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1.
Medicine (Baltimore) ; 99(7): e19194, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049856

RESUMO

The incidence of invasive fungal infections (IFIs) has recently increased, and early and accurate diagnosis of IFIs is important for the rational selection of antifungal drugs with high efficacy. We developed a method for rapid and accurate clinical diagnosis of IFIs and provide a reference for personalized drug treatment.We designed and screened fungal internal transcribed spacer regions with universal primers and designed 8 TaqMan detection probes to establish a multi-channel real-time fluorescent polymerase chain reaction (PCR) melting curve analysis (MCA) method. The sensitivity, specificity, and reproducibility of this method were investigated using standard fungal strains and clinical isolates. Candidemia was detected using the MCA method.The limit of detection and assay cut-off (melting temperature [Tm]) for Candida albicans were 0.05 pg/µL and 66.50 °C; Candida glabrata were 0.1 pg/µL and 66.25 °C; Candida tropicalis were 0.1 pg/µL and 60.15 °C; Candida krusei were 0.1 pg/µL and 72.15 °C; Candida parapsilosis were 0.2 pg/µL and 63.10 °C; Candida guilliermondii were 0.1 pg/µL and 61.84 °C; Cryptococcus neoformans were 0.1 pg/µL and 65.50 °C; Aspergillus flavus were 0.05 pg/µL and 71.50 °C; Aspergillus terreus, Aspergillus fumigatus, and Aspergillus niger were 0.05 pg/µL and 76.80 °C. Analytical specificity was evaluated using 13 clinical pathogens including Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae, etc. No false-positive results were obtained for any of these samples. The MCA method can detect and identify different candidemia simulations. The limit detection concentration of C albicans was 44 cfu/mL, C glabrata was 73 cfu/mL, C tropicalis was 29 cfu/mL, C parapsilosis was 21 cfu/mL, C krusei was 71 cfu/mL, and C guilliermondii was 53 cfu/mL.The multi-channel real-time fluorescence PCR melting curve analysis displayed high sensitivity and specificity in detecting various clinically invasive fungi. Furthermore, it simultaneously detected the genera Candida, Cryptococcus, and Aspergillus and identified Candida at the species level. Our method can facilitate early and accurate clinical diagnosis and personalized medication regimens.


Assuntos
Aspergillus/isolamento & purificação , Candida/isolamento & purificação , Cryptococcus/isolamento & purificação , Infecções Fúngicas Invasivas/diagnóstico , Aspergillus/classificação , Candida/classificação , Cryptococcus/classificação , Corantes Fluorescentes , Humanos , Infecções Fúngicas Invasivas/microbiologia , Melhoria de Qualidade , Reação em Cadeia da Polimerase em Tempo Real
2.
Infection ; 48(2): 275-284, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32052287

RESUMO

BACKGROUND: The aim of this study was to analyse temporal changes in the epidemiology of candidemia assessing patient's characteristics, risk factors, diagnostic management, treatment, and outcome in a tertiary care hospital in South Eastern Germany. METHODS: In this retrospective cohort study patients with blood cultures positive for Candida spp. were identified from the microbiological database in the years 2006-2018. A detailed collection of patients' characteristics was obtained for the time periods 2006-2008 and 2016-2018. Risk factors for survival were analysed in a logistic regression analysis. RESULTS: In the years 2006-2018, a total of 465 episodes of candidemia were identified. An increase in candidemia cases was evident in the period of 2016-2018 compared to 2006-2015 and to 2006-2008 in absolute numbers and adjusted to patient-days. C. albicans was responsible for 62.8% of cases in 2006-2008 and 51.2% of all cases in the years 2016-2018, respectively, whereas there was a significant increase of C. glabrata in the latter period (16.3-31.5%). Overall mortality was not significantly different in the two periods. Infectious diseases consultation led to a lower mortality of patients with candidemia and to a higher adherence to guidelines. In multivariate analysis, only complete change or extraction of intravascular indwelling material and female gender were independent predictors for survival. CONCLUSION: We observed an increase in candidemia rates and rates of non-albicans spp. over time. A complete change of all catheters and/or indwelling devices improved survival. ID consultation led to a better guideline adherence.


