scholarly journals Non-albicans CandidaInfection: An Emerging Threat

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Sachin C. Deorukhkar ◽  
Santosh Saini ◽  
Stephen Mathew
Keyword(s):  
Candida Albicans ◽  
Virulence Factors ◽  
High Resistance ◽  
Fungal Pathogens ◽  
Antifungal Agents ◽  
Antifungal Susceptibility ◽  
Clinical Specimen ◽  
Antifungal Drugs ◽  
Clinical Specimens ◽  
The Past

The very nature of infectious diseases has undergone profound changes in the past few decades. Fungi once considered as nonpathogenic or less virulent are now recognized as a primary cause of morbidity and mortality in immunocompromised and severely ill patients.Candidaspp. are among the most common fungal pathogens.Candida albicanswas the predominant cause of candidiasis. However, a shift toward non-albicans Candidaspecies has been recently observed. These non-albicans Candidaspecies demonstrate reduced susceptibility to commonly used antifungal drugs. In the present study, we investigated the prevalence of non-albicans Candidaspp. amongCandidaisolates from various clinical specimens and analysed their virulence factors and antifungal susceptibility profile. A total of 523Candidaspp. were isolated from various clinical specimens. Non-albicans Candidaspecies were the predominant pathogens isolated. Non-albicans Candidaspecies also demonstrated the production of virulence factors once attributed toCandida albicans. Non-albicans Candidademonstrated high resistance to azole group of antifungal agents. Therefore, it can be concluded that non-albicans Candidaspecies have emerged as an important cause of infections. Their isolation from clinical specimen can no longer be ignored as a nonpathogenic isolate nor can it be dismissed as a contaminant.

scholarly journals Identification of Fungal Pathogens in Otomycosis and Their Drug Sensitivity: Our Experience

2018 ◽  
Vol 22 (04) ◽  
pp. 400-403 ◽  
Author(s):  
Khaled Ali ◽  
Mahmood Hamed ◽  
Hameda Hassan ◽  
Amira Esmail ◽  
Abeer Sheneef
Keyword(s):  
Enzymatic Activity ◽  
Candida Species ◽  
Fungal Pathogens ◽  
Antifungal Agents ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Antifungal Susceptibility Testing ◽  
Antifungal Drugs ◽  
High Recurrence Rate ◽  
Fungal Culture

Introduction Otomycosis is a common problem in otolaryngology practice. However, we usually encounter some difficulties in its treatment because many patients show resistance to antifungal agents, and present high recurrence rate. Objectives To determine the fungal pathogens that cause otomycosis as well as their susceptibility to the commonly used antifungal agents. Additionally, to discover the main reasons for antifungal resistance. Methods We conducted an experimental descriptive study on 122 patients clinically diagnosed with otomycosis from April 2016 to April 2017. Aural discharge specimens were collected for direct microscopic examination and fungal culture. In vitro antifungal susceptibility testing was performed against the commonly used antifungal drugs. We tested the isolated fungi for their enzymatic activity. Results Positive fungal infection was found in 102 samples. The most common fungal pathogens were Aspergillus and Candida species, with Aspergillus niger being the predominant isolate (51%). The antifungal susceptibility testing showed that mold isolates had the highest sensitivity to voriconazole (93.48%), while the highest resistance was to fluconazole (100%). For yeast, the highest sensitivity was to nystatin (88.24%), followed by amphotericin B (82.35%), and the highest resistance was to terbinafine (100%), followed by Itraconazole (94.12%). Filamentous fungi expressed a high enzymatic ability, making them more virulent. Conclusion The Aspergillus and Candida species are the most common fungal isolates in otomycosis. Voriconazole and Nystatin are the medications of choice for the treatment of otomycosis in our community. The high virulence of fungal pathogens is owed to their high enzymatic activity. Empirical use of antifungals should be discouraged.

scholarly journals Speciation of Candida using CHROMagar from various clinical specimens and their antifungal susceptibility pattern at a tertiary care hospital.

