dentistry , University of São Paulo , São Paulo , SP , Brazil.,c Department of Microbiology, Institute of Biomedical Sciences , University of São Paulo , São Paulo , SP , Brazil
| | - L P Samaranayake
- a School of Dentistry , The University of Queensland , Herston , QLD , Australia.,d Faculty of Dentistry , University of Kuwait , Kuwait
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Masomi F, Hassanshahian M. Antimicrobial Activity of Five Medicinal Plants on Candida Albicans. IRANIAN JORNAL OF TOXICOLOGY 2016. [DOI: 10.29252/arakmu.10.6.39] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Cobo F, Rodríguez-Granger J, López EM, Jiménez G, Sampedro A, Aliaga-Martínez L, Navarro-Marí JM. Candida-induced prosthetic joint infection. A literature review including 72 cases and a case report. Infect Dis (Lond) 2016; 49:81-94. [DOI: 10.1080/23744235.2016.1219456] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Mushi MF, Mtemisika CI, Bader O, Bii C, Mirambo MM, Groß U, Mshana SE. High Oral Carriage of Non-albicans Candida spp. among HIV-infected individuals. Int J Infect Dis 2016; 49:185-8. [PMID: 27401585 DOI: 10.1016/j.ijid.2016.07.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/03/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Non-albicans Candida (NAC) spp. in immunocompromised patients are linked to invasive infections with narrow treatment choice. This study aimed at comparing the oral colonization of NAC spp. between HIV and non-HIV infected individuals in Mwanza, Tanzania. METHOD Oral rinse of 351 HIV-infected and 639 non-HIV infected individuals were collected between March and July 2015. Phenotypic identifications of Candida spp. was done using Candida Chromogenic agar and confirmed by MALDI-TOF MS. RESULTS NAC spp. were detected in 36/351 (10.3%) HIV-infected individuals compared to 28/639 (4.4%) of non-HIV infected individuals; P=0.0003. In HIV infected individuals, commonly isolated NAC spp. were Candida tropicalis, 10(2.8%), C. krusei (Issatschenki orientalis) 9(2.6%) and C. glabrata 8(2.3%). While for non-HIV infected individuals C. dubliniensis 8(1.3%) and C. tropicalis 5(0.9%) were commonly detected. As CD4 count/μl decreases by one unit the risk of being colonized by NAC spp. among HIV infected individuals increases by 1% (OR 1.01, 95% CI; 1.001-1.004, P=0.001). CONCLUSION The prevalence of NAC spp. is high among HIV-infected individuals with low CD4 count placing them at higher risk of invasive infections. Further studies to investigate the role of NAC spp. in causing invasive infections among immunocompromised patients are recommended.
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Affiliation(s)
- Martha F Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania.
| | - Conjester I Mtemisika
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania.
| | - Oliver Bader
- Institute of Medical Microbiology, University Medical Center Kreuzbergring 57, 37075 Göttingen Germany.
| | - Christine Bii
- Kenya Medical Research Institute, Center for Microbiology Research P.O Box 54840 00200, Nairobi, Kenya.
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania.
| | - Uwe Groß
- Institute of Medical Microbiology, University Medical Center Kreuzbergring 57, 37075 Göttingen Germany.
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania.
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Morgan J, Meltzer MI, Plikaytis BD, Sofair AN, Huie-White S, Wilcox S, Harrison LH, Seaberg EC, Hajjeh RA, Teutsch SM. Excess Mortality, Hospital Stay, and Cost Due to Candidemia: A Case-Control Study Using Data From Population-Based Candidemia Surveillance. Infect Control Hosp Epidemiol 2016; 26:540-7. [PMID: 16018429 DOI: 10.1086/502581] [Citation(s) in RCA: 300] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractObjective:To determine the mortality, hospital stay, and total hospital charges and cost of hospitalization attributable to candidemia by comparing patients with candidemia with control-patients who have otherwise similar illnesses. Prior studies lack broad patient and hospital representation or cost-related information that accurately reflects current medical practices.Design:Our case-control study included case-patients with candidemia and their cost-related data, ascertained from laboratory-based candidemia surveillance conducted among all residents of Connecticut and Baltimore and Baltimore County, Maryland, during 1998 to 2000. Control-patients were matched on age, hospital type, admission year, discharge diagnoses, and duration of hospitalization prior to candidemia onset.Results:We identified 214 and 529 sets of matched case-patients and control-patients from the two locations, respectively. Mortality attributable to candidemia ranged between 19% and 24%. On multivariable analysis, candidemia was associated with mortality (OR, 5.3 for Connecticut and 8.5 for Baltimore and Baltimore County;P< .05), whereas receiving adequate treatment was protective (OR, 0.5 and 0.4 for the two locations, respectively;P< .05). Candidemia itself did not increase the total hospital charges and cost of hospitalization; when treatment status was accounted for, having received adequate treatment for candidemia significantly increased the total hospital charges and cost of hospitalization ($6,000 to $29,000 and $3,000 to $22,000, respectively) and the length of stay (3 to 13 days).Conclusion:Our findings underscore the burden of candidemia, particularly regarding the risk of death, length of hospitalization, and cost associated with treatment (Infect Control Hosp Epidemiol2005;26:540-547).