Assuntos
Candida/fisiologia , Candidemia/epidemiologia , Candidemia/mortalidade , Encaminhamento e Consulta/normas , Idoso , Candida/classificação , Candida/isolamento & purificação , Candidemia/diagnóstico , Candidemia/tratamento farmacológico , Estudos de Coortes , Feminino , Alemanha/epidemiologia , Hospitais/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
3.
Int J Infect Dis ; 92: 123-126, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31935536

RESUMO

BACKGROUND: Candida haemulonii is an emergent, multi-resistant opportunistic pathogenic yeast that like Candida auris, can be misidentified when conventional diagnostic methods are used. Timely molecular identification using DNA sequence analysis variation in the internal transcriber spacer region, ITS1-ITS4 and the 28S ribosomal DNA gene (28S rDNA), and in vitro antifungal susceptibility assessment can lead to rapid therapeutic success. CASE REPORT: A case of Candida haemulonii candidiasis suffered by a male paediatric patient attended at Federico Gómez Children's Hospital of México City in September 2016 is reported. The isolate was yielded from peripheral blood and central catheter blood specimens. From in vitro antifungal susceptibility data, caspofungin was administered to the patient, who showed clear improvements at the end of antimicrobial administration, and the removal of the central venous catheter. Using a molecular phylogenetic approach, we identified the clinical isolate as C. haemulonii. The clinical isolate has been named as Candida haemulonii ENCB-87 from now on. C. haemulonii ENCB-87 grew well between the temperatures, 28 °C and 35 °C but not at 37 °C in YPD culture medium. The clinical isolate was susceptible to caspofungin, which resulted in therapeutic success for the patient. CONCLUSIONS: C. haemulonii is an emergent, opportunistic pathogen, closely related to C. auris, therefore, the timely and accurate identification and antifungal susceptibility assessments are paramount in generating a robust epidemiology of this emerging Candida species.


Assuntos
Candida/isolamento & purificação , Candidíase/etiologia , Infecções Relacionadas a Cateter/microbiologia , Hospitais Pediátricos , Antifúngicos/uso terapêutico , Candida/classificação , Candidíase/tratamento farmacológico , Caspofungina/uso terapêutico , DNA Fúngico , DNA Ribossômico , Humanos , Lactente , Masculino , México , Testes de Sensibilidade Microbiana , Tipagem Molecular , Filogenia , Análise de Sequência de DNA
4.
Int J Syst Evol Microbiol ; 70(1): 199-203, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31596197

RESUMO

Two yeast strains, DMKU-WBL1-3 and DMKU GT3-16, were obtained from grease samples collected from grease traps at the Kasetsart University canteen, Thailand. Pairwise sequence analysis indicated that the strains were closely related to Candida cylindracea NRRL Y-17506T, but differed by 11 and 35 nucleotide substitutions in the D1/D2 domain of the large subunit (LSU) rRNA gene and the ITS region, respectively. Based on sequence divergences, the novel species was distinguished from C. cylindracea. The results of phylogenetic analysis based on the concatenated sequences from small subunit rRNA, ITS region and LSU rRNA genes showed that the two strains and C. cylindracea NRRL Y-17506T formed a distinct lineage related to the genus Babjeviella. A novel genus, Limtongozyma, is proposed to accommodate these clade members. Hence, Candida cylindracea NRRL Y-17506T is transferred to this genus and assigned as the type species of the genus. The holotype of Limtongozyma siamensis is DMKU-WBL1-3.


Assuntos
Filogenia , Saccharomycetales/classificação , Candida/classificação , DNA Fúngico/genética , DNA Espaçador Ribossômico/genética , Técnicas de Tipagem Micológica , RNA Ribossômico/genética , Saccharomycetales/isolamento & purificação , Análise de Sequência de DNA , Tailândia
5.
Food Chem Toxicol ; 135: 110987, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31759067

RESUMO

The Piper mikanianum species were investigated by the antimicrobial potential and chemical composition. Chemical analysis was performed by gas chromatography coupled to mass spectrometry (GC/MS). The Minimum Inhibitory Concentration (MIC) as well as the 50% Inhibitory Concentration against Candida strains were determined by microdilution. The effect of the drug-oil combination was also evaluated to verify possible synergism. The Minimum Fungicidal Concentration (MFC) was evaluated by subculturing the microdilution in Petri dishes and the anti-pleomorphism potential of the oil was tested in humid chambers. Chemical analysis revealed safrol as the major compound. The results from the intrinsic activity evaluation of the oil did not reveal a clinical importance, however, it presented a synergistic effect when associated with gentamicin against the multidrug resistant E. coli strain and when associated with fluconazole against fungal strains. Moreover, the oil possessed a fungistatic effect. Total inhibition of filamentous structures occurred in both Candida species in the anti-virulence test. The P. mikanianum essential oil showed a potentiating activity of drugs for which resistance exists and an inhibitory effect of one of the main virulence factors of the Candida genus, morphological transition, which has been previously shown to be responsible for causing invasive infections in human tissues.


