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Hizlisoy H, Dishan A, Bekdik IK, Barel M, Koskeroglu K, Ozkaya Y, Aslan O, Yilmaz OT. Candida albicans in the oral cavities of pets: biofilm formation, putative virulence, antifungal resistance profiles and classification of the isolates. Int Microbiol 2024:10.1007/s10123-024-00552-4. [PMID: 38955904 DOI: 10.1007/s10123-024-00552-4] [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: 04/16/2024] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
The study aimed to investigate Candida albicans presence, antifungal resistance, biofilm formation, putative virulence genes, and molecular characterization in oral samples of dogs and cats. A total of 239 oral samples were collected from cats and dogs of various breeds and ages at Erciyes University, Faculty of Veterinary Medicine Clinics, between May 2017 and April 2018. Among 216 isolates obtained, 15 (6.95%) were identified as C. albicans, while 8 (3.7%) were non-albicans Candida species. Antifungal susceptibility testing revealed sensitivities to caspofungin, fluconazole, and flucytosine in varying proportions. Molecular analysis indicated the presence of fluconazole and caspofungin resistance genes in all C. albicans isolates. Additionally, virulence genes ALS1, HWP1, and HSP90 showed variable presence. Biofilm formation varied among isolates, with 46.7% strong, 33.3% moderate, and 20% weak producers. PCA analysis categorized isolates into two main clusters, with some dog isolates grouped separately. The findings underscore the significance of oral care and protective measures in pets due to C. albicans prevalence, biofilm formation, virulence factors, and antifungal resistance in their oral cavity, thereby aiding clinical diagnosis and treatment in veterinary medicine.
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Affiliation(s)
- Harun Hizlisoy
- Faculty of Veterinary Medicine, Department of Veterinary Public Health, Erciye University, Kayseri, Türkiye.
| | - Adalet Dishan
- Faculty of Veterinary Medicine, Department of Food Hygiene and Technology, Bozok University, Yozgat, Türkiye
| | - Ilknur Karaca Bekdik
- Faculty of Veterinary Medicine, Department of Internal Medicine, Erciyes University, Kayseri, Türkiye
| | - Mukaddes Barel
- Faculty of Veterinary Medicine, Department of Veterinary Public Health, Erciye University, Kayseri, Türkiye
| | | | - Yasin Ozkaya
- Health Sciences Institute, Erciyes University, Kayseri, Türkiye
| | - Oznur Aslan
- Faculty of Veterinary Medicine, Department of Internal Medicine, Erciyes University, Kayseri, Türkiye
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Kan S, Song N, Pang Q, Mei H, Zheng H, Li D, Cui F, Lv G, An R, Li P, Xiong Z, Fan S, Zhang M, Chen Y, Qiao Q, Liang X, Cui M, Li D, Liao Q, Li X, Liu W. In Vitro Antifungal Activity of Azoles and Other Antifungal Agents Against Pathogenic Yeasts from Vulvovaginal Candidiasis in China. Mycopathologia 2022; 188:99-109. [PMID: 36378354 DOI: 10.1007/s11046-022-00687-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Vulvovaginal candidiasis (VVC) is a public health issue worldwide. Little is known of the optimal treatment of recurrent VVC (RVVC) has not been established. OBJECTIVE Through the in vitro antifungal susceptibility profiling of VVC isolates, we hope to foster significant improvements in the control and treatment of this disease. METHODS Candida isolates from VVC patients were collected from 12 hospitals in 10 cities across China. Species were identified by phenotype analysis and DNA sequencing. Species were identified by phenotype analysis and DNA sequencing. Susceptibilities to 11 drugs were determined by Clinical and Laboratory Standards Institute broth microdilution. RESULTS 543 strains were isolated from those VVC patients enrolled in this study, of which, 15.7% were from RVVC. The most commonly identified species was C. albicans (460, 84.71%), and the most commonly non-albicans Candida spp. (NAC) was C. glabrata (47, 8.66%). NAC also included C. Krusei, Meyerozyma Guillermondii, Meyerozyma Caribbica, C. Tropicalis, C. Parapsilosis, and C. Nivariensis. Most C. albicans isolates were susceptible to caspofungin (99.8%), followed by fluconazole (92%) and voriconazole (82.6%). The proportion of C. albicans strains with wild type (WT) MICs that were susceptible to amphotericin B and caspofungin were 98%, followed by posaconazole at 95%, itraconazole at 86%, fluconazole at 74% and voriconazole at 54%. The fluconazole MICs for C. albicans were lower than those for NAC (P < 0.05), while the itraconazole MICs showing no significant difference (P > 0.05). The susceptible rate of uncomplicated VVC to fluconazole was 92%. The proportion of WT strains to fluconazole in RVVC was much lower than that in other types of VVC (67 vs. 77%, P < 0.05). However, the proportions of WT strains to itraconazole in RVVC was over 85%, which was much higher than that to fluconazole (87 vs. 67%, P < 0.05). CONCLUSIONS C. albicans was still the predominant pathogen for VVC in China, while C. glabrata was the main species in NAC. Fluconazole could still be used as an empirical treatment for uncomplicated VVC. However, fluconazole may not be the first choice for the therapy of RVVC. In such cases, itraconazole appears to be the more appropriate treatment. As for VVC caused by NAC, nonfluconazole drugs, such as itraconazole, may be a good choice.
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Affiliation(s)
- Siyue Kan
- Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Nana Song
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, 210042, China
| | - Qiuyu Pang
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Huan Mei
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, 210042, China
| | - Hailin Zheng
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, Jiangsu, People's Republic of China
| | - Dongmei Li
- Department of Microbiology/Immunology, Georgetown University, Washington, DC, 20057, USA
| | - Fan Cui
- Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32, Western 2nd Section, 1st Ring Road, Chengdu, Sichuan, China
| | - Guixia Lv
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, 210042, China
| | - Ruifang An
- The First Affiliated Teaching Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Ping Li
- Nanjing Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Zhengai Xiong
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Shangrong Fan
- Peking University Shenzhen Hospital, Shenzhen, 518035, China
| | - Mengzhen Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yanhong Chen
- The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Qiao Qiao
- The Affiliated Hospital of Inner Mongolia Medical University, Huhehaote, 010050, China
| | - Xudong Liang
- Peking University People's Hospital, Beijing, 100044, China
| | - Manhua Cui
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, 130041, China
| | - Dongyan Li
- The Second Hospital of Shanxi Medical University, Taiyuan, 030001, China
| | - Qinping Liao
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medical, Tsinghua University, Beijing, 102218, China
| | - Xiaofang Li
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, 210042, China.
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, Jiangsu, People's Republic of China.
| | - Weida Liu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, 210042, China.
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, Jiangsu, People's Republic of China.
