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1.
Medicine (Baltimore) ; 99(9): e19391, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118790

RESUMO

RATIONALE: The emphysematous prostatic abscess is a rare but potentially life-threatening clinical condition. The early diagnosis is difficult due to nonspecific symptoms. PATIENT CONCERNS: A 72-year-old man with poorly controlled diabetes mellitus was admitted to hospital because of dysuria and acute urine retention. He had a refractory fever after admission. DIAGNOSES: The diagnosis of emphysematous prostatic abscess was confirmed by culture of catheterized urine and pelvic CT. INTERVENTIONS: We tried to give antimicrobial treatment and control of blood glucose at first, but the infection could not be controlled by antibiotic therapy and control of blood glucose. TRUS-guided aspiration was performed, but obviously not adequate for abscess drainage and the abscess progressed. TUR was then performed and the infection was gradually controlled. OUTCOMES: Pelvic CT scan 1 month after discharge showed complete resolution of the EPA. LESSONS: Given the poor conservative treatment effect of emphysematous prostatic abscesses, CT or TRUS should be performed in the patients with suspected diagnosis. Early and appropriate drainage with proper antibiotic therapy is important to achieve a favorable outcome.


Assuntos
Abscesso/etiologia , Candidíase/complicações , Próstata/anormalidades , Abscesso/cirurgia , Idoso , Antibacterianos/uso terapêutico , Candida tropicalis/efeitos dos fármacos , Candida tropicalis/patogenicidade , Candidíase/tratamento farmacológico , Disuria/etiologia , Humanos , Masculino , Próstata/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Retenção Urinária/etiologia
2.
Int J Antimicrob Agents ; 55(3): 105901, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31954831

RESUMO

Antifungal combination is an interesting approach for the treatment of several fungal infections but there is currently little evidence to support combined therapy in Candida auris infections. The antibacterial colistin has recently been shown to interact synergistically with antifungals against Candida spp., including azole-resistant isolates. The current study evaluated the in vitro interaction between colistin and either caspofungin or micafungin against 15 C. auris isolates by a checkerboard methodology based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) reference method. Results were analysed by two approaches: calculation of the fractional inhibitory concentration index (FICI) and response surface analysis based on the Bliss model. The minimum inhibitory concentration (MIC) range (geometric mean [Gmean]) of caspofungin and micafungin was 0.25 to 1 µg/mL (0.691 µg/mL) and 0.03 to 0.125 µg/mL (0.114 µg/mL), respectively. No activity was observed for colistin alone with MIC of >64 µg/mL for all the isolates. When colistin was combined with caspofungin, synergistic interactions were observed for all strains with FICI values of 0.08 to 0.14. In contrast, indifferent interactions were observed for the combination of colistin with micafungin with FICI values of 0.51 to 1.01. Synergy was also demonstrated using the Bliss model against all isolates for the colistin-caspofungin combination and in 60% of isolates for the colistin-micafungin combination. Antagonism was not observed for any combination.


Assuntos
Antibacterianos/farmacologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Colistina/farmacologia , Equinocandinas/farmacologia , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Caspofungina/farmacologia , Caspofungina/uso terapêutico , Colistina/uso terapêutico , Sinergismo Farmacológico , Equinocandinas/uso terapêutico , Humanos , Micafungina/farmacologia , Micafungina/uso terapêutico
3.
Int J Antimicrob Agents ; 55(3): 105865, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31866465