Assuntos
Anti-Infecciosos/farmacologia , Cromatografia Gasosa-Espectrometria de Massas/métodos , Óleos Voláteis/farmacologia , Piper/química , Candida/classificação , Candida/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , Especificidade da Espécie , Staphylococcus aureus/efeitos dos fármacos
6.
Pol J Microbiol ; 68(3): 303-308, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31880875

RESUMO

The data on susceptibility to antifungals of new species within Candida glabrata complex are limited. Our study was to enrich a global knowledge of yeast epidemiology and drug resistance. The study was focused on the identification of species within clinical isolates of the C. glabrata complex and on the determination of their resistance to antifungals. Four hundred forty-five clinical C. glabrata sensu lato strains were isolated from different clinical samples at routine mycological exams at the Infant Jesus Teaching Hospital in Warsaw. The identification of the most of tested isolates to species complex level was performed using the ID 32 C system. The identification of C. nivariensis and C. bracarensis species within the C. glabrata complex was performed by DNA sequencing. The MICs of amphotericin B, fluconazole, itraconazole, posaconazole, voriconazole, caspofungin, anidulafungin, and micafungin were determined by E-test. Twenty-four isolates did not have an ITS-1 region, characteristic of C. glabrata sensu stricto and their D1/D2 regions of the 26S rRNA were 99% homologous to C. nivariensis 26S rRNA. No strains of C. bracarensis were recovered. C. nivariensis strains were very susceptible to amphotericin B, anidulafungin, micafungin, and caspofungin. Ninety-two percent of C. nivariensis were resistant to itraconazole. The halves of the strains was resistant to posaconazole. Eighty-three percent of C. nivariensis were susceptible to voriconazole. None of the tested strains were susceptible to fluconazole. In the present study, none of the C. nivariensis strains were simultaneously resistant to azoles and echinocandins. C. nivariensis should be recognized as an emerging pathogen, resistant to azoles.The data on susceptibility to antifungals of new species within Candida glabrata complex are limited. Our study was to enrich a global knowledge of yeast epidemiology and drug resistance. The study was focused on the identification of species within clinical isolates of the C. glabrata complex and on the determination of their resistance to antifungals. Four hundred forty-five clinical C. glabrata sensu lato strains were isolated from different clinical samples at routine mycological exams at the Infant Jesus Teaching Hospital in Warsaw. The identification of the most of tested isolates to species complex level was performed using the ID 32 C system. The identification of C. nivariensis and C. bracarensis species within the C. glabrata complex was performed by DNA sequencing. The MICs of amphotericin B, fluconazole, itraconazole, posaconazole, voriconazole, caspofungin, anidulafungin, and micafungin were determined by E-test. Twenty-four isolates did not have an ITS-1 region, characteristic of C. glabrata sensu stricto and their D1/D2 regions of the 26S rRNA were 99% homologous to C. nivariensis 26S rRNA. No strains of C. bracarensis were recovered. C. nivariensis strains were very susceptible to amphotericin B, anidulafungin, micafungin, and caspofungin. Ninety-two percent of C. nivariensis were resistant to itraconazole. The halves of the strains was resistant to posaconazole. Eighty-three percent of C. nivariensis were susceptible to voriconazole. None of the tested strains were susceptible to fluconazole. In the present study, none of the C. nivariensis strains were simultaneously resistant to azoles and echinocandins. C. nivariensis should be recognized as an emerging pathogen, resistant to azoles.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidíase/microbiologia , Anfotericina B/farmacologia , Candida/classificação , Candida/genética , Candida/isolamento & purificação , Candidíase/epidemiologia , Farmacorresistência Fúngica , Fluconazol/farmacologia , Hospitais de Ensino/estatística & dados numéricos , Humanos , Testes de Sensibilidade Microbiana , Polônia/epidemiologia , Prevalência , Triazóis/farmacologia
7.
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
8.
Curr Top Med Chem ; 19(28): 2567-2578, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31654510

RESUMO

BACKGROUND: Biofilm is a critical virulence factor associated with the strains of Candida spp. pathogens as it confers significant resistance to the pathogen against antifungal drugs. METHODS: A systematic review of the literature was undertaken by focusing on natural products, which have been reported to inhibit biofilms produced by Candida spp. The databases explored were from PubMed and Google Scholar. The abstracts and full text of the manuscripts from the literature were analyzed and included if found significant. RESULTS: Medicinal plants from the order Lamiales, Apiales, Asterales, Myrtales, Sapindales, Acorales, Poales and Laurales were reported to inhibit the biofilms formed by Candida spp. From the microbiological sources, lactobacilli, Streptomyces chrestomyceticus and Streptococcus thermophilus B had shown the strong biofilm inhibition potential. Further, the diverse nature of the compounds from classes like terpenoids, phenylpropanoid, alkaloids, flavonoids, polyphenol, naphthoquinone and saponin was found to be significant in inhibiting the biofilm of Candida spp. CONCLUSION: Natural products from both plant and microbial origins have proven themselves as a goldmine for isolating the potential biofilm inhibitors with a specific or multi-locus mechanism of action. Structural and functional characterization of the bioactive molecules from active extracts should be the next line of approach along with the thorough exploration of the mechanism of action for the already identified bioactive molecules.


