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Sarpong AK, Odoi H, Boakye YD, Boamah VE, Agyare C. Resistant C. albicans implicated in recurrent vulvovaginal candidiasis (RVVC) among women in a tertiary healthcare facility in Kumasi, Ghana. BMC Womens Health 2024; 24:412. [PMID: 39030542 PMCID: PMC11264716 DOI: 10.1186/s12905-024-03217-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/19/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Vulvovaginal candidiasis is a common fungal infection that affects the female lower genital tract. This study determined the major risk factors associated with vulvovaginal infection (VVI) in the Ashanti region of Ghana and also determined the antifungal resistance patterns of Candida albicans isolates to some antifungals. METHODS Three hundred and fifty (350) high vaginal swab (HVS) samples were collected from women who presented with signs and symptoms of VVI. A structured questionnaire was administered to one hundred and seventy-two (172) of the women. HVS samples were cultured on Sabouraud dextrose agar with 2% chloramphenicol. The polymerase chain reaction was employed to confirm C. albicans. Antifungal susceptibility testing was performed and the susceptibility of C. albicans isolates to fluconazole, clotrimazole, amphotericin B, nystatin, miconazole and 5-flurocytosine were assessed. RESULTS Vaginal infection was most prevalent amongst females in their reproductive age (21 to 30 years; 63.0%). The study found a significant association between vaginal infections and some risk factors such as sexual practices (p < 0.001), antibiotic misuse (p < 0.05), poor personal hygiene (p < 0.005) and birth control methods (p < 0.049). Out of the 350 HVS samples collected, 112 yielded yeast cells with 65 (58%) identified as C. albicans. The C. albicans isolates were resistant to 5' flucytosine (100%), fluconazole (70%), voriconazole (69.2%), miconazole (58.5%) and nystatin (49.2%). C. albicans isolates were more susceptible to amphotericin B (53.8%) and clotrimazole (45.1%), although an appreciable number of isolates showed resistance (46.1% and 52.3%, respectively). CONCLUSION There should be nationwide education on all associated risk factors of VVI. Also, use of the various antifungal agents in vaginal candidiasis should proceed after antifungal susceptibility testing to ensure efficacious use of these agents.
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Affiliation(s)
- Abena Kyeraa Sarpong
- Pharmaceutical Microbiology Section, Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Laboratory Technology Department , Kumasi Technical University, Kumasi, Ghana
| | - Hayford Odoi
- Department of Pharmaceutical Microbiology, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - Yaw Duah Boakye
- Pharmaceutical Microbiology Section, Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Vivian Etsiapa Boamah
- Pharmaceutical Microbiology Section, Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- Pharmaceutical Microbiology Section, Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Christian Agyare
- Pharmaceutical Microbiology Section, Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Dunaiski CM, Kock MM, Chan WY, Ismail A, Peters RPH. Molecular epidemiology and antimicrobial resistance of vaginal Candida glabrata isolates in Namibia. Med Mycol 2024; 62:myae009. [PMID: 38308518 DOI: 10.1093/mmy/myae009] [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: 10/17/2023] [Revised: 12/16/2023] [Accepted: 02/01/2024] [Indexed: 02/04/2024] Open
Abstract
Candida glabrata is the most common non-albicans Candida species that causes vulvovaginal candidiasis (VVC). Given the intrinsically low susceptibility of C. glabrata to azole drugs, investigations into C. glabrata prevalence, fungal susceptibility profile, and molecular epidemiology are necessary to optimise the treatment of VVC. This molecular epidemiological study was conducted to determine antifungal drug profile, single nucleotide polymorphisms (SNPs) associated with phenotypic antifungal resistance and epidemic diversity of C. glabrata isolates from women with VVC in Namibia. Candida glabrata isolates were identified using phenotypic and molecular methods. Antifungal susceptibility of strains was determined for fluconazole, itraconazole, amphotericin B, and anidulafungin. Whole genome sequencing was used to determine SNPs in antifungal resistance genes and sequence type (ST) allocation. Among C. glabrata isolates, all (20/20; 100%) exhibited phenotypic resistance to the azole class antifungal drug, (fluconazole), and phenotypic susceptibility to the polyene class (amphotericin B), and the echinocandins (anidulafungin). Non-synonymous SNPs were identified in antifungal resistance genes of all fluconazole-resistant C. glabrata isolates including ERG6 (15%), ERG7 (15%), CgCDR1 (25%), CgPDR1 (60%), SNQ2 (10%), FKS1 (5.0%), FKS2 (5.0%), CgFPS1 (5.0%), and MSH2 (15%). ST15 (n = 8/20, 40%) was predominant. This study provides important insight into phenotypic and genotypic antifungal resistance across C. glabrata isolates from women with VVC in Namibia. In this study, azole resistance is determined by an extensive range of SNPs, while the observed polyene and echinocandin resistance-associated SNPs despite phenotypic susceptibility require further investigation.
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Affiliation(s)
- Cara M Dunaiski
- Namibia University of Sciences and Technology, Department of Health and Applied Sciences, Windhoek 10005, Namibia
- University of Pretoria, Department of Medical Microbiology, Pretoria 0001, South Africa
| | - Marleen M Kock
- University of Pretoria, Department of Medical Microbiology, Pretoria 0001, South Africa
- National Health Laboratory Service, Tshwane, Academic Division, Pretoria 3191, South Africa
| | - Wai Yin Chan
- Sequencing Core Facility, National Institute for Communicable Diseases a Division of the National Health Laboratory Service, Johannesburg 2131, South Africa
- Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria 0081, South Africa
- Right to care, Centurion 0157, South Africa
| | - Arshad Ismail
- Sequencing Core Facility, National Institute for Communicable Diseases a Division of the National Health Laboratory Service, Johannesburg 2131, South Africa
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa
| | - Remco P H Peters
- University of Pretoria, Department of Medical Microbiology, Pretoria 0001, South Africa
- University of Cape Town, Division of Medical Microbiology, Cape Town 7701, South Africa
- Foundation for Professional Development, Research Unit, East London 5217, South Africa
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Kola-Mustapha AT, Aliu MH, Bello RH, Adedeji OJ, Ghazali YO. The Formulation and Evaluation of Melaleuca alternifolia Cheel and Cymbopogon flexuosus Linn Essential Oils Emulgel for the Treatment of Vulvovaginal Candidiasis. Gels 2023; 9:949. [PMID: 38131935 PMCID: PMC10743309 DOI: 10.3390/gels9120949] [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: 11/13/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
The global concern regarding the occurrence of antifungal resistance to synthetic conventional azoles used for treating vulvovaginal candidiasis, along with the associated side effects, is significant. Consequently, the pursuit for substitutes such as natural therapies has ensued. Essential oils, derived from plants, have been extensively researched and found to possess antibacterial and antifungal properties. This study aimed to assess the antifungal efficacy of two essential oils, both alone and in combination, against Candida albicans. Essential oils were formulated into an emulgel separately and as combinations. The essential oils of Melaleuca alternifolia and Cymbopogon flexuosus were used in this study. The resulting emulgel formulations were characterized for their antifungal activity against Candida albicans. Physiochemical properties such as pH, viscosity, and appearance were also determined. The prepared emulgels were thereafter observed for stability over a period of 1 month. The MIC of Melaleuca alternifolia was seen to be 50 µL/mL while Cymbopogon flexuous was seen to be more potent at 25 µL/mL against C. albicans exhibiting strong synergistic effect at 0.4. The emulgel formed was white in color, smooth on skin, and had the odor of the essential oils, which is sweet to the nose. The pH of the formulations with the essential oils were acidic in the range of 3.70-3.83, making them suitable for vagina application. The emulgels had viscosities ranging from 4417.6 to 8968.7 mPas, owing to the thickness of the essential oils contained. The emulgel formulation with the combination of essential oils was more potent that the two with individual essential oils; furthermore, the one with Cymbopogon flexuous was more potent than the one with Melaleuca alternifolia. Based on the properties of the formulated emulgels and their activity against the test organism, the preparations have significant potential in the management of vulvovaginal candidiasis.