2020 ◽  
Vol 16 (2) ◽  
pp. 107-111
Author(s):  
Sanjana Raj Kumari ◽  
Neetu Adhikaree
Keyword(s):  
Candida Albicans ◽  
Candida Species ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Antifungal Susceptibility Testing ◽  
Antifungal Drugs ◽  
Care Hospital ◽  
Clinical Specimens

Background: Candida albicans remains the most common and are responsible for various clinical infections ranging from mucocutaneous infection to life threatening invasive diseases. But recent epidemiological data shift from C.albicans to non albicans Candida species and also increased resistance to antifungal drugs made the scenario a serious concern. Methods: A total of 156 Candida isolates from various clinical specimens received in the department of Microbiology were taken up for the study over a period of one year i.e. from March 2019 to February 2020. The Candida were grown on Sabouraud dextrose agar to be  evaluated for colony  appearance, macroscopic examination, Gram staining, germ tube, urea hydrolysis etc. The Candida isolates were speciated by using CHROMagar medium. Antifungal susceptibility testing was performed as recommended by Clinical and Laboratory Standards Institute (CLSI) M44-A document. Results: The isolation of non albicans Candida (54.5%) predominated over Candida albicans (45.5%). Non albicans Candida isolated were Candida tropcalis 40(25.6%), Candida krusei 21(13.4%), Candida glabrata 17(10.8%) and Candida dublinensis 07(4.4%) each. Candida species were all susceptible to Amphotericin B, followed by fluconazole (67.4%), miconazole (51.9%) and ketoconazole (22.5%). Conclusions: The accurate species identification of Candida is important for the treatment because not all species respond to the same treatment and also because of the increasing antifungal resistance. CHROMagar is a convenient and rapid method of identification of Candida species specially in resource limited poor settings.   Keywords: antifungal susceptibility testing; Candida albicans; CHROMagar; non albicans Candida

Recent Advances in Azole Based Scaffolds as Anticandidal Agents

2019 ◽  
Vol 16 (5) ◽  
pp. 492-501 ◽  
Author(s):  
Prabhuodeyara Math Gurubasavaraj ◽  
Jasmith Shivayya Charantimath
Keyword(s):  
Drug Delivery ◽  
Drug Resistance ◽  
Candida Albicans ◽  
Drug Interactions ◽  
Fungal Pathogens ◽  
Antifungal Agents ◽  
Fungal Infections ◽  
Antifungal Drugs ◽  
Fungal Virulence ◽  
Compromised Patients

Aim:The present review aims to explore the development of novel antifungal agents, such as pharmacology, pharmacokinetics, spectrum of activity, safety, toxicity and other aspects that involve drug-drug interactions of the azole antifungal agents.Introduction:Fungal infections in critically ill and immune-compromised patients are increasing at alarming rates, caused mainly by Candida albicans an opportunistic fungus. Despite antifungal annihilators like amphotericin B, azoles and caspofungin, these infections are enormously increasing. The unconventional increase in such patients is a challenging task for the management of antifungal infections especially Candidiasis. Moreover, problem of toxicity associated with antifungal drugs on hosts and rise of drug-resistance in primary and opportunistic fungal pathogens has obstructed the success of antifungal therapy.Conclusion:Hence, to conflict these problems new antifungal agents with advanced efficacy, new formulations of drug delivery and novel compounds which can interact with fungal virulence are developed and used to treat antifungal infections.

scholarly journals In vitro activity of four triazole antifungal drugs against clinically common and uncommon yeast species

2019 ◽  
Author(s):  
Narges Aslani ◽  
Tahereh Shokohi ◽  
Mohammad Reza Ataollahi ◽  
Saham Ansari ◽  
Yousef Gholampour ◽  
...  
Keyword(s):  
Fungal Pathogens ◽  
Antifungal Agents ◽  
Yeast Species ◽  
Fungal Infections ◽  
Geometric Mean ◽  
Antifungal Susceptibility ◽  
Active Agent ◽  
Antifungal Drugs ◽  
Selection Of