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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3
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Dunaiski CM, Kock MM, Jung H, Peters RPH. Importance of Candida infection and fluconazole resistance in women with vaginal discharge syndrome in Namibia. Antimicrob Resist Infect Control 2022; 11:104. [PMID: 35971143 PMCID: PMC9377096 DOI: 10.1186/s13756-022-01143-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vaginal discharge syndrome (VDS) is a common condition. Clinical management targets sexually transmitted infections (STIs) and bacterial vaginosis (BV); there is limited focus on Candida infection as cause of VDS. Lack of Candida treatment coverage and, if present, antifungal resistance may result in VDS treatment failure. This study aimed to determine the prevalence of Candida infection, antifungal resistance, and coinfections in Namibian women with VDS. METHODS A cross-sectional study was performed using 253 vaginal swabs from women with VDS in Namibia. Demographic data was collected, and phenotypic and molecular detection of Candida species was performed followed by fluconazole susceptibility testing of Candida isolates. BV was diagnosed using Nugent score microscopy; molecular detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis was performed. RESULTS Candida species was detected in 110/253 women (43%). Ninety women (36%) had Candida albicans and 24 (9.5%) had non-albicans Candida species. The non-albicans species detected were 19 (17%) Candida glabrata, 4.0 (3.5%) Candida krusei, and 1.0 (0.9%) Candida parapsilosis. Candida albicans were more frequently isolated in younger (p = 0.004) and pregnant women (p = 0.04) compared to non-albicans Candida species. Almost all (98%) Candida albicans isolates were susceptible to fluconazole while all non-albicans Candida species were fluconazole resistant. STIs were diagnosed in 92 women (36%): 30 (12%) with C. trachomatis, 11 (4.3%) N. gonorrhoeae, and 70 (28%) T. vaginalis; 98 (39%) women had BV. Candida infection alone was diagnosed in 30 women (12%), combined with STIs in 42 women (17%) and was concurrent with BV in 38 women (15%). Candida infection was more often detected in swabs from women without C. trachomatis detected (6.4% vs. 16%; OR 0.30; 95% CI 0.10-0.77, p = 0.006). CONCLUSIONS The high prevalence of Candida infection, especially those due to non-albicans Candida species that are resistant to fluconazole, is a great concern in our setting and may lead to poor treatment outcomes. Access to microbiological testing for Candida species in the context of syndromic management is warranted.
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Affiliation(s)
- Cara M Dunaiski
- Department of Health and Applied Sciences, Namibia University of Sciences and Technology, Windhoek, Namibia
- Department of Medical Microbiology, University of Pretoria, Prinshof Campus, Pathology Building, Room 3-11, Pretoria, South Africa
| | - Marleen M Kock
- Department of Medical Microbiology, University of Pretoria, Prinshof Campus, Pathology Building, Room 3-11, Pretoria, South Africa
- Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa
| | - Hyunsul Jung
- Department of Medical Microbiology, University of Pretoria, Prinshof Campus, Pathology Building, Room 3-11, Pretoria, South Africa
| | - Remco P H Peters
- Department of Medical Microbiology, University of Pretoria, Prinshof Campus, Pathology Building, Room 3-11, Pretoria, South Africa.
- Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa.
- Research Unit, Foundation for Professional Development, East London, South Africa.
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Song N, Kan S, Pang Q, Mei H, Zheng H, Li D, Cui F, Lv G, An R, Li P, Xiong Z, Fan S, Zhang M, Chen Y, Qiao Q, Liang X, Cui M, Li D, Liao Q, Li X, Liu W. A prospective study on vulvovaginal candidiasis: multicentre molecular epidemiology of pathogenic yeasts in China. J Eur Acad Dermatol Venereol 2021; 36:566-572. [PMID: 34908189 DOI: 10.1111/jdv.17874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/17/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Vulvovaginal candidiasis (VVC) is frequent in women of reproductive age, but very limited data are available on the epidemiology in cases of VVC in China. OBJECTIVES The current study has been conducted to reveal the prevalence, species distribution of yeast causing VVC and molecular genetics of Candida albicans in China. METHODS Vaginal swabs were collected from 543 VVC outpatients recruited in 12 hospitals in China between September 2017 and March 2018. They were preliminarily incubated on Sabouraud dextrose agar and then positive subjects of which were then transmitted to our institute for further identification. CHROMagar™ was used to isolate Candida species, and all isolates were finally identified by DNA sequencing. Multilocus sequence typing (MLST) was used to analyse phylogenetic relationships of the various C. albicans isolates. RESULTS Eleven different yeast species were identified in 543 isolates, among which C. albicans (84.7%) was the most frequent, followed by C. glabrata (8.7%). We obtained 117 unique diploid sequence types from 451 clinical C. albicans isolates and 92 isolates (20.4%) belonged to a New Clade. All the strains appearing in the New Clade were from northern China and they were isolated from non-recurrent VVC. CONCLUSIONS Our findings suggest that C. albicans are still the main cause of VVC in China and the majority of C. albicans isolates belongs to Clade 1 with DST 79 and DST 45 being two most common. Moreover, the New Clade revealed in our study seems to be specific to northern China.
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Affiliation(s)
- N Song
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - S Kan
- Shanghai Skin Disease Hospital, Department of Medical Mycology, Tongji University School of Medicine, Shanghai, China
| | - Q Pang
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - H Mei
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - H Zheng
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - D Li
- Department of Microbiology/Immunology, Georgetown University, Washington, DC, USA
| | - F Cui
- Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - G Lv
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - R An
- The First Affiliated Teaching Hospital of Xi'an Jiaotong University, Xi'an, China
| | - P Li
- Nanjing Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China
| | - Z Xiong
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - S Fan
- Peking University Shenzhen Hospital, Shenzhen, China
| | - M Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Y Chen
- The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Q Qiao
- The Affiliated Hospital of Inner Mongolia Medical University, Huhehaote, China
| | - X Liang
- Peking University People's Hospital, Beijing, China
| | - M Cui
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, China
| | - D Li
- The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Q Liao
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medical, Tsinghua University, Beijing, China
| | - X Li
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - W Liu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.,Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Sasani E, Rafat Z, Ashrafi K, Salimi Y, Zandi M, Soltani S, Hashemi F, Hashemi SJ. Vulvovaginal candidiasis in Iran: A systematic review and meta-analysis on the epidemiology, clinical manifestations, demographic characteristics, risk factors, etiologic agents and laboratory diagnosis. Microb Pathog 2021; 154:104802. [PMID: 33741400 DOI: 10.1016/j.micpath.2021.104802] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 02/08/2021] [Indexed: 11/24/2022]
Abstract
Vulvovaginal candidiasis is a global issue of concern due to its association with economic costs, sexually transmitted infections, and ascending genital tract diseases. This infection affects 75% of women on at least one occasion over a lifetime. The present systematic review and meta-analysis is the first to determine the prevalence of vulvovaginal candidiasis in Iranian women. We searched national (SID, IranDoc, Iranmedex, and Magiran) and international (PubMed, Scopus, Google Scholar, and web of science) databases for studies published between May 2000 until May 2020 reporting the epidemiologic features of vulvovaginal candidiasis in Iranian women. Inclusion and exclusion criteria were defined to select eligible studies. Data were extracted and presented according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The results of the meta-analysis were visualized as a forest plot representing the prevalence estimates of each study. Heterogeneity was also analyzed using the I2, and Chi2 statistics. The literature search revealed 1929 studies, of which 39 studies met the eligibility criteria, consisting of 10536 women with vulvovaginal symptoms from 24 different cities covering all parts of Iran. The city with the highest number of studies was Tehran (5/39). The overall prevalence of vulvovaginal candidiasis among Iranian women was 47% (95% CI, 0/38-0/55%) and Candida albicans was the most prevalent etiologic agent. The use of oral contraceptive pills (OCPs) was the predominant risk factor for developing vulvovaginal candidiasis and vaginal cheese-like discharges were the predominant clinical manifestation in Iranian women suffering from vulvovaginal candidiasis. The 25-34-year-old age group has the highest prevalence. A high level of I2 (I2 = 98.7%, P = 0.000) and Chi2 (Chi2 = 2993.57, P < 0.001) was obtained among studies, which provides evidence of notable heterogeneity between studies. The present meta-analysis revealed a high prevalence of vulvovaginal candidiasis in Iranian women. Given that this infection is associated with the enhanced susceptibility to sexually transmitted diseases (HIV, chlamydia, genital herpes, genital warts, gonorrhea, hepatitis, syphilis, and trichomoniasis) and also is related to the increased probability of preterm birth, congenital cutaneous candidiasis, preterm labor, and infertility, taking preventive measures such as awareness of patients as well as monitoring and controlling of the syndrome are essential.