RESUMO

BACKGROUND: Candida species are one of the most common causes of nosocomial bloodstream infections among the opportunistic fungi. Extensive use of antifungal agents, most of which were launched on the market more than 20 years ago, led to the selection of drug-resistant or even multidrug-resistant fungi. We recently described a novel class of antifungal macrocyclic compounds with an amidinourea moiety that is highly active against azole-resistant Candida strains. OBJECTIVE: A compound from this family, BM1, was investigated in terms of in vitro activity against various Candida species, including C. auris isolates, interaction with the ABC transporter, CDR6, and in vivo distribution and safety. METHODS: In vitro assays (CYP inhibition, microsomal stability, permeability, spot assays) were used to collect chemical and biological data; animal models (rat) paired with LC-MS analysis were utilised to evaluate in vivo toxicology, pharmacokinetics, and distribution. RESULTS: The current research shows BM1 has a low in vivo toxicity profile, affinity for the renal system in rats, and good absorption, distribution, metabolism, and excretion (ADME). BM1 also has potent activity against azole-resistant fungal strains, including C. auris isolates and CDR6-overexpressing strains. CONCLUSIONS: The results confirmed low minimum inhibitory concentrations (MICs) against several Candida species, including preliminary data vs. C. auris. BM1 has good ADME and biochemical characteristics, is suitable and safe for daily administration and is particularly indicated for renal infections. These data indicate BM1 and its derivatives form a novel, promising antifungal class.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Guanidina/análogos & derivados , Ureia/análogos & derivados , Animais , Antifúngicos/uso terapêutico , Azóis/farmacologia , Candidíase/tratamento farmacológico , Farmacorresistência Fúngica/efeitos dos fármacos , Guanidina/farmacologia , Guanidina/uso terapêutico , Testes de Sensibilidade Microbiana , Ratos , Ureia/farmacologia , Ureia/uso terapêutico
4.
Zhonghua Nei Ke Za Zhi ; 59(1): 5-17, 2020 Jan 01.
Artigo em Chinês | MEDLINE | ID: mdl-31887830

RESUMO

In this consensus we mainly present the etiology, epidemiology, risk factors, microbiology, clinical diagnosis and general principles of treatment, as well as the detailed diagnosis and treatment of common candidiasis. Though mucocutaneous candidiasis such as oral, esophageal and vulvovaginal infections are known as non-invasive diseases, they are included in this consensus, considering their high prevalence and the potential to be the source of systematic infections.In order to be accordant with the practical situation in China, new technologies and drugs that have not been well developed or routinely applied are not recommended in this consensus. As to the differences from foreign guidelines, we address the explanations. Individualized treatment and management should be administrated based on the specific underlying conditions, organism distribution and drug resistance profile of Candida species.


Assuntos
Antifúngicos/uso terapêutico , Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Adulto , Antifúngicos/administração & dosagem , Candida/efeitos dos fármacos , China , Consenso , Humanos , Prevalência , Fatores de Risco
5.
Chem Commun (Camb) ; 55(100): 15145-15148, 2019 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-31790115

RESUMO

A lipase-triggered drug release nanoplatform (PGL-DPP-FLU NPs) for multi-modal antifungal therapy is developed. The lipases secreted by C. albicans can accelerate FLU release. The ROS and heat produced by PGL-DPP-FLU NPs make C. albicans more vulnerable to FLU, thereby PGL-DPP-FLU NPs exhibit high performance for combating azole-resistant C. albicans biofilms and wound infection.


Assuntos
Antifúngicos/farmacologia , Azóis/química , Candida albicans/efeitos dos fármacos , Lipase/metabolismo , Nanopartículas/química , Animais , Antifúngicos/química , Antifúngicos/uso terapêutico , Azóis/farmacologia , Candidíase/tratamento farmacológico , Candidíase/patologia , Candidíase/veterinária , Farmacorresistência Fúngica/efeitos dos fármacos , Etilenoglicóis/química , Fluconazol/química , Cetonas/química , Lasers , Camundongos , Fotoquimioterapia , Fototerapia , Poliésteres/química , Pirróis/química
7.
Pan Afr Med J ; 33: 280, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692736

RESUMO

Esophageal intramural pseudo-diverticulosis is a rare disease of unknown etiology. It is characterized by multiple pseudodiverticula with segmental or diffuse involvement of the esophagus. We report, the case of a 78-year-old male who suffered from severe dysphagia. Diagnosis of esophageal intramural pseudo-diverticulosis was based on endoscopic and radiologic explorations. Histological analysis of esophageal mucosal biopsies has shown the presence of candida albicans. Antifungal treatment leads to spectacular improvement of dysphasia. Subsequently, the patient presented a cardio-respiratory failure and died despite adequate treatment.


