Candida Bloodstream Infection and Antifungal Susceptibility Over Three Years in a Single Center from Medinah, Saudi Arabia

In the healthcare setting, Candida bloodstream infections significantly increase morbidity and mortality. There is little proof that invasive infections in Saudi Arabia are brought on by Candida spp. To identify Candida species that cause bloodstream infections and ascertain the clinical outcome and risk factors for mortality in a Saudi Arabian tertiary hospital. This retrospective analysis covered all instances in which patients hospitalized to Ohud hospital, a tertiary care facility in Madinah, Saudi Arabia, between January 2019 and December 2021, had positive blood cultures for Candida. Anaerobic and aerobic Bactec bottles were inoculated with blood samples and then incubated at 35°C for five days. Identification-YST card kits from VITEK II (BioMerieux, France) for yeast and yeast-like organisms. Testing for antifungal susceptibility was done using AST YS07. A total of 78 patients (71% men, 29% women) were found to have candidemia. Candida albicans (51.3%), Candida parapsilosis (16.7%), and Candida tropicalis (16.7%) were the three Candida spp. that were most frequently isolated. Those with Saudi (51%; P = 0.500), leukopenia (40%; P = 0.001), neutrophilia (92%; P = 0.638), and thrombocytopenia (42%; P = 0.374) had a higher incidence of candidemia. Fluconazole sensitivity in non-albicans Candida species was 39.5%. Nonetheless, caspofungin was effective against all species. This study discovered an epidemiological shift toward more non-albicans Candida spp. in Saudi Arabia as well as a changing pattern in the Candida spp. causing bloodstream infections.

Isolation of Candida spp. from denture-related stomatitis in Pará, Brazil

ABSTRACT The aim of this study was to isolate and identify Candida species from the oral cavity of denture wearers with denture-related stomatitis who were attended at the University Federal of Pará (Belém City, Pará State, Brazil). A total of 36 denture wearers with denture-related stomatitis were included, and type I (50%), type II (33%) and type III (17%) stomatitis were observed. Candida spp. were isolated from 89% of the cases and included five different Candida species. C. albicans was the most frequently recovered species (78% of the cases), followed by C. famata and C. tropicalis. We observed a significant association between Candida species isolation and unsatisfactory denture condition (p = 0.0017). Our results demonstrated the highly frequency of Candida species isolation in denture wearers with denture-related stomatitis and showed the relationship between these species and poor denture maintenance.

A study on fluconazole resistance among candida species isolated from patients attending STD OPD in a tertiary care hospital.

Back ground: Sexually transmitted infections are a significant public health problem worldwide as they cause widespread morbidity and mortality in both male & female. In developing countries, STI are the third most common public health problem in young people of reproductive age group. Aim of the Study: This study was conducted to determine the prevalence of Candida species causing genital candidiasis in patients attending STD clinic in tertiary care hospital & to know the fluconazole resistance pattern of the isolated Candida species. Materials and methods: KOH mount is done by adding 10% KOH to the smear made with the vaginal discharge to look for the presence of yeast cells/ hyphal elements. Gram stain is done to look for the presence of gram positive budding yeast cells. Results: In this present study, Candida glabrata was the most common species causing vaginal candidiasis (47%) and fluconazole resistance is more among the Candida non-albicans isolates (62%). Candida albicans is the most common species isolated from male samples. Fluconazole resistance is also increasing among the Candida albicans isolates (32% in females and 30% in males). Conclusion: Prevalence of fluconazole resistance among Candida isolates is also increasing. This is due to the inappropriate and over the counter usage of antifungal agents. The emergence of Kavitha M, Hemalatha S, Shanmugapriya V. A study on fluconazole resistance among candida species isolated from patients attending STD OPD in a tertiary care hospital. IAIM, 2017; 4(4): 35-40. Page 36 fluconazole resistant C. albicans and non albicans species emphasises the need of species identification and antifungal susceptibility in the diagnosis and management of vaginal candidiasis.

Sensibilidad in vitro a fluconazol y voriconazol de especies de Candida aisladas de las manos de trabajadores de salud y pacientes / In vitro susceptibility to fluconazole and voriconazole of Candida species isolated from the hands of health care workers and patients

Las manos del personal de salud se consideran importantes para la colonización e infección por Candida spp. El objetivo del estudio fue determinar la prevalencia y distribución de levaduras aisladas en las manos de trabajadores de salud y algunos pacientes, así como su sensibilidad in vitro frente al fluconazol y voriconazol. El estudio se realizó en tres servicios del Complejo Hospitalario Universitario “Ruíz y Páez”: unidad de cuidados intensivos, retén patológico y retén sano. El estudio de sensibilidad se realizó mediante el método de difusión con discos (Documento M44-A2). Se obtuvieron 79 aislamientos, de los cuales el 50,6% fue Candida albicans y el 49,4% especies no albicans. Las especies no albicans predominantes fueron C. tropicalis (n=25; 31,6%) seguidas del Complejo C. parapsilosis (n=13; 16,5%). El 87,3% y 91,1% de los aislados fue sensible al fluconazol y voriconazol, respectivamente. El 11,4% y 6,3% fue resistente al fluconazol y al voriconazol. Los resultados de este estudio demuestran que el estado de portador de levaduras en las manos del personal de salud es importante, por lo tanto es indispensable educarlos sobre el lavado adecuado de las manos, uso de guantes y uso de antisépticos para evitar o minimizar la posibilidad de transmisión de estos agentes.