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Affiliation(s)
- Adeola Tawakalitu Kola-Mustapha
- College of Pharmacy, Alfaisal University, Riyadh 11461, Saudi Arabia
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, University of Ilorin, P.M.B 1515, Ilorin 240101, Nigeria
| | - Miracle Halima Aliu
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, University of Ilorin, P.M.B 1515, Ilorin 240101, Nigeria
| | - Ronke Hadiyat Bello
- Department of Pharmaceutical Microbiology and Biotechnology, University of Ilorin, P.M.B 1515, Ilorin 240003, Nigeria
| | - Oluwakorede Joshua Adedeji
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, University of Ilorin, P.M.B 1515, Ilorin 240101, Nigeria
| | - Yusuf Oluwagbenga Ghazali
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, University of Ilorin, P.M.B 1515, Ilorin 240101, Nigeria
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Rawat S, Singh R, Mittal G. Phenotypic characterization and antifungal susceptibility profile of Candida isolates from women with vulvovaginal candidiasis at a community health center linked to a teaching institution in the Sub-Himalayan region of North India. J Family Med Prim Care 2023; 12:3326-3331. [PMID: 38361850 PMCID: PMC10866227 DOI: 10.4103/jfmpc.jfmpc_1082_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction Vulvovaginal candidiasis (VVC) is considered a common gynecological problem among females of reproductive age group. 70-75% of women report having had candidal vulvovaginitis at some point in their lifetimes and 40-50% suffer recurrent candidal vulvovaginitis. Objectives This study aims to identify the Candida species involved in VVC and to determine their antifungal susceptibility pattern. Materials and Methods The present study was a cross-sectional study conducted on 257 females (18-55 yr) with complaints of abnormal vaginal discharge. For detection of Candida, the swab samples were subjected to Gram stain, 10% KOH mount, and culture on Sabouraud dextrose agar (SDA). Candida species identification was done by subculturing Candida isolates onto CHROMagar, corn meal agar (Himedia), and further confirmation was done by MALDI-TOF MS. Antifungal testing was done using the disk diffusion method. Results A total of 257 females with complaints of abnormal discharge were enrolled in this study. Out of 257, C. albicans 37 (58.7%) and 26 (41.3%) isolates were identified as non-albicans Candida. Out of 63 positive cases, a maximum number of study subject belongs to the age group 26-35 years (50.8%). Along with vaginal discharge, itching (65.37%) is the most common complaint. VVC was found to be most predominant in patients with prolonged antibiotic therapy (38.1%), and in pregnant females (15.9%). Conclusion Understanding the emerging fungal pathogens and their drug susceptibility patterns is essential for the effective management of infections. Drug resistance can lead to treatment failure and highlights the need for alternative treatment options or strategies.
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Affiliation(s)
- Sangeeta Rawat
- Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
| | - Rajender Singh
- Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
| | - Garima Mittal
- Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India
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Headley SA, Gomes ALPL, Martinelli TM, Fritzen JTT, Teixeira Vanzela AL, Silva FHP, Gaspar T, Giordano LGP, Alfieri AA, Gomes LA. The pathology of canine mammary candidiasis with embolic dissemination in a dog. Microb Pathog 2023; 185:106424. [PMID: 37913829 DOI: 10.1016/j.micpath.2023.106424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/24/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023]
Abstract
Candidiasis is a fungal disease caused by Candida albicans or other members of the genus Candida. Descriptions of candidiasis are comparatively reduced in veterinary relative to human medicine, with no cases of mammary candidiasis being identified in pet animals. This report presents the cytological, pathological, and molecular findings of mammary candidiasis with embolic dissemination in a postpartum dog. A 1-year-old, female Shih-tzu dog that had recently given birth was admitted to a veterinary teaching hospital in Southern Brazil after repeated episodes of intermittent mammary disease and a neurological syndrome. The dog was euthanized due to worsened clinical status and poor prognosis despite adequate clinical therapy and was submitted for routine post-mortem evaluation to determine the cause of the neurological manifestations. Cytological analysis of purulent mastitis identified intralesional fungal hyphae. Gross evaluation revealed multiple masses within the kidneys, liver, myocardium, pancreas, and brain. Routine histopathology and histochemistry identified fungal nephritis, hepatitis, myocarditis, pancreatitis, and encephalitis associated with intralesional fungal hyphae, frequently with fungal emboli and vasculitis. Pure cultures of C. albicans were obtained from fragments of the masses observed at the myocardium and kidneys, with the typical germ tube of C. albicans being identified by microscopic evaluation. A PCR assay that targeted the ITS1 and 4 generic regions of fungi, amplified the desired amplicon, and direct sequencing confirmed C. albicans. Immunohistochemical and molecular assays designed to identify common infectious disease pathogens of dogs did not confirm the participation of canine distemper virus, canine parvovirus, or canine adenovirus in the target tissues of this dog. These findings suggest that this dog suffered an initial cutaneous lesion, that probably served as portal of entry to the mammary gland, resulting in mammary candidiasis with subsequent embolic dissemination to multiple organs. This report represent the first description of mammary candidiasis in pet animals and probably one of the few pathological descriptions of mammary candidiasis in domestic animals. In this case, the cause of the fungal infection was probably associated with factors intrinsic to abdominal surgery, pregnancy, and the utilization of antibiotics.
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Affiliation(s)
- Selwyn Arlington Headley
- Laboratory of Animal Pathology, Department of Preventive Veterinary Medicine, Universidade Estadual de Londrina, Paraná, Brazil; Multi-User Animal Health Laboratory (LAMSA), Universidade Estadual de Londrina, Paraná, Brazil.
| | - Ana Laura Paulino Leite Gomes
- Laboratory of Animal Pathology, Department of Preventive Veterinary Medicine, Universidade Estadual de Londrina, Paraná, Brazil
| | - Tayná Mesias Martinelli
- Small Animal Internal Medicine, Department of Veterinary Clinics, Universidade Estadual de Londrina, Paraná, Brazil
| | - Juliana Torres Tomazi Fritzen
- Laboratory of Animal Virology, Department of Preventive Veterinary Medicine, Universidade Estadual de Londrina, Paraná, Brazil
| | - Ana Laura Teixeira Vanzela
- Small Animal Internal Medicine, Department of Veterinary Clinics, Universidade Estadual de Londrina, Paraná, Brazil
| | - Flavia Helena Pereira Silva
- Laboratory of Animal Pathology, Department of Preventive Veterinary Medicine, Universidade Estadual de Londrina, Paraná, Brazil
| | - Taís Gaspar
- Small Animal Internal Medicine, Department of Veterinary Clinics, Universidade Estadual de Londrina, Paraná, Brazil
| | - Lucienne Garcia Pretto Giordano
- Laboratory of Animal Mycology, Department of Preventive Veterinary Medicine, Universidade Estadual de Londrina, Paraná, Brazil
| | - Amauri Alcindo Alfieri
- Multi-User Animal Health Laboratory (LAMSA), Universidade Estadual de Londrina, Paraná, Brazil; Laboratory of Animal Virology, Department of Preventive Veterinary Medicine, Universidade Estadual de Londrina, Paraná, Brazil
| | - Lucas Alecio Gomes
- Small Animal Internal Medicine, Department of Veterinary Clinics, Universidade Estadual de Londrina, Paraná, Brazil
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Boahen A, Chew SY, Neela VK, Than LTL. Limosilactobacillus reuteri 29A Cell-Free Supernatant Antibiofilm and Antagonistic Effects in Murine Model of Vulvovaginal Candidiasis. Probiotics Antimicrob Proteins 2023; 15:1681-1699. [PMID: 36881331 DOI: 10.1007/s12602-023-10050-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 03/08/2023]
Abstract
Vaginal dysbiosis advocates burgeoning of devious human vaginal pathobionts like Candida species that possess multiple virulence properties and metabolic flexibility to cause infections. Inevitably, antifungal resistance may emerge due to their innate nature (e.g., biofilm formation), which assists in their virulence as well as the formation of persister cells after dispersal. In consequence, the phenomenon of biofilm involvement in vulvovaginal candidiasis (VVC) and its recurrence is becoming paramount. Lactic acid bacteria and their derivatives have proven to be hostile to Candida species. Here, we throw more light on the potency of the derivatives, i.e., cell-free supernatant (CFS) produced by an indigenously isolated vaginal Lactobacillus strain, Limosilactobacillus reuteri 29A. In the present study, we investigated the antibiofilm and antagonistic effects of L. reuteri 29A CFS, against biofilms of Candida species and in murine model of vulvovaginal candidiasis. In our in vitro biofilm study, the CFS disrupted and inhibited preformed biofilms of C. albicans and C. glabrata. Scanning electron microscopy displayed the destruction of preformed biofilms and impediment of C. albicans morphogenesis by the CFS. Gas chromatography-mass spectrometry analysis showed multiple key compounds that may act singly or synergistically. In vivo, the CFS showed no collateral damage to uninfected mice; the integrity of infected vaginal tissues was restored by the administration of the CFS as seen from the cytological, histopathological, and electron microscopical analyses. The results of this study document the potential use of CFS as an adjuvant or prophylactic option in addressing vaginal fungal infections.