Assuntos
Candida albicans/isolamento & purificação , Candidíase/diagnóstico , Transtornos de Deglutição/diagnóstico , Diverticulose Esofágica/diagnóstico , Idoso , Antifúngicos/administração & dosagem , Candidíase/tratamento farmacológico , Transtornos de Deglutição/tratamento farmacológico , Humanos , Masculino
8.
Curr Top Med Chem ; 19(28): 2629-2639, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31670621

RESUMO

BACKGROUND: In the last few decades, mycoses caused by opportunistic fungi namely Candida species has gained significant attention. Such infections are very common and present high mortality rates, especially in immunocompromised patients. Currently, a limited number of antifungal drugs are available for the treatment of these infections and are also often related to severe adverse side effects. Therefore, new drugs and innovative technologies for the treatment of this infection are necessary. OBJECTIVE: The aim of this study was to evaluate the development of new drugs, formulations, as well as patents for the treatment of infections caused by Candida spp. METHODS: The present patent review was carried out through a specialized search database Espacenet. The patent selection was based on the following inclusion criteria: Recent patents published in English or Spanish containing candidiasis as the keyword in the title, abstract or full text. This survey was conducted in October and November 2018. RESULTS: As a result of that, 22 patents were selected to the final selection, the most common routes of application were oral (n = 6), vaginal (n = 6), topical (n = 5) and others (n = 5). This fact is related to the clinical manifestations of candidiasis. CONCLUSION: Through this review, it was possible to identify significant improvements and advances in the area of antifungal therapeutic innovation research. In addition, we demonstrated the growing interest of academic and industrial groups in pharmaceutical development and novel formulations for the treatment of candidiasis. New therapeutic options can contribute to improve the quality of patient's life, prevent infections and promote the search for an innovative and effective treatment of Candida infections.


Assuntos
Antifúngicos/uso terapêutico , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Animais , Antifúngicos/administração & dosagem , Humanos
9.
J Med Microbiol ; 68(12): 1802-1812, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31702539

RESUMO

Introduction. Candida albicans is responsible for several types of oral and systemic infections. In light of emerging resistance to antifungals, studies have demonstrated the antifungal effect of lactoferrin (LF), which is part of the innate immune system, has anticandidal activities.Methodology. C. albicans (2×106 c.f.u. ml-1) were incubated either with PBS or human LF (hLF) (100 µg ml-1) at 37 °C for 24 h and then RNA was isolated and virulence factors analysed. C. albicans (1×105 c.f.u.) was injected into the tail vein of immunocompromised wild-type and Ltf -/-. Then, 24 h later, the Ltf -/-I mice received hLF intravenously (100 µg g-1 body weight), while the control group received PBS. Then, 48 h later, the organs were collected, homogenized and C. albicans c.f.u.s were counted. In addition, the inflammatory mediators of kidneys and the virulence factors of C. albicans were analysed.Results. hLF-treated Ltf -/-I mice showed significant clearance of C. albicans in different organ tissues when compared to untreated Ltf -/-I mice. The inflammatory cytokines, such as IL-1ß, IL-6 , TNF-α and MPO and iNOS were downregulated in hLF-treated Ltf -/-I mice when compared to untreated Ltf -/-I mice. Whereas, IL-10 and IL-17A were upregulated at 72 h post infection when compared to Ltf -/-C mice. Histological analysis also revealed a significant decrease in the size and number of infectious foci in the hLF-treated groups. hLF treatment significantly downregulated several virulence factors of C. albicans both in vitro and in vivo.Conclusion. We concluded that hLF-treated Ltf -/- mice can reduce the severity of C. albicans-induced systemic infection.


