1
|
Hanifah R, Wahid M, Yasmon A. First report of amphotericin B resistant Candida haemulonii isolated from the ICU of a referral hospital in Indonesia. IRANIAN JOURNAL OF MICROBIOLOGY 2024; 16:280-284. [PMID: 38854988 PMCID: PMC11162170 DOI: 10.18502/ijm.v16i2.15363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background and Objectives Amphotericin B is a broad-spectrum antifungal agent commonly used to treat Candida haemulonii infection. C. haemulonii was isolated from patients reported to be intrinsically resistant to amphotericin B, encoded by the ERG2 and ERG11 genes. However, there have been limited studies concerning amphotericin B-resistant C. haemulonii in Indonesia. The objective of this study is to explore the phenotypic and genotypic characteristics (ERG2 and ERG11) of C. haemulonii isolated from the ICU of a referral hospital in Indonesia. Materials and Methods Identification and susceptibility tests were conducted using VITEK2. Thereafter, DNA was extracted and amplified using conventional PCR followed by DNA sequencing (Sanger method). Results The results of the phenotypic susceptibility test showed that all C. haemulonii were resistant to amphotericin B. ERG2 and ERG11 sequences showed the same amino acid sequence and corresponded to references that are resistant to amphotericin B. Conclusion The resistant properties of C. haemulonii against amphotericin B found in this study require further exploration, including comparing resistant and sensitive C. haemulonii to amphotericin B. In addition, it is necessary to analyze other genes besides ERG2 and ERG11.
Collapse
Affiliation(s)
- Rifdah Hanifah
- Department of Microbiology, Master’s Programme in Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Mardiastuti Wahid
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Andi Yasmon
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| |
Collapse
|
2
|
Özmerdiven GE, İrvem A, Şahin AS. Risk analysis of candidemia and its effect on mortality in COVID 19 and non COVID 19 patients. IRANIAN JOURNAL OF MICROBIOLOGY 2024; 16:236-242. [PMID: 38854981 PMCID: PMC11162174 DOI: 10.18502/ijm.v16i2.15357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background and Objectives Candidemia is the most common serious fungal infection in critically ill patients in intensive care units (ICU). It series fourth among bloodstream infectious agents. In this study, candidemia risk analysis was examined in COVID 19 and non-COVID 19 patients during the pandemic period. Materials and Methods COVID 19 and non-COVID 19 cases who were followed up with candidemia in the ICU of our hospital were retrospectively screened. Demographic data, intubation, central venous catheter (CVC), medications, and total parenteral nutrition (TPN) status were evaluated in terms of risk between the two groups. Isolated Candida species and susceptibilty were evaluated. Results When age, gender, medication, intubation, TPN and CVC were evaluated, no difference was seen in terms of risk. Differences were detected in terms of comorbidities. While the most frequently identified Candida species was C. albicans, the most frequently detected species in the COVID19 patient group was C. parapsilosis. Conclusion There was no difference in candidemia incidence and risk factors between the two groups. Since candidemias were evaluated in terms of comorbidities, it was determined that Diabetes Mellitus (DM) and chronic obstructive pulmoner disease (COPD) were more common in patients with COVID 19 and less common in coronary artery disease (CAD) and malignancy.
Collapse
Affiliation(s)
- Gülşah Ece Özmerdiven
- Department of Microbiology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Arzu İrvem
- Department of Microbiology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Ayça Sultan Şahin
- Department of Anesthesia and Reanimation, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| |
Collapse
|
3
|
Thomsen J, Abdulrazzaq NM, Oulhaj A, Nyasulu PS, Alatoom A, Denning DW, Al Dhaheri F, Menezes GA, Moubareck CA, Senok A, Everett DB. Emergence of highly resistant Candida auris in the United Arab Emirates: a retrospective analysis of evolving national trends. Front Public Health 2024; 11:1244358. [PMID: 38292390 PMCID: PMC10826512 DOI: 10.3389/fpubh.2023.1244358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/08/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction The Centers for Disease Prevention and Control lists Candida auris, given its global emergence, multidrug resistance, high mortality, and persistent transmissions in health care settings as one of five urgent threats. As a new threat, the need for surveillance of C. auris is critical. This is particularly important for a cosmopolitan setting and global hub such as the United Arab Emirates (UAE) where continued introduction and emergence of resistant variant strains is a major concern. Methods The United Arab Emirates has carried out a 12 years of antimicrobial resistance surveillance (2010-2021) across the country, spanning all seven Emirates. A retrospective analysis of C. auris emergence from 2018-2021 was undertaken, utilising the demographic and microbiological data collected via a unified WHONET platform for AMR surveillance. Results Nine hundred eight non-duplicate C. auris isolates were reported from 2018-2021. An exponential upward trend of cases was found. Most isolates were isolated from urine, blood, skin and soft tissue, and the respiratory tract. UAE nationals nationals comprised 29% (n = 186 of 632) of all patients; the remainder were from 34 other nations. Almost all isolates were from inpatient settings (89.0%, n = 809). The cases show widespread distribution across all reporting sites in the country. C. auris resistance levels remained consistently high across all classes of antifungals used. C. auris in this population remains highly resistant to azoles (fluconazole, 72.6% in 2021) and amphotericin. Echinocandin resistance has now emerged and is increasing annually. There was no statistically significant difference in mortality between Candida auris and Candida spp. (non-auris) patients (p-value: 0.8179), however Candida auris patients had a higher intensive care unit (ICU) admission rate (p-value <0.0001) and longer hospital stay (p < 0.0001) compared to Candida spp. (non-auris) patients. Conclusion The increasing trend of C. auris detection and associated multidrug resistant phenotypes in the UAE is alarming. Continued C. auris circulation in hospitals requires enhanced infection control measures to prevent continued dissemination.