Background and Purpose: Incidence of fungal infections caused by opportunistic fungal pathogens, such as yeasts and yeast-like species, has undergone an increase in otherwise healthy individuals. These pathogens account for high mortality and show reduced susceptibility to the routine antifungal drugs. Accordingly, antifungal susceptibility testing is an urgent need in the determination of the susceptibility spectrum of antifungals and selection of appropriate antifungal agents for the management of patients with fungal infection.Materials and Methods: The present study was conducted on 110 yeast strains belonging to 15 species recovered from clinical specimens. Susceptibility of the isolates to four antifungal drugs (i.e., fluconazole, itraconazole, voriconazole, and posaconazole) was tested according to the Clinical and Laboratory Standards Institute guidelines M27-A3 and M27-S4.Results: Fluconazole exhibited no activity against 4.3% (n=2) of C. albicans isolates, whereas the remaining 44 isolates had a minimum inhibitory concentration (MIC) range of 0.125-4 μg/ml. Voriconazole had the lowest geometric mean MIC (0.03 μg/ml) against all isolated yeast species, followed by posaconazole (0.07 μg/ml), itraconazole (0.10 μg/ml), and fluconazole (0.60 μg/ml). Overall, all of the isolates had reduced voriconazole MICs with a MIC range of 0.016-0.5 μg/ml, except for one isolate of C. albicans that had a MIC of 1 μg/ml. Candida haemulonii as a multidrug-resistant fungus showed a fluconazole MIC of > 64 μg/ml.Conclusion: The current study provides insight into the antifungal susceptibility profiles of clinically common and uncommon yeast species to four triazole antifungal agents. According to our findings, voriconazole was the most active agent. Awareness about antifungal susceptibility patterns is highly helpful in the selection of appropriate antifungal drugs and identification of the efficiency of the currently used agents.

scholarly journals ISOLATION, IDENTIFICATION AND ANTIFUNGAL SUSCEPTIBILITY TESTINGOF CANDIDA ISOLATES FROM VARIOUS CLINICAL SPECIMENS AT A TERTIARY CARE HOSPITAL, WESTERN RAJASTHAN

2021 ◽  
Vol 9 (11) ◽  
pp. 809-814
Author(s):  
Sandeep Arora ◽  
◽  
Smita Kulshreshtha ◽  
Usha Verma ◽  
Prameshwar Lal ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Candida Species ◽  
Antifungal Agents ◽  
Large Population ◽  
Antifungal Susceptibility ◽  
Clinical Samples ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Candida Spp ◽  
Clinical Specimens

Background: Candida spp is a member of the normal flora of the skin, mucous membrane and gastrointestinal tract. Candida continues to be leading cause of morbidity and mortality in large population of immunocompromised and hospitalized patients. Invasive Candidiasis due to non-albicans candida has been on the rise in last few years. This study aims to Spectate Candida using chromogenic medium.The emerging pathogens are resistant to conventional antifungal therapy. Objective: To identify the various species of candida isolated from different clinical specimens and to compare the susceptibility pattern of these isolated species towards different antifungal agents. Methods: All Candida isolates recovered from various clinical samples during the period from September 2017 and august 2018 were studied., These isolates were subjected to grams stain, germ tube test and inoculation on commercially available CHROM agar (HiMedia India). Results: A total of 155 Candida species were isolated from the different clinical specimens of suspected candida infection cases. Most of the isolates obtained were from urine samples 93 (60%) followed by blood 26(16.77%). Non albicans Candida were isolated at a higher rate 101 (65.16%) than Candida albicans 54 (34.84%) . Among 101 non C. albicans, C. tropicalis 55 (35.48%) was the most common species followed by 19 (12.26%) C. parapsilosis. Among all species of Candida commonest isolate was C. tropicalis 55(35.48%) followed by C. albicans 54(34.83%). Candida species from various samples were high resistant to itraconazole (72.26%) followed by fluconazole(70.92%), voriconazole (68.39%) and ketoconazole (57.42%)while there was minimum resistance to amphotericin-B (20%).This study emphasizes the need for monitoring local epidemiologic data and antifungal susceptibility pattern of candida isolates for proper treatment. Conclusions: Along with Candida albicans, non-albicans candida spp like C. tropicalis, parapsilosis, C. krusei and C. glabrata are increasingly being isolated from clinical samples. CHROM agar is a simple, rapid and inexpensive method for identification of such species. Characterization to species level helps to identify species which might be intrinsically resistant to commonly used antifungal agents.