The hands of health care workers are considered important for colonization and infection by Candida spp. The aim of the study was to determine the prevalence and distribution of yeasts isolated from the hands of health personnel and some patients and their in vitro susceptibility to fluconazole and voriconazole. The study was conducted in three services of the Hospital Universitario “Ruiz y Páez”: Neonatal Intensive Care Unit and Healthy and Pathologic Newborn Units. The susceptibility tests were performed by the disk diffusion method (document M44-A2). A total of 79 isolates were obtained, of which 50.6% were Candida albicans and 49.4% non-albicans species. Among the non-albicans species were C. tropicalis (n = 25; 31.6%) followed by C. parapsilosis complex (n = 13; 16.5%). 87.3% and 91.1% of isolates were sensitive to fluconazole and voriconazole, respectively. 11.4% and 6.3% were resistant to fluconazole and voriconazole. The results of this study demonstrate the importance of the carriage of yeasts in the hands of health personnel; therefore it is essential to educate them about proper hand washing, use of gloves and antiseptic products to prevent or minimize the transmission of these agents.

Candidemia em hospital terciário do nordeste do Brasil / Candidemia in a tertiary hospital in northeastern Brazil

Realizou-se um estudo observacional, prospectivo, de base laboratorial, para investigar a incidência de candidemia, distribuição de espécies e condições clínicas entre setembro 2003 e março 2004, em um hospital privado terciário em Recife, Nordeste do Brasil. Um caso de candidemia foi definido como isolamento de Candida spp de hemocultura. A taxa de incidência foi calculada por 1.000 admissões. Um total de 5.532 pacientes foram admitidos no hospital durante o período de estudo, e 1.745 culturas de sangue foram processadas. Foram observados 21 episódios de candidemia em 18 pacientes. A taxa de incidência de candidemia foi de 3,9 episódios por 1.000 admissões. Espécies não-albicans representaram mais de 50 por cento dos casos, predominando Candida parapsilosis (33 por cento) e Candida tropicalis (24 por cento). Onze (61 por cento) pacientes morreram. A incidência de candidemia foi mais alta que aquela observada em estudo multicêntrico brasileiro. Candidemia foi predominantemente causada por espécies não-albicans.

We conducted a prospective, observational, laboratory-based study on candidemia to investigate the incidence of candidemia, species distribution and clinical conditions between September 2003 and March 2004 in a private tertiary hospital in Recife, northeastern Brazil. Cases of candidemia were defined as occurrences of isolation of Candida spp from blood cultures. The incidence rate was calculated per 1,000 admissions. A total of 5,532 patients were admitted to the hospital during the study period, and 1,745 blood cultures were processed. Twenty-one episodes of candidemia were observed in 18 patients. The incidence rate of candidemia was 3.9 episodes per 1,000 admissions. Non-albicans species accounted for more than 50 percent of the cases, and Candida parapsilosis (33 percent) and Candida tropicalis (24 percent) predominated. Eleven (61 percent) patients died. The incidence of candidemia was higher than that observed in a Brazilian multicenter study. Candidemia was caused predominantly by non-albicans species.

Vulvovaginal candidosis caused by Candida Non-Albicans, proportion and clinical characteristics in the Dr. Cipto Mangunkusumo National General Hospital, Jakarta.

The prevalence of vulvovaginal candidosis (VVC) caused by C. non-albicans tends to increase, recently. The aim of this study was to obtain data about proportion and clinical characteristic of C. non-albicans VVC at dr. Cipto Mangunkusumo General Hospital, Jakarta. This is a cross-sectional study on all female patients with symptoms of VVC visiting Obstetri-gynaecology and Dermatovenereology outpatient clinics at dr. Cipto Mangunkusumo General Hospital, Jakarta. All subjects had positive Gram stain, showed Candida spp. on culture with CHROMagar Candida, and had no other specific genital infections. Sixty nine subjects aged 26–44 years old (averaged 29 years old) were included in this study. Candida non-albicans was found in 30.4% subject, and consisted of: C. glabrata (61.9%), C. tropicalis (28.6%) and C. parapsilosis (9.5%). We found that C. non-albicans VVC infections are more common in women above 45 years old, using non-hormonal contraceptives, whose sexual partner has erythema and pruritus in glands penis, and having the disease for more than 1 year. No differences in clinical symptoms were noted between C. albicans and C. non-albicans infection. We concluded from this study that the proportion of C. non-albicans infections at dr. Cipto Mangunkusumo General Hospital, Jakarta, with C. glabrata represents the most prevalent species. No characteristic clinical symptoms were found from the subjects with C. non-albicans VVC when compared with those infected by C. albicans.