Assuntos
Antifúngicos/farmacologia , Biofilmes/efeitos dos fármacos , Produtos Biológicos/farmacologia , Candida/efeitos dos fármacos , Candida/patogenicidade , Antifúngicos/química , Antifúngicos/metabolismo , Produtos Biológicos/química , Produtos Biológicos/metabolismo , Candida/classificação , Humanos , Testes de Sensibilidade Microbiana , Plantas Medicinais , Especificidade da Espécie
9.
Curr Top Med Chem ; 19(28): 2527-2553, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31654512

RESUMO

Fungal infections are a veritable public health problem worldwide. The increasing number of patient populations at risk (e.g. transplanted individuals, cancer patients, and HIV-infected people), as well as the use of antifungal agents for prophylaxis in medicine, have favored the emergence of previously rare or newly identified fungal species. Indeed, novel antifungal resistance patterns have been observed, including environmental sources and the emergence of simultaneous resistance to different antifungal classes, especially in Candida spp., which are known for the multidrug-resistance (MDR) profile. In order to circumvent this alarming scenario, the international researchers' community is engaged in discovering new, potent, and promising compounds to be used in a near future to treat resistant fungal infections in hospital settings on a global scale. In this context, many compounds with antifungal action from both natural and synthetic sources are currently under clinical development, including those that target either ergosterol or ß(1,3)-D-glucan, presenting clear evidence of pharmacologic/pharmacokinetic advantages over currently available drugs against these two well-known fungal target structures. Among these are the tetrazoles VT-1129, VT-1161, and VT-1598, the echinocandin CD101, and the glucan synthase inhibitor SCY-078. In this review, we compiled the most recent antifungal compounds that are currently in clinical trials of development and described the potential outcomes against emerging and rare Candida species, with a focus on C. auris, C. dubliniensis, C. glabrata, C. guilliermondii, C. haemulonii, and C. rugosa. In addition to possibly overcoming the limitations of currently available antifungals, new investigational chemical agents that can enhance the classic antifungal activity, thereby reversing previously resistant phenotypes, were also highlighted. While novel and increasingly MDR non-albicans Candida species continue to emerge worldwide, novel strategies for rapid identification and treatment are needed to combat these life-threatening opportunistic fungal infections.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Farmacorresistência Fúngica/efeitos dos fármacos , Micoses/tratamento farmacológico , Micoses/microbiologia , Animais , Antifúngicos/química , Candida/classificação , Humanos , Testes de Sensibilidade Microbiana , Especificidade da Espécie
10.
An Acad Bras Cienc ; 91(3): e20180735, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31553366

RESUMO

Candida haemulonii complex (C. haemulonii, C. haemulonii var. vulnera and C. duobushaemulonii) consists of emergent multidrug-resistant pathogens that cause bloodstream and deep-seated infections. However, little is known about their virulence factors. Herein, we evaluated the presence of extracellular serine peptidases in this fungal complex. Serine peptidase activity was measured by spectrophotometry using chromogenic peptide substrates to the S1 family. Chymotrypsin-, trypsin- and elastase-like activities were detected in all fungal isolates. Since higher chymotrypsin- and trypsin-like activities were observed from the cleavage of N-succinyl-Ala-Ala-Pro-Phe-pNa and N-benzoyl-Phe-Val-Arg-pNa, respectively, these substrates were selected for further experiments. Overall, pHs 7.0 and 9.0 were those in which higher chymotrypsin- and trypsin-like activities were observed, respectively, displaying higher hydrolytic activities at 37-45°C. Additionally, the serine peptidases produced by C. haemulonii complex were inhibited by PMSF and AEBSF in a typically concentration-dependent manner. Although the Michaelis constant (Km) values obtained for chymotrypsin-like peptidases were similar, greater differences were observed for trypsin-like enzymes secreted by the different fungal isolates. This is the first time that peptidases belonging to the S1 family are described in the C. haemulonii species complex. Thus, these data open the doors for more detailed studies into potential roles of these peptidases in fungal virulence.