Assuntos
Candidíase/tratamento farmacológico , Lactoferrina/uso terapêutico , Animais , Aderência Bacteriana , Candida albicans/fisiologia , Candidíase/imunologia , Candidíase/patologia , Citocinas/análise , Humanos , Rim/microbiologia , Rim/patologia , Lactoferrina/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL
10.
Curr Top Med Chem ; 19(28): 2593-2609, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31746290

RESUMO

BACKGROUND: Candida species are the important etiologic agents for candidiasis, the most prevalent cause of opportunistic fungal infections. Candida invasion results in mucosal to systemic infections through immune dysfunction and helps in further invasion and proliferation at several sites in the host. The host defence system utilizes a wide array of the cells, proteins and chemical signals that are distributed in blood and tissues which further constitute the innate and adaptive immune system. The lack of antifungal agents and their limited therapeutic effects have led to high mortality and morbidity related to such infections. METHODS: The necessary information collated on this review has been gathered from various literature published from 1995 to 2019. RESULTS: This article sheds light on novel drug delivery approaches to target the immunological axis for several Candida species (C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. krusei, C. rugose, C. hemulonii, etc.). CONCLUSION: It is clear that the novel drug delivery approaches include vaccines, adoptive transfer of primed immune cells, recombinant cytokines, therapeutic antibodies, and nanoparticles, which have immunomodulatory effects. Such advancements in targeting various underpinning mechanisms using the concept of novel drug delivery will provide a new dimension to the fungal infection clinic particularly due to Candida species with improved patient compliance and lesser side effects. This advancement in knowledge can also be extended to target various other similar microbial species and infections.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Sistemas de Liberação de Medicamentos , Animais , Candida/classificação , Candida/imunologia , Candidíase/imunologia , Humanos , Testes de Sensibilidade Microbiana , Especificidade da Espécie
11.
Curr Top Med Chem ; 19(28): 2610-2628, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31663480

RESUMO

BACKGROUND: The considerable increase in the incidence of Candida infection in recent times has prompted the use of numerous antifungal agents, which has resulted in the development of resistance towards various antifungal agents. With rising Candida infections, the need for design and development of novel antifungal agents is in great demand. However, new therapeutic approaches are very essential in preventing the mortality rate and improving the patient outcome in those suffering from Candida infections. OBJECTIVE: The present review objective is to describe the burden, types of Candidiasis, mechanism of action of antifungal agents and its resistance and the current novel approaches used to combat candidiasis. METHODS: We have collected and analyzed 135 different peer-reviewed literature studies pertinent to candidiasis. In this review, we have compiled the major findings from these studies. RESULTS AND CONCLUSION: The review describes the concerns related to candidiasis, its current treatment strategy, resistance mechanisms and imminent ways to tackle the problem. The review explored that natural plant extracts and essential oils could act as sources of newer therapeutic agents, however, the focus was on novel strategies, such as combinational therapy, new antibodies, utilization of photodynamic therapy and adaptive transfer primed immune cells with emphasis on the development of effective vaccination.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candida/imunologia , Candidíase/tratamento farmacológico , Candidíase/imunologia , Animais , Antifúngicos/síntese química , Antifúngicos/química , Candidíase/microbiologia , Humanos , Testes de Sensibilidade Microbiana
12.
BMC Infect Dis ; 19(1): 911, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664917

RESUMO

BACKGROUND: Cyst infection is a prevalent complication in autosomal dominant polycystic kidney disease (ADPKD) patients, however therapeutic and diagnostic approaches towards this condition remain unclear. The confirmation of a likely episode of cyst infection by isolating the pathogenic microorganism in a clinical scenario is possible only in the minority of cases. The available antimicrobial treatment guidelines, therefore, might not be appropriate to some patients. CASE PRESENTATION: We describe two unique cases of kidney cyst infection by Candida albicans, a condition that has not been previously described in literature. Both cases presented clear risk factors for Candida spp. infection. However, since there was no initial indication of cyst aspiration and culture, antifungal therapy was not immediately started and empirical treatment was initiated as recommended by the current guidelines. Antifungal treatment was instituted in both cases along the clinical course, according to their specificities. CONCLUSION: Our report highlights the possibility of Candida spp. cyst infection. Failure of clinical improvement with antibiotics should raise the suspicion of a fungal infection. Identification of infected cysts should be pursued in such cases, particularly with PET-CT, and when technically possible followed by cyst aspiration and culture to guide treatment. Risk factors for this condition, such as Candida spp. colonization, previous antimicrobial therapy, hemodialysis, necrotizing pancreatitis, gastrointestinal/hepatobiliary surgical procedure, central venous catheter, total parenteral nutrition, diabetes mellitus and immunodeficiency (neutropenia < 500 neutrophils/mL, hematologic malignancy, chemotherapy, immunosuppressant drugs), should be also considered accepted criteria for empirical antifungal therapy.