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Affiliation(s)
- Elahe Sasani
- Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zahra Rafat
- Department. of Medical Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Keyhan Ashrafi
- Department. of Medical Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Yahya Salimi
- Social Developing & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Milad Zandi
- Department of Medical Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saber Soltani
- Department of Medical Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshid Hashemi
- School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Jamal Hashemi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Gómez LA, De Avila J, Castillo DM, Montenegro DA, Trujillo TG, Suárez LJ, Lafaurie GI. Porphyromonas gingivalis Placental Atopobiosis and Inflammatory Responses in Women With Adverse Pregnancy Outcomes. Front Microbiol 2020; 11:591626. [PMID: 33343532 PMCID: PMC7738622 DOI: 10.3389/fmicb.2020.591626] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/16/2020] [Indexed: 12/29/2022] Open
Abstract
The microbiome modulates inflammation at the fetal maternal interface on both term and preterm labor. Inflammophilic oral bacteria, such as Porphyromonas gingivalis, as well as urogenital microorganisms (UGM) could translocate to the placenta and activate immune mechanisms in decidual tissue that is associated with adverse pregnancy outcomes (APO). This study establishes the associations between the presence of microbes in the placenta and placental cytokine patterns in women who presented APO, e.g., low birth weight (LBW), preterm premature rupture of membranes (PPROM), preterm birth (PTB) and other clinical signs related to Chorioamnionitis (CA). A total of 40 pregnant women were included in the study and divided into five groups according to placental infection (PI) and APO, as follows: (1) women without PI and without APO (n = 17), (2) women with P. gingivalis-related PI and APO (n = 5), (3) women with P. gingivalis-related PI and without APO (n = 4), (4) women with PI related to UGM and APO (n = 5) and (5) women without PI with APO (n = 9). Obstetric, clinical periodontal status evaluation, and subgingival plaque sampling were performed at the time of delivery. Placental levels of interleukin IL-1β, IL-6, IL-10, IL-15, IL-17A, IL-17F, IL-21, IL-12p70, tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 α (MCP-1α), granzyme B, and interferon-γ (IFN-γ) were determined using a multiplex flow cytometry assay. All patients showed a predominant Th-1 cytokine profile related to labor, characterized by IFN-γ overexpression. The analysis by groups suggests that Th-1 profile was trending to maintain cytotoxic cell activity by the expression of IL-15 and granzyme B, except for the group with P. gingivalis-related PI and APO, which exhibited a reduction of IL-10 and IL-17F cytokines (p < 0.05) and a Th-1 profile favoring macrophage activation by MCP-1 production (p < 0.05). This study confirms a pro-inflammatory pattern associated with labor, characterized by a Th-1 profile and the activity of cytotoxic cells, which is enhanced by PI with UGM. However, PI associated with P. gingivalis suggests a switch where the Th-1 profile favors an inflammatory response mediated by MCP-1 and macrophage activity as a mechanistic explanation of its possible relationship with adverse outcomes in pregnancy.
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Affiliation(s)
- Luz Amparo Gómez
- Unit of Basic Oral Investigations-UIBO, School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Juliette De Avila
- Cellular and Molecular Immunology Group, School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Diana Marcela Castillo
- Unit of Basic Oral Investigations-UIBO, School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | | | - Tammy Gorety Trujillo
- Unit of Basic Oral Investigations-UIBO, School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Lina J Suárez
- Basic Science and Oral Medicine Department, School of Dentistry, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Gloria Inés Lafaurie
- Unit of Basic Oral Investigations-UIBO, School of Dentistry, Universidad El Bosque, Bogotá, Colombia
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Huntington S, Weston G, Seedat F, Marshall J, Bailey H, Tebruegge M, Ahmed I, Turner K, Adams E. Repeat screening for syphilis in pregnancy as an alternative screening strategy in the UK: a cost-effectiveness analysis. BMJ Open 2020; 10:e038505. [PMID: 33444184 PMCID: PMC7678359 DOI: 10.1136/bmjopen-2020-038505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the cost-effectiveness of universal repeat screening for syphilis in late pregnancy, compared with the current strategy of single screening in early pregnancy with repeat screening offered only to high-risk women. DESIGN A decision tree model was developed to assess the incremental costs and health benefits of the two screening strategies. The base case analysis considered short-term costs during the pregnancy and the initial weeks after delivery. Deterministic and probabilistic sensitivity analyses and scenario analyses were conducted to assess the robustness of the results. SETTING UK antenatal screening programme. POPULATION Hypothetical cohort of pregnant women who access antenatal care and receive a syphilis screen in 1 year. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the cost to avoid one case of congenital syphilis (CS). Secondary outcomes were the cost to avoid one case of intrauterine fetal demise (IUFD) or neonatal death and the number of women needing to be screened/treated to avoid one case of CS, IUFD or neonatal death. The cost per quality-adjusted life year gained was assessed in scenario analyses. RESULTS Base case results indicated that for pregnant women in the UK (n=725 891), the repeat screening strategy would result in 5.5 fewer cases of CS (from 8.8 to 3.3), 0.1 fewer cases of neonatal death and 0.3 fewer cases of IUFD annually compared with the single screening strategy. This equates to an additional £1.8 million per case of CS prevented. When lifetime horizon was considered, the incremental cost-effectiveness ratio for the repeat screening strategy was £120 494. CONCLUSIONS Universal repeat screening for syphilis in pregnancy is unlikely to be cost-effective in the current UK setting where syphilis prevalence is low. Repeat screening may be cost-effective in countries with a higher syphilis incidence in pregnancy, particularly if the cost per screen is low.
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Affiliation(s)
| | | | - Farah Seedat
- UK National Screening Committee, Public Health England, London, UK
| | - John Marshall
- UK National Screening Committee, Public Health England, London, UK
| | - Heather Bailey
- UCL Institute for Global Health, University College London, London, UK
| | - Marc Tebruegge
- Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, London, UK
- Department of Paediatrics, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
| | | | - Katy Turner
- School of Veterinary Science, University of Bristol, Bristol, UK
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Varnasiri M, Salmanzadeh S, Mahmoudabadi AZ, Halvaeezadeh M, Taghipour S, Molavi S, Alavi SM, Nezhad KH, Choghakabodi PM. The occurrence of vulvovaginal Candida species and their antifungal susceptibility pattern in HIV seropositive women in Ahvaz, Southwest Iran. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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9
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Okoli ML, Alao S, Ojukwu S, Emechebe NC, Ikhuoria A, Kip KE. Predictive and spatial analysis for estimating the impact of sociodemographic factors on contraceptive use among women living with HIV/AIDS (WLWHA) in Kenya: Implications for policies and practice. BMJ Open 2019; 9:e022221. [PMID: 30617098 PMCID: PMC6326424 DOI: 10.1136/bmjopen-2018-022221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite the availability and knowledge of various contraceptive methods, consistent utilisation in women living with HIV/AIDS (WLWHA) within the reproductive age group remains below the Sustainable Development Goals (SDGs) and Family Planning 2020 goals. This study examines the association between sociodemographic factors and contraceptive use including the effect of clustering tendencies of these factors on contraceptive usage among WLWHA in Kenya. METHODS Weighted multivariate logistic regression models were conducted to determine the association of sociodemographic factors on contraception use among WLWHA using the 2008-2009 Kenya Demographic Health Survey. Spatial autocorrelation techniques were used to explore clustering tendencies of these factors on contraception utilisation. Our study population included 304 HIV positive women, aged 15-49 years. RESULTS Among 304 HIV-positive women in our study population, 92 (30.3%) reported using one method of contraception. Contraceptive use was significantly associated with wealth and education after adjustment for other sociodemographic variables. Women classified as having low and middle wealth index were less likely to use contraceptives (OR=0.17, 95% CI 0.07 to 0.43; OR=0.33, 95% CI 0.11 to 0.98, respectively) compared with women classified as having high wealth index. Similarly, women with primary education only were less likely to use contraceptives compared with women with secondary or higher education (OR=0.42, 95% CI 0.18 to 0.98). Spatial autocorrelation revealed significant positive clusters with weak clustering tendencies of non-contraceptive use among different levels of wealth index and education within different regions of Kenya. CONCLUSION These findings underscores the need for intervention programmes to further target socially disadvantaged WLWHA, which is necessary for achieving the SDGs.