Collapse
Affiliation(s)
- Jens Thomsen
- Department of Environmental and Occupational Health and Safey, Abu Dhabi Publich Health Center, Abu Dhabi, United Arab Emirates
- Department of Pathology and Infectious Diseases, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Najiba M. Abdulrazzaq
- Al Kuwait Hospital Dubai, Emirates Health Services Establishment (EHS), Dubai, United Arab Emirates
| | - Abderrahim Oulhaj
- Department of Epidemiology and Public Health, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Peter S. Nyasulu
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Adnan Alatoom
- Department of Pathology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - David W. Denning
- Manchester Fungal Infection Group, The University of Manchester, Manchester, United Kingdom
| | - Fatima Al Dhaheri
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Godfred Antony Menezes
- Department of Medical Microbiology and Immunology, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | | | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- School of Dentistry, Cardiff University, Cardiff, United Kingdom
| | - Dean B. Everett
- Department of Pathology and Infectious Diseases, Khalifa University, Abu Dhabi, United Arab Emirates
- Biotechnology Research Center, Khalifa University, Abu Dhabi, United Arab Emirates
- Infection Research Unit, Khalifa University, Abu Dhabi, United Arab Emirates
| |
Collapse
|
4
|
Choe KW, Lim YK, Lee MK. Comparison of new and old BacT/ALERT aerobic bottles for detection of Candida species. PLoS One 2023; 18:e0288674. [PMID: 38019833 PMCID: PMC10686453 DOI: 10.1371/journal.pone.0288674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023] Open
Abstract
PURPOSE A new version of aerobic blood culture media has been developed for the BacT/ALERT (bioMérieux) blood culture system. We evaluated the time to detection and yeast cell counts in positive blood cultures for each Candida spp. according to changes in media. METHODS Isolates from defibrinated horse blood were inoculated into three types of bottles: the old version of aerobic bottle, new version of aerobic bottle, and anaerobic bottle. All bottles were incubated in the BacT/ALERT Virtuo blood culture system. The time to detection was monitored for each bottle, and yeast cell counts were performed immediately after testing positive, determined via the plate count method. Clinical retrospective data of the candidemia samples before and after aerobic bottle change also were analyzed. RESULTS The median time to detection was 52.47 hours in the old aerobic bottles versus 19.92 hours in the new aerobic bottles (P < 0.001) for Candida glabrata, and standard and clinical strains showed similar results. C. albicans (27.6 to 24.95 hours) and C. guilliermondii (28.92 to 26.9 hours) had shorter time to detection. However, C. auris (25.43 to 28.25 hours) had a longer time to detection in the new aerobic bottle. The retrospective clinical analysis showed a significant decrease in time to detection (45.0 to 19.4 hours) for C. glabrata, which is consistent with our simulated study result for C. glabrata. As a result of analysis including all blood specimens, C. tropicalis showed a significant delay in time to detection in new aerobic bottles. In an analysis limited to peripheral blood specimens, the time to detection of C. parapsilosis was longer in new aerobic bottles than in old aerobic bottles. CONCLUSION Most Candida species did not show remarkable TTD differences, but TTD of C. glabrata was markedly reduced in the New FA Plus bottle. The reduction of time to detection enables faster detection and therapeutic approach for C. glabrata infections.
Collapse
Affiliation(s)
- Kye Won Choe
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yong Kwan Lim
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Mi-Kyung Lee
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
5
|
Thasu Dinakaran V, Santhaseelan H, Krishnan M, Devendiran V, Dahms HU, Duraikannu SL, Rathinam AJ. Gracilaria salicornia as potential substratum for green synthesis of Cerium Oxide Nanoparticles coupled hydrogel: An effective antimicrobial thin film. Microb Pathog 2023; 184:106360. [PMID: 37722491 DOI: 10.1016/j.micpath.2023.106360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/09/2023] [Accepted: 09/14/2023] [Indexed: 09/20/2023]
Abstract
Sodium alginate based (SA) hydrogel supplemented Cerium Oxide nanoparticles (CeO2NPs) was produced to fabricate an antimicrobial thin film using an aqueous extract of G. salicornia (Gs). The Gs-CeO2NPs were characterized via SEM, FT-IR, EDX, XRD and DLS, the particle size was 200 nm, agreed with XRD. Gs-SA powder was extracted and incorporated with CeO2NPs. The Gs-SA and its composite thin film (Gs-CeO2NPs-SATF) were characterized including viscosity, FT-IR, TGA, and SEM. The adhesion of Gs-SA coating around Gs-CeO2NPs confirmed via FTIR. The antimicrobial properties of Gs-CeO2NPs and CeO2NPs-SATF were proved in MICs for E. coli and Candida albicans at 62.5 and 250.0 μg/mL. The biofilm inhibition efficiency of CeO2NPs-SATF was 74.67 ± 0.98% and 65.45 ± 0.40% for E. coli and Candida albicans. The CeO2NPs-SATF was polydisperse in nature and film structure gets fluctuated with NPs concentration. Increased NPs into SATF enhances pore size of gel and corroborated with viscous behaviour. The cytotoxicity of Gs-CeO2NP-SA in Artemia salina at higher concentration 100 μg/mL provides less lethal effect into the adult. The antioxidant activity of Gs-CeO2NP-SA in DPPH assay was noticed at 0.6 mg ml-1 with radical scavenging activity at 65.85 ± 0.81%. Thus the Gs-CeO2NP-SATF would be suitable in antimicrobial applications.