Assuntos
Candida albicans , Candidíase/diagnóstico por imagem , Candidíase/etiologia , Rim Policístico Autossômico Dominante/complicações , Adulto , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Cistos/diagnóstico por imagem , Cistos/microbiologia , Cistos/terapia , Drenagem , Evolução Fatal , Feminino , Fluconazol/uso terapêutico , Humanos , Masculino , Nefrectomia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Diálise Renal , Insuficiência Renal/terapia , Resultado do Tratamento
13.
Curr Top Med Chem ; 19(28): 2554-2566, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31654511

RESUMO

BACKGROUND: Candida species are in various parts of the human body as commensals. However, they can cause local mucosal infections and, sometimes, systemic infections in which Candida species can spread to all major organs and colonize them. OBJECTIVE: For the effective treatment of the mucosal infections and systemic life-threatening fungal diseases, a considerably large number of antifungal drugs have been developed and used for clinical purposes that comprise agents from four main drug classes: the polyenes, azoles, echinocandins, and antimetabolites. METHODS: The synthesis of some of these drugs is available, allowing synthetic modification of the molecules to improve the biological activity against Candida species. The synthetic methodology for each compound is reviewed. RESULTS: The use of these compounds has caused a high-level resistance against these drugs, and therefore, new antifungal substances have been described in the last years. The organic synthesis of the known and new compounds is reported. CONCLUSION: This article summarizes the chemistry of the existing agents, both the old drugs and new drugs, in the treatment of infections due to C. albicans, including the synthesis of the existing drugs.


Assuntos
Antifúngicos/química , Antifúngicos/farmacologia , Candida albicans/efeitos dos fármacos , Candidíase/tratamento farmacológico , Animais , Antifúngicos/síntese química , Humanos , Testes de Sensibilidade Microbiana
14.
Curr Top Med Chem ; 19(28): 2579-2592, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31654513

RESUMO

BACKGROUND: Human infections associated with skin and mucosal surfaces, mainly in tropical and sub-tropical parts of the world. During the last decade, there have been an increasing numbers of cases of fungal infections in immunocompromised patients, coupled with an increase in the number of incidences of drug resistance and toxicity to anti fungal agents. Hence, there is a dire need for safe, potent and affordable new antifungal drugs for the efficient management of candidal infections with minimum or no side effects. INTRODUCTION: Candidiasis represents a critical problem to human health and a serious concern worldwide. Due to the development of drug resistance, there is a need for new antifungal agents. Therefore, we reviewed the different medicinal plants as sources of novel anticandidal drugs. METHODS: The comprehensive and detailed literature on medicinal plants was carried out using different databases, such as Google Scholar, PubMed, and Science Direct and all the relevant information from the articles were analyzed and included. RESULTS: Relevant Publications up to the end of November 2018, reporting anticandidal activity of medicinal plants has been included in the present review. In the present study, we have reviewed in the light of SAR and mechanisms of action of those plants whose extracts or phytomolecules are active against candida strains. CONCLUSION: This article reviewed natural anticandidal drugs of plant origin and also summarized the potent antifungal bioactivity against fungal strains. Besides, mechanism of action of these potent active plant molecules was also explored for a comparative study. We concluded that the studied active plant molecules exhibit potential antifungal activity against resistant fungal strains.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Compostos Fitoquímicos/farmacologia , Plantas Medicinais , Antifúngicos/química , Antifúngicos/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana , Compostos Fitoquímicos/química , Compostos Fitoquímicos/isolamento & purificação , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/farmacologia
15.
Acta Biochim Pol ; 66(3): 361-364, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31518088