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Affiliation(s)
- Angela Boahen
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400 UPM, Malaysia
| | - Shu Yih Chew
- Department of Microbiology and Immunology, Pathology Division, School of Medicine, International Medical University, Kuala Lumpur, Selangor, 57000, Malaysia
| | - Vasantha Kumari Neela
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400 UPM, Malaysia
| | - Leslie Thian Lung Than
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400 UPM, Malaysia.
- Laboratory of Vaccine and Biomolecules, Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia.
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Gamberini C, Juliana NCA, de Brouwer L, Vogelsang D, Al-Nasiry S, Morré SA, Ambrosino E. The association between adverse pregnancy outcomes and non-viral genital pathogens among women living in sub-Saharan Africa: a systematic review. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1107931. [PMID: 37351522 PMCID: PMC10282605 DOI: 10.3389/frph.2023.1107931] [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: 11/25/2022] [Accepted: 05/18/2023] [Indexed: 06/24/2023] Open
Abstract
Adverse pregnancy outcomes are the main causes of maternal and neonatal morbidity and mortality, including long-term physical and psychological sequelae. These events are common in low- and middle-income countries, particularly in Sub Saharan Africa, despite national efforts. Maternal infections can cause complications at any stage of pregnancy and contribute to adverse outcomes. Among infections, those of the genital tract are a major public health concern worldwide, due to limited availability of prevention, diagnosis and treatment approaches. This applies even to treatable infections and holds true especially in Sub-Saharan Africa. As late as 2017, the region accounted for 40% of all reported treatable non-viral genital pathogens worldwide, many of which have been independently associated with various adverse pregnancy outcomes, and that include Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Treponema pallidum. Two databases (PubMed and Embase) were examined to identify eligible studies published up to October 2022. This study reviewed findings on the association between infections by treatable non-viral genital pathogens during pregnancy and adverse pregnancy outcomes among women living in Sub-Saharan Africa. Articles' title and abstract were screened at first using keywords as "sexually transmitted infections", "non-viral", "adverse pregnancy outcome", "Africa", "sub-Saharan Africa", "pregnant women", "pregnancy", and "pregnancy outcome". Subsequently, according to the eligibility criteria, potential articles were read in full. Results showed that higher risk of preterm birth is associated with Treponema pallidum, Chlamydia trachomatis and Candida albicans infections. Additionally, rates of stillbirth, neonatal death, low birth weight and intrauterine growth restriction are also associated with Treponema pallidum infection. A better insight on the burden of non-viral genital pathogens and their effect on pregnancy is needed to inform antenatal care guidelines and screening programs, to guide the development of innovative diagnostic tools and other strategies to minimize transmission, and to prevent short- and long-term complications for mothers and children.
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Affiliation(s)
- Carlotta Gamberini
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
- Research School GROW for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
| | - Naomi C. A. Juliana
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
- Research School GROW for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
| | - Lenya de Brouwer
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
| | - Dorothea Vogelsang
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
| | - Salwan Al-Nasiry
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
- Department of Obstetrics and Gynecology, Research School GROW for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Servaas A. Morré
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
- Research School GROW for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Allahabad, UP, India
- Dutch Chlamydia trachomatis Reference Laboratory on Behalf of the Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Elena Ambrosino
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
- Research School GROW for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
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Ngom NS, Gassama O, Dieng A, Diakhaby EB, Ndiaye SML, Tine A, Karam F, Lo G, Ba-Diallo A, Boye CSB, Toure-Kane C, Seck A, Diop-Ndiaye H, Camara M. Vaginal Carriage of Group B Streptococcus (GBS) in Pregnant Women, Antibiotic Sensitivity and Associated Risk Factors in Dakar, Senegal. Microbiol Insights 2023; 16:11786361231174419. [PMID: 37275206 PMCID: PMC10233617 DOI: 10.1177/11786361231174419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/20/2023] [Indexed: 06/07/2023] Open
Abstract
The eradication of neonatal Group B Streptococcus (GBS) infections, considered as a major public health priority, necessarily requires a mastery of the data on vaginal carriage in pregnant women. The aims of this study were to determine the prevalence of vaginal carriage of GBS in pregnant women, antibiotic susceptibility, and associated risk factors. This was a cross-sectional, descriptive study conducted over a period of 9 months (July 2020 to March 2021) in pregnant women between 34 and 38 weeks of gestation (WG) followed at the Nabil Choucair health center in Dakar. Identification and antibiotic susceptibility of GBS isolates were performed on the Vitek 2 from vaginal swabs cultured on Granada medium. Demographic and obstetric interview data were collected and analyzed on SPSS (version 25). The level of significance for all statistical tests was set at P < .05. The search of GBS vaginal carriage had involved 279 women aged 16 to 46 years, with a median pregnancy age of 34 (34-37) weeks' gestation. GBS was found in 43 women, for a vaginal carriage rate of 15.4%. In 27.9% (12/43) of volunteers screened, this carriage was monomicrobial, while in 72.1% (31/43) of women, GBS was associated with other pathogens such as Candida spp. (60.5%), Trichomonas vaginalis (2.3%), Gardnerella vaginalis (34.9%) and/or Mobiluncus spp. (11.6%). The level of resistance was 27.9% (12/43) for penicillin G, 53.5% (23/43) for erythromycin, 25.6% (11/43) for clindamycin and 100% for tetracycline. However, the strains had retained fully susceptible to vancomycin and teicoplanin. The main risk factor associated with maternal GBS carriage were ectocervical inflammation associated with contact bleeding (OR = 3.55; P = .005). The high rate of maternal vaginal GBS carriage and the levels of resistance to the various antibiotics tested confirm the importance of continuous GBS surveillance in our resource-limited countries.
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Affiliation(s)
- Ndeye Safietou Ngom
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Omar Gassama
- Gynecological and Obstetrical Clinic,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Assane Dieng
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Elhadji Bambo Diakhaby
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Serigne Mbaye Lo Ndiaye
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Alioune Tine
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Farba Karam
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Gora Lo
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Awa Ba-Diallo
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Cheikh Saad Bouh Boye
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Coumba Toure-Kane
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Abdoulaye Seck
- Laboratory of Medical Biology, Pasteur
Institute of Dakar, Senegal
| | - Halimatou Diop-Ndiaye
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
| | - Makhtar Camara
- Bacteriology-Virology Laboratory,
National University Hospital Center Aristide Le Dantec, Dakar, Senegal
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Harley BK, Quagraine AM, Neglo D, Aggrey MO, Orman E, Mireku-Gyimah NA, Amengor CD, Jato J, Saaka Y, Fleischer TC. Metabolite profiling, antifungal, biofilm formation prevention and disruption of mature biofilm activities of Erythrina senegalensis stem bark extract against Candida albicans and Candida glabrata. PLoS One 2022; 17:e0278096. [PMID: 36441750 PMCID: PMC9704668 DOI: 10.1371/journal.pone.0278096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022] Open
Abstract
The antifungal activity of the 70% ethanol stem bark extract of Erythrina senegalensis (ESB) against different strains and drug resistant clinical isolates of Candida albicans and Candida glabrata were evaluated in the study. The effect of ESB on biofilms as well as its activity in combination with fluconazole, nystatin or caspofungin against the Candida strains were also evaluated. We then evaluated the antifungal activity of a microemulsion formulation of ESB against planktonic and biofilms of the Candida species. UPLC-QTOF-MS2 analysis was then undertaken to identify the phytoconstituents of the extract and UPLC fingerprints developed for the routine authentication as part of quality control measures. ESB exerted strong antifungal activities against C. albicans ATCC 10231 and SC5314 strains, and C. glabrata ATCC 2001 strain with minimum inhibitory concentration (MIC) values from 3.91 to 31.25 μg/mL and minimum fungicidal concentrations (MFCs) that ranged from 62.5 to 250 μg/mL. It also exhibited potent antifungal activities (MIC = 4-64 μg/mL) against a collection of C. albicans and C. glabrata clinical isolates that were resistant to either nystatin or azole antifungals. The formulated ESB demonstrated higher antifungal potency against the C. albicans and C. glabrata strains with MIC values of 3.91-31.25 μg/mL which was the same as the MFC values. The extract and its microemulsion formulation were active against biofilms of the strains of the Candida species inhibiting their biofilm formations (SMIC50 = 16-64 μg/mL) and their preformed biofilms (SMIC50 = 128 ->512 μg/mL). ESB also exhibited synergistic antifungal action with fluconazole and nystatin against C. albicans ATCC 10231 and C. glabrata ATCC 2001 strains in the checkerboard assay. Chemical characterization of the extract revealed the presence of phenolic compounds such as flavonoids and their prenylated derivatives, anthracene glycosides and alkaloids. UPLC Fingerprints of the extract was also developed and validated for routine identification and authentication of the stem bark of E. senegalensis. The study findings have demonstrated that the stem bark of E. senegalensis is as a potential source of bioactive compounds that could be developed as novel antifungal agents.