Collapse
Affiliation(s)
| | - Henciya Santhaseelan
- Department of Marine Science, Bharathidasan University, Tiruchirappalli, 620 024, Tamil Nadu, India
| | - Muthukumar Krishnan
- Department of Petrochemical Technology, Bharathidasan Institute of Technology Campus, University College of Engineering, Anna University, Tiruchirappalli, 620 024, Tamil Nadu, India
| | - Velmurugan Devendiran
- Department of Marine Science, Bharathidasan University, Tiruchirappalli, 620 024, Tamil Nadu, India
| | - Hans Uwe Dahms
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | | | - Arthur James Rathinam
- Department of Marine Science, Bharathidasan University, Tiruchirappalli, 620 024, Tamil Nadu, India.
| |
Collapse
|
6
|
Fakhim H, Vaezi A, Morovati H, Bandegani A, Abbasi K, Emami S, Nasiry D, Hashemi SM, Ahangarkani F, Badali H. In-vivo efficiency of the novel azole compounds (ATTAF-1 and ATTAF-2) against systemic candidiasis in a murine model. J Mycol Med 2023; 33:101437. [PMID: 37804566 DOI: 10.1016/j.mycmed.2023.101437] [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: 03/13/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Antifungal resistance is the main health concern in the control of invasive fungal infections. This research was designed to further assess the antifungal activity of aryl-1,2,4-triazole-3-ylthio analogs of fluconazole (ATTAFs) against Candida albicans systemic candidiasis in the murine model. MATERIALS & METHODS The murine model of systemic candidiasis was designed via the inoculation of 1 × 106 CFU of Candida albicans. The treatment dosages of 3.5 and 35 mg/kg per day were selected for ATTAFs and fluconazole, respectively. The median survival time (MST) was assayed for 30 days post-infection. The quantitative and qualitative (via histopathology staining) fungal burden was also assessed. Furthermore, immunohistochemistry and biochemistry assays were performed to monitor anti-inflammatory activity using the Cyclooxygenase-2 (Cox-2) marker and changes in serum protein levels. RESULTS ATTAFs considerably improved the survival of the murine model (P < 0.003). Compared with fluconazole, the antifungal activity of ATTAFs and their MST showed no difference (P > 0.05). However, these compounds decreased the fungal burden in the kidneys, spleen, and liver. CONCLUSION Our research indicates that ATTAF-1 and ATTAF-2 are effective therapeutic agents due to their fungal clearing and increasing the MST in the murine model of systemic candidiasis. Although we concluded that these components are novel and promising candidates for the management of invasive candidiasis, further studies are warranted to correlate these findings with clinical outcomes.
Collapse
Affiliation(s)
- Hamed Fakhim
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Afsane Vaezi
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Morovati
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Bandegani
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kiana Abbasi
- Department of Microbiology, Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | - Saeed Emami
- Department of Medicinal Chemistry and Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Davood Nasiry
- Amol Faculty of Paramedicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyedeh Mahdieh Hashemi
- Department of Medicinal Chemistry and Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Ahangarkani
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamid Badali
- Department of Molecular Microbiology & Immunology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, USA.
| |
Collapse
|
7
|
Park E, Park HR, Lee JH. Barriers to Learning Healthcare-Associated Infections Prevention and Control during Clinical Practicum among Nursing Students in Korea: A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6430. [PMID: 37510662 PMCID: PMC10380072 DOI: 10.3390/ijerph20146430] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
Healthcare-associated infections (HAI) refer to infections that patients may acquire from healthcare facilities through nursing activities. Nursing students involved in patient care are regularly exposed to an array of pathogens and clinical practicum is essential for them to appropriately practice HAI prevention and control. This study aimed to explore the barriers to learning HAI prevention and control experienced by nursing students during their clinical practicum. A qualitative study was performed using focus group interviews. A total of 12 nursing students from South Korea, consisting of six third-year students and six fourth-year students, were enrolled. Both groups had taken clinical practicum courses. Data were collected using semi-structured questions and analyzed with conventional content analysis. Barriers experienced by the participants when learning HAI prevention and control were limited learning opportunities, inadequate infection control-related knowledge, inadequate practicum experience, and passive learning attitudes. Addressing the identified barriers would allow nursing students to effectively acquire infection control competencies during their clinical practicum.