Assuntos
Candida/enzimologia , Quimotripsina/metabolismo , Farmacorresistência Fúngica Múltipla , Tripsina/metabolismo , Candida/classificação , Meios de Cultura , Espectrofotometria , Temperatura
11.
BMC Infect Dis ; 19(1): 759, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31470800

RESUMO

BACKGROUND: Surveillance of current changes in the epidemiology of Invasive Fungal Diseases (IFDs) as an important component of the antifungal stewardship programs (ASP), requires careful regular monitoring, especially in high-risk settings such as oncology centers. This study aimed to examine Candida colonization status and corresponding current changes in children with malignancy during repeated admissions and also investigate the possible epidemiological shifts after the implementation of ASP. METHODS: In this prospective observational study, all eligible patients younger than 18 years were recruited during 2016-2017 at Amir Medical Oncology Center (AMOC) in Shiraz, Iran. Totally, 136 patients were enrolled and 482 samples were collected from different sites (oral/nasal discharges, urine and stool). Weekly regular sampling was carried out during hospitalization. Candida colonization status and epidemiological changes were monitored during repeated admissions. Samples were cultivated on Sabouraud Dextrose agar medium and identified by Polymerase Chain Reaction -Restriction Fragment Length Polymorphism (PCR-RFLP). RESULTS: Estimated Candida colonization incidence was 59.9% (82/136) in our patients. Candida colonization was found to be higher in oral cavity and rectum than that in nasal cavity. Among those long-term follow ups and repetitive hospitalizations, a significant number of patients exhibited changes in their colonization patterns (37.7%). Candida colonization did not reveal any significant relationship with age, sex, oncologic diseases and degree of neutropenia. C. albicans (72.0%) was found as the most common Candida species in colonized patients, followed by C. krusei, C. kefyr, C. glabrata and C. parapsilosis. CONCLUSION: Given the high incidence of Candida infections in children with cancers, close monitoring of epidemiologic changes is essential for judicious management, based on local surveillance data and improvement of overall quality of care in high risk patients.


Assuntos
Candida/classificação , Candida/isolamento & purificação , Infecção Hospitalar/microbiologia , Neoplasias Hematológicas/microbiologia , Readmissão do Paciente , Adolescente , Candida/genética , Candidíase/epidemiologia , Candidíase/microbiologia , Criança , Pré-Escolar , Infecção Hospitalar/epidemiologia , Feminino , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/epidemiologia , Neoplasias Hematológicas/terapia , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Boca/microbiologia , Nariz/microbiologia , Readmissão do Paciente/estatística & dados numéricos , Readmissão do Paciente/tendências , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Estudos Prospectivos , Reto/microbiologia , Recidiva
12.
J Biol Regul Homeost Agents ; 33(3 Suppl. 1): 35-41, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31538448

RESUMO

Candida species are commensal yeasts of the oral cavity, which, under predisposing systemic and/or local circumstances, are responsible for a wide variety of clinical manifestations, globally known as oral candidiasis. Candida-associated denture stomatitis is an oral candidiasis particularly affecting the oral mucosa covered by a dental prosthesis, with several degree of severity. Diabetics suffer oral candidiasis more frequently than healthy individuals do and if they are denture wearers, the risk increases. Since various controversies still remain regarding the interrelationship among diabetes, oral Candida spp. strains involved in denture stomatitis and the presence of dentures, the present review aims to investigate the differences in Candida species frequencies and degree of denture stomatitis severity existing among diabetic and non- diabetic individuals, with and without dentures.


Assuntos
Candida/classificação , Candidíase Bucal/complicações , Complicações do Diabetes/microbiologia , Diabetes Mellitus , Estomatite sob Prótese/complicações , Dentaduras , Humanos , Estomatite sob Prótese/microbiologia
13.
J Basic Microbiol ; 59(8): 792-806, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31368594

RESUMO

The aim of this study was to examine four strains of two yeast species in relation to their capability for assimilating alkanes in the presence of heavy metals (HMs). The four strains tested were Candida pseudoglaebosa ENCB-7 and Kodamaea ohmeri ENCB-8R, ENCB-23, and ENCB-VIK. Determination was made of the expression of CYP52 genes involved in alkane hydroxylation. When exposed to Cu2+ , Zn2+ , Pb2+ , Cd2+ , and As3+ at pH 3 and 5, all four strains could assimilate several n-alkanes having at least six carbon atoms. The three K. ohmeri strains could also utilize branched alkanes, cycloalkanes, and n-octanol as sole carbon sources. Kinetic assays demonstrated greater biomass production and specific growth of the yeasts exposed to long-chain n-alkanes. Fragments of paralogous CYP52 genes of C. pseudoglaebosa ENCB-7 and K. ohmeri ENCB-23 were amplified, sequenced, and phylogenetically evaluated. Reverse-transcription polymerase chain reaction revealed that n-nonane and n-decane induced to CpCYP52-G3, CpCYP52-G9, and CpCYP52-G10. KoCYP52-G3 was induced with n-decane and n-octanol. Also, CpCYP52-G3 and CpCYP52-G9 were induced by glucose. In conclusion, C. pseudoglaebosa and K. ohmeri were able to degrade several alkanes in the presence of HMs and under acidic conditions. These yeasts harbor paralogous alkane-induced CYP52 genes, which display different profiles of transcriptional expression.