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Affiliation(s)
- Menkeoma Laura Okoli
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Samuel Alao
- Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Somtochukwu Ojukwu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Nnadozie C Emechebe
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida, USA
| | | | - Kevin E Kip
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida, USA
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10
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Makanjuola O, Bongomin F, Fayemiwo SA. An Update on the Roles of Non- albicans Candida Species in Vulvovaginitis. J Fungi (Basel) 2018; 4:E121. [PMID: 30384449 PMCID: PMC6309050 DOI: 10.3390/jof4040121] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/16/2018] [Accepted: 10/16/2018] [Indexed: 02/08/2023] Open
Abstract
Candida species are one of the commonest causes of vaginitis in healthy women of reproductive age. Vulvovaginal candidiasis (VVC) is characterized by vulvovaginal itching, redness and discharge. Candida albicans, which is a common genito-urinary tract commensal, has been the prominent species and remains the most common fungal agent isolated from clinical samples of patients diagnosed with VVC. In recent times, however, there has been a notable shift in the etiology of candidiasis with non-albicans Candida (NAC) species gaining prominence. The NAC species now account for approximately 10% to as high as 45% of VVC cases in some studies. This is associated with treatment challenges and a slightly different clinical picture. NAC species vaginitis is milder in presentation, often occur in patients with underlying chronic medical conditions and symptoms tend to be more recurrent or chronic compared with C. albicans vaginitis. C. glabrata is the most common cause of NAC-VVC. C. tropicalis, C. krusei, C. parapsilosis, and C. guilliermondii are the other commonly implicated species. Treatment failure is common in NAC-VVC, since some of these species are intrinsically resistant or show low susceptibilities to commonly used antifungal agents. This article reviews the etiology, pathogenesis, clinical features, diagnosis, and management of NAC vulvovaginitis.
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Affiliation(s)
- Olufunmilola Makanjuola
- Department of Medical Microbiology and Parasitology, University of Ibadan, Ibadan 200284, Nigeria.
| | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Gulu University, Gulu P.O. Box 166, Uganda.
| | - Samuel A Fayemiwo
- Department of Medical Microbiology and Parasitology, University of Ibadan, Ibadan 200284, Nigeria.
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK.
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11
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Identification of Candida Species Isolated from Vulvovaginal Candidiasis Patients by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) in Yasuj Southwestern Iran. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.65359] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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12
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Sadeghi G, Ebrahimi-Rad M, Mousavi SF, Shams-Ghahfarokhi M, Razzaghi-Abyaneh M. Emergence of non-Candida albicans species: Epidemiology, phylogeny and fluconazole susceptibility profile. J Mycol Med 2018; 28:51-58. [PMID: 29366545 DOI: 10.1016/j.mycmed.2017.12.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 12/05/2017] [Accepted: 12/15/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Non-Candida albicans (NCA) species now account for a significant part of clinical candidiasis worldwide. In the present study, epidemiology and antifungal susceptibility profile of NCA isolated from various forms of candidiasis were studied with special focus on their phylogenetic relationship by ITS sequencing. PATIENTS AND METHODS Seventy-nine NCA isolates were isolated from skin and nail scrapings (67.0%), vaginal discharges (8.8%), blood (8.8%), sputa (5.0%), urine (5.0%), oral swabs (2.6%), biopsy and eye tumor, each (1.4%). These isolates were identified by morphological, biochemical and molecular (ITS sequencing) techniques. In vitro antifungal susceptibility of the isolates to fluconazole (FCZ) was tested according to the CLSI method (M27-S4). RESULTS Among a total number of 79 cases of proven NCA infections, C. parapsilosis (36.8%) was the most prevalent species followed by C. glabrata (32.9%), C. orthopsilosis (11.4%), C. tropicalis (8.9%), C. krusei (5.0%) and C. guilliermondii (5.0%). The susceptibility to FCZ was assessed for C. parapsilosis (96.5%), C. orthopsilosis (88.9%), C. tropicalis (85.7%) and C. guilliermondii (50.0%). C. glabrata and C. krusei isolates were not susceptible to FCZ. NCA species were distributed in various phylogenetic clades including C. glabrata (1), C. tropicalis (3), C. parapsilosis (6) and C. orthopsilosis, C. krusei and C. guilliermondii (each 2). CONCLUSION C. parapsilosis and C. glabrata were the most predominant NCA species involve in the etiology of candidiasis. C. orthopsilosis was reported from superficial candidiasis. Taken together, our results further substantiate the increasing importance of the involvement of NCA species in the etiology of candidiasis.
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Affiliation(s)
- G Sadeghi
- Department of Medical Mycology, Pasteur Institute of Iran, 1316943551 Tehran, Iran
| | - M Ebrahimi-Rad
- Department of Biochemistry, Pasteur Institute of Iran, 1316943551 Tehran, Iran
| | - S F Mousavi
- Department of Microbiology, Pasteur Institute of Iran, 1316943551 Tehran, Iran
| | - M Shams-Ghahfarokhi
- Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, 14115-331 Tehran, Iran
| | - M Razzaghi-Abyaneh
- Department of Medical Mycology, Pasteur Institute of Iran, 1316943551 Tehran, Iran.