Collapse
Affiliation(s)
- Eunyoung Park
- College of Nursing, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Hyung-Ran Park
- Department of Nursing Science, College of Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Ji-Hye Lee
- Department of Nursing Science, College of Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea
| |
Collapse
|
8
|
Alves AMCV, Lopes BO, Leite ACRDM, Cruz GS, Brito ÉHSD, Lima LFD, Černáková L, Azevedo NF, Rodrigues CF. Characterization of Oral Candida spp. Biofilms in Children and Adults Carriers from Eastern Europe and South America. Antibiotics (Basel) 2023; 12:antibiotics12050797. [PMID: 37237699 DOI: 10.3390/antibiotics12050797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Candida albicans and non-Candida albicans Candida species (NCACs) are known to colonize and invade various tissues, including the oral mucosa. In this work, we aimed to characterize mature biofilms of several Candida spp. clinical isolates (n = 33) obtained from the oral mucosa of children, adults, and elders of Eastern Europe and South America. METHODS Each strain was evaluated for its capacity to form biofilms in terms of total biomass using the crystal violet assay and for matrix components production (proteins and carbohydrates) using the BCA and phenol-sulfuric tests, respectively. The effect of different antifungals on biofilm formation was studied. RESULTS in the children's group, a predominance of C. krusei (81%) was observed, while, among adults, the main species was C. albicans (59%). Most strains showed a reduced response to antimicrobial drugs when in biofilm form (p < 0.01). Moreover, it was observed that strains isolated from children produced more matrix, with higher levels of protein and polysaccharides. CONCLUSIONS children were more likely to be infected by NCACs than adults. More importantly, these NCACs were able to form biofilms richer in matrix components. This finding is of clinical importance, particularly in pediatric care, since stronger biofilms are highly associated with antimicrobial resistance, recurrent infections, and higher therapeutic failure.
Collapse
Affiliation(s)
- Anelise Maria Costa Vasconcelos Alves
- Institute of Health Sciences, University of International Integration of Af-ro-Brazilian Lusophony, Av. da Abolição, 3-Centro, Redenção 62790-000, Ceará, Brazil
- LEPABE-Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Doutor Roberto Frias, 4200-465 Porto, Portugal
- ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Doutor Roberto Frias, 4200-465 Porto, Portugal
| | - Beatriz Oliveira Lopes
- Institute of Health Sciences, University of International Integration of Af-ro-Brazilian Lusophony, Av. da Abolição, 3-Centro, Redenção 62790-000, Ceará, Brazil
| | - Ana Caroline Rocha de Melo Leite
- Institute of Health Sciences, University of International Integration of Af-ro-Brazilian Lusophony, Av. da Abolição, 3-Centro, Redenção 62790-000, Ceará, Brazil
| | - Gabriela Silva Cruz
- Institute of Health Sciences, University of International Integration of Af-ro-Brazilian Lusophony, Av. da Abolição, 3-Centro, Redenção 62790-000, Ceará, Brazil
| | - Érika Helena Salles de Brito
- Institute of Health Sciences, University of International Integration of Af-ro-Brazilian Lusophony, Av. da Abolição, 3-Centro, Redenção 62790-000, Ceará, Brazil
| | - Laritza Ferreira de Lima
- Laboratory of Oocytes and Preantral Follicles Manipulation-LAMOFOPA, Post-Graduate Program in Veterinary Science, Faculty of Veterinary Medicine, State University of Ceará-UECE, Av. Doutor Silas Munguba, 1700, Campus do Itaperi, Fortaleza 60714-903, Ceará, Brazil
| | - Lucia Černáková
- Department of Microbiology and Virology, Faculty of Natural Sciences, Comenidus University in Bratislava, Ilkovičova 6, 842 15 Bratislava, Slovakia
| | - Nuno Filipe Azevedo
- LEPABE-Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Doutor Roberto Frias, 4200-465 Porto, Portugal
- ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Doutor Roberto Frias, 4200-465 Porto, Portugal
| | - Célia Fortuna Rodrigues
- LEPABE-Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Doutor Roberto Frias, 4200-465 Porto, Portugal
- ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Doutor Roberto Frias, 4200-465 Porto, Portugal
- TOXRUN-Toxicology Research Unit, Cooperativa de Ensino Superior Politécnico e Universitário-CESPU, 4585-116 Gandra PRD, Portugal
| |
Collapse
|
9
|
Simonetti O, Zerbato V, Sincovich S, Cosimi L, Zorat F, Costantino V, Di Santolo M, Busetti M, Di Bella S, Principe L, Luzzati R. Candida lipolytica Bloodstream Infection in an Adult Patient with COVID-19 and Alcohol Use Disorder: A Unique Case and a Systematic Review of the Literature. Antibiotics (Basel) 2023; 12:antibiotics12040691. [PMID: 37107053 PMCID: PMC10135169 DOI: 10.3390/antibiotics12040691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Candida lipolytica is an uncommon Candida species causing invasive fungemia. This yeast is mainly associated with the colonisation of intravascular catheters, complicated intra-abdominal infections, and infections in the paediatric population. Here, we report a case of C. lipolytica bloodstream infection in a 53-year-old man. He was admitted for an alcohol withdrawal syndrome and mild COVID-19. Among the primary risk factors for candidemia, only the use of broad-spectrum antimicrobials was reported. The empiric treatment was commenced with caspofungin and then targeted with intravenous fluconazole. Infective endocarditis was ruled out using echocardiography, and PET/TC was negative for other deep-seated foci of fungal infection. The patient was discharged after blood culture clearance and clinical healing. To the best of our knowledge, this is the first case of C. lipolytica candidemia in a patient with COVID-19 and alcohol use disorder. We performed a systematic review of bloodstream infections caused by C. lipolytica. Clinicians should be aware of the possibility of C. lipolytica bloodstream infections in patients with alcohol use disorder, especially in a COVID-19 setting.