scholarly journals Spectrum and theIn VitroAntifungal Susceptibility Pattern of Yeast Isolates in Ethiopian HIV Patients with Oropharyngeal Candidiasis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Birhan Moges ◽  
Adane Bitew ◽  
Aster Shewaamare
Keyword(s):  
Antifungal Agents ◽  
Antifungal Susceptibility ◽  
Antifungal Drugs ◽  
Assay Method ◽  
Cryptococcus Laurentii ◽  
Susceptibility Pattern ◽  
Test Procedures ◽  
Disk Diffusion Assay ◽  
Diffusion Assay

Background.In Ethiopia, little is known regarding the distribution and thein vitroantifungal susceptibility profile of yeasts.Objective.This study was undertaken to determine the spectrum and thein vitroantifungal susceptibility pattern of yeasts isolated from HIV infected patients with OPC.Method.Oral pharyngeal swabs taken from oral lesions of study subjects were inoculated onto Sabouraud Dextrose Agar. Yeasts were identified by employing conventional test procedures and the susceptibility of yeasts to antifungal agents was evaluated by disk diffusion assay method.Result.One hundred and fifty-five yeast isolates were recovered of which 91 isolates were from patients that were not under HAART and 64 were from patients that were under HAART.C. albicanswas the most frequently isolated species followed byC. glabrata, C. tropicalis, C. krusei, C. kefyr, Cryptococcus laurentii, and Rhodotorulaspecies. Irrespective of yeasts isolated and identified, 5.8%, 5.8%, 12.3%, 8.4%, 0.6%, and 1.3% of the isolates were resistant to amphotericin B, clotrimazole, fluconazole, ketoconazole, miconazole, and nystatin, respectively.Conclusion.Yeast colonization rate of 69.2% and 31% resistance to six antifungal agents was documented. These highlight the need for nationwide study on the epidemiology of OPC and resistance to antifungal drugs.

scholarly journals CaNdt80 Is Involved in Drug Resistance in Candida albicans by Regulating CDR1

2004 ◽  
Vol 48 (12) ◽  
pp. 4505-4512 ◽  
Author(s):  
Chia-Geun Chen ◽  
Yun-Liang Yang ◽  
Hsin-I Shih ◽  
Chia-Li Su ◽  
Hsiu-Jung Lo
Keyword(s):  
Saccharomyces Cerevisiae ◽  
Drug Resistance ◽  
Candida Albicans ◽  
Type Strain ◽  
Antifungal Agents ◽  
Wild Type Strain ◽  
Efflux Pump ◽  
Antifungal Drugs ◽  
Galactosidase Activity ◽  
Wild Type

ABSTRACT Overexpression of CDR1, an efflux pump, is one of the major mechanisms contributing to drug resistance in Candida albicans. CDR1 p-lacZ was constructed and transformed into a Saccharomyces cerevisiae strain so that the lacZ gene could be used as the reporter to monitor the activity of the CDR1 promoter. Overexpression of CaNDT80, the C. albicans homolog of S. cerevisiae NDT80, increases the β-galactosidase activity of the CDR1 p-lacZ construct in S. cerevisiae. Furthermore, mutations in CaNDT80 abolish the induction of CDR1 expression by antifungal agents in C. albicans. Consistently, the Candt80/Candt80 mutant is also more susceptible to antifungal drugs than the wild-type strain. Thus, the gene for CaNdt80 may be the first gene among the regulatory factors involved in drug resistance in C. albicans whose function has been identified.