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Affiliation(s)
- Benjamin Kingsley Harley
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
- * E-mail:
| | - Anthony Martin Quagraine
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - David Neglo
- Department of Basic Science, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Mike Okweesi Aggrey
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - Emmanuel Orman
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - Nana Ama Mireku-Gyimah
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Ghana, Accra, Ghana
| | - Cedric Dzidzor Amengor
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - Jonathan Jato
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - Yussif Saaka
- Department of Pharmaceutics, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - Theophilus Christian Fleischer
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
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Impact assessment of particulate pollution on maternal mortality in Nigeria. Sci Rep 2022; 12:19669. [PMID: 36385256 PMCID: PMC9668819 DOI: 10.1038/s41598-022-19518-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Recently, the World Health Organization reported that 20% of all global maternal deaths happened in Nigeria between 2005 and 2015. In developing countries, these maternal deaths are mainly from air pollution. Due to poor facilities and documentation, the extent of danger is not known. This research seeks to estimate the available pollutants and its direct and indirect impact on maternal mortality. Ten (10) years (2010-2019) datasets of black carbon, sulfur dioxide, dust, carbon monoxide, organic carbon particulates, sea-salts, and sulphate particulates were obtained from the second modern-era retrospective analysis for research and applications (MERRA-2). The dataset was obtained for the six geopolitical zones of Nigeria and analyzed using statistical tool, models, spatial interpolation, and risk analysis. The volumetric and radioecological risk was also analyzed. It was observed the dust content had minute volume of heavy metal and/or radionuclide particles that may be unharmful in the short term but lethal in the long term. The risk quotient and total dose rate per organism are given as 0.00000396 and 0.0000396 µGy h-1. The result in this manuscript corroborates existing data on maternal mortality in Nigeria. It is recommended that the safety of pregnant woman depends on significant efforts of authorities to enact and enforce environmental laws to mitigate air pollution.
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High diversity of yeast species and strains responsible for vulvovaginal candidiasis in South-East Gabon. J Mycol Med 2022; 33:101354. [PMID: 36473325 DOI: 10.1016/j.mycmed.2022.101354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/10/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Candida albicans generally remains the principal pathogenic yeast responsible for vulvovaginal candidiasis (VVC), although with variable prevalence. In this study, we evaluated the evolution of the prevalence of the non-Candida albicans Candida (NCAC) species and investigated the genotypic diversity and the population genetic structure of the circulating C. albicans strains associated with VVC in the vicinity of Franceville (Gabon). METHODS A total of 110 independent isolates were identified using both MALDI-TOF MS and conventional techniques. The population genetic structure of the C. albicans strains was determined by multiple locus variable-number tandem repeat analysis using 4 microsatellite markers. RESULTS The mean and median age of the patients was 31 years. Seven patients had a mixed infection. C. albicans accounted for 62 % (n=68) of the total isolates. NCAC were dominated by C. glabrata, followed by P. kudriavzevii, C. parapsilosis, C. tropicalis, M. guilliermondii, and C. nivariensis. The cluster analysis revealed a high diversity, with a total of 50 different genotypes. The most represented genotype was shared by only four strains, while the vast majority (39 strains) had a unique MLVA pattern. Geographic clusters were not detected. CONCLUSION The study provides information on species distribution and possible changing epidemiology while reporting for the first time C. nivariensis in VVC in Africa. This study is also the first to investigate the genotypic diversity of the circulating C. albicans strains associated with VVC in Central Africa. Such analyses would help understand the molecular epidemiology of C. albicans.
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Sathi FA, Paul SK, Ahmed S, Alam MM, Nasreen SA, Haque N, Islam A, Nila SS, Afrin SZ, Aung MS, Kobayashi N. Prevalence and Antifungal Susceptibility of Clinically Relevant Candida Species, Identification of Candida auris and Kodamaea ohmeri in Bangladesh. Trop Med Infect Dis 2022; 7:tropicalmed7090211. [PMID: 36136623 PMCID: PMC9506023 DOI: 10.3390/tropicalmed7090211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Candida species are major fungal pathogens in humans. The aim of this study was to determine the prevalence of individual Candida species and their susceptibility to antifungal drugs among clinical isolates in a tertiary care hospital in Bangladesh. During a 10-month period in 2021, high vaginal swabs (HVSs), blood, and aural swabs were collected from 360 patients. From these specimens, Candida spp. was isolated from cultures on Sabouraud dextrose agar media, and phenotypic and genetic analyses were performed. A total of 109 isolates were recovered, and C. albicans accounted for 37%, being derived mostly from HVSs. Among non-albicans Candida (NAC), C. parapsilosis was the most frequent, followed by C. ciferrii, C. tropicalis, and C. glabrata. Three isolates from blood and two isolates from aural discharge were genetically identified as C. auris and Kodamaea ohmeri, respectively. NAC isolates were more resistant to fluconazole (overall rate, 29%) than C. albicans (10%). Candida isolates from blood showed 95% susceptibility to voriconazole and less susceptibility to fluconazole (67%). Two or three amino acid substitutions were detected in the ERG11 of two fluconazole-resistant C. albicans isolates. The present study is the first to reveal the prevalence of Candida species and their antifungal susceptibility in Bangladesh.
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Affiliation(s)
- Fardousi Akter Sathi
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | | | - Salma Ahmed
- Department of Microbiology, Mugda Medical College, Dhaka 1214, Bangladesh
| | | | | | - Nazia Haque
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Arup Islam
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Sultana Shabnam Nila
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Sultana Zahura Afrin
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Meiji Soe Aung
- Department of Hygiene, School of Medicine, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Nobumichi Kobayashi
- Department of Hygiene, School of Medicine, Sapporo Medical University, Sapporo 060-8556, Japan
- Correspondence: ; Tel.: +81-11-611-2111
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13
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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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Dovo EE, Zohoncon TM, Tovo SF, Soubeiga ST, Kiendrebeogo IT, Yonli AT, Ouedraogo RA, Dabire AM, Djigma FW, Nadembega CW, Belemgnegre M, Ouedraogo P, Obiri-Yeboah D, Simpore J. First detection of mutated ERG11 gene in vulvovaginal Candida albicans isolates at Ouagadougou/Burkina Faso. BMC Infect Dis 2022; 22:678. [PMID: 35941587 PMCID: PMC9361531 DOI: 10.1186/s12879-022-07619-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Vulvovaginal candidiasis is an important cause of morbidity among women due to Candida species. In the last decades, resistance to azoles, first-line antifungals has increased. One molecular mechanism of azole resistance by Candida involves mutations in the ERG11 gene encoding lanosterol 14-α-demethylase, the target enzyme. This study was conducted to identify the clinical Candida species associated in vulvovaginal candidiasis; to determine the rate of antifungal resistance among Candida albicans isolates and to determine mutated ERG11 gene at Saint Camille Hospital in Ouagadougou, Burkina Faso. Methods Antifungals susceptibility were performed using Kirby–Bauer disk diffusion method. ERG11 gene was detected using conventional PCR in C. albicans isolates resistant to at least one azole. Results Out of 262 clinical strains isolated, C. albicans accounted for 59.90%, followed by Candida glabrata 27.86%, Candida famata 7.25%, Candida tropicalis 3.05% and Saccharomyces cerevisiae 1.91%. Resistance rate of fluconazole to C. albicans was 59.54%. ERG11 gene was found in 9.79% of 92 C. albicans strains resistant to azoles. Conclusions This detection of mutated ERG11 gene in C. albicans is the first in Burkina Faso and may be a cause of azole resistance in recurrent Candida vulvovaginitis. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07619-5.