Collapse
Affiliation(s)
- Omar Simonetti
- Infectious Diseases Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy
| | - Verena Zerbato
- Infectious Diseases Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy
| | - Sara Sincovich
- Infectious Diseases Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy
| | - Lavinia Cosimi
- Infectious Diseases Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy
| | - Francesca Zorat
- Operative Unit of Medicina Clinica, Trieste University Hospital (ASUGI), 34125 Trieste, Italy
| | - Venera Costantino
- Microbiology Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy
| | - Manuela Di Santolo
- Microbiology Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy
| | - Marina Busetti
- Microbiology Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy
| | - Stefano Di Bella
- Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 34149 Trieste, Italy
| | - Luigi Principe
- Clinical Pathology and Microbiology Unit, “S. Giovanni di Dio” Hospital, 88900 Crotone, Italy
| | - Roberto Luzzati
- Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 34149 Trieste, Italy
| |
Collapse
|
10
|
Husni R, Bou Zerdan M, Samaha N, Helou M, Mahfouz Y, Saniour R, Hourani S, Kolanjian H, Afif C, Azar E, El Jisr T, Mokhbat J, Abboud E, Feghali R, Abboud E, Matta H, Karayakouboglo G, Matar M, Moghnieh R, Daoud Z. Characterization and susceptibility of non-albicans Candida isolated from various clinical specimens in Lebanese hospitals. Front Public Health 2023; 11:1115055. [PMID: 36969669 PMCID: PMC10036786 DOI: 10.3389/fpubh.2023.1115055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
BackgroundInvasive fungal infections have presented a challenge in treatment. In the past, it was known that the frontrunner in such infections is Candida albicans with little emphasis placed on non-albicans Candida species (NAC). Studies worldwide have shown a rise in fungal infections attributed to non-albicans Candida species. The aim of this study is to describe the epidemiology of NAC infections along with an overview of resistance in Lebanese hospitals.MethodsThis is a two-year observational multi-central descriptive study. Between September 2016 and May of 2018, a total of 1000 isolates were collected from 10 different hospitals distributed all over the country. For the culture, Sabouraud Dextrose Agar was used. Antifungal Susceptibility was evaluated by determining the Minimum Inhibitory Concentration (MIC) in broth (microdilution) of the different antifungal treatments.ResultsOut of the 1000 collected isolates, Candida glabrata, being the most isolated species (40.8%), followed by Candida tropicalis: 231(23.1%), Candida parapsilosis: 103(10.3%), and other NAC species at lower percentage. Most of these isolates (88.67%) were susceptible to posaconazole, 98.22% were susceptible to micafungin, and 10% were susceptible to caspofungin.ConclusionThe change of etiology of fungal infections involving a significant increase in NAC cases is alarming due to the different antifungal susceptibility patterns and the lack of local guidelines to guide the treatment. In this context, proper identification of such organisms is of utmost importance. The data presented here can help in establishing guidelines for the treatment of candida infections to decrease morbidity and mortality. Future surveillance data are needed.
Collapse
Affiliation(s)
- Rola Husni
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon
- *Correspondence: Rola Husni
| | - Maroun Bou Zerdan
- Department of Internal Medicine, SUNY Upstate Medical University Hospital, Syracuse, NY, United States
| | - Nadia Samaha
- Georgetown University School of Medicine, Washington, DC, United States
| | - Mariana Helou
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon
| | - Youssef Mahfouz
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli, Lebanon
| | - Rim Saniour
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli, Lebanon
| | - Sawsan Hourani
- Faculty of Medicine and Medical Sciences, University of Balamand, Tripoli, Lebanon
| | - Harout Kolanjian
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon
| | - Claude Afif
- Department of Internal Medicine, Saint George Hospital-University Medical Center, Beirut, Lebanon
| | - Eid Azar
- Department of Internal Medicine, Saint George Hospital-University Medical Center, Beirut, Lebanon
| | - Tamima El Jisr
- Department of Laboratory, Makased General Hospital, Beirut, Lebanon
| | - Jacques Mokhbat
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon
| | - Emma Abboud
- Department of Laboratory, Mount Liban Hospital, Hazmiyeh, Lebanon
| | - Rita Feghali
- Department of Laboratory, Rafic Hariri University Hospital, Beirut, Lebanon
| | - Edmond Abboud
- Department of Laboratory, The Middle East Institute of Health University Hospital, Mount Lebanon, Lebanon
| | - Hiam Matta
- Saint Georges Ajaltoun Hospital, Ajaltoun, Lebanon
| | | | - Madonna Matar
- Department of Internal Medicine, Notre Dame de Secours University Hospital, Byblos, Lebanon
| | - Rima Moghnieh
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon
| | - Ziad Daoud
- College of Medicine, Central Michigan University, Saginaw, MI, United States
- Department of Clinical Microbiology and Infection Prevention, Michigan Health Clinics, Saginaw, MI, United States
| |
Collapse
|
11
|
Incidence, susceptibility and outcomes of candidemia in adults living in Calgary, Alberta, Canada (2010-2018). BMC Infect Dis 2023; 23:100. [PMID: 36803357 PMCID: PMC9940426 DOI: 10.1186/s12879-023-08050-0] [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: 09/26/2022] [Accepted: 02/02/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Candidemia is increasing in frequency and is associated with high mortality. We sought to determine the burden of illness, the population it affects and its resistance profile in our region. METHODS The Calgary Zone (CZ) provides all care for residents of Calgary and surrounding communities (~ 1.69 million) via five tertiary hospitals each served by a common single laboratory for acute care microbiology. All adult patients in the CZ with at least one Candida spp.-positive blood culture between January 1, 2010, and December 31, 2018, were identified using microbiological data from Calgary Lab Services, the laboratory that processes > 95% of all blood culture samples in the CZ, were reviewed for the study. RESULTS The overall annual incidence of candidemia among individuals living in the CZ was 3.8 per 100,000 persons (Median age 61 years (IQR 48-72) and 221/455 (47.4%) were female). C. albicans was the most common species (50.6%), followed by C. glabrata, (24.0%). No other species accounted for more than 7% of cases. Overall mortality at 30, 90, and 365 days was 32.2, 40.1, and 48.1% respectively. Mortality rate did not differ by Candida species. Of individuals who developed candidemia, more than 50% died within the next year. No new resistance pattern has emerged in the most common Candida species in Calgary, Alberta. CONCLUSIONS In Calgary, Alberta, the incidence of candidemia has not increased in the last decade. C. albicans was the most common species and it remains susceptible to fluconazole.
