Candida auris in a tertiary healthcare setting in south India: A case series.

Candida species can produce a variety of clinical manifestations, and several non-albicans species of Candida, including Candida auris, have been linked to the rise of invasive fungal infections with high rates of treatment failure. Nosocomial outbreaks and high mortality rates in healthcare institutions across the globe have been associated with C. auris, an emerging infectious yeast that was initially discovered in the ear canal of an elderly Japanese patient in 2009. The fact that C. auris has been found on six continents after it was initially isolated has raised serious concerns among scientists and healthcare practitioners. At present, healthcare facilities lack defined protocols for the effective prevention and control of C. auris infections, as well as appropriate treatment alternatives. This leads to frequent therapeutic failures and complicates the eradication of C. auris infection in healthcare facilities. Studies on C. auris in South India are often limited, and healthcare workers urgently need to be made aware of infections caused by it in order to assess its impact and possible implications for the healthcare system. This study aimed to report seven patients hospitalized in our center who developed C. auris infections with varying clinical manifestations.

A rare occurrence of Serratia rubidaea in a patient with ear discharge.

Serratia species are not as frequent as with more virulent members of the Enterobacteriaceae. However, when infections do arise, they are largely associated with Serratia marcescens. Presently, about 10 species of Serratia are recognized and infections caused by the remaining Serratia species are seldom recorded in literature, as they are not often isolated from clinical specimens. This is a case report of Serratia rubidaea isolated from ear discharge of a 35-year old female patient with no co-morbidities and with known history of chronic otomastoiditis for which the patient had undergone left modified radical mastoidectomy. Isolation of this bacterium from clinical specimens is rare; however, it can be an etiological agent for infections in patients who have undergone invasive procedures. The patient was managed with antibiotics and on otoendoscopy at follow-up, no discharge was observed.

Fluorescence of Candida in diagnosis of oral candidiasis.

BACKGROUND: Many pathogenic fungi fluoresce in hematoxylin and eosin stained sections, and Papanicolaou (PAP)-stained smears under ultraviolet illumination. In theory, this phenomenon could aid in the diagnosis of common fungal infections without the delay which is usually associated with special stains. OBJECTIVE: To evaluate the role of fluorescence as a rapid screening technique for oral infections caused by Candida organisms in exfoliative smears of oral candidiasis. MATERIALS AND METHODS: Two smears and one swab were collected from each of 62 clinically diagnosed cases of oral candidiasis. Smears were stained with (PAP) and periodic acid-Schiff stain (PAS). Both smears were evaluated under light microscopy (LM). Later, PAP smears were observed under fluorescent microscopy (PAP-FM). The swab was inoculated on Sabouraud's agar plate. Each technique was evaluated for sensitivity and specificity. RESULTS: It was found that the PAS-stained smears were more reliable for detection of Candida species than other methods (sensitivity = 100%; specificity = 66.7%). The PAP-LM and PAP-FM showed less sensitivity (67.9% and 85.7%) and specificity (66.7% and 33.3%), respectively. Combined results of both light and fluorescent microscopy of PAP (LM + FM) showed increased sensitivity (89.3%) but reduced specificity (16.7%). CONCLUSION: PAP autofluorescence is less sensitive than PAS, still it accentuates the distinct morphological features of Candida.