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Affiliation(s)
- Essi Etonam Dovo
- Molecular Biology and Genetics Laboratory (LABIOGENE), University of Joseph Ki ZERBO, BP 7021, Ouagadougou 03, Burkina Faso
| | - Théodora Mahoukèdè Zohoncon
- Molecular Biology and Genetics Laboratory (LABIOGENE), University of Joseph Ki ZERBO, BP 7021, Ouagadougou 03, Burkina Faso.
| | - Sessi Frida Tovo
- Molecular Biology and Genetics Laboratory (LABIOGENE), University of Joseph Ki ZERBO, BP 7021, Ouagadougou 03, Burkina Faso
| | | | | | - Albert Théophane Yonli
- Biomolecular Research Center Pietro Annigoni (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
| | - Rogomenona Alice Ouedraogo
- Molecular Biology and Genetics Laboratory (LABIOGENE), University of Joseph Ki ZERBO, BP 7021, Ouagadougou 03, Burkina Faso
| | | | - Florencia Wendkuuni Djigma
- Molecular Biology and Genetics Laboratory (LABIOGENE), University of Joseph Ki ZERBO, BP 7021, Ouagadougou 03, Burkina Faso
| | - Christelle Wendyam Nadembega
- Molecular Biology and Genetics Laboratory (LABIOGENE), University of Joseph Ki ZERBO, BP 7021, Ouagadougou 03, Burkina Faso
| | - Marius Belemgnegre
- Saint Camille Hospital of Ouagadougou (HOSCO), 01 BP 444, Ouagadougou 01, Burkina Faso
| | - Paul Ouedraogo
- Saint Camille Hospital of Ouagadougou (HOSCO), 01 BP 444, Ouagadougou 01, Burkina Faso
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, PMB, Cape Coast, Ghana
| | - Jacques Simpore
- Molecular Biology and Genetics Laboratory (LABIOGENE), University of Joseph Ki ZERBO, BP 7021, Ouagadougou 03, Burkina Faso
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Prevalence and Risk Factors of Vulvovaginal Candidosis during Pregnancy: A Review. Infect Dis Obstet Gynecol 2022; 2022:6195712. [PMID: 35910510 PMCID: PMC9329029 DOI: 10.1155/2022/6195712] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Vulvovaginal candidosis (VVC) is a symptomatic vaginal yeast infection, especially caused by Candida spp. Although VVC is common among reproductive-age women, prevalence studies notice the uprise of vaginal Candida colonization to 30% during pregnancy by culture, especially in the last trimester. Recent studies have considered it a severe problem due to the emerging evidence showing the association of VVC with a higher chance of pregnancy-related complexities (e.g., preterm labor, premature rupture of membranes, congenital cutaneous candidosis, and chorioamnionitis). In this review, we have reassessed and summarized the prevalence rate of VVC in expecting mothers and analyzed the association of several factors to the increased risk of VVC during pregnancy in different regions of the world. Altogether, these data collected from various studies showed the highest prevalence of VVC during pregnancy, mostly in Asian and African countries (90.38%, 62.2%, and 61.5% in Kenya, Nigeria, and Yemen, respectively). The prevalence rate of VVC during pregnancy was also found to differ with age, gestation period, parity, educational status, and socioeconomic level. Some pregnancy-related factors (e.g., weakened immunity; elevated level of sex hormones, glycogen deposition; low vaginal pH; decreased cell-mediated immunity) and several clinical and behavioral factors can be suggested as potential risk factors of candidosis during pregnancy.
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Antifungal Activities of Phytochemically Characterized Hydroethanolic Extracts of Sclerocarya birrea Leaves and Stem Bark against Fluconazole-Resistant Candida albicans Strains. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4261741. [PMID: 35711520 PMCID: PMC9197620 DOI: 10.1155/2022/4261741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022]
Abstract
The study evaluated the antifungal activities of the 70% ethanol extracts of Sclerocarya birrea leaves (SBL) and stem bark (SBB) against C. albicans strains and fluconazole-resistant isolates, their antifungal effects in combination with conventional antifungals as well as their effects on the biofilms of the C. albicans strains and isolates. UPLC-QTOF-MS/MS analysis was then carried out to investigate the metabolite profile of the extracts and UPLC fingerprints developed for their routine identification as part of quality control measures. The extracts exhibited considerable antifungal activity with MIC ranging from 12.21 to 97.66 μg/mL and MFC from 12.21 to 390.63 μg/mL against the C. albicans strains and isolates. The antifungal activity of the stem bark extract was higher than the leaf extract. SBL and SBB also significantly inhibited biofilm formation (IC50 = 12.49 to 164.42 μg/mL) and the mature biofilms (IC50 = 91.50 to 685.20 μg/mL) of the strains and isolates of the C. albicans and demonstrated potential for their use in combination therapies with currently used antifungals especially the stem bark extract with nystatin. Metabolite profiling identified the presence of polyphenolic compounds in both leaves and stem bark mostly flavonoids, their derivatives, and proanthocyanidins, which contribute in part to the bioactivity of the plant. Whereas flavonoids like quercetin, myricetin, and their derivatives were abundant in the leaves, epicatechin monomers with their condensed tannins, including procyanidin B2 and procyanidin C, were abundant in the stem bark. Fingerprints of SBL and SBB were developed and validated and could be used as qualitative tools to authenticate the plant. The outcomes of the study show the promise of the leaf and stem bark extracts of S. birrea to be studied further and developed as antifungal agents.
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Boahen A, Than LTL, Loke YL, Chew SY. The Antibiofilm Role of Biotics Family in Vaginal Fungal Infections. Front Microbiol 2022; 13:787119. [PMID: 35694318 PMCID: PMC9179178 DOI: 10.3389/fmicb.2022.787119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/25/2022] [Indexed: 11/15/2022] Open
Abstract
“Unity in strength” is a notion that can be exploited to characterize biofilms as they bestow microbes with protection to live freely, escalate their virulence, confer high resistance to therapeutic agents, and provide active grounds for the production of biofilms after dispersal. Naturally, fungal biofilms are inherently resistant to many conventional antifungals, possibly owing to virulence factors as their ammunitions that persistently express amid planktonic transition to matured biofilm state. These ammunitions include the ability to form polymicrobial biofilms, emergence of persister cells post-antifungal treatment and acquisition of resistance genes. One of the major disorders affecting vaginal health is vulvovaginal candidiasis (VVC) and its reoccurrence is termed recurrent VVC (RVVC). It is caused by the Candida species which include Candida albicans and Candida glabrata. The aforementioned Candida species, notably C. albicans is a biofilm producing pathogen and habitually forms part of the vaginal microbiota of healthy women. Latest research has implicated the role of fungal biofilms in VVC, particularly in the setting of treatment failure and RVVC. Consequently, a plethora of studies have advocated the utilization of probiotics in addressing these infections. Specifically, the excreted or released compounds of probiotics which are also known as postbiotics are being actively researched with vast potential to be used as therapeutic options for the treatment and prevention of VVC and RVVC. These potential sources of postbiotics are harnessed due to their proven antifungal and antibiofilm. Hence, this review discusses the role of Candida biofilm formation in VVC and RVVC. In addition, we discuss the application of pro-, pre-, post-, and synbiotics either individually or in combined regimen to counteract the abovementioned problems. A clear understanding of the role of biofilms in VVC and RVVC will provide proper footing for further research in devising novel remedies for prevention and treatment of vaginal fungal infections.
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18
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Abnormal vaginal flora correlates with pregnancy outcomes: A retrospective study from 737 pregnant women. Eur J Obstet Gynecol Reprod Biol 2022; 272:64-68. [PMID: 35286920 DOI: 10.1016/j.ejogrb.2022.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Abnormal vaginal flora (AVF) is a common cause of vulvovaginal symptoms in women. This study aims to investigate the prevalence of AVF in pregnant women and assess associations between diverse AVF subtypes and pregnancy outcomes. METHODS This study retrospectively collected clinical data of pregnant women who had vaginal flora tests (VFT) between January 2015 and December 2018 in the First Affiliated Hospital of Xi'an Jiaotong University. AVF were defined into different subtypes according to the results of VFT, including bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), aerobic bacteria (AV), cytolytic vaginosis (CV), and trichomoniasis. Pregnancy outcomes included gestational age at delivery, preterm birth (PTB), premature rupture of membranes (PROM), and infant birth weight. Student's t-test and Fisher's exact test was used for analyses using SPSS 22.0. P < 0.05 was considered as statistical significance. RESULTS A total of 737 pregnant women were included in this study. Pregnant women in AVF group suffered more PROM than women in normal vaginal flora (NVF) group (18.8% [33/176] vs 10.6% [32/302], P = 0.012); pregnant women with BV (31.3% [5/16] vs 10.6% [32/302], P = 0.018) and mixed vaginitis (55.6% [5/9] vs 10.6% [32/302], P = 0.001) had higher PROM rates than women in the NVF group. In addition, pregnant women in NVF and AVF groups had similar PTB rates (5.0% [15/302] vs 3.5% [32/302], P = 0.38). CONCLUSIONS AVF, including BV and Mixed vaginitis, augments PROM risk in pregnant women, demonstrating the need for vaginal flora examination during pregnancy.