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Affiliation(s)
- Juliette Morgan
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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31
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Fujitani S, Ricardo-Dukelow M, Kamiya T, Sullivan L, Low L. Ethnicity and Other Possible Risk Factors for Candidemia at 3 Tertiary Care University Hospitals in Hawaii. Infect Control Hosp Epidemiol 2016; 27:1261-3. [PMID: 17080389 DOI: 10.1086/508831] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2005] [Accepted: 11/28/2005] [Indexed: 11/03/2022]
Abstract
A total of 108 cases of candidemia detected in 3 tertiary care university hospitals in Hawaii between January 2001 and December 2002 were retrospectively reviewed. Candida albicans, Candida glabrata, and Candida tropicalis accounted for 28% of the cases. Mortality among Filipino patients was significantly higher than that among other ethnic groups (71% vs 48%; P<.05).
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Affiliation(s)
- Shigeki Fujitani
- Department of Medicine, University of Hawaii, Honolulu, HI, USA.
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32
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Geng L, Xu M, Yu L, Li J, Zhou Y, Wang Y, Chen J. Risk factors and the clinical and surgical features of fungal prosthetic joint infections: A retrospective analysis of eight cases. Exp Ther Med 2016; 12:991-999. [PMID: 27446310 PMCID: PMC4950886 DOI: 10.3892/etm.2016.3353] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 03/01/2016] [Indexed: 12/16/2022] Open
Abstract
Fungal prosthetic joint infections (PJI) and reports of their clinical investigation are rare. In addition, there has been little evidence regarding the outcome of the two-stage exchange protocol for the treatment of fungal PJI. In order to investigate the risk factors and clinical, microbiological and pathological features of fungal PJIs, as well as the effects of the two-stage exchange protocol on their outcome, the present study analyzed eight retrospective fungal PJI cases, involving four cases affecting the hips and four affecting the knees, between May 2000 and March 2012. In all cases, a cemented spacer saturated with antimicrobials was used during the two-stage exchange protocol, and systematic antifungal agents were administrated during the interim period. The average follow-up duration was 4.4 years. Of the eight cases, six had undergone additional surgery on the infected joint prior to infection with the fungus. Following histological analyses, it was determined that the average number of polymorphonuclear cells in the three patients infected with a fungus was only <5/high power field (HPF; magnification, ×400), and that of the five patients with a hybrid infection was >5/HPF. The average Harris Hip scores or Hospital for Special Surgery knee scores were 43.6 preoperatively and 86 at the last follow-up. The two-stage exchange protocol was performed eight times in seven cases, with a failure rate of 12.5%. The remaining case was successfully treated by resection arthroplasty. The average duration of antifungal agent administration during the interim period in five of the eight cases was 1.5 months. For three of the patients, the duration of antifungal agent administration was prolonged until the c-reactive protein levels were decreased to normal. The average duration of spacer implantation into the joint was 4.3 months. The results of the present study suggested that undergoing surgery on a prosthetic joint may be a potential risk factor for the development of fungal PJI. In addition, infiltration of polymorphonuclear leukocytes into the site of the infection may not occur at the same rate as bacterial PJI. Therefore, a two-stage exchange protocol with implantation of a cement spacer saturated with antimicrobials may be considered an effective therapeutic strategy for the treatment of fungal PJI.
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Affiliation(s)
- Lei Geng
- Department of Orthopaedics, The General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Meng Xu
- Department of Orthopaedics, The General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Ligang Yu
- Department of Orthopaedics, The General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Jie Li
- Department of Pathology, The General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Yonggang Zhou
- Department of Orthopaedics, The General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Yan Wang
- Department of Orthopaedics, The General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Jiying Chen
- Department of Orthopaedics, The General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
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Magill SS, Dumyati G, Ray SM, Fridkin SK. Evaluating Epidemiology and Improving Surveillance of Infections Associated with Health Care, United States. Emerg Infect Dis 2016; 21:1537-42. [PMID: 26291035 PMCID: PMC4550137 DOI: 10.3201/eid2109.150508] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
This national resource provides much-needed data on pathogens, infections, and antimicrobial drug use. The Healthcare-Associated Infections Community Interface (HAIC), launched in 2009, is the newest major activity of the Emerging Infections Program. The HAIC activity addresses population- and laboratory-based surveillance for Clostridium difficile infections, candidemia, and multidrug-resistant gram-negative bacilli. Other activities include special projects: the multistate Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey and projects that evaluate new approaches for improving surveillance. The HAIC activity has provided information about the epidemiology and adverse health outcomes of health care–associated infections and antimicrobial drug use in the United States and informs efforts to improve patient safety through prevention of these infections.
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Venturini J, Fraga-Silva TFC, Marchetti CM, Mimura LAN, Conti BJ, Golim MDA, Mendes RP, de Arruda MSP. Imbalanced Macrophage and Dendritic Cell Activations in Response to Candida albicans in a Murine Model of Diabetes Mellitus. Immunol Invest 2016; 45:420-38. [DOI: 10.3109/08820139.2016.1162798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- James Venturini
- Faculdade de Ciências, UNESP – Universidade Estadual Paulista, Bauru, SP, Brazil
| | - Thais Fernanda Campos Fraga-Silva
- Faculdade de Ciências, UNESP – Universidade Estadual Paulista, Bauru, SP, Brazil
- Instituto de Biocências de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | | | - Luiza Ayumi Nishiyama Mimura
- Faculdade de Ciências, UNESP – Universidade Estadual Paulista, Bauru, SP, Brazil
- Instituto de Biocências de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Bruno José Conti
- Instituto de Biocências de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Márjorie de Assis Golim
- Faculdade de Medicina de Botucatu, UNESP – Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Rinaldo Poncio Mendes
- Faculdade de Medicina de Botucatu, UNESP – Universidade Estadual Paulista, Botucatu, SP, Brazil
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Oud L. Temporal Trends of the Clinical, Resource Use and Outcome Attributes of ICU-Managed Candidemia Hospitalizations: A Population-Level Analysis. J Clin Med Res 2016; 8:303-11. [PMID: 26985250 PMCID: PMC4780493 DOI: 10.14740/jocmr2484w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND There are mixed findings on the longitudinal patterns of the incidence of intensive care unit (ICU)-managed candidemia, with scarcity of reports on the corresponding evolving patterns of patients' clinical characteristics and outcomes. No population-level data were reported on the temporal trends of the attributes, care and outcomes of ICU-managed adults with candidemia. METHODS The Texas Inpatient Public Use Data File was used to identify hospitalizations aged 18 years or older with a diagnosis of candidemia and ICU admission (C-ICU hospitalizations) between 2001 and 2010. Temporal trends of the demographics, clinical features, use of healthcare resources, and short-term outcomes were examined. Average annual percent changes (AAPCs) were derived. RESULTS C-ICU hospitalizations (n = 7,552) became (AAPC) increasingly younger (age ≥ 65 years: -1.0%/year). The Charslon comorbidity index rose 4.2%/year, while the mean number of organ failures (OFs) increased by 8.2%/year, with a fast rise in the rate of those developing ≥ 3 OFs (+15.5%/year). Between 2001 and 2010, there was no significant change in utilization of mechanical ventilation and new hemodialysis among C-ICU hospitalizations with reported respiratory and renal failures (68.9% vs. 73.3%, P = 0.3653 and 15.5% vs. 21.8%, P = 0.8589, respectively). Hospital length of stay or total hospital charges remained unchanged during study period. Hospital mortality decreased between 2001 and 2010 from 39.3% to 23.8% (-5.2%/year). The majority of hospital survivors (61.6%) were discharged to another facility, and increasingly to long-term acute care hospitals, with routine home discharge decreasing to 11% by 2010. CONCLUSIONS C-ICU hospitalizations demonstrated increasing comorbidity burden and rising development of OF, and matching rise in use of selected life-support interventions, though with unchanged in-hospital fiscal impact. There has been marked decrease in hospital mortality, but survivors had substantial residual morbidity with the majority discharged increasingly to another post-acute care facility.
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Affiliation(s)
- Lavi Oud
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center at the Permian Basin, 701 W. 5th St., Odessa, TX 79763, USA.
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36
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Sanguinetti M, Posteraro B, Lass-Flörl C. Antifungal drug resistance among Candida species: mechanisms and clinical impact. Mycoses 2016; 58 Suppl 2:2-13. [PMID: 26033251 DOI: 10.1111/myc.12330] [Citation(s) in RCA: 254] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 03/23/2015] [Indexed: 11/29/2022]
Abstract
The epidemiology of Candida infections has changed in recent years. Although Candida albicans is still the main cause of invasive candidiasis in most clinical settings, a substantial proportion of patients is now infected with non-albicans Candida species. The various Candida species vary in their susceptibility to the most commonly used antifungal agents, and the intrinsic resistance to antifungal therapy seen in some species, along with the development of acquired resistance during treatment in others, is becoming a major problem in the management of Candida infection. A better understanding of the mechanisms and clinical impact of antifungal drug resistance is essential for the efficient treatment of patients with Candida infection and for improving treatment outcomes. Herein, we report resistance to the azoles and echinocandins among Candida species.
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Affiliation(s)
| | - Brunella Posteraro
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria
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37
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Zhao L, Jiang J, Zhu Z, Liao Z, Yao X, Yang Y, Cao Y, Jiang Y. Lysine enhances the effect of amphotericin B against Candida albicans in vitro. Acta Biochim Biophys Sin (Shanghai) 2016; 48:182-93. [PMID: 26711896 DOI: 10.1093/abbs/gmv125] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 10/18/2015] [Indexed: 01/11/2023] Open
Abstract
Amphotericin B (AmB) is a polyene antibiotic produced by Streptomyces nodosus and has been used for >50 years in the treatment of acute systemic fungal infections. In the present study, we demonstrated that lysine, an essential amino acid, could enhance the effect of AmB against Candida albicans in vitro, although lysine itself did not exert a fungicidal effect. In addition, the combination of AmB with lysine could provide an enhanced action against Candida parapsilosis and Cryptococcus neoformans compared with AmB alone. Lysine could also enhance the antifungal effect of caspofungin or nystatin. An enhanced effect of the combination of lysine with AmB was observed for the prevention of biofilm and hypha formation. Furthermore, our results demonstrated that lysine-mediated oxidative damage, such as the generation of endogenous reactive oxygen species, may be the mechanism underlying the enhancing effect of lysine on AmB. Our results also showed that CaMCA1 gene plays an important role in increasing the sensitivity of C. albicans cells upon AmB treatment. Using AmB together with lysine may be a promising strategy for the therapy of disseminated candidiasis.
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Affiliation(s)
- Liuya Zhao
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China Pharmacy Department, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jingchen Jiang
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China
| | - Zhenyu Zhu
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China
| | - Zebin Liao
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China
| | - Xiangwen Yao
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China
| | - Yu Yang
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China
| | - Yingying Cao
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China
| | - Yuanying Jiang
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China
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Teoh F, Pavelka N. How Chemotherapy Increases the Risk of Systemic Candidiasis in Cancer Patients: Current Paradigm and Future Directions. Pathogens 2016; 5:pathogens5010006. [PMID: 26784236 PMCID: PMC4810127 DOI: 10.3390/pathogens5010006] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 01/08/2016] [Accepted: 01/11/2016] [Indexed: 02/07/2023] Open
Abstract
Candida albicans is a fungal commensal and a major colonizer of the human skin, as well as of the gastrointestinal and genitourinary tracts. It is also one of the leading causes of opportunistic microbial infections in cancer patients, often presenting in a life-threatening, systemic form. Increased susceptibility to such infections in cancer patients is attributed primarily to chemotherapy-induced depression of innate immune cells and weakened epithelial barriers, which are the body’s first-line defenses against fungal infections. Moreover, classical chemotherapeutic agents also have a detrimental effect on components of the adaptive immune system, which further play important roles in the antifungal response. In this review, we discuss the current paradigm regarding the mechanisms behind the increased risk of systemic candidiasis in cancer patients. We also highlight some recent findings, which suggest that chemotherapy may have more extensive effects beyond the human host, in particular towards C. albicans itself and the bacterial microbiota. The extent to which these additional effects contribute towards the development of candidiasis in chemotherapy-treated patients remains to be investigated.
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Affiliation(s)
- Flora Teoh
- Singapore Immunology Network, Agency for Science, Technology and Research (A*STAR), 8A Biomedical Grove, Immunos Building, Singapore 138648, Singapore.
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore.
| | - Norman Pavelka
- Singapore Immunology Network, Agency for Science, Technology and Research (A*STAR), 8A Biomedical Grove, Immunos Building, Singapore 138648, Singapore.
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore.
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Ng KP, Kuan CS, Kaur H, Na SL, Atiya N, Velayuthan RD. Candida species epidemiology 2000-2013: a laboratory-based report. Trop Med Int Health 2015. [PMID: 26216479 DOI: 10.1111/tmi.12577] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe a prospective laboratory-based surveillance of Candida species that were collected from different anatomical sites of patients admitted to the University of Malaya Medical Centre, Malaysia, from the year 2000 to 2013. METHODS Conventional (culture, microscopic examination and carbohydrate assimilation test) and molecular (PCR amplification and DNA sequencing) techniques were used to identify Candida species. RESULTS A total of 16 Candida species isolated from 34 392 clinical samples were from the oral cavity (oral swabs and throat swabs), blood, respiratory tract (sputum, tracheal secretions, nasopharyngeal aspirates, bronchoalveolar lavage), high vaginal swab, pus and urine. C. albicans (66.70%, 22 941/34 392), C. glabrata (11.71%, 4029/34 392), C. parapsilopsis (10.74%, 3692/34 392), C. tropicalis (9.19%, 3162/34 392) and C. krusei (1.15%, 396/34 392) were the five predominant Candida species. C. albicans was the predominant species isolated from the oral cavity, respiratory tract and high vaginal swab; while the Candida species isolated from blood, urine and pus were predominant non-albicans Candida. Uncommon Candida species, such as C. lusitaniae, C. haemulonii, C. humicola, Pichia ohmeri and C. ciferrii, were also isolated in this study. CONCLUSION Our study expands the current knowledge of the epidemiology of non-invasive and invasive candidiasis in Malaysia. The variability of the Candida species distribution from different anatomical sites highlights the significance of local epidemiology in disease management and selection of antifungal agents.
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Affiliation(s)
- Kee Peng Ng
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chee Sian Kuan
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Harvinder Kaur
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shiang Ling Na
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nadia Atiya
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rukumani Devi Velayuthan
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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40
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Zavrel M, White TC. Medically important fungi respond to azole drugs: an update. Future Microbiol 2015; 10:1355-73. [DOI: 10.2217/fmb.15.47] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The increased numbers of patients with compromised immune systems in the last three decades have increased the chances of life-threatening fungal infections. Numerous antifungal drugs have been developed in the last 20 years to treat these infections. The largest group, the azoles, inhibits the synthesis of fungal sterols. The use of these fungistatic azoles has subsequently led to the emergence of acquired azole resistance. The most common mechanisms that result in azole resistance include the overexpression or mutation of the azole target enzyme, and overexpression of drug transporters that are responsible for azole efflux from cells. Additional, less-frequent mechanisms have also been identified. Understanding azole resistance mechanisms is crucial for current antifungal treatment and for the future development of new treatment strategies.
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Affiliation(s)
- Martin Zavrel
- University of Missouri-Kansas City, School of Biological Sciences, Division of Cell Biology & Biophysics, 5007 Rockhill Road, BSB 404, Kansas City, MO 64110, USA
| | - Theodore C White
- University of Missouri-Kansas City, School of Biological Sciences, Division of Cell Biology & Biophysics, 5007 Rockhill Road, BSB 404, Kansas City, MO 64110, USA
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41
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Markowski J, Helbig G, Widziszowska A, Likus W, Kyrcz-Krzemień S, Jarosz U, Dziubdziela W, Markiewicz M. Fungal colonization of the respiratory tract in allogeneic and autologous hematopoietic stem cell transplant recipients: a study of 573 transplanted patients. Med Sci Monit 2015; 21:1173-80. [PMID: 25907308 PMCID: PMC4423175 DOI: 10.12659/msm.893267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Fungal colonization and infections remain a major cause of infection morbidity and mortality following hematopoietic stem cell transplantation (HSCT) in patients with hematological malignancies. The aim of this study was to analyze the spectrum of fungal microflora of the respiratory tract (oral cavity, pharynx, epiglottis, and sputum) in patients undergoing HSCT and to evaluate the relationship between HSCT type and incidence of mycotic colonization and infections. Material/Methods Retrospective analysis of fungal isolates collected from the respiratory tract (oral cavity, pharynx, epiglottis, and sputum) of 573 patients undergoing HSCT was performed. Results The overall rate of fungal colonization in patients undergoing HSCT was 8.7%. Patients undergoing allogeneic HSCT were statistically significantly more often colonized (12.95%) compared to autologous HSCT recipients (4.7%). Colonizing cultures were mainly C. albicans and C. krusei, and sporadically C. glabrata, C. famata, Aspergillus spp. and Saccharomyces cerevisiae. C. albicans was the most frequent species found in isolates from the pharynx, sputum, and oral cavity collected from patients undergoing HSCT. Aspergillosis was more common after allogeneic than after autologous HSCT. The pharynx was the most frequently colonized site. Conclusions Allogeneic HSCT recipients are more susceptible to fungal infections compared to the autologous group. Selection of species during prophylaxis and antifungal therapy requires developing more effective prevention and treatment strategies based on new antifungal drugs and microbe-specific diagnoses.
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Affiliation(s)
- Jarosław Markowski
- ENT Department, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Helbig
- Department of Hematology and Bone Marrow Transplantation, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Widziszowska
- ENT Department, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Wirginia Likus
- Department of Human Anatomy, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Sławomira Kyrcz-Krzemień
- Department of Hematology and Bone Marrow Transplantation, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Urszula Jarosz
- Department of Microbilology, Mielęcki Memorial Hospital, Katowice, Poland
| | | | - Mirosław Markiewicz
- Department of Hematology and Bone Marrow Transplantation, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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Zilberberg M, Yu HT, Chaudhari P, Emons MF, Khandelwal N, Shorr AF. Relationship of fluconazole prophylaxis with fungal microbiology in hospitalized intra-abdominal surgery patients: a descriptive cohort study. Crit Care 2014; 18:590. [PMID: 25358521 PMCID: PMC4234884 DOI: 10.1186/s13054-014-0590-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 10/14/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Historically, Candida albicans has represented the most common cause of candidemia. However, the proportion of bloodstream infections due to non-albicans Candida species has increased. Because of the risk for candidemia in intra-abdominal surgical patients, some experts advocate the use of fluconazole prophylaxis. The impact of this practice on the distribution of Candida species isolated in breakthrough fungal infections in this population is unknown. We examined the association of fluconazole prophylaxis with the distribution of Candida species in intra-abdominal surgery patients. METHODS We retrospectively identified cases with a positive blood culture (BCx) for Candida among hospitalized adult intra-abdominal surgery patients between July 2005 and October 2012. Distribution of Candida species isolated represented our primary endpoint. Qualifying surgical cases were determined based on a review of discharge International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Patients receiving low-dose fluconazole prior to the positive BCx with a known indication for prophylaxis including neutropenia, ICU exposure or history of organ transplantation were classified as prophylaxis. Appropriateness of fungal treatment was determined by the timing and selection of antifungal agent based on fungal isolate. RESULTS Among 10,839 intra-abdominal surgery patients, 227 had candidemia. The most common Candida species isolated was C. albicans (n = 90, 39.6%) followed by C. glabrata (n = 81, 35.7%) and C. parapsilosis (n = 38, 16.7%). Non-albicans Candida accounted for 57.7% of isolates among the 194 non-prophylaxis patients and 75.8% among the 33 prophylaxis patients (P = 0.001). C. glabrata, the most common non-C. albicans species, was more prevalent than C. albicans in persons given prophylaxis, but not in those without prophylaxis. A total of 63% of those with candidemia were treated inappropriately based on the timing and selection of antifungal administration. CONCLUSIONS Selection pressure from fluconazole prophylaxis in at-risk surgical patients may be associated with a drift toward fluconazole-resistant species in subsequent candidemia. Tools are needed to guide appropriate treatment through the prompt recognition and characterization of candidemia.
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Fochtmann A, Forstner C, Hagmann M, Keck M, Muschitz G, Presterl E, Ihra G, Rath T. Predisposing factors for candidemia in patients with major burns. Burns 2014; 41:326-32. [PMID: 25239850 DOI: 10.1016/j.burns.2014.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 07/03/2014] [Accepted: 07/05/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite advances in surgery and critical care, candidemia remains a significant cause of morbidity and mortality in patients with extensive burns. METHODS A retrospective single-center cohort study was performed on 174 patients admitted to the Burn Intensive Care Unit of the General Hospital of Vienna (2007-2013). An AIC based model selection procedure for logistic regression models was utilized to identify factors associated with the presence of candidemia. RESULTS Twenty (11%) patients developed candidemia on median day 16 after ICU admission associated with an increased overall mortality (30% versus 10%). Statistical analysis identified the following factors associated with proven candidemia: younger age (years) odds ratio (OR):0.96, 95% confidence interval (95% CI):0.92-1.0, female gender (reference male) OR:5.03, 95% CI:1.25-24.9, gastrointestinal (GI) complications requiring surgery (reference no GI complication) OR:20.37, 95% CI:4.25-125.8, non-gastrointestinal thromboembolic complications (reference no thromboembolic complication) OR:17.3, 95% CI:2.57-170.4 and inhalation trauma (reference no inhalation trauma) OR:7.96, 95% CI:1.4-48.4. CONCLUSIONS Above-mentioned patient groups are at considerably high risk for candidemia and might benefit from a prophylactic antifungal therapy. Younger age as associated risk factor is likely to be the result of the fact that older patients with a great extent of burn body surface have a lower chance of survival compared to younger patients with a comparable TBSA.
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Affiliation(s)
- Alexandra Fochtmann
- Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria.
| | - Christina Forstner
- Medical University of Vienna, Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Vienna, Austria.
| | - Michael Hagmann
- Medical University of Vienna, Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Vienna, Austria.
| | - Maike Keck
- Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria.
| | - Gabriela Muschitz
- Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria.
| | - Elisabeth Presterl
- Medical University of Vienna, Clinical Institute of Infection Control and Hospital Epidemiology, Vienna, Austria.
| | - Gerald Ihra
- Medical University of Vienna, Department of Anesthesiology and General Intensive Care, Vienna, Austria.
| | - Thomas Rath
- Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria.
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Epidemiology of Invasive Candidiasis and Challenges for the Mycology Laboratory: Specificities of Candida glabrata. CURRENT CLINICAL MICROBIOLOGY REPORTS 2014. [DOI: 10.1007/s40588-014-0002-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Milazzo L, Peri AM, Mazzali C, Grande R, Cazzani C, Ricaboni D, Castelli A, Raimondi F, Magni C, Galli M, Antinori S. Candidaemia observed at a university hospital in Milan (northern Italy) and review of published studies from 2010 to 2014. Mycopathologia 2014; 178:227-41. [PMID: 25056143 DOI: 10.1007/s11046-014-9786-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 07/07/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Candida species represent the fourth leading cause of nosocomial bloodstream infections (BSI) worldwide. However, candidaemia rates and species involved vary geographically. OBJECTIVES To evaluate the epidemiological pattern, risk factors for mortality and antifungal therapy of Candida BSI over a 5-year period (2008-2012) in a university hospital in northern Italy together with a review of the recent literature concerning candidaemia. METHODS A retrospective cohort study cross-linked with microbiology database was performed. RESULTS A total of 89 Candida BSI were identified in 42 males (47 %) and 47 females (52.8 %). The median age was 69 years (interquartile range 55-78) with 61.8 % of patients being older than 65 years. Considering all hospitalized patients, the overall incidence rate of candidaemia increased significantly from 2008 to 2012 (from 0.4 to 1.68 episodes per 10,000 patient/days) (p = 0.0001) with a mean linear increase in 5 new cases per year. Candida albicans was the predominant species isolated (64 %) followed by C. glabrata (19.1 %). The latter species was observed with significantly higher frequency in Internal Medicine and Intensive Care Units (ICU). In-hospital crude mortality was 41.6 %. CONCLUSIONS Candidaemia is an increasing BSI in our university hospital, in accordance with that observed in northern Italy, and it is still associated with high in-hospital crude mortality.
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Affiliation(s)
- Laura Milazzo
- III Division of Infectious Diseases, Department of Biomedical and Clinical Sciences L. Sacco, Luigi Sacco Hospital, University of Milan, Via G.B. Grassi 74, 20157, Milan, Italy,
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Morii D, Seki M, Binongo JN, Ban R, Kobayashi A, Sata M, Hashimoto S, Shimizu J, Morita S, Tomono K. Distribution of Candida species isolated from blood cultures in hospitals in Osaka, Japan. J Infect Chemother 2014; 20:558-62. [PMID: 25009091 DOI: 10.1016/j.jiac.2014.05.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/27/2014] [Accepted: 05/15/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Candida species are clinically important causes of bloodstream infections because their mortality is very high. Given that some species of Candida are azole-resistant, identifying the distributions of Candida species could facilitate the formulation of an appropriate empirical antifungal therapy. It has been shown that the distribution varies depending on the continent, country, city, and hospital. In this paper, we describe the distributions of species in hospitals in northern Osaka, Japan. METHOD We evaluated blood culture results obtained from six tertiary hospitals in the northern Osaka area between 2004 and 2011. We also obtained comorbidity information from the patients' hospital medical records. Kaplan-Meier curves were drawn to compare the risk of death related to the different species. RESULTS Of the 165 cases of candidemia confirmed by blood culture, 66% were male and the mean age was 62 years (range = 0-96). Overall, Candida albicans comprised 70 cases (43%), followed by Candida parapsilosis with 36 cases (22%), Candida glabrata with 25 cases (15%), Candida tropicalis with 11 cases (7%), Candida krusei with 10 cases (6%), and other Candida species with 13 cases (8%). C. tropicalis had higher associated mortality than other species, although it was not statistically significant. CONCLUSIONS C. albicans was the most frequently isolated species, but the proportion of non-albicans Candida species was not negligible. The relatively high frequency of non-albicans Candida species distinguished the Japanese distribution from other areas. This characteristic distribution may have important implications when formulating an empirical antifungal therapy for Japanese clinical practice.
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Affiliation(s)
- Daiichi Morii
- Division of Infection Control and Prevention, Osaka University, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Masafumi Seki
- Division of Infection Control and Prevention, Osaka University, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - José N Binongo
- Division of Infection Control and Prevention, Osaka University, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Ryoichi Ban
- Division of Infection Control and Prevention, Osaka University, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Atsuko Kobayashi
- Division of Infection Control and Prevention, Osaka University, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Makoto Sata
- Division of Infection Control and Prevention, Osaka University, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Shigeki Hashimoto
- Division of Infection Control and Prevention, Osaka University, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Junzo Shimizu
- Division of Infection Control and Prevention, Osaka University, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Shunji Morita
- Division of Infection Control and Prevention, Osaka University, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
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Luca V, Olivi M, Di Grazia A, Palleschi C, Uccelletti D, Mangoni ML. Anti-Candida activity of 1-18 fragment of the frog skin peptide esculentin-1b: in vitro and in vivo studies in a Caenorhabditis elegans infection model. Cell Mol Life Sci 2014; 71:2535-46. [PMID: 24221134 PMCID: PMC11113354 DOI: 10.1007/s00018-013-1500-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/10/2013] [Accepted: 10/14/2013] [Indexed: 11/26/2022]
Abstract
Candida albicans represents one of the most prevalent species causing life-threatening fungal infections. Current treatments to defeat Candida albicans have become quite difficult, due to their toxic side effects and the emergence of resistant strains. Antimicrobial peptides (AMPs) are fascinating molecules with a potential role as novel anti-infective agents. However, only a few studies have been performed on their efficacy towards the most virulent hyphal phenotype of this pathogen. The purpose of this work is to evaluate the anti-Candida activity of the N-terminal 1-18 fragment of the frog skin AMP esculentin-1b, Esc(1-18), under both in vitro and in vivo conditions using Caenorhabditis elegans as a simple host model for microbial infections. Our results demonstrate that Esc(1-18) caused a rapid reduction in the number of viable yeast cells and killing of the hyphal population. Esc(1-18) revealed a membrane perturbing effect which is likely the basis of its mode of action. To the best of our knowledge, this is the first report showing the ability of a frog skin AMP-derived peptide (1) to kill both growing stages of Candida; (2) to promote survival of Candida-infected living organisms and (3) to inhibit transition of these fungal cells from the roundish yeast shape to the more dangerous hyphal form at sub-inhibitory concentrations.
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Affiliation(s)
- Vincenzo Luca
- Dipartimento di Scienze Biochimiche “A. Rossi Fanelli”, Istituto Pasteur-Fondazione Cenci Bolognetti, Sapienza Università di Roma, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Massimiliano Olivi
- Dipartimento di Biologia e Biotecnologie “Charles Darwin”, Sapienza Università di Roma, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Antonio Di Grazia
- Dipartimento di Scienze Biochimiche “A. Rossi Fanelli”, Istituto Pasteur-Fondazione Cenci Bolognetti, Sapienza Università di Roma, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Claudio Palleschi
- Dipartimento di Biologia e Biotecnologie “Charles Darwin”, Sapienza Università di Roma, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Daniela Uccelletti
- Dipartimento di Biologia e Biotecnologie “Charles Darwin”, Sapienza Università di Roma, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Maria Luisa Mangoni
- Dipartimento di Scienze Biochimiche “A. Rossi Fanelli”, Istituto Pasteur-Fondazione Cenci Bolognetti, Sapienza Università di Roma, Piazzale Aldo Moro, 5, 00185 Rome, Italy
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Identification of CandidaSpecies Using MP65 Gene and Evaluation of the Candida albicansMP65 Gene Expression in BALB/C Mice. Jundishapur J Microbiol 2014. [DOI: 10.5812/jjm.18984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Autmizguine J, Guptill JT, Cohen-Wolkowiez M, Benjamin DK, Capparelli EV. Pharmacokinetics and pharmacodynamics of antifungals in children: clinical implications. Drugs 2014; 74:891-909. [PMID: 24872147 PMCID: PMC4073603 DOI: 10.1007/s40265-014-0227-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Invasive fungal disease (IFD) remains life threatening in premature infants and immunocompromised children despite the recent development of new antifungal agents. Optimal dosing of antifungals is one of the few factors clinicians can control to improve outcomes of IFD. However, dosing in children cannot be extrapolated from adult data because IFD pathophysiology, immune response, and drug disposition differ from adults. We critically examined the literature on pharmacokinetics (PK) and pharmacodynamics (PD) of antifungal agents and highlight recent developments in treating pediatric IFD. To match adult exposure in pediatric patients, dosing adjustment is necessary for almost all antifungals. In young infants, the maturation of renal and metabolic functions occurs rapidly and can significantly influence drug exposure. Fluconazole clearance doubles from birth to 28 days of life and, beyond the neonatal period, agents such as fluconazole, voriconazole, and micafungin require higher dosing than in adults because of faster clearance in children. As a result, dosing recommendations are specific to bracketed ranges of age. PD principles of antifungals mostly rely on in vitro and in vivo models but very few PD studies specifically address IFD in children. The exposure-response relationship may differ in younger children compared with adults, especially in infants with invasive candidiasis who are at higher risk of disseminated disease and meningoencephalitis, and by extension severe neurodevelopmental impairment. Micafungin is the only antifungal agent for which a specific target of exposure was proposed based on a neonatal hematogenous Candida meningoencephalitis animal model. In this review, we found that pediatric data on drug disposition of newer triazoles and echinocandins are lacking, dosing of older antifungals such as fluconazole and amphotericin B products still need optimization in young infants, and that target PK/PD indices need to be clinically validated for almost all antifungals in children. A better understanding of age-specific PK and PD of new antifungals in infants and children will help improve clinical outcomes of IFD by informing dosing and identifying future research areas.
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Affiliation(s)
- Julie Autmizguine
- Duke Clinical Research Institute, 2400 Pratt St, Durham, NC 27705, USA
| | | | | | | | - Edmund V. Capparelli
- Department of Pediatric Pharmacology, University of California, 9500 Gilman Drive, La Jolla, CA 92093-0831, USA
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Alnuaimi A, Wiesenfeld D, O'Brien-Simpson N, Reynolds E, Peng B, McCullough M. The development and validation of a rapid genetic method for species identification and genotyping of medically important fungal pathogens using high-resolution melting curve analysis. Mol Oral Microbiol 2014; 29:117-30. [DOI: 10.1111/omi.12050] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2014] [Indexed: 11/26/2022]
Affiliation(s)
- A.D. Alnuaimi
- Melbourne Dental School; Oral Health CRC; The University of Melbourne; Melbourne Vic. Australia
| | - D. Wiesenfeld
- Melbourne Dental School; Oral Health CRC; The University of Melbourne; Melbourne Vic. Australia
- Head and Neck Oncology; The Royal Melbourne Hospital; Melbourne Vic. Australia
| | - N.M. O'Brien-Simpson
- Melbourne Dental School; Oral Health CRC; The University of Melbourne; Melbourne Vic. Australia
| | - E.C. Reynolds
- Melbourne Dental School; Oral Health CRC; The University of Melbourne; Melbourne Vic. Australia
| | - B. Peng
- Melbourne Dental School; Oral Health CRC; The University of Melbourne; Melbourne Vic. Australia
| | - M.J. McCullough
- Melbourne Dental School; Oral Health CRC; The University of Melbourne; Melbourne Vic. Australia
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