RESUMO

PURPOSE: Candida spp. are ranked as one of the four major causative agents of fungal infections. The number of infections caused by Candida species resistant to fluconazole, which is applied as the first line drug in candidiasis treatment, increases every year. In such cases the application of echinocandin is necessary. Echinocandin susceptibility testing has become a routine laboratory practice in many countries due to the increasing frequency of clinical failures during treatment with these drugs. METHODS: We performed anidulafungin, micafungin and caspofungin susceptibility testing according to the microdilution broth method on 240 Candida isolates collected in Polish hospitals. RESULTS: We identified 12 isolates resistant to all echinocandins within 240 examined isolates. Moreover, 6 of the examined samples were identified as rare Candida species and among them we observed very high echinocandin MIC values. CONCLUSION: Our research proves that in Poland there is a problem of echinocandin resistance. Moreover, we identified two species of Candida which are rare causative agents of human infections, and there was no reported incidence of such infections in Poland until now.


Assuntos
Antifúngicos/uso terapêutico , Candida/efeitos dos fármacos , Candidíase/tratamento farmacológico , Candidíase/epidemiologia , Farmacorresistência Fúngica/efeitos dos fármacos , Equinocandinas/uso terapêutico , Anidulafungina/uso terapêutico , Candida/isolamento & purificação , Candidíase/microbiologia , Caspofungina/uso terapêutico , Equinocandinas/efeitos adversos , Humanos , Micafungina/uso terapêutico , Testes de Sensibilidade Microbiana , Polônia/epidemiologia
16.
Res Microbiol ; 170(8): 417-425, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31562919

RESUMO

ABC transporters of the Pleiotropic Drug Resistance (PDR) family are the main actors of antifungal resistance in pathogenic fungi. While their involvement in clinical resistant strains has been proven, their transport mechanism remains unclear. Notably, one hallmark of PDR transporters is their asymmetry, with one canonical nucleotide-binding site capable of ATP hydrolysis while the other site is not. Recent publications reviewed here show that the so-called "deviant" site is of crucial importance for drug transport and is a step towards alleviating the mystery around the existence of non-catalytic binding sites.


Assuntos
Transportadores de Cassetes de Ligação de ATP/metabolismo , Antifúngicos/metabolismo , Candida albicans/metabolismo , Farmacorresistência Fúngica/fisiologia , Antifúngicos/farmacologia , Sítios de Ligação/fisiologia , Transporte Biológico/fisiologia , Candida albicans/efeitos dos fármacos , Candidíase/tratamento farmacológico , Candidíase/patologia , Humanos
17.
Future Microbiol ; 14: 1083-1085, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31512518

RESUMO

In this exclusive interview, Dimitrios P Kontoyiannis discusses current mycology hot topic, Candida auris. With a focus on the current knowns and unknowns for the pathogenesis, resistance and transmission of this emerging fungal pathogen, in addition to a look at therapeutics and future perspectives. This interview was conducted by Ellen Colvin, Commissioning Editor of Future Microbiology. Dimitrios P Kontoyiannis is the Texas 4000 distinguished endowed professor and deputy head in the Division of Internal Medicine at MD Anderson Cancer Center in Houston (TX, USA). Dr Kontoyiannis has authored over 550 peer-reviewed manuscripts and has given over 330 lectures in national and international conferences and academic institutions in the USA and abroad. He is considered a leading mycology expert world-wide with an H index of 101 and over 43,000 citations. His research group is credited for many and sustained contributions to clinical, translational and experimental mycology. He is the recipient of many national and international awards and is the past president elect of Immunocompromised Host Society (2016-2018).


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candidíase/epidemiologia , Infecção Hospitalar/epidemiologia , Transmissão de Doença Infecciosa , Farmacorresistência Fúngica Múltipla , Antifúngicos/uso terapêutico , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Candidíase/transmissão , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/microbiologia , Doenças Transmissíveis Emergentes/transmissão , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Infecção Hospitalar/transmissão , Gerenciamento Clínico , História do Século XX , História do Século XXI , Prevalência , Texas
18.
Middle East Afr J Ophthalmol ; 26(2): 110-113, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31543670

RESUMO

Postpartum endogenous fungal endophthalmitis in otherwise healthy females is extremely rare disease. We report a case of a 25-year-old female patient referred with a history of decreased vision in her right eye 1 month after uncomplicated vaginal delivery. She presented with multifocal chorioretinal infiltrates. The patient showed persistent inflammation in her right eye then after. Systemic workup was unremarkable apart from a history of vaginal discharge during peripartum period. Vaginal swap confirmed the presence of Candida albicans. Culture of the vitreous sample confirmed the growth of C. albicans. The patient was managed with intravitreal amphotericin B in addition to systemic antifungal treatment followed by pars plana vitrectomy. The patient achieved 20/40 vision with quiet eye after 6 months of follow-up.