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Jafarzadeh L, Ranjbar M, Nazari T, Naeimi Eshkaleti M, Aghaei Gharehbolagh S, Sobel JD, Mahmoudi S. Vulvovaginal candidiasis: An overview of mycological, clinical, and immunological aspects. J Obstet Gynaecol Res 2022; 48:1546-1560. [PMID: 35445492 DOI: 10.1111/jog.15267] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 03/11/2022] [Accepted: 04/04/2022] [Indexed: 12/28/2022]
Abstract
AIM To provide an overview of clinical, immunological, and mycological aspects of vulvovaginal candidiasis (VVC). METHODS A literature search was conducted to find relevant articles about different aspects of VVC. Related data from retrieved articles were summarized in different headings. RESULTS VVC has a global distribution and Candida albicans is the leading cause of infection except for specific patient groups like postmenopausal, diabetic, or immunocompromised women. VVC has a range of clinical presentations, accordingly, its diagnosis should be based on clinical examination coupled with laboratory investigations. The best therapeutic regimen depends on the patient's conditions and the causative agent. Moreover, factors like drug resistance of the causative agents and different mutations in the immunity-related genes could affect the treatment outcome. CONCLUSION As a globally distributed disease, VVC needs further attention, especially in areas related to the treatment failure and recurrence of the disease.
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Affiliation(s)
- Leila Jafarzadeh
- Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maryam Ranjbar
- Department of Persian Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tina Nazari
- Department of Medical Geriatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Naeimi Eshkaleti
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Aghaei Gharehbolagh
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Jack D Sobel
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Shahram Mahmoudi
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Prevalence and species distribution of microorganisms isolated among non-pregnant women affected by vulvovaginal candidiasis: a retrospective study over a 20 year-period. J Mycol Med 2022; 32:101278. [DOI: 10.1016/j.mycmed.2022.101278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/09/2022] [Accepted: 04/14/2022] [Indexed: 11/19/2022]
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21
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Dong Z, Fan C, Hou W, Rui C, Wang X, Fan Y, Zhao L, Wang Q, Wang Z, Zeng X, Feng S, Li P. Vaginal Exposure to Candida albicans During Early Gestation Results in Adverse Pregnancy Outcomes via Inhibiting Placental Development. Front Microbiol 2022; 12:816161. [PMID: 35281308 PMCID: PMC8908259 DOI: 10.3389/fmicb.2021.816161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
Vulvovaginal candidiasis (VVC) is considered the second most common cause of vaginitis after bacterial vaginosis and the most common lower genital tract infection during pregnancy. Candida albicans (C. albicans), an opportunistic pathogen, is the major species causing VVC. Recently, increasing researches have shown that lower reproductive tract infection during pregnancy can lead to various adverse pregnancy outcomes. However, the underlying mechanisms are not fully understood. Hence, we successfully established a mouse model of vaginal C. albicans infection and characterized the adverse pregnancy outcomes. C. albicans infection strikingly increased abortion rate and decreased litter size. Further analysis of placental development demonstrated that placental structure was abnormal, including that the area of spongiotrophoblast (Spo) and labyrinth (Lab) was reduced, and the formation of placental vessel was decreased in Lab zone. Accordingly, the expression of marker genes during placental development was downregulated. Collectively, the above findings revealed that vaginal C. albicans infection during pregnancy can inhibit placental development and ultimately lead to adverse pregnancy outcomes. This study enhances our comprehension of the effect of VVC on pregnancy, and placental dysplasia as a feasible orientation to explore VVC during pregnancy.
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Affiliation(s)
- Zhiyong Dong
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Chong Fan
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Wenwen Hou
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Can Rui
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Xinyan Wang
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yuru Fan
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Ling Zhao
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Qing Wang
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Zhichong Wang
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Xin Zeng
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
- *Correspondence: Xin Zeng,
| | - Shanwu Feng
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- Shanwu Feng,
| | - Ping Li
- Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- Ping Li,
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REVISITING THE CONTENT OF NON-SPECIFIC INFLAMMATORY PROCESS MARKERS AND 25-HYDROXYVITAMIN D IN THE BLOOD OF PREGNANT WOMEN OF HIGH INFECTIOUS RISK. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-4-82-118-123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bioactive triterpenoids from Solanum torvum fruits with antifungal, resistance modulatory and anti-biofilm formation activities against fluconazole-resistant candida albicans strains. PLoS One 2021; 16:e0260956. [PMID: 34962953 PMCID: PMC8714089 DOI: 10.1371/journal.pone.0260956] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/20/2021] [Indexed: 12/18/2022] Open
Abstract
Vulvovaginal candidiasis (VVC) is the second most common vaginal infection that affects women of reproductive age. Its increased occurrence and associated treatment cost coupled to the rise in resistance of the causative pathogen to current antifungal therapies has necessitated the need for the discovery and development of novel effective antifungal agents for the treatment of the disease. We report in this study the anti-Candida albicans activity of Solanum torvum 70% ethanol fruit extract (STF), fractions and some isolated compounds against four (4) fluconazole-resistant strains of C. albicans. We further report on the effect of the isolated compounds on the antifungal activity of fluconazole and voriconazole in the resistant isolates as well as their inhibitory effect on C. albicans biofilm formation. STF was fractionated using n-hexane, chloroform (CHCl3) and ethyl acetate (EtOAc) to obtain four respective major fractions, which were then evaluated for anti-C. albicans activity using the microbroth dilution method. The whole extract and fractions recorded MICs that ranged from 0.25 to 16.00 mg/mL. From the most active fraction, STF- CHCl3 (MIC = 0.25-1.00 mg/mL), four (4) known compounds were isolated as Betulinic acid, 3-oxo-friedelan-20α-oic acid, Sitosterol-3-β-D-glucopyranoside and Oleanolic acid. The compounds demonstrated considerably higher antifungal activity (0.016 to 0.512 mg/mL) than the extract and fractions and caused a concentration-dependent anti-biofilm formation activity. They also increased the sensitivity of the C. albicans isolates to fluconazole. This is the first report of 3-oxo-friedelan-20α-oic acid in the plant as well as the first report of betulinic acid, sitosterol-3-β-D-glucopyranoside and oleanolic acid from the fruits of S. torvum. The present study has demonstrated the anti-C. albicans activity of the constituents of S. torvum ethanol fruit extract and also shown that the constituents possess anti-biofilm formation and resistance modulatory activities against fluconazole-resistant clinical C. albicans isolates.
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Antifungal Resistance in Clinical Isolates of Candida glabrata in Ibero-America. J Fungi (Basel) 2021; 8:jof8010014. [PMID: 35049954 PMCID: PMC8781625 DOI: 10.3390/jof8010014] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 12/14/2022] Open
Abstract
In different regions worldwide, there exists an intra-and inter-regional variability in the rates of resistance to antifungal agents in Candida glabrata, highlighting the importance of understanding the epidemiology and antifungal susceptibility profiles of C. glabrata in each region. However, in some regions, such as Ibero-America, limited data are available in this context. Therefore, in the present study, a systematic review was conducted to determine the antifungal resistance in C. glabrata in Ibero-America over the last five years. A literature search for articles published between January 2015 and December 2020 was conducted without language restrictions, using the PubMed, Embase, Cochrane Library, and LILACS databases. The search terms that were used were "Candida glabrata" AND "antifungal resistance" AND "Country", and 22 publications were retrieved from different countries. The use of azoles (fluconazole, itraconazole, voriconazole, posaconazole, isavuconazole, ketoconazole, and miconazole) varied between 4.0% and 100%, and that of echinocandins (micafungin, caspofungin, and anidulafungin) between 1.1% and 10.0%. The limited information on this subject in the region of Ibero-America emphasizes the need to identify the pathogens at the species level and perform antifungal susceptibility tests that may lead to the appropriate use of these drugs and the optimal doses in order to avoid the development of antifungal resistance or multi-resistance.