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Momenzadeh M, Vard A, Talebi A, Mehri Dehnavi A, Rabbani H. Computer-aided diagnosis software for vulvovaginal candidiasis detection from Pap smear images. Microsc Res Tech 2017; 81:13-21. [DOI: 10.1002/jemt.22951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/14/2017] [Accepted: 09/26/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Mohammadreza Momenzadeh
- Department of Biomedical Engineering, School of Advanced Technologies in Medicine; Isfahan University of Medical Sciences; Isfahan Iran
- Student Research Committee, School of Advanced Technologies in Medicine; Isfahan University of Medical Sciences; Isfahan Iran
| | - Alireza Vard
- Department of Biomedical Engineering, School of Advanced Technologies in Medicine; Isfahan University of Medical Sciences; Isfahan Iran
- Medical Image and Signal Processing Research Center; Isfahan University of Medical Sciences; Isfahan Iran
| | - Ardeshir Talebi
- Department of Pathology, School of Medicine; Isfahan University of Medical Sciences; Isfahan Iran
| | - Alireza Mehri Dehnavi
- Department of Biomedical Engineering, School of Advanced Technologies in Medicine; Isfahan University of Medical Sciences; Isfahan Iran
- Medical Image and Signal Processing Research Center; Isfahan University of Medical Sciences; Isfahan Iran
| | - Hossein Rabbani
- Department of Biomedical Engineering, School of Advanced Technologies in Medicine; Isfahan University of Medical Sciences; Isfahan Iran
- Medical Image and Signal Processing Research Center; Isfahan University of Medical Sciences; Isfahan Iran
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14
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Blostein F, Levin-Sparenberg E, Wagner J, Foxman B. Recurrent vulvovaginal candidiasis. Ann Epidemiol 2017; 27:575-582.e3. [PMID: 28927765 DOI: 10.1016/j.annepidem.2017.08.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 01/13/2023]
Abstract
PURPOSE Recurrent vulvovaginal candidiasis (RVVC), multiple episodes of vulvovaginal candidiasis (VVC; vaginal yeast infection) within a 12-month period, adversely affects quality of life, mental health, and sexual activity. Diagnosis is not straightforward, as VVC is defined by the combination of often nonspecific vaginal symptoms and the presence of yeast-which is a common vaginal commensal. Estimating the incidence and prevalence is challenging: most VVC is diagnosed and treated empirically, the availability for purchase of effective therapies over the counter enables self-diagnosis and treatment, and the duration of the relatively benign VVC symptoms is short, introducing errors into any estimates relying on medical records or patient recall. METHODS We evaluate current estimates of VVC and RVVC and provide new prevalence estimates using data from a 2011 seven-country (n = 7345) internet panel survey on VVC conducted by Ipsos Health (https://www.ipsos.com/en). We also evaluate information on VVC-associated visits using the National Ambulatory Medical Care Survey. RESULTS The estimated probability of VVC by age 50 varied widely by country (from 23% to 49%, mean 39%), as did the estimated probability of RVVC after VVC (from 14% to 28%, mean 23%). CONCLUSIONS However estimated, the probability of RVVC was high suggesting RVVC is a common condition.
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Affiliation(s)
- Freida Blostein
- Center for Molecular and Clinical Epidemiology, University of Michigan, School of Public Health, Ann Arbor
| | - Elizabeth Levin-Sparenberg
- Center for Molecular and Clinical Epidemiology, University of Michigan, School of Public Health, Ann Arbor
| | | | - Betsy Foxman
- Center for Molecular and Clinical Epidemiology, University of Michigan, School of Public Health, Ann Arbor.
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15
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Abstract
OBJECTIVE Vaginitis may be diagnosed as bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis, or coinfection. A new molecular test assays the vaginal microbiome and organisms that cause three common infections. The objective of the trial was to evaluate the clinical accuracy of the investigational test for vaginal swabs collected by patients (self) or clinicians. The primary and secondary outcomes were to compare the investigational test with reference methods for the three most common causes of vaginitis and compare clinician-collected with self-collected swabs. METHODS We conducted a cross-sectional study in which women with symptoms of vaginitis were recruited at ten clinical centers and consented to the investigation between May and September 2015. The woman collected a vaginal swab, sheathed, and then handed it to the clinician. These swabs were to evaluate how self-collected swabs compared with clinician-collected swabs. The clinician collected an investigational test swab and reference test swabs. From 1,740 symptomatic patients, clinician-collected and self-collected vaginal swabs were evaluated by the molecular test and six tests. The reference methods for bacterial vaginosis were Nugent's score and Amsel's criteria for intermediate Nugent results. The reference methods for Candida infection were isolation of any potential Candida microorganisms from inoculation of two culture media: chromogenic and Sabouraud agar and sequencing. The reference methods for trichomoniasis were wet mount and culture. RESULTS For clinician-collected swabs, by reference methods, bacterial vaginosis was diagnosed in 56.5%, vaginal candidiasis in 32.8%, trichomoniasis in 8%, and none of the three infections in 24% with a coinfection rate of 20%. The investigational test sensitivity was 90.5% (95% confidence interval [CI] 88.3-92.2%) and specificity was 85.8% (95% CI 83.0-88.3%) for bacterial vaginosis. The investigational test sensitivity was 90.9% (95% CI 88.1-93.1%) and specificity was 94.1% (95% CI 92.6-95.4%) for the Candida group. Sensitivity for Candida glabrata was 75.9% (95% CI 57.9-87.8%) and specificity was 99.7% (95% CI 99.3-99.9%). Investigational test sensitivity was 93.1% (95% CI 87.4-96.3%) and specificity was 99.3% (95% CI 98.7-99.6%) for trichomoniasis. Results from self-collected swabs were similar to clinician-collected swabs. CONCLUSION A molecular-based test using vaginal swabs collected by clinicians or patients can accurately diagnose most common bacterial, fungal, and protozoan causes of vaginitis. Women and their clinicians seeking accurate diagnosis and appropriate selection of efficacious treatment for symptoms of vaginitis might benefit from this molecular test.
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16
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Kumar D, Banerjee T, Chakravarty J, Singh SK, Dwivedi A, Tilak R. Identification, antifungal resistance profile, in vitro biofilm formation and ultrastructural characteristics of Candida species isolated from diabetic foot patients in Northern India. Indian J Med Microbiol 2017; 34:308-14. [PMID: 27514952 DOI: 10.4103/0255-0857.188320] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Diabetic foot ulcers are a serious cause of diagnostic and therapeutic concern. The following study was undertaken to determine the fungal causes of diabetic foot ulcers, with their phenotypic and genotypic characterisation. MATERIALS AND METHODS A total of 155 diabetic foot ulcers were studied for 1 year. Deep tissue specimen was collected from the wounds, and crushed samples were plated on Sabouraud dextrose agar with chloramphenicol (0.05 g). Identification was done by growth on cornmeal agar, germ tube formation and urease test. For molecular identification, conserved portion of the 18S rDNA region, the adjacent internal transcribed spacer 1 (ITS1) and a portion of the 28S rDNA region were amplified, using the ITS1 and ITS2 primers. Antifungal susceptibility against voriconazole, fluconazole and amphotericin B was determined by standard broth microdilution method. Biofilm formation was studied in three steps. First, on the surface of wells of microtiter plates followed by quantification of growth by fungal metabolism measurement. Finally, biofilms were analysed by scanning electron microscopy (SEM). RESULTS Fungal aetiology was found in 75 patients (48.38%). All were identified as Candida species (100%). The prevalence of different species was Candida tropicalis (34.6%), Candida albicans (29.3%), Candida krusei (16.0%), Candida parapsilosis (10.6%), Candida glabrata (9.33%). All were susceptible to amphotericin B (100%). On microtiter plate, all the isolates were viable within 48 h showing biofilms. The metabolic activity of cells in the biofilm increased with cellular mass, especially in the first 24 h. On SEM, majority showed budding yeast form. CONCLUSION Non-albicans Candida spp. with potential biofilm forming ability are emerging as a predominant cause of diabetic foot ulcers.