Assuntos
Candida albicans/isolamento & purificação , Candidíase/microbiologia , Endoftalmite/microbiologia , Infecções Oculares Fúngicas/microbiologia , Período Pós-Parto , Complicações Infecciosas na Gravidez/microbiologia , Descarga Vaginal/microbiologia , Corpo Vítreo/microbiologia , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Terapia Combinada , Endoftalmite/diagnóstico , Endoftalmite/tratamento farmacológico , Infecções Oculares Fúngicas/diagnóstico , Infecções Oculares Fúngicas/tratamento farmacológico , Feminino , Humanos , Injeções Intravítreas , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Vitrectomia
19.
Infez Med ; 27(3): 328-331, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31545778

RESUMO

Bloodstream infections caused by non-albicans Candida species are increasing and echinocandins have been extensively used especially in patients with hemodynamic instability, previous antifungal treatment and hospital risk factors for intrinsic or acquired resistance to azoles. Candida glabrata resistance to echinocandins is reported and is generally associated with previous use of echinocandins; FKS gene mutations have been associated with a worse outcome. We report the case of a 65-year-old woman who developed candidemia and endocarditis by C. glabrata with a newly acquired FKS mutation 24 months after successful treatment of infective endocarditis by C. glabrata with a double dosage of anidulafungin (200 mg daily) followed by oral voriconazole. Driven by high echinocandin MICs the strain taken by intraoperative cultures was further analyzed in a referral microbiology laboratory, confirming the new onset of point mutation S633P of the FKS2 gene.


Assuntos
Anidulafungina/efeitos adversos , Antifúngicos/efeitos adversos , Candida glabrata/genética , Candidíase/tratamento farmacológico , Endocardite/tratamento farmacológico , Proteínas Fúngicas/genética , Mutação Puntual , Idoso , Anidulafungina/uso terapêutico , Antifúngicos/uso terapêutico , Candida glabrata/efeitos dos fármacos , Candidemia/tratamento farmacológico , Candidíase/cirurgia , Endocardite/microbiologia , Endocardite/cirurgia , Feminino , Proteínas Fúngicas/efeitos dos fármacos , Implante de Prótese de Valva Cardíaca , Humanos , Testes de Sensibilidade Microbiana , Voriconazol/uso terapêutico
20.
Ghana Med J ; 53(2): 184-186, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31481816

RESUMO

Oesophageal intramural pseudodiverticulosis is an uncommon condition, characterized by multiple small rounded cavities seen in the oesophageal wall during oesophagogastroduodenoscopy. It is often associated with gastro-oesophageal reflux disease, achalasia, oesophageal candidiasis and diabetes mellitus. We report a 40 year old Nigerian man who presented with recurrent dysphagia and endoscopic findings typical of oesophageal intramural pseudodiverticulosis. The patient was managed medically with resolution of the dysphagia. This report highlights the occurrence of this rare and benign cause of dysphagia in Nigeria. Funding: None declared.


Assuntos
Candidíase/diagnóstico , Doenças do Esôfago/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Candidíase/complicações , Candidíase/tratamento farmacológico , Transtornos de Deglutição/etiologia , Endoscopia do Sistema Digestório , Doenças do Esôfago/complicações , Doenças do Esôfago/tratamento farmacológico , Esofagite/complicações , Esofagite/diagnóstico , Esofagite/tratamento farmacológico , Fluconazol/uso terapêutico , Humanos , Masculino , Inibidores da Bomba de Prótons/uso terapêutico
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