Biosynthesis of selenium nanoparticles by Aspergillus flavus and Candida albicans and comparison of their effects with antifungal drugs

2021 ◽  
Author(s):  
Mahdi Hosseini Bafghi ◽  
Razieh Nazari ◽  
Majid Darroudi ◽  
Mohsen Zargar ◽  
Hossein Zarrinfar
Keyword(s):  
Candida Albicans ◽  
Aspergillus Flavus ◽  
Fungal Pathogens ◽  
Chemical Properties ◽  
Cost Effective ◽  
Antifungal Drugs ◽  
Selenium Nanoparticles ◽  
Fungal Strains ◽  
Vis Spectroscopy ◽  
Physical And Chemical

Abstract Biosynthesis of nanoparticles can stand as a replacement for the available chemical and physical methods by offering new procedures as green syntheses that have proved to be simple, biocompatible, safe, and cost-effective. Considering how nanoparticles with a size of 1 to 100 nanometers contain unique physical and chemical properties, recent reports are indicative of observing the antifungal qualities of selenium nanoparticles (Se-NPs). Recently, the observance of antifungal resistance towards different species of these fungi is often reported. Therefore, due to the antifungal effects of biological nanoparticles, this study aimed to investigate the exertion of these nanoparticles and evaluate their effects on the growth of fungal pathogens. Se-NPs were biosynthesized by the application of wet reduction method, which included specific concentrations of Aspergillus flavus and Candida albicans. The presence of nanoparticles was confirmed by methods such as UV-Vis spectroscopy, FT-IR analysis, and FESEM electron microscope that involved FESEM and EDAX diagram. The fungal strains were cultured in sabouraud dextrose agar medium to perform the sensitivity test based on the minimum inhibitory concentration (MIC) method in duplicate. The utilization of Se-NPs at concentrations of 1 µg/ ml and below resulted in zero growth of fungal agents. However, their growth was inhibited by antifungal drugs at concentrations of 2 µg/ ml and higher. Based on the obtained results, biological nanoparticles produced by fungal agents at different concentrations exhibited favorable inhibitory effects on the growth of fungal strains.

scholarly journals Evaluation of semisolid agar method for antifungal susceptibility test of T. rubrum

2016 ◽  
Vol 7 (1) ◽  
pp. 11
Author(s):  
Sultana Razia ◽  
Shahida Anwar ◽  
Md. Ruhul Amin Miah ◽  
Najmun Nahar ◽  
Ripon Barua
Keyword(s):  
Antifungal Agents ◽  
Antifungal Susceptibility ◽  
Antifungal Drugs ◽  
Test Method ◽  
Susceptibility Test ◽  
Broth Microdilution ◽  
Microdilution Method ◽  
Broth Microdilution Method ◽  
Antifungal Susceptibility Test ◽  
Mic Value

<p><strong>Background:</strong> With increasing fungal disease many newer antifungal drugs are available with different spectrum of activ­ity. Antifungal susceptibility test will help clinicians for selection of effective drug and thereby treatment of patient.<strong> </strong></p><p><strong>Objective:</strong> The study was undertaken to perform a simple screening drug susceptibility test of T. rnbrum by Semi Solid Agar Antifungal Susceptibility (SAAS) <strong></strong></p><p><strong>Method:</strong> Perfonnance of susceptibility method was assessed by comparing the MICs of three commonly prescribed antifungal agents namely- tluconazole (FCZ), itraconazole (ITZ) and terbinafine (TER) to the CLSI (Clinical and Laboratory Standard Institute) recommended M-38, a broth microdilution method. <strong></strong></p><p><strong>Results:</strong> In SAAS method, among twenty nine T. rubrum, twenty five (86.2%) were susceptible (MIC range 0.5-64 µg/ml) to Fluconazole (FCZ) and four (13.7%) were resistant (MIC value &gt;64 µg/ml). In broth microdilution method, among twenty nine T. rubrum, twenty six (89.6%) were susceptible (MIC range 0.3-64 µg/ml) to FCZ and three (10.3%) were resistant (MIC value &gt;64 µg/ml). In case of both ITZ and TER, all were susceptible (MIC range 0.3-64 µg/ml) to both methods. The SAAS method demonstrated the susceptibility pattern of T. rubrum against FCZ, ITZ and TER usually within 72 to 96 hours after organism isolation and results were concordance with the results of CLSI broth microdilution method. <strong></strong></p><p><strong>Conclusion:</strong> Though it is a newer method with proper standardization of the test method, SAAS method is simple and easily applicable screening method for susceptibility testing of antifungal agents against dermatophytes in any microbiology laboratories.</p>