Collapse
|
12
|
Epidemiology, Antifungal Susceptibility, and Risk Factors of Invasive Candidiasis in a Tertiary Hospital During a Four-Year Period. Jundishapur J Microbiol 2023. [DOI: 10.5812/jjm-132098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: Candida infections are a significant cause of morbidity and mortality in hospitalized patients. Acquired resistance to antifungal agents and strains with intrinsic resistance makes it hard to manage the infection. Objectives: We aimed to examine the risk factors of candidemia associated with patient mortality, the species causing candidemia, and their antifungal susceptibility. Methods: Patient data were collected from medical records retrospectively. MALDI-TOF MS was used to identify Candida species. Antifungal susceptibility testing was conducted by the colorimetric broth microdilution method. Results: A total of 155 patients were included in the study. The incidences of candidemia were 0.92, 0.72, 0.99, 0.97, and 2.28 per 1,000 cases in 2016, 2017, 2018, 2019, and 2020, respectively. Candida albicans accounted for 45% of all cases, followed by C. parapsilosis complex (28%), C. tropicalis (10%), and C. glabrata (8%). The 30-day crude mortality was 45%. There was no significant difference in mortality between C. albicans and non-albicans yeast species. The susceptibility rates for anidulafungin, micafungin, caspofungin, voriconazole, and fluconazole were as follows: 97%, 97%, 97%, 97%, and 90% in C. albicans, 95%, 95%, 98%, 72%, and 67% in C. parapsilosis complex, and 100%, 100%, 100%, 38%, and 63% in C. tropicalis. The susceptibility rates for anidulafungin, micafungin, and caspofungin in C. glabrata were 100%, 100%, and 92%, respectively. All 12 C. glabrata strains were susceptible-dose-dependent against fluconazole and uninterpretable for voriconazole. Conclusions: Incidences of candidemia and susceptibility patterns of strains may vary over time and amongst the regions. Candida albicans was the predominant strain, and echinocandins demonstrated the highest susceptibility rates against the most common species isolated in this study. Antifungal susceptibility tests are crucial in guiding patient treatment.
Collapse
|
13
|
Nationwide Surveillance of Antifungal Resistance of Candida Bloodstream Isolates in South Korean Hospitals: Two Year Report from Kor-GLASS. J Fungi (Basel) 2022; 8:jof8100996. [PMID: 36294562 PMCID: PMC9604804 DOI: 10.3390/jof8100996] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
We incorporated nationwide Candida antifungal surveillance into the Korea Global Antimicrobial Resistance Surveillance System (Kor-GLASS) for bacterial pathogens. We prospectively collected and analyzed complete non-duplicate blood isolates and information from nine sentinel hospitals during 2020−2021, based on GLASS early implementation protocol for the inclusion of Candida species. Candida species ranked fourth among 10,758 target blood pathogens and second among 4050 hospital-origin blood pathogens. Among 766 Candida blood isolates, 87.6% were of hospital origin, and 41.3% occurred in intensive care unit patients. Adults > 60 years of age accounted for 75.7% of cases. Based on species-specific clinical breakpoints, non-susceptibility to fluconazole, voriconazole, caspofungin, micafungin, and anidulafungin was found in 21.1% (154/729), 4.0% (24/596), 0.1% (1/741), 0.0% (0/741), and 0.1% (1/741) of the isolates, respectively. Fluconazole resistance was determined in 0% (0/348), 2.2% (3/135, 1 Erg11 mutant), 5.3% (7/133, 6 Pdr1 mutants), and 5.6% (6/108, 4 Erg11 and 1 Cdr1 mutants) of C. albicans, C. tropicalis, C. glabrata, and C. parapsilosis isolates, respectively. An echinocandin-resistant C. glabrata isolate harbored an F659Y mutation in Fks2p. The inclusion of Candida species in the Kor-GLASS system generated well-curated surveillance data and may encourage global Candida surveillance efforts using a harmonized GLASS system.
