ABSTRACT
Candida auris, a newly emergent fungal species, has been spreading in health care systems and causing life-threatening infections. Intact innate immunity is essential for protection against many invasive fungal infections, including candidiasis. Here, we highlight recent studies exploring immune interactions with C. auris, including investigations using animal models and ex vivo immune cells. We summarize innate immune studies comparing C. auris and the common fungal pathogen Candida albicans. We also discuss how structures of the C. auris cell wall influence immune recognition, the role of soluble host factors in immune recognition, and areas of future study.
Subject(s)
Candida auris , Candidiasis , Immunity, Innate , Humans , Animals , Candidiasis/immunology , Candidiasis/microbiology , Candida auris/immunology , Candida auris/genetics , Candida albicans/immunology , Cell Wall/immunology , Host-Pathogen Interactions/immunology , Candida/immunologyABSTRACT
Candida auris recently emerged as an urgent public health threat, causing outbreaks of invasive infections in healthcare settings throughout the world. This fungal pathogen persists on the skin of patients and on abiotic surfaces despite antiseptic and decolonization attempts. The heightened capacity for skin colonization and environmental persistence promotes rapid nosocomial spread. Following skin colonization, C. auris can gain entrance to the bloodstream and deeper tissues, often through a wound or an inserted medical device, such as a catheter. C. auris possesses a variety of virulence traits, including the capacity for biofilm formation, production of adhesins and proteases, and evasion of innate immune responses. In this review, we highlight the interactions of C. auris with the host, emphasizing the intersection of laboratory studies and clinical observations.
Subject(s)
Candida , Candidiasis , Humans , Candidiasis/microbiology , Virulence , Candida auris , Disease Outbreaks , Antifungal AgentsABSTRACT
Interpretation of acid-base disturbances is an essential skill for critical care nurses. Using the H model makes this process easy. When students and novice critical care nurses feel competent with certain skills, their confidence levels are greatly enhanced. One of us (K.M.K.) has been using the H model for many years to teach students how to interpret the results of arterial blood gas analysis. The students are often amazed at how easy and fun the model makes learning a subject many perceive as complex.
Subject(s)
Blood Gas Analysis , Acidosis/diagnosis , Acidosis, Respiratory/diagnosis , Adolescent , Adult , Aged , Alkalosis/diagnosis , Alkalosis, Respiratory/diagnosis , Arteries , Female , Humans , Male , Models, BiologicalABSTRACT
The power that prayer and spirituality exerts on healing cannot be underestimated. Body, mind, and spirit are connected to each other. Although patients in hospitals may have the best medical and nursing care available, many seek alternative or complementary therapies. One adjunctive therapy that has grown in popularity recently is the incorporation of prayer and spirituality into the traditional approaches used with acute and critically ill patients. Spirituality is returning to healthcare because many patients believe in it and seek it as part of their treatment. Although spirituality is only one of the many types of alternative and complementary therapies available to patients, it can be powerful approach to their care. This article explores the use of spirituality with a special focus on prayer.
Subject(s)
Critical Care/psychology , Holistic Nursing/methods , Mental Healing , Pastoral Care/methods , Acute Disease/nursing , Acute Disease/psychology , Critical Care/methods , Humans , Nursing Staff, Hospital/psychologyABSTRACT
The death of a child or young adult is always tragic, regardless of the cause. Cases of autoerotic asphyxia are often labeled as suicide, or are underreported because of embarrassment of relatives or misidentification of the initial clinical manifestations. It may be that autoerotic asphyxial death is far more common than realized. Many emergency nurses and physicians lack adequate knowledge about this phenomenon to make an accurate diagnosis. Family members are often reluctant or unwilling to provide enough data surrounding the circumstances in which the patient was found, and the cause of death is mislabeled as suicide. Autoerotic asphyxia is frequently labeled as a sexual aberrancy and an act that society would rather not acknowledge. But there are a number of implications for emergency nurses, such as prevention and sensitive support of family in the emergency department, that demand our attention.