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25
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Frías-De-León MG, Hernández-Castro R, Conde-Cuevas E, García-Coronel IH, Vázquez-Aceituno VA, Soriano-Ursúa MA, Farfán-García ED, Ocharán-Hernández E, Rodríguez-Cerdeira C, Arenas R, Robledo-Cayetano M, Ramírez-Lozada T, Meza-Meneses P, Pinto-Almazán R, Martínez-Herrera E. Candida glabrata Antifungal Resistance and Virulence Factors, a Perfect Pathogenic Combination. Pharmaceutics 2021; 13:pharmaceutics13101529. [PMID: 34683822 PMCID: PMC8538829 DOI: 10.3390/pharmaceutics13101529] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/03/2021] [Accepted: 09/14/2021] [Indexed: 02/07/2023] Open
Abstract
In recent years, a progressive increase in the incidence of invasive fungal infections (IFIs) caused by Candida glabrata has been observed. The objective of this literature review was to study the epidemiology, drug resistance, and virulence factors associated with the C. glabrata complex. For this purpose, a systematic review (January 2001-February 2021) was conducted on the PubMed, Scielo, and Cochrane search engines with the following terms: "C. glabrata complex (C. glabrata sensu stricto, C. nivariensis, C. bracarensis)" associated with "pathogenicity" or "epidemiology" or "antibiotics resistance" or "virulence factors" with language restrictions of English and Spanish. One hundred and ninety-nine articles were found during the search. Various mechanisms of drug resistance to azoles, polyenes, and echinocandins were found for the C. glabrata complex, depending on the geographical region. Among the mechanisms found are the overexpression of drug transporters, gene mutations that alter thermotolerance, the generation of hypervirulence due to increased adhesion factors, and modifications in vital enzymes that produce cell wall proteins that prevent the activity of drugs designed for its inhibition. In addition, it was observed that the C. glabrata complex has virulence factors such as the production of proteases, phospholipases, and hemolysins, and the formation of biofilms that allows the complex to evade the host immune response and generate fungal resistance. Because of this, the C. glabrata complex possesses a perfect pathogenetic combination for the invasion of the immunocompromised host.
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Affiliation(s)
- María Guadalupe Frías-De-León
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico; (M.G.F.-D.-L.); (M.R.-C.)
| | - Rigoberto Hernández-Castro
- Departamento de Ecología de Agentes Patógenos, Hospital General “Dr. Manuel Gea González”, Ciudad de México 14080, Mexico; (R.H.-C.); (V.A.V.-A.)
| | - Esther Conde-Cuevas
- Maestría en Ciencias de la Salud, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (E.C.-C.); (I.H.G.-C.); (P.M.-M.)
| | - Itzel H. García-Coronel
- Maestría en Ciencias de la Salud, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (E.C.-C.); (I.H.G.-C.); (P.M.-M.)
| | - Víctor Alfonso Vázquez-Aceituno
- Departamento de Ecología de Agentes Patógenos, Hospital General “Dr. Manuel Gea González”, Ciudad de México 14080, Mexico; (R.H.-C.); (V.A.V.-A.)
| | - Marvin A. Soriano-Ursúa
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (M.A.S.-U.); (E.D.F.-G.); (E.O.-H.)
| | - Eunice D. Farfán-García
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (M.A.S.-U.); (E.D.F.-G.); (E.O.-H.)
| | - Esther Ocharán-Hernández
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (M.A.S.-U.); (E.D.F.-G.); (E.O.-H.)
| | - Carmen Rodríguez-Cerdeira
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain; (C.R.-C.); (R.A.)
- Dermatology Department, Hospital Vithas Ntra. Sra. de Fátima and University of Vigo, 36206 Vigo, Spain
- Campus Universitario, University of Vigo, 36310 Vigo, Spain
| | - Roberto Arenas
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain; (C.R.-C.); (R.A.)
- Sección de Micología, Hospital General “Dr. Manuel Gea González”, Tlalpan, Ciudad de México 14080, Mexico
| | - Maura Robledo-Cayetano
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico; (M.G.F.-D.-L.); (M.R.-C.)
| | - Tito Ramírez-Lozada
- Servicio de Ginecología y Obstetricia, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico;
| | - Patricia Meza-Meneses
- Maestría en Ciencias de la Salud, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (E.C.-C.); (I.H.G.-C.); (P.M.-M.)
- Servicio de Infectología, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico
| | - Rodolfo Pinto-Almazán
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico; (M.G.F.-D.-L.); (M.R.-C.)
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (M.A.S.-U.); (E.D.F.-G.); (E.O.-H.)
- Correspondence: (R.P.-A.); (E.M.-H.); Tel.: +52-555-972-9800 (R.P.-A. or E.M.-H.)
| | - Erick Martínez-Herrera
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico; (M.G.F.-D.-L.); (M.R.-C.)
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (M.A.S.-U.); (E.D.F.-G.); (E.O.-H.)
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain; (C.R.-C.); (R.A.)
- Correspondence: (R.P.-A.); (E.M.-H.); Tel.: +52-555-972-9800 (R.P.-A. or E.M.-H.)
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Carvalho GC, de Oliveira RAP, Araujo VHS, Sábio RM, de Carvalho LR, Bauab TM, Corrêa I, Chorilli M. Prevalence of vulvovaginal candidiasis in Brazil: a systematic review. Med Mycol 2021; 59:946-957. [PMID: 34137857 DOI: 10.1093/mmy/myab034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/26/2021] [Accepted: 06/15/2021] [Indexed: 12/18/2022] Open
Abstract
Vulvovaginal candidiasis (CVV) is a condition whose signs and symptoms are related to inflammation caused by Candida spp infection. It is the second leading cause of vaginitis in the world, representing a public health problem. The present systematic review comes with the proposal of analyze and identify the available evidence on CVV prevalence in Brazil, pointing out its variability by regions. For this, a systematic literature review was carried out with meta-analysis of cross-sectional and cohort studies, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guide recommendations, and was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2020 CRD42020181695). The databases used for survey were LILACS, Scielo, Scopus, PUBMED, Web of Science and CINAHL. Fifteen studies were selected to estimate CVV prevalence in the Brazilian territory. South and Southeast regions have higher prevalences than the North and Northeast regions, no data were found for the Midwest region. The estimated prevalence for Brazil is 18%, however, it is suggested that this number is higher due to underreporting and the presence of asymptomatic cases. Therefore, new epidemiological studies are recommended throughout Brazil, to elucidate the profile of this disease in the country, in addition to assisting in the elaboration of an appropriate prevention plan by state. LAY ABSTRACT Data found in the literature regarding the epidemiological profile of VVC in Brazil are obsolete and incomplete, so the present systematic review has the proposal to analyze and identify the evidence on VVC prevalence in Brazil. The estimated prevalence is 18%, however, this number can be higher.
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Affiliation(s)
- Gabriela Corrêa Carvalho
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | | | - Victor Hugo Sousa Araujo
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | - Rafael Miguel Sábio
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | - Lídia Raquel de Carvalho
- Biostatistics department, Institute of Biosciences, São Paulo State University (UNESP), 18618687 Botucatu, Brazil
| | - Taís Maria Bauab
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | - Ione Corrêa
- Nursing department, Medical School, São Paulo State University (UNESP), 18618687 Botucatu, Brazil
| | - Marlus Chorilli
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
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Anh DN, Hung DN, Tien TV, Dinh VN, Son VT, Luong NV, Van NT, Quynh NTN, Van Tuan N, Tuan LQ, Bac ND, Luc NK, Anh LT, Trung DM. Prevalence, species distribution and antifungal susceptibility of Candida albicans causing vaginal discharge among symptomatic non-pregnant women of reproductive age at a tertiary care hospital, Vietnam. BMC Infect Dis 2021; 21:523. [PMID: 34082699 PMCID: PMC8176683 DOI: 10.1186/s12879-021-06192-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022] Open
Abstract
Background Vaginal candidiasis is frequent in women of reproductive age. Accurate identification Candida provides helpful information for successful therapy and epidemiology study; however, there are very limited data from the Vietnam have been reported. This study was performed to determine the prevalence, species distribution of yeast causing vaginal discharge and antifungal susceptibility patterns of Candida albicans among symptomatic non-pregnant women of reproductive age. Methods Vaginal discharge samples were collected from 462 women of reproductive age in Hanoi, Vietnam between Sep 2019 and Oct 2020. Vaginal swabs from these patients were examined by direct microscopic examination (10% KOH). CHROMagar™ Candida medium and Sabouraud dextrose agar supplemented with chloramphenicol (0.5 g/l) were used to isolate yeast, and species identification was performed using morphological tests and molecular tools (PCR and sequencing). Antifungal susceptibility testing was determined according to the Clinical and Laboratory Standards Institute guidelines (M27-A3 and M27-S4). Results The prevalence of vaginal yeast colonization in non-pregnant women was 51.3% of 462 participants. Nine different yeast species were identified. Among these isolates, C. albicans (51.37%) was the most frequent, followed by C. parapsilosis (25.88%), C. glabrata (11.37%), C. tropicalis (4.31%), C. krusei (3.92%), C. africana (1.57%), Saccharomyces cerevisiae (0.78%), C. nivariensis (1 isolates, 0.39%), and C. lusitaniae (1 isolates, 0.39%), respectively. Among C. albicans, all 46 isolates were 100% susceptible to micafungin, caspofungin, and miconazole. The susceptibility rates to amphotericine B, 5-flucytosine, fluconazole, itraconazole and voriconazole were 95.65, 91.30, 91.30, 82.61 and 86.95%, respectively. Conclusions The prevalence of VVC among symptomatic non-pregnant women of reproductive age in Vietnam was higher than many parts of the world. The high frequency of non-albicans Candida species, which were often more resistant to antifungal agents, was a notable feature. Resistance rates of vaginal C. albicans isolates to antifungal agents was low. Our findings suggest that continued surveillance of changes in species distribution and susceptibility to antifungals should be routinely screened and treated. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06192-7.