Assuntos
Alcanos/metabolismo , Metais Pesados/metabolismo , Saccharomycetales/metabolismo , Alcanos/química , Biodegradação Ambiental , Biomassa , Candida/classificação , Candida/genética , Candida/crescimento & desenvolvimento , Candida/metabolismo , Sistema Enzimático do Citocromo P-450/genética , DNA Ribossômico/genética , Proteínas Fúngicas/genética , Concentração de Íons de Hidrogênio , Cinética , Filogenia , Saccharomycetales/classificação , Saccharomycetales/genética , Saccharomycetales/crescimento & desenvolvimento
14.
J Mycol Med ; 29(3): 245-252, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31400864

RESUMO

In recent decades, the epidemiology of invasive candidiasis (IC) has progressively changed worldwide. This notably includes emergence of several Candida species. Although some surveillance programs provided global trends in IC epidemiology, data from countries from the Middle East and North Africa (MENA) remain scarce. In this manuscript, we reviewed the existing available data on the epidemiology of Candida species associated with IC, particularly candidemia, in MENA region regarding species distribution. As witnessed worldwide, an evident shift of Candidaalbicans towards non-albicansCandida (NAC) has been observed in the MENA region. The worrying emergence of multi-drug resistant Candida species in MENA calls for a better understanding of their epidemiology. This represents an essential prerequisite for the implementation of effective infection control strategies and surveillance systems to prevent IC among high-risk patients.


Assuntos
Candidemia/epidemiologia , Candidíase Invasiva/epidemiologia , Farmacorresistência Fúngica Múltipla , África do Norte/epidemiologia , Antifúngicos/uso terapêutico , Candida/classificação , Candida/fisiologia , Candidemia/tratamento farmacológico , Candidemia/prevenção & controle , Candidíase Invasiva/tratamento farmacológico , Candidíase Invasiva/prevenção & controle , Humanos , Oriente Médio/epidemiologia
15.
Internist (Berl) ; 60(10): 1106-1110, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31435719

RESUMO

We describe a patient with ANCA (antineutrophil cytoplasmic antibodies) associated vasculitis and acute-on-chronic renal failure. He had initially presented with severe pulmonary hemorrhage and anuric renal failure and improved rapidly with immunosuppressive therapy. Repeat renal biopsy revealed candida interstitial nephritis. Candida was also detected in bronchoalveolar lavage. Kidney function improved with long-term antifungal therapy. This report adds induction therapy for ANCA vasculitis to the conditions where invasive candidal infections including nephritis need to be considered.


Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/tratamento farmacológico , Antifúngicos/uso terapêutico , Candida/isolamento & purificação , Falência Renal Crônica/diagnóstico , Doença Aguda , Lesão Renal Aguda , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/complicações , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/microbiologia , Anticorpos Anticitoplasma de Neutrófilos/imunologia , Biópsia , Candida/classificação , Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Ciclofosfamida/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Falência Renal Crônica/microbiologia , Masculino , Pessoa de Meia-Idade , Nefrite Intersticial/tratamento farmacológico , Nefrite Intersticial/patologia , Resultado do Tratamento
16.
Mycoses ; 62(11): 1023-1028, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31393662

RESUMO

Culture-based diagnosis of candidaemia suffers poor sensitivity and prolonged turnaround time. The 1,3-beta-D-glucan (BDG) assay is a non-culture-based broad fungal antigen with rapid turnaround time. To assess overall, species-specific and population-specific sensitivity of the BDG assay for candidaemia, to determine if the BDG assay is able to detect candidaemia prior to blood culture collection, and to evaluate the performance of the assay for the detection of Candida auris candidaemia. A retrospective review of all blood cultures (BC) with C albicans, C parapsilosis, C glabrata, C krusei and C auris was performed. A corresponding BDG result (Fungitell® ) within 10 days of the BC was sought on the laboratory information system. Overall sensitivity of the assay was 79% (95% CI 73-85; 173/218). Per species sensitivity was 81% (95% CI 72-90; 66/81) for C albicans, 72% (61-83; 60/83) for C parapsilosis, 90% (95% CI 79-100; 27/30) for C glabrata, 71% (95% CI 43-99; 10/14) C auris and 100% (10/10) for C krusei. No statistically significant difference in sensitivity between species was noted (P = .093). The assay demonstrated 92% (59/64) sensitivity in neonatal ICU (P = .047) compared to 94% (15/16) in surgery, 81% (59/73) in adult ICUs and 71% (15/21) in Oncology. BDG results were positive up to 10 days prior to blood culture collection with no significant difference in detection rate (P = .563). BDG results were positive up to 10 days prior to blood culture collection. BDG when collected a mean of 2.5 days (range 1-10 days) prior to blood culture collection were positive.