Collapse
|
14
|
Lima R, Ribeiro FC, Colombo AL, de Almeida JN. The emerging threat antifungal-resistant Candida tropicalis in humans, animals, and environment. FRONTIERS IN FUNGAL BIOLOGY 2022; 3:957021. [PMID: 37746212 PMCID: PMC10512401 DOI: 10.3389/ffunb.2022.957021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/28/2022] [Indexed: 09/26/2023]
Abstract
Antifungal resistance in humans, animals, and the environment is an emerging problem. Among the different fungal species that can develop resistance, Candida tropicalis is ubiquitous and causes infections in animals and humans. In Asia and some Latin American countries, C. tropicalis is among the most common species related to candidemia, and mortality rates are usually above 40%. Fluconazole resistance is especially reported in Asian countries and clonal spread in humans and the environment has been investigated in some studies. In Brazil, high rates of azole resistance have been found in animals and the environment. Multidrug resistance is still rare, but recent reports of clinical multidrug-resistant isolates are worrisome. The molecular apparatus of antifungal resistance has been majorly investigated in clinical C. tropicalis isolates, revealing that this species can develop resistance through the conjunction of different adaptative mechanisms. In this review article, we summarize the main findings regarding antifungal resistance and Candida tropicalis through an "One Health" approach.
Collapse
Affiliation(s)
- Ricardo Lima
- Special Mycology Laboratory, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Felipe C. Ribeiro
- Special Mycology Laboratory, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Arnaldo L. Colombo
- Special Mycology Laboratory, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Joăo N. de Almeida
- Special Mycology Laboratory, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
- Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
| |
Collapse
|
15
|
Ayalon O, Cohen MJ, Orenbuch-Harroch E, Sviri S, van Heerden PV, Korem M. Invasive fungal infections in critically ill COVID-19 patients in a large tertiary university hospital in Israel. J Crit Care 2022; 69:154004. [PMID: 35152143 PMCID: PMC8830264 DOI: 10.1016/j.jcrc.2022.154004] [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: 11/21/2021] [Revised: 01/31/2022] [Accepted: 01/31/2022] [Indexed: 11/07/2022]
Abstract
An increasing number of studies have tried to determine the incidence of invasive fungal infections (IFIs) in COVID-19 patients. Challenges in the diagnosis of pulmonary aspergillosis in these patients have led to new definitions of COVID-19-associated pulmonary aspergillosis (CAPA). The aim of this study was to determine the incidence and outcomes of and risk factors for IFIs in critically-ill COVID-19 patients, using the new definitions, in a tertiary center in Israel. Methods A case-controlled study (from 1 September 2020 to 31 March 2021) in which data from COVID-19 critically-ill patients with a diagnosis of IFI were collected and compared to a control group without IFI. Results The incidence of IFI amongst 311 COVID-19 critically-ill patients was 6.1%. 3.5% had CAPA and 3.5% had candidemia. In-hospital mortality was higher amongst patients with IFI compared to those without IFI (89.4% vs 60%, p < 0.03). The most significant predictors of IFI were cardiovascular co-morbidity and carbapenem use. Conclusions The low incidence of CAPA in our group of COVID-19 critically-ill patients was consistent with recent reports, underscoring the importance of differentiating between true infection and colonization. Awareness and timely diagnosis of IFIs in COVID-19 critically-ill patients are imperative considering the associated high mortality.
Collapse
|
16
|
Asadzadeh M, Mokaddas E, Ahmad S, Abdullah AA, de Groot T, Meis JF, Shetty SA. Molecular characterisation of Candida auris isolates from immunocompromised patients in a tertiary-care hospital in Kuwait reveals a novel mutation in FKS1 conferring reduced susceptibility to echinocandins. Mycoses 2021; 65:331-343. [PMID: 34953089 DOI: 10.1111/myc.13419] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/17/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Candida auris is an emerging, potentially multidrug-resistant pathogen that exhibits clade-specific resistance to fluconazole and also develops resistance to echinocandins and amphotericin B easily. This study analysed 49 C auris isolates for alterations in hotspot-1 and hotspot-2 of FKS1 for the detection of mutations conferring reduced susceptibility to echinocandins. METHODS C auris isolates (n = 49) obtained from 18 immunocompromised patients during June 2016-December 2018 were analysed. Antifungal susceptibility testing was performed by Etest and broth microdilution-based MICRONAUT-AM assay. Mutations in hotspot-1 and hotspot-2 regions of FKS1 were detected by PCR sequencing and fingerprinting of the isolates was done by short tandem repeat typing. RESULTS The patients had multiple comorbidities/risk factors for Candida spp. infection including cancer/leukaemia/lymphoma/myeloma (n = 16), arterial/central line (n = 17), urinary catheter (n = 17), mechanical ventilation (n = 14) and major surgery (n = 9) and received antifungal drugs as prophylaxis and/or empiric treatment. Seven patients developed C auris candidemia/breakthrough candidemia, nine patients had candiduria with/without candidemia and four patients developed surgical site/respiratory infection. Resistance to fluconazole and amphotericin B was detected in 44 and four isolates, respectively. Twelve C auris isolates from eight patients showed reduced susceptibility to echinocandins. Seven isolates contained hostspot-1 mutations and three isolates from a candidemia patient contained R1354H mutation in hotspot-2 of FKS1. Ten patients died, five were cured, two were lost to follow-up and treatment details for one patient were not available. CONCLUSIONS Our findings describe development of a novel mutation in FKS1 conferring reduced susceptibility to echinocandins in one patient during treatment and unfavourable clinical outcome for many C auris-infected patients.
Collapse
Affiliation(s)
- Mohammad Asadzadeh
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Eiman Mokaddas
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.,Microbiology Department, Ibn Sina Hospital, Shuwaikh, Kuwait
| | - Suhail Ahmad
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | | | - Theun de Groot
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.,Center of Expertise in Mycology, Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.,Bioprocess Engineering and Biotechnology Graduate Program, Federal University of Paraná, Curitiba, Brazil
| | - Shama A Shetty
- Microbiology Department, Ibn Sina Hospital, Shuwaikh, Kuwait
| |
Collapse
|
17
|
Epidemiology of Candidemia in Kuwait: A Nationwide, Population-Based Study. J Fungi (Basel) 2021; 7:jof7080673. [PMID: 34436212 PMCID: PMC8399751 DOI: 10.3390/jof7080673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 02/07/2023] Open
Abstract
The Candida species cause a majority of invasive fungal infections. In this article, we describe the nationwide epidemiology of candidemia in Kuwait in 2018. Yeast bloodstream isolates submitted from all major hospitals and identified by phenotypic MALDI-TOF MS and/or by molecular methods were studied. Susceptibility testing was performed by Etest. Out of 313 bloodstream yeasts, 239 Candida spp. isolates (excluding duplicate isolates) were obtained during 234 candidemic episodes among 223 patients. Mixed-species candidemia and re-infection occurred in 5 and 11 patients, respectively. C. albicans (n = 74), C. parapsilosis (n = 54), C. tropicalis (n = 35), C. auris (n = 33), C. glabrata (n = 32), other Candida spp. (n = 11), and other yeasts (n = 9) caused fungemia. Nearly 50% of patients were in intensive care units. Candida spp. isolates (except C. glabrata) were susceptible to caspofungin and 27% of C. auris were amphotericin B-resistant. Resistance to fluconazole was 100% in C. auris, 17% in C. parapsilosis, 12% in C. glabrata, and 1% in C. albicans. Mortality was 47% for other Candida/yeast infections. Nationwide candidemia incidence in 2018 was 5.29 cases/100,000 inhabitants. Changes in species spectrum, increasing fluconazole resistance in C. parapsilosis, and the emergence of C. auris as a major pathogen in Kuwait are noteworthy findings. The data could be of help in informing decisions regarding planning, in the allocation of resources, and in antimicrobial stewardship.
Collapse
|
18
|
Chen B, Xie Y, Zhang N, Li W, Liu C, Li D, Bian S, Jiang Y, Yang Z, Li R, Feng Y, Zhang X, Shi D. Evaluation of Droplet Digital PCR Assay for the Diagnosis of Candidemia in Blood Samples. Front Microbiol 2021; 12:700008. [PMID: 34603226 PMCID: PMC8480469 DOI: 10.3389/fmicb.2021.700008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/26/2021] [Indexed: 12/14/2022] Open
Abstract
Numerous studies have shown that droplet digital PCR (ddPCR) is a promising tool for the diagnosis of pathogens, especially in samples with low concentrations of pathogenic DNA. An early diagnosis of candidemia is critical for the effective treatment of patients. In this study, we evaluated the sensitivity and specificity of ddPCR assay for Candida DNA detection both in vitro by mixing fungal cells with human blood and in vivo by analyzing blood samples from infected mice and patients with suspected candidemia. The results showed that ddPCR assay could detect a minimum of 4.5 DNA copies per reaction in blood samples. ddPCR showed higher sensitivity and specificity for Candida DNA detection than traditional culture and quantitative PCR (qPCR) methods and also exhibited significantly better positive and negative predictive values than the culture and qPCR methods that were commonly used in clinical practice. Hence, our study demonstrates that ddPCR assay is a promising method for the timely diagnosis of candidemia and could be useful for monitoring the treatment of candidemia.
Collapse
Affiliation(s)
- Biao Chen
- The Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, China
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yingguang Xie
- Intensive Care Unit, Jining No. 1 People’s Hospital, Jining, China
| | - Ning Zhang
- The Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, China
| | - Wenqiang Li
- Intensive Care Unit, Jining No. 1 People’s Hospital, Jining, China
| | - Chen Liu
- The Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, China
| | - Dongmei Li
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, United States
| | - Shaodong Bian
- The Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, China
| | - Yufeng Jiang
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Jinan, China
- Clinical Laboratory, Jining No. 1 People’s Hospital, Jining, China
| | - Zhiya Yang
- The Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, China
| | - Renzhe Li
- Clinical Laboratory, Jining No. 1 People’s Hospital, Jining, China
| | - Yahui Feng
- Clinical Medicine College, Jining Medical College, Jining, China
| | - Xiaojie Zhang
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Jinan, China
- Xiaojie Zhang,
| | - Dongmei Shi
- The Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, China
- Department of Dermatology, Jining No. 1 People’s Hospital, Jining, China
- *Correspondence: Dongmei Shi,
| |
Collapse
|