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Affiliation(s)
- D Kumar
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - T Banerjee
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - J Chakravarty
- Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - S K Singh
- Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - A Dwivedi
- Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - R Tilak
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Whaley SG, Berkow EL, Rybak JM, Nishimoto AT, Barker KS, Rogers PD. Azole Antifungal Resistance in Candida albicans and Emerging Non- albicans Candida Species. Front Microbiol 2017; 7:2173. [PMID: 28127295 PMCID: PMC5226953 DOI: 10.3389/fmicb.2016.02173] [Citation(s) in RCA: 410] [Impact Index Per Article: 58.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/28/2016] [Indexed: 12/15/2022] Open
Abstract
Within the limited antifungal armamentarium, the azole antifungals are the most frequent class used to treat Candida infections. Azole antifungals such as fluconazole are often preferred treatment for many Candida infections as they are inexpensive, exhibit limited toxicity, and are available for oral administration. There is, however, extensive documentation of intrinsic and developed resistance to azole antifungals among several Candida species. As the frequency of azole resistant Candida isolates in the clinical setting increases, it is essential to elucidate the mechanisms of such resistance in order to both preserve and improve upon the azole class of antifungals for the treatment of Candida infections. This review examines azole resistance in infections caused by C. albicans as well as the emerging non-albicans Candida species C. parapsilosis, C. tropicalis, C. krusei, and C. glabrata and in particular, describes the current understanding of molecular basis of azole resistance in these fungal species.
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Affiliation(s)
- Sarah G Whaley
- Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center Memphis, TN, USA
| | - Elizabeth L Berkow
- Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center Memphis, TN, USA
| | - Jeffrey M Rybak
- Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center Memphis, TN, USA
| | - Andrew T Nishimoto
- Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center Memphis, TN, USA
| | - Katherine S Barker
- Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center Memphis, TN, USA
| | - P David Rogers
- Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science CenterMemphis, TN, USA; Center for Pediatric Pharmacokinetics and Therapeutics, University of Tennessee Health Science CenterMemphis, TN, USA
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Khattab RA, Abdelfattah MM. Study of the prevalence and association of ocular chlamydial conjunctivitis in women with genital infection by Chlamydia trachomatis, Mycoplasma genitalium and Candida albicans attending outpatient clinic. Int J Ophthalmol 2016; 9:1176-86. [PMID: 27588273 DOI: 10.18240/ijo.2016.08.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/31/2015] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the association between chlamydial conjunctivitis and genital infection by Chlamydia trachomatis, Mycoplasma genitalium and Candida albicans, in addition to the possible relationship between cultured bacterial pathogens and oculogenital chlamydial infection. METHODS This study was performed on 100 (50 symptomatic and 50 asymptomatic) women attending the Gynecological and Obstetric outpatient clinic of Alzahra hospital, Alazhar University. Simultaneously a conjunctival swab was taken from these patients. Polymerase chain reaction (PCR) was done on DNA extracted from both vaginal and conjunctival swab samples. Culture for both vaginal and conjunctival swabs was also done. RESULTS Candida albicans was the predominant organism isolated by culture in 20% and 40% of conjunctival and vaginal swabs respectively. By the PCR method, ocular Chlamydia trachomatis was present in 60% of symptomatic women, while genital Chlamydia trachomatis infection was present in 30% of symptomatic women. The results of this method also indicated that 25/50 (50%) vaginal swabs were positive with PCR for Candida albicans versus 15/50 (30%) were PCR positive in conjunctival swab. Mycoplasma genitalium was present in only 10% of vaginal swabs. Concomitant oculogenital PCR positive results for Chlamydia trachomatis and Candida albicans were 30% and 28% respectively. CONCLUSION Ocular Chlamydia trachomatis was associated with genital Chlamydia trachomatis in a high percentage of women followed by Candida albicans. Cultured bacterial organisms do not play a role in enhancement of Chlamydia trachomatis infection.
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Affiliation(s)
- Rania Abdelmonem Khattab
- Microbiology and Immunology Department, Faculty of Pharmacy, Cairo University, Kasr Al-Aini, Cairo 11562, Egypt
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Zahedi N, Abedian Kenari S, Mohseni S, Aslani N, Ansari S, Badali H. Is human Dectin-1 Y238X gene polymorphism related to susceptibility to recurrent vulvovaginal candidiasis? Curr Med Mycol 2016; 2:15-19. [PMID: 28681024 PMCID: PMC5490285 DOI: 10.18869/acadpub.cmm.2.3.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background and Purpose: Vulvovaginal candidiasis is a frequent disease affecting approximately more than %75 of all childbearing women at least once in their lifetime by overgrowth of opportunistic Candida species. Recurrent vulvovaginal candidiasis (RVVC) is common in otherwise healthy individuals. Several risk factors were reported to contribute to RVVC susceptibility. A polymorphism in Dectin-1 (Y238X, rs16910526 ) was identified in patients with RVVC and hypothesized that genetic factors play an important role in susceptibility to RVVC. Herein, we aimed to survey the polymorphisms in the Dectin-1 gene, linked to susceptibility to RVVC. Materials and Methods: In the current study, blood samples were obtained from 25 patients who had frequent vulvovaginal candidiasis relapses and were diagnosed as RVVC. In addition, blood cultures were obtained from control group comprising of healthy individuals (n=25) with no history of RVVC, vaginal discharge, or itching on the day of examination. Dectin-1 Y238X gene polymorphism was investigated using Bi-PASA and DNA sequencing. Results: The analysis revealed that all of the patients were wild-type homozygous for Dectin-1 Y238X polymorphisms. None of the individuals showed heterozygous or mutant homozygous Dectin-1 polymorphism. Conclusion: No significant correlations were observed between the susceptibility to RVVC and Dectin-1 Y238X polymorphism in the Iranian population, which was not previously studied.
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Affiliation(s)
- N Zahedi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - S Abedian Kenari
- Immunogenetics Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - S Mohseni
- Department of Microbiology, Sari Branch, Islamic Azad University, Sari, Iran
| | - N Aslani
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - S Ansari
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - H Badali
- Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Invasive Fungi Research Centre (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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McCarthy MW, Walsh TJ. PCR methodology and applications for the detection of human fungal pathogens. Expert Rev Mol Diagn 2016; 16:1025-36. [PMID: 27484841 DOI: 10.1080/14737159.2016.1219253] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Polymerase chain reaction (PCR) has emerged as a promising technology for the rapid and reliable detection and identification of medical mycoses. Recent technological advancements - including microarray, multiplex PCR with magnetic resonance, and beacon probes - have mitigated the technical difficulties of performing nucleic amplification in fungi, thereby improving the sensitivity and specificity of PCR-based assays. In this paper, we examine current applications of PCR in the diagnosis of human fungal infections and look ahead to emerging techniques that may play a larger role in molecular diagnostics in the future. AREAS COVERED This review includes a brief overview of the advantages and disadvantages of PCR using various clinical specimens, manual versus automated DNA extraction procedures, panfungal versus specific targets, and spectrum of pathogens detected. This is followed by a brief synopsis of species-specific PCR approaches and a more in-depth look at the obstacles to widespread implementation. Expert commentary: The review concludes with a short perspective for the next five years, including the hurdles to standardization and validation, as well as the role of PCR coupled with electrospray-ionization mass spectrometry (PCR/ESI-MS) or nuclear magnetic resonance for the diagnosis of medical mycoses.