Assuntos
Candida/isolamento & purificação , Candidemia/diagnóstico , beta-Glucanas/sangue , Adulto , Hemocultura/normas , Candida/classificação , Candidemia/microbiologia , DNA Fúngico/sangue , Humanos , Recém-Nascido , Unidades de Terapia Intensiva , Unidades de Terapia Intensiva Neonatal , Estudos Retrospectivos , Sensibilidade e Especificidade , África do Sul
17.
Infect Dis Obstet Gynecol ; 2019: 5016810, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31467477

RESUMO

Objective: Candida species colonize the vagina in at least 20% of women, with rates rising to 30% during pregnancy. This study aimed at determining the prevalence and risk factors of vulvovaginal candidiasis (VVC) in pregnant women at 35-37 weeks of gestation. It also aims at finding possible correlations between VVC and vaginal colonization by other agents, such as Group B Streptococcus (GBS) and bacterial vaginosis. Methodology: Over a one-year period, high vaginal swabs were collected from pregnant women during their regular antenatal checkup in different polyclinics in Beirut and South Lebanon. Swabs were examined microscopically, cultured on Sabouraud Dextrose Agar, and Candida isolates were identified using Chromatic Candida medium and Germ Tube Test. Results: VVC was detected in 44.8% of samples, with C. glabrata (44.4%) and C. albicans (43.4%) being the most isolated species. Approximately, half of pregnant women (57.7%) were coinfected with Candida and bacterial vaginosis, while 26% of them carried simultaneously Candida spp. and GBS. No significant correlation was found between the occurrence of VVC and demographic, clinical, medical, and reproductive health characteristics of pregnant women. In contrast, participants with previous miscarriages and those being hospitalized during the past 12 months were more susceptible to develop vaginal C. krusei infection in comparison to other Candida species (p=0.0316 and p=0.0042, respectively). Conclusion: The prevalence of VVC in pregnant women is an increasing trend in our community. Therefore, routine medical examination and regular screening for candidiasis in the antenatal care program is highly recommended to manage the disease and its complications.


Assuntos
Candida/patogenicidade , Candidíase Vulvovaginal/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Adulto , Candida/classificação , Feminino , Humanos , Líbano/epidemiologia , Gravidez , Prevalência , Fatores de Risco , Vagina/microbiologia , Adulto Jovem
18.
Clin Lab ; 65(7)2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31307163

RESUMO

BACKGROUND: Candidemia has a high mortality rate. Identifying prognostic factors of candidemia, based on each regional data, is essential for better management. The Clinical and Laboratory Standards Institute (CLSI) recently revised Candida species-specific breakpoints (R-BP) for antifungal agents. Few studies have investigated the detection performance of resistance in Candida species by comparing the R-BP and previous species non-specific CLSI breakpoint (P-BP) among patients with candidemia. The primary objective was to investigate the impact of the R-BP on the antifungal susceptibility patterns of Candida species, while the secondary objective was to identify the prognostic factors of candidemia. METHODS: A total of 193 Candida species isolated from 187 patients with candidemia between January 2007 and December 2016 were examined. Susceptibility based on CLSI M27-A3 was defined as the P-BP and based on species-specific CLSI M59 or M60 breakpoint was defined as the R-BP. Multivariate Cox's hazard analysis was performed to identify prognostic factors within 30 days of the diagnosis of candidemia. RESULTS: A significant difference was observed in the susceptibility rate to fluconazole (FLCZ) (P-BP; 93.0% vs. R-BP; 79.4%) and to voriconazole (VRCZ) (P-BP; 97.2% vs. R-BP; 91.0%). The susceptibilities of C. parapsilosis, C. glabrata, and C. tropicalis to azole antifungal agents were markedly lower with the R-BP. Based on the R-BP, anti-fungal therapy was regarded as inappropriate for approximately 10% of the patients. The 30-day mortality rate was 29.4%. In a multivariate Cox's hazard analysis, age, lung disease, C. albicans, and the absence of antifungal therapy were associated with a high mortality rate, whereas serum albumin, C. parapsilosis, surgical wards, the removal of central venous catheter (CVC), and follow-up blood culture tests to confirm the clearance of Candida species were associated with a lower mortality rate. CONCLUSIONS: Early initiation of antifungal therapy, removal of CVC, and follow-up blood culture tests are essential for improving the outcome. The R-BP efficiently detected non-susceptible strains to FLCZ and VRCZ, particularly in non-albicans Candida species. The present results support the importance of antifungal susceptibility tests and interpretations based on the R-BP among patients with candidemia.