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Affiliation(s)
- Do Ngoc Anh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam. .,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam.
| | - Dao Nguyen Hung
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Tran Viet Tien
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Vu Nhat Dinh
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Vu Tung Son
- Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam
| | | | - Nguyen Thi Van
- Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Nguyen Thi Nhu Quynh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Van Tuan
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Le Quoc Tuan
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Nguyen Duy Bac
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Khac Luc
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Le Tran Anh
- Department of Medical Parasitology, Vietnam Military Medical University, Hanoi, Vietnam.,Laboratory of Parasitology and Medical Mycology, 103 Military Hospital, Hanoi, Vietnam
| | - Do Minh Trung
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam.
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28
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Scorzoni L, Fuchs BB, Junqueira JC, Mylonakis E. Current and promising pharmacotherapeutic options for candidiasis. Expert Opin Pharmacother 2021; 22:867-887. [PMID: 33538201 DOI: 10.1080/14656566.2021.1873951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Candida spp. are commensal yeasts capable of causing infections such as superficial, oral, vaginal, or systemic infections. Despite medical advances, the antifungal pharmacopeia remains limited and the development of alternative strategies is needed.Areas covered: We discuss available treatments for Candida spp. infections, highlighting advantages and limitations related to pharmacokinetics, cytotoxicity, and antimicrobial resistance. Moreover, we present new perspectives to improve the activity of the available antifungals, discussing their immunomodulatory potential and advances on drug delivery carriers. New therapeutic approaches are presented including recent synthesized antifungal compounds (Enchochleated-Amphotericin B, tetrazoles, rezafungin, enfumafungin, manogepix and arylamidine); drug repurposing using a diversity of antibacterial, antiviral and non-antimicrobial drugs; combination therapies with different compounds or photodynamic therapy; and innovations based on nano-particulate delivery systems.Expert opinion: With the lack of novel drugs, the available assets must be leveraged to their best advantage through modifications that enhance delivery, efficacy, and solubility. However, these efforts are met with continuous challenges presented by microbes in their infinite plight to resist and survive therapeutic drugs. The pharmacotherapeutic options in development need to focus on new antimicrobial targets. The success of each antimicrobial agent brings strategic insights to the next phased approach in treatingCandida spp. infections.
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Affiliation(s)
- Liliana Scorzoni
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University/UNESP, SP Brazil
| | - Beth Burgwyn Fuchs
- Division of Infectious Diseases, Rhode Island Hospital, Alpert Medical School, Brown University, Providence, RI USA
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University/UNESP, SP Brazil
| | - Eleftherios Mylonakis
- Division of Infectious Diseases, Rhode Island Hospital, Alpert Medical School, Brown University, Providence, RI USA
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29
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Joao I, Bujdáková H, Jordao L. Opportunist Coinfections by Nontuberculous Mycobacteria and Fungi in Immunocompromised Patients. Antibiotics (Basel) 2020; 9:E771. [PMID: 33147819 PMCID: PMC7693372 DOI: 10.3390/antibiotics9110771] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 12/14/2022] Open
Abstract
Nontuberculous mycobacteria (NTM) and many fungal species (spp.) are commonly associated with opportunistic infections (OPIs) in immunocompromised individuals. Moreover, occurrence of concomitant infection by NTM (mainly spp. of Mycobacterium avium complex and Mycobacterium abscessus complex) and fungal spp. (mainly, Aspergillus fumigatus, Histoplasma capsulatum and Cryptococcus neoformans) is very challenging and is associated with poor patient prognosis. The most frequent clinical symptoms for coinfection and infection by single agents (fungi or NTM) are similar. For this reason, the accurate identification of the aetiological agent(s) is crucial to select the best treatment approach. Despite the significance of this topic it has not been sufficiently addressed in the literature. This review aims at summarizing case reports and studies on NTM and fungi coinfection during the last 20 years. In addition, it briefly characterizes OPIs and coinfection, describes key features of opportunistic pathogens (e.g., NTM and fungi) and human host predisposing conditions to OPIs onset and outcome. The review could interest a wide spectrum of audiences, including medical doctors and scientists, to improve awareness of these infections, leading to early identification in clinical settings and increasing research in the field. Improved diagnosis and availability of therapeutic options might contribute to improve the prognosis of patients' survival.
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Affiliation(s)
- Ines Joao
- National Institute of Health Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal;
| | - Helena Bujdáková
- Department of Microbiology and Virology, Faculty of Natural Sciences, Comenius University in Bratislava, 842 15 Bratislava, Slovakia
| | - Luisa Jordao
- National Institute of Health Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal;
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Osman Mohamed A, Suliman Mohamed M, Abdelrahman Hussain M, Fatahalrahman Ahmed I. Detection of antifungal drug-resistant and ERG11 gene mutations among clinical isolates of Candida species isolated from Khartoum, Sudan. F1000Res 2020; 9:1050. [PMID: 34035903 PMCID: PMC8114185 DOI: 10.12688/f1000research.24854.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 11/20/2022] Open
Abstract
Background:
Candida species are one of the most important opportunistic fungal pathogens that cause both superficial and systemic infections, especially in immunocompromised individuals. Considering the sharp increase in the rate of
Candida infections, and resistance to commonly used antifungal agents in the last decades; this study was conducted to determine the rate of resistance among clinical isolates of
Candida species, and to characterize some of the resistant genes among resistant isolates collected in Khartoum. Methods: This is a cross-sectional laboratory-based study included 100 pre-screened
Candida species isolates from Khartoum state hospitals. Chromogenic media was used for
Candida isolation and/or identification. The standard disc diffusion method was performed to investigate the susceptibility to fluconazole, itraconazole, and amphotericin. Following genomic DNA extraction, the entire
ERG11 gene was amplified from some
C. albicans resistant isolates, sequenced, and further analyzed. Results: Out of 100 clinical isolates collected, 51% were
C. albicans, followed by
C. glabrata (31%),
C. krusie (8%),
C. tropicals (5%), and
C. dupliniens (5%). Resistance rate was 23% for fluconazole, 4% for itraconazole, while there were no amphotericin resistant isolates detected.
C. albicans
ERG11 gene sequence reveals 15 different mutations. Among these, three (D116E, E266D, and V488I) were missense mutations; however, these substitutions do not contribute to fluconazole resistance. Conclusion:
C. albicans was found to be the most common species. Resistance against fluconazole was observed most frequently; however, mutations in
ERG11 are unlikely to be the reason behind fluconazole resistance among these isolates.
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Affiliation(s)
- Ahmed Osman Mohamed
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, International University of Africa, Khartoum, 11111, Sudan.,Department of Pharmaceutics, Faculty of Pharmacy, Sudan International University, Khartoum, 11111, Sudan
| | - Malik Suliman Mohamed
- Department of Pharmaceutics, College of Pharmacy, Jouf University, Sakaka, Al Jouf, P.O.Box 2014, Saudi Arabia.,Department of Pharmaceutics, Faculty of Pharmacy, University of Khartoum, Khartoum, P. O. Box 1996, Sudan
| | - Mohamed Abdelrahman Hussain
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, International University of Africa, Khartoum, 11111, Sudan
| | - Ibrahim Fatahalrahman Ahmed
- Department of Microbiology, Faculty of Pure and Applied Science, International University of Africa, Khartoum, 11111, Sudan
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