scholarly journals Distribution and antifungal susceptibility of Candida species in patients with increased risk for fungal infections

2016 ◽  
Vol 62 (1) ◽  
pp. 65-76
Author(s):  
Gordana Mirchevska ◽  
Maja Jurhar Pavlova ◽  
Elena Trajkovska-Dokic ◽  
Zaklina Cekovska ◽  
Gordana Jankoska ◽  
...  
Keyword(s):  
Blood Culture ◽  
Amphotericin B ◽  
Critically Ill Patients ◽  
Candida Species ◽  
Antifungal Agents ◽  
Fungal Infections ◽  
Antifungal Susceptibility ◽  
Clinical Specimens ◽  
Fourth Group ◽  
Increased Risk

Candida species are opportunistic yeasts that can be a serious threat for immunocompromised and critically ill patients, and a cause for increased morbidity and mortality in hospitalized patients. The aim of this study was to determine the frequency and distribution of different Candida species in clinical specimens in patients with increased risk for fungal infections, and to determine the antifungal susceptibility profile of invasive Candida species to antifungal agents. During a two year period, clinical specimens from 120 patients divided into 4 groups were analysed at the Institute of microbiology and parasitology, Faculty of Medicine, Skopje, Republic of Macedonia. Each of these 4 groups consisted of specimens from 30 patients, with primary immune deficiency, critically ill patients treated in the intensive care units (ICU), patients with mucosal candidiasis only, and patients with cystic fibrosis. All specimens were investigated with conventional mycological methods. Identification of Candida species was performed with VITEK-2 system (bioMérieux, France). E-test strips of fluconazole, voriconazole, amphotericin B and caspofungin (AB bioMerieux, France) were used for determination of the antifungal susceptibility profile. In this study, a total of 115 isolates of Candida species were confirmed in different clinical specimens (91 isolates from mucosal surfaces and 24 isolates from blood culture). Colonisation of mucosal membranes of gastrointestinal, respiratory and/or urinary tracts was registered in 56.67% (17/30), 56.67% (17/30), 90% (27/30) and 100% (30/30) of the specimens in the first, second, third and fourth group respectively. In all four groups of patients, the following Candida species were confirmed: C. albicans - 55%, C. glabrata - 17.6%, C. parapsilosis - 7.7%, C. tropicalis - 6.6%, unidentified Candida species - 4.4%, C. dubliniensis - 3.3%, C. kefyr - 2.2%, and one isolate of C. rugosa, C. pelliculosa and C. krusei each. Positive blood culture was registered in 23.33% specimens from the first group, 43.33% in the second group, 23.08% of the third group, and in one specimen of the fourth group. The most frequent isolates from blood culture were C. tropicalis and C. krusei, followed by C. albicans, C. parapsilosis and C. tropicalis, and in the second group C. albicans and C. pelliculosa were equally distributed, followed by C. parapsilosis and C. glabrata. All invasive isolates of Candida species were susceptible to amphotericin B, voriconazole and caspofungin. Resistance to fluconazole was registered in 8.3% (2/24) of all confirmed Candida species. Dose-dependent susceptibility to fluconazole was confirmed in 46% (11/24) of the isolates. Our study confirms high prevalence of colonisation and candidemia with non-albicans Candida species. Resistance to antifungal agents was registered only in two isolates of C. krusei. An epidemiological study is necessary for surveillance of dynamics of candidemia and antifungal susceptibility profile of invasive isolates of Candida species in our patients.

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