Assuntos
Antifúngicos/uso terapêutico , Candida/efeitos dos fármacos , Candidemia/tratamento farmacológico , Serviços de Laboratório Clínico/estatística & dados numéricos , Testes de Sensibilidade Microbiana/métodos , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/classificação , Candida/classificação , Candida/isolamento & purificação , Candidemia/epidemiologia , Candidemia/microbiologia , Serviços de Laboratório Clínico/normas , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Especificidade da Espécie , Análise de Sobrevida
19.
Int J Antimicrob Agents ; 54(4): 471-477, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31271830

RESUMO

In vitro and clinical data were analysed to evaluate the susceptibility profile of itraconazole in light of the new cut-off points. The in vitro activity of itraconazole was compared with that of eight comparators against 119 Candida bloodstream isolates from 2015 to 2018. Minimum inhibitory concentrations (MICs) were measured by the colorimetric MICRONAUT-S assay. The content of wells without any color change was sub-cultured to measure killing efficacy. No major differences were found against Candida albicans. Itraconazole, posaconazole and amphotericin B were the most active agents against Candida parapsilosis. Of the 32 isolates of C. parapsilosis that were resistant to fluconazole, 96.9%, 78.1% and 93.8% were susceptible to itraconazole, voriconazole and posaconazole, respectively. The ratio of the minimum fungicidal concentration (MFC) to the MIC of itraconazole was lower than for the other azoles against C. parapsilosis and C. glabrata. Itraconazole achieved greater inhibition over-time of the growth of C. parapsilosis than fluconazole. Seventy-three critically ill patients who were unresponsive to antibiotics received intravenous empirical treatment with itraconazole (n = 28) or comparators (n = 45). Case-control matching was conducted for severity, comorbidities, risk factors for candidemia, administered antibiotics and days of antifungal treatment. Breakthrough candidemia was found in 3.6% of patients treated with itraconazole and in 32.1% of patients treated with comparators (P: 0.020); breakthrough candidemia by C. parapsilosis was found in 3.6% and 28.6% of patients, respectively. Results indicate that itraconazole retains a valuable susceptibility profile against Candida isolates, particularly C. parapsilosis. This superior profile may explain the clinical efficacy in the occurrence of breakthrough candidemia and warrants further clinical investigation.


Assuntos
Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Candida/efeitos dos fármacos , Candidemia/tratamento farmacológico , Candidemia/microbiologia , Itraconazol/farmacologia , Itraconazol/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Candida/classificação , Candida/isolamento & purificação , Estado Terminal , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
20.
J Microbiol Immunol Infect ; 52(5): 728-735, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31302087

RESUMO

BACKGOUND: Conventional diagnosis of invasive fungal disease from blood cultures is often notoriously delayed and inadequately sensitive. We aimed to develop a universal primers-based polymerase chain reaction (PCR) assay and restriction fragment length polymorphisms (RFLP) for rapid identification of invasive fungal disease (IFD). METHODS: We evaluated 16 clinical fungal species using a combination of PCR assays with 3 different restriction endonucleases targeting various internal transcribed spacer (ITS) regions and high resolution melting analysis (HRMA). Serial samples from 75 patients suspected to have IFD were analyzed for clinical verification. RESULTS: We have designed a universal PCR capable of amplifying a portion of the 18S rRNA gene of 16 clinically important fungal species. The restriction patterns of most PCR products generated by EcoRI or double digested by ClaI and AvaI were different, except Aspergillus niger and Aspergillus flavus had a similar pattern, and Aspergillus fumigatus and Aspergillus terreus had a similar pattern. All these species had a unique melting curve shape using the HRMA. Both HRMA and universal PCR had adequate sensitivity, and all sixteen reference fungal species can be clearly distinguished by the universal PCR-RFLP-HRMA assay. With a reference library of 176 clinically relevant fungal strains, and 75 clinical samples from patients with suspicious IFD were tested, our assay identified 100% and 61.1% of isolates from the reference library and clinical samples, respectively. CONCLUSIONS: Universal PCR and RFLP coupled with HRMA could be a highly discriminative and useful molecular diagnostic that could enhance the current diagnostic, treatment, and surveillance methods of invasive fungal disease.


Assuntos
Primers do DNA , Enzimas de Restrição do DNA , Fungos/isolamento & purificação , Espécies Introduzidas , Técnicas de Tipagem Micológica/métodos , Micoses/microbiologia , Reação em Cadeia da Polimerase/métodos , Aspergilose/diagnóstico , Aspergilose/microbiologia , Aspergillus/classificação , Aspergillus/genética , Aspergillus/isolamento & purificação , Candida/classificação , Candida/genética , Candida/isolamento & purificação , DNA Fúngico/genética , Fungos/classificação , Fungos/genética , Humanos , Micoses/diagnóstico , Polimorfismo de Fragmento de Restrição , RNA Ribossômico 18S/genética , Sensibilidade e Especificidade
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