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Affiliation(s)
- Matthew William McCarthy
- a Hospital Medicine , Joan and Sanford I Weill Medical College of Cornell University Ringgold Standard Institution , New York , NY , USA
| | - Thomas J Walsh
- b Transplantation-Oncology Infectious Diseases Program , Weill Cornell Medical Center , New York , NY , USA
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Nash EE, Peters BM, Lilly EA, Noverr MC, Fidel PL. A Murine Model of Candida glabrata Vaginitis Shows No Evidence of an Inflammatory Immunopathogenic Response. PLoS One 2016; 11:e0147969. [PMID: 26807975 PMCID: PMC4726552 DOI: 10.1371/journal.pone.0147969] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/11/2016] [Indexed: 01/11/2023] Open
Abstract
Candida glabrata is the second most common organism isolated from women with vulvovaginal candidiasis (VVC), particularly in women with uncontrolled diabetes mellitus. However, mechanisms involved in the pathogenesis of C. glabrata-associated VVC are unknown and have not been studied at any depth in animal models. The objective of this study was to evaluate host responses to infection following efforts to optimize a murine model of C. glabrata VVC. For this, various designs were evaluated for consistent experimental vaginal colonization (i.e., type 1 and type 2 diabetic mice, exogenous estrogen, varying inocula, and co-infection with C. albicans). Upon model optimization, vaginal fungal burden and polymorphonuclear neutrophil (PMN) recruitment were assessed longitudinally over 21 days post-inoculation, together with vaginal concentrations of IL-1β, S100A8 alarmin, lactate dehydrogenase (LDH), and in vivo biofilm formation. Consistent and sustained vaginal colonization with C. glabrata was achieved in estrogenized streptozotocin-induced type 1 diabetic mice. Vaginal PMN infiltration was consistently low, with IL-1β, S100A8, and LDH concentrations similar to uninoculated mice. Biofilm formation was not detected in vivo, and co-infection with C. albicans did not induce synergistic immunopathogenic effects. This data suggests that experimental vaginal colonization of C. glabrata is not associated with an inflammatory immunopathogenic response or biofilm formation.
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Affiliation(s)
- Evelyn E. Nash
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Brian M. Peters
- Department of Oral and Craniofacial Biology, Dental School, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Elizabeth A. Lilly
- Department of Oral and Craniofacial Biology, Dental School, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Mairi C. Noverr
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
- Department of Oral and Craniofacial Biology, Dental School, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
- Prosthodontics, Dental School, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Paul L. Fidel
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
- Department of Oral and Craniofacial Biology, Dental School, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
- * E-mail:
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22
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Luo X, Dong X, Pen Z. Distribution and Drug Susceptibility of Candida spp. Associated With Female Genital Tract Infection, Chongqing, China. Jundishapur J Microbiol 2015; 9:e19386. [PMID: 28138369 PMCID: PMC5240156 DOI: 10.5812/jjm.19386] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 02/09/2015] [Accepted: 03/04/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Vulvovaginal candidiasis is defined as vulvovaginitis associated with vaginal carriage of Candida spp. and is a common problem with a high rate of morbidity. OBJECTIVES To investigate the distribution of Candida spp. and evaluate the corresponding antifungal susceptibility in women with genital tract infection in Chongqing, southwestern China. PATIENTS AND METHODS Samples (n = 2.129) were obtained from female patients with symptoms of genital tract infection. Candida spp. were isolated from the specimens and were identified using a coloration medium and the VITEK 2 Compact automatic microbial identification system. Antifungal susceptibility testing was performed using the ATB FUNGUS drug susceptibility testing system. RESULTS From 2,129 samples, 478 (22.45%) isolates of Candida were isolated, of which 395 (82.64%) were Candida albicans, 39 (8.16%) were C. glabrata, 21 (4.39%) were C. tropicalis, 9 (1.88%) were C. parapsilosis, and 14 (2.93%) were other Candida spp. The resistance of C. albicans, C. glabrata, and C. tropicalis to 5 antifungal drugs (amphotericin B, voriconazole, fluconazole, 5-fluorocytosine, and itraconazole) ranged from 0.5% to 6.4%, 0% to 7.7%, and 0% to 9.6%, respectively. CONCLUSIONS Candida albicans was the major pathogen associated with candidiasis of the female genital tract in patients in Chongqing. The results of the antifungal sensitivity of the isolates suggest that it is important for clinicians to administer appropriate antifungals for the treatment of Candida spp. infections.
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Affiliation(s)
- Xiaodong Luo
- Department of Obstetrics and Gynecology, Second Affiliate Hospital, Chongqing University of Medical Sciences, Chongqing, China
- Corresponding author: Xiaodong Luo, Department of Obstetrics and Gynecology, the Second Affiliate Hospital, Chongqing University of Medical Sciences, Chongqing, China. Tel: +86-2363693484, Fax: +86-2363693484, E-mail:
| | - Xiaojing Dong
- Department of Obstetrics and Gynecology, Second Affiliate Hospital, Chongqing University of Medical Sciences, Chongqing, China
| | - Zhi Pen
- Department of Obstetrics and Gynecology, Second Affiliate Hospital, Chongqing University of Medical Sciences, Chongqing, China
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23
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Shi XY, Yang YP, Zhang Y, Li W, Wang JD, Huang WM, Fan YM. Molecular identification and antifungal susceptibility of 186 Candida isolates from vulvovaginal candidiasis in southern China. J Med Microbiol 2015; 64:390-393. [PMID: 25596116 DOI: 10.1099/jmm.0.000024] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 01/06/2015] [Indexed: 11/18/2022] Open
Abstract
There is limited information regarding the molecular epidemiology and antifungal susceptibilities of Candida isolates using the Neo-Sensitabs method in patients with vulvovaginal candidiasis (VVC). From August 2012 to March 2013, 301 non-pregnant patients aged 18-50 years with suspected VVC were prospectively screened at a teaching hospital in southern China. The vaginal isolates were identified by DNA sequencing of internal transcribed spacer and the D1/D2 domain. Antifungal susceptibility testing of seven antifungal agents was performed using the Neo-Sensitabs tablet diffusion method. Candida species were isolated from 186 cases (61.79 %). The most common pathogen was Candida albicans (91.4 %), followed by Candida glabrata (4.3 %), Candida tropicalis (3.2 %) and Candida parapsilosis (1.1 %). The susceptibility rates to C. albicans were higher for caspofungin, voriconazole and fluconazole than those for itraconazole, miconazole, ketoconazole and terbinafine (P<0.01). The resistance rates to C. albicans were 4.7, 6.5, 7.1, 7.6, 12.3, 27.7 and 74.7 % for caspofungin, miconazole, itraconazole, voriconazole, fluconazole, ketoconazole and terbinafine, respectively. No drugs tested apart from fluconazole exhibited differences in resistance between C. albicans and non-albicans Candida isolates. The results demonstrate that, using DNA sequencing, C. albicans is the most common isolate from Chinese patients with VVC. Caspofungin, voriconazole and fluconazole may be preferable to other azoles and terbinafine in the treatment of VVC.
