scholarly journals Oral Candidiasis among Cancer Patients Attending a Tertiary Care Hospital in Chennai, South India: An Evaluation of Clinicomycological Association and Antifungal Susceptibility Pattern

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Abirami Lakshmy Jayachandran ◽  
Radhika Katragadda ◽  
Ravinder Thyagarajan ◽  
Leela Vajravelu ◽  
Suganthi Manikesi ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Amphotericin B ◽  
Oral Candidiasis ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Antifungal Drug ◽  
Dilution Method ◽  
Care Hospital ◽  
Susceptibility Pattern

Oropharyngeal candidiasis is one of the common manifestations seen in cancer patients on cytotoxic therapy and invasion into deeper tissues can occur if not treated promptly. Emergence of antifungal drug resistance is of serious concern owing to the associated morbidity and mortality. The present study aims at evaluation of clinicomycological association and antifungal drug susceptibility among the 180 recruited patients with cancer on chemotherapy and/or radiotherapy with signs or symptoms suggestive of oral candidiasis. Speciation and antifungal susceptibility was done by Microbroth dilution method for fluconazole, Itraconazole, and Amphotericin B as per standard microbiological techniques. Chi-square test was used for statistical analysis (p<0.05was considered statistically significant).Candida albicanswas the predominant species isolated (94) (58%) followed byCandida tropicalis(34) (20.9%). Fluconazole and Itraconazole showed an overall resistance rate of 14% and 14.8%, respectively. All the isolates were susceptible to Amphotericin B. There was a significant association between the presence of dry mouth and isolation ofCandida(p<0.001). Such clinicomicrobiological associations can help in associating certain symptoms with the isolation ofCandida. Species level identification with in vitro antifungal susceptibility pattern is essential to choose the appropriate drug and to predict the outcome of therapy.

A study on the antifungal susceptibility pattern of dermatophytes isolated in a tertiary care hospital

2017 ◽  
Vol 6 (05) ◽  
pp. 5379
Author(s):  
Vanathi Sabtharishi* ◽  
Radhika Katragadda ◽  
Thyagarajan Ravinder
Keyword(s):  
Tertiary Care Hospital ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Antifungal Drugs ◽  
Dilution Method ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Superficial Mycosis ◽  
Broth Dilution ◽  
Common Infections

Recent years, due to increased usage of antifungal treatment worldwide, there is an increased chance of rising resistance among antifungal drugs too. Dermatophytic infections causes’ superficial mycosis and it affects skin, hair and nail. These infections are more common and antifungal drugs are used everywhere to treat those common infections. To conduct a study by determining the antifungal susceptibility pattern in dermatophytic isolates from patients attending dermatology OPD in a tertiary care hospital. A total of 217 samples like hair, nail and skin scrapings were obtained and isolation of dermatophytes was done. Antifungal susceptibility testing for dermatophytes was performed by micro broth dilution method. Antifungal drugs tested were Griseofulvin, Fluconazole, Itraconazole and Ketoconazole. Minimum inhibitory concentration for each drug for fungal isolates was tested and results studied. Fluconazole showed a higher MIC values in the range of 1-8µg/ml. Itraconazole showed the lowest MIC values by micro broth dilution method. Since there is limitