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Candida sp. Infections in Patients with Diabetes Mellitus. J Clin Med 2019; 8:jcm8010076. [PMID: 30634716 PMCID: PMC6352194 DOI: 10.3390/jcm8010076] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 12/27/2018] [Accepted: 01/03/2019] [Indexed: 02/07/2023] Open
Abstract
Candidiasis has increased substantially worldwide over recent decades and is a significant cause of morbidity and mortality, especially among critically ill patients. Diabetes mellitus (DM) is a metabolic disorder that predisposes individuals to fungal infections, including those related to Candida sp., due to a immunosuppressive effect on the patient. This review aims to discuss the latest studies regarding the occurrence of candidiasis on DM patients and the pathophysiology and etiology associated with these co-morbidities. A comprehensive review of the literature was undertaken. PubMed, Scopus, Elsevier’s ScienceDirect, and Springer’s SpringerLink databases were searched using well-defined search terms. Predefined inclusion and exclusion criteria were applied to classify relevant manuscripts. Results of the review show that DM patients have an increased susceptibility to Candida sp. infections which aggravates in the cases of uncontrolled hyperglycemia. The conclusion is that, for these patients, the hospitalization periods have increased and are commonly associated with the prolonged use of indwelling medical devices, which also increase the costs associated with disease management.
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Badiee P, Badali H, Boekhout T, Diba K, Moghadam AG, Hossaini Nasab A, Jafarian H, Mohammadi R, Mirhendi H, Najafzadeh MJ, Shamsizadeh A, Soltani J. Antifungal susceptibility testing of Candida species isolated from the immunocompromised patients admitted to ten university hospitals in Iran: comparison of colonizing and infecting isolates. BMC Infect Dis 2017; 17:727. [PMID: 29157206 PMCID: PMC5697407 DOI: 10.1186/s12879-017-2825-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 11/12/2017] [Indexed: 12/12/2022] Open
Abstract
Background Antifungal susceptibility testing is a subject of interest in the field of medical mycology. The aim of the present study were the distributions and antifungal susceptibility patterns of various Candida species isolated from colonized and infected immunocompromised patients admitted to ten university hospitals in Iran. Methods In totally, 846 Candida species were isolated from more than 4000 clinical samples and identified by the API 20 C AUX system. Antifungal susceptibility testing was performed by broth microdilution method according to CLSI. Results The most frequent Candida species isolated from all patients was Candida albicans (510/846). The epidemiological cutoff value and percentage of wild-type species for amphotericin B and fluconazole in Candida albicans, Candida tropicalis, Candida glabrata and Candida krusei were 0.5 μg/ml (95%) and 4 μg/ml (96%); 1 μg/ml (95%) and 8 μg/ml (95%); 0.5 μg/ml (99%) and 19 μg/ml (98%); and 4 μg/ml (95%) and 64 μg/ml (95%), respectively. The MIC90 and epidemiological cutoff values to posaconazole in Candida krusei were 0.5 μg/ml. There were significant differences between infecting and colonizing isolates of Candida tropicalis in MIC 90 values of amphotericin B, and isolates of Candida glabrata in values of amphotericin B, caspofungin, and voriconazole (P < 0.05). Conclusions Our findings suggest that the susceptibility patterns of Candida species (colonizing and infecting isolates) in immunocompromised patients are not the same and acquired resistance was seen in some species.
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Affiliation(s)
- Parisa Badiee
- Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hamid Badali
- Department of Medical Mycology and Parasitology/Invasive Fungi Research Centre (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.,Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, Netherlands
| | - Kambiz Diba
- Urmia University of Medical Sciences, Urmia, Iran
| | | | - Ali Hossaini Nasab
- Department of Pediatrics, Kerman University of Medical Science, Kerman, Iran
| | - Hadis Jafarian
- Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rasoul Mohammadi
- Department of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Mirhendi
- Department of Medical Mycology and Parasitology, School of Public Health and Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Najafzadeh
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ahmad Shamsizadeh
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahwaz Jundishapur University of Medical Scienses, Ahvaz, Iran
| | - Jafar Soltani
- Department of Pediatrics, Besat Tertiary Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Abastabar M, Shokohi T, Rouhi Kord R, Badali H, Hashemi SJ, Ghasemi Z, Ghojoghi A, Baghi N, Abdollahi M, Hosseinpoor S, Rahimi N, Seifi Z, Gholami S, Haghani I, Jabari MR, Pagheh A. In vitro activity of econazole in comparison with three common antifungal agents against clinical Candida strains isolated from superficial infections. Curr Med Mycol 2015; 1:7-12. [PMID: 28680998 PMCID: PMC5490275 DOI: 10.18869/acadpub.cmm.1.4.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background and Purpose: Candida species are the most common organisms involved in superficial fungal infections, worldwide. Although econazole is among the most frequently used topical formulations for the treatment of candidiasis, no information is available regarding the susceptibility profiles of Candida species in Iran. Materials and Methods: In vitro susceptibility of 100 clinical Candida isolates belonging to 6 species from superficial candidiasis of Iran towards to econazole was compared with three other common antifungal agents including itraconazole, fluconazole, and miconazole. Minimum inhibitory concentrations (MICs) values were analyzed according to the Clinical and Laboratory Standards Institute (CLSI) M38-A3 document. All isolates were previously identified to the species level, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) on ITS region. Results: The MIC of econazole, itraconazole, miconazole, and fluconazole were within the range of 0.016-16, 0.032-16, 0.016-16, and 0.25-64 μg/ml, respectively. In general, econazole and miconazole were more active against Candida isolates, compared to the other two agents. Conclusion: The present study demonstrated that for Candida albicans isolates, miconazole and econazole had the best effect, but in non-albicans Candida species, itraconazole and miconazole displayed more activity than other antifungal agents.
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Affiliation(s)
- M Abastabar
- Invasive Fungi Research Center (IFRC), Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - T Shokohi
- Invasive Fungi Research Center (IFRC), Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - R Rouhi Kord
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - H Badali
- Invasive Fungi Research Center (IFRC), Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - S J Hashemi
- Department of Medical Parasitology and Mycology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Z Ghasemi
- Department of Medical Parasitology and Mycology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ghojoghi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - N Baghi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - M Abdollahi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Microbiology and Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - S Hosseinpoor
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - N Rahimi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Z Seifi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - S Gholami
- Invasive Fungi Research Center (IFRC), Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - I Haghani
- Invasive Fungi Research Center (IFRC), Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - M R Jabari
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - A Pagheh
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.,Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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