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Affiliation(s)
- Xiao-Yu Shi
- Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China
| | - Yan-Ping Yang
- Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China
| | - Ying Zhang
- Department of Gynecology and Obstetrics, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China
| | - Wen Li
- Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China
| | - Jie-Di Wang
- Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China
| | - Wen-Ming Huang
- Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China
| | - Yi-Ming Fan
- Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, PR China
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24
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Cakiroglu Y, Caliskan S, Doger E, Ozcan S, Caliskan E. Does removal of CU-IUD in patients with biofilm forming candida really maintain regression of clinical symptoms? J OBSTET GYNAECOL 2014; 35:600-3. [PMID: 25496204 DOI: 10.3109/01443615.2014.986442] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate whether symptoms and recurrence would differ with and without Cu-IUD removal in patients with concomitant biofilm forming Candida spp. METHODS The data of 270 consecutive patients wearing TCu380A Cu-IUD were evaluated. Among these patients, 100/270 were found to have Candida spp. isolated from the tail of Cu-IUD or vaginal samples. These patients were investigated in four groups: Group 1 (n = 24; Biofilm (+), Cu-IUD removed), Group 2 (n = 14; Biofilm (+), Cu-IUD not removed), Group 3 (n = 29; Biofilm (-), Cu-IUD removed), Group 4 (n = 33; Biofilm (-), Cu-IUD not removed). Patients in each group were followed for clinical signs and symptoms for 8-16 months and compared to each other. RESULTS Symptoms, physical findings and candida positivity have decreased statistically significantly in Group 1 one year after removal of Cu-IUD (95.8% vs. 4.2%, p < 0.01; 95.8% vs. 4.2%, p < 0.01; 100% vs. 8.3%, p < 0.01 respectively). In Group 2, symptoms, physical findings and candida positivity have decreased after follow-up, but without a statistical significance. In Group 3, all the parameters have decreased, but only decrease in candida positivity has reached statistical significance (100% vs. 48.3%, p < 0.01). In Group 4 - as in Group 1- symptoms, physical findings and candida positivity have decreased statistically significantly (48.5% vs. 18.2%, p = 0.01; 72.7% vs. 48.5%, p = 0.05; 100% vs. 51.5%, p < 0.01 respectively). CONCLUSION Biofilm forming microorganisms should be considered in the management of vaginal infections or symptoms for safer use of intrauterine devices.
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Affiliation(s)
- Y Cakiroglu
- a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey
| | - S Caliskan
- b Department of Clinical Microbiology , Sakarya University Education and Research Hospital , Sakarya , Turkey
| | - E Doger
- a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey
| | - S Ozcan
- c Department of Clinical Microbiology , Kocaeli University , Kocaeli , Turkey
| | - E Caliskan
- a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey
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Antifungal susceptibility patterns, in vitro production of virulence factors, and evaluation of diagnostic modalities for the speciation of pathogenic Candida from blood stream infections and vulvovaginal candidiasis. J Pathog 2014; 2014:142864. [PMID: 25110589 PMCID: PMC4119684 DOI: 10.1155/2014/142864] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 06/23/2014] [Indexed: 12/24/2022] Open
Abstract
Candida spp. have emerged as successful pathogens in both invasive and mucosal infections. Varied virulence factors and growing resistance to antifungal agents have contributed to their pathogenicity. We studied diagnostic accuracy of HiCrome Candida Differential Agar and Vitek 2 Compact system for identification of Candida spp. in comparison with species-specific PCR on 110 clinical isolates of Candida from blood stream infections (54, 49%) and vulvovaginal candidiasis (56, 51%). C. albicans (61%) was the leading pathogen in VVC, while C. tropicalis (46%) was prominent among BSIs. HiCrome Agar and Vitek 2 Compact had good measures of agreement (κ) 0.826 and 0.895, respectively, in comparison with PCR. We also tested these isolates for in vitro production of proteinase, esterase, phospholipases, and biofilms. Proteinase production was more among invasive isolates (P = 0.017), while phospholipase production was more among noninvasive isolates (P = 0.001). There was an overall increase in the production of virulence factors among non-albicans Candida. Identification of clinical isolates of Candida up to species level either by chromogenic agar or by Vitek 2 Compact system should be routinely done to choose appropriate therapy.
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26
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Razzaghi-Abyaneh M, Sadeghi G, Zeinali E, Alirezaee M, Shams-Ghahfarokhi M, Amani A, Mirahmadi R, Tolouei R. Species distribution and antifungal susceptibility of Candida spp. isolated from superficial candidiasis in outpatients in Iran. J Mycol Med 2014; 24:e43-50. [DOI: 10.1016/j.mycmed.2014.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Revised: 12/04/2013] [Accepted: 01/07/2014] [Indexed: 01/10/2023]
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Rathod SD, Buffler PA. Highly-cited estimates of the cumulative incidence and recurrence of vulvovaginal candidiasis are inadequately documented. BMC WOMENS HEALTH 2014; 14:43. [PMID: 24612727 PMCID: PMC3975582 DOI: 10.1186/1472-6874-14-43] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 03/05/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND Available literature concerning the epidemiologic or clinical features of vulvovaginal candidiasis commonly reports that: 75% of women will experience an episode of vulvovaginal candidiasis in their lifetimes, 50% of whom will experience at least a second episode, and 5-10% of all women will experience recurrent vulvovaginal candidiasis (≥4 episodes/1 year). In this debate we traced the three commonly cited statistics to their presumed origins. DISCUSSION It is apparent that these figures were inadequately documented and lacked supporting epidemiologic evidence. Population-based studies are needed to make reliable estimates of the lifetime risk of vulvovaginal candidiasis and the proportion of women who experience recurrent candidiasis. SUMMARY The extent to which vulvovaginal candidiasis is a source of population-level morbidity remains uncertain.
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Affiliation(s)
- Sujit D Rathod
- Division of Epidemiology, University of California, Berkeley, USA.
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28
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López-Monteon A, Gómez-Figueroa FS, Ramos-Poceros G, Guzmán-Gómez D, Ramos-Ligonio A. Codetection of Trichomonas vaginalis and Candida albicans by PCR in urine samples in a low-risk population attended in a clinic first level in central Veracruz, Mexico. BIOMED RESEARCH INTERNATIONAL 2013; 2013:281892. [PMID: 24069593 PMCID: PMC3773406 DOI: 10.1155/2013/281892] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 07/18/2013] [Accepted: 07/31/2013] [Indexed: 11/18/2022]
Abstract
The aim of this study is to estimate the prevalence of Trichomonas vaginalis and Candida albicans in low-risk patients treated at a first level clinic (primary health care represents the first level of contact of individuals, families, and the community with the system national health). Using a cross-sectional study in patients treated in clinical laboratory of the Sanitary District no. 7 of the city of Orizaba during the months June-July, 252 urine samples were collected for the identification of T. vaginalis and C. albicans by PCR. Furthermore, we analyzed the sociodemographic characteristics of the studied population. We observed an overall prevalence of 23.41% (95% CI 22.10-24.72) for T. vaginalis and 38.88% (95% CI 37.73-40.03) for C. albicans. There was also presence of coinfection in 14.28% (95% CI 13.10-15.46), which was associated with the presence of pain. Most of the positive cases were observed in women house-maker (80%, 95% CI 50.36-48.98). The results of this study provide evidence that the majority of positive cases observed in the studied population are presented in an asymptomatic form and usually are not associated with any risk factor.
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Affiliation(s)
- A. López-Monteon
- LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, 94340 Orizaba, VER, Mexico
- Centro de Investigaciones Biomédicas, Universidad Veracruzana, 91000 Xalapa, VER, Mexico
| | - F. S. Gómez-Figueroa
- LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, 94340 Orizaba, VER, Mexico
| | - G. Ramos-Poceros
- LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, 94340 Orizaba, VER, Mexico
| | - D. Guzmán-Gómez
- LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, 94340 Orizaba, VER, Mexico
- Centro de Investigaciones Biomédicas, Universidad Veracruzana, 91000 Xalapa, VER, Mexico
| | - A. Ramos-Ligonio
- LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, 94340 Orizaba, VER, Mexico
- Centro de Investigaciones Biomédicas, Universidad Veracruzana, 91000 Xalapa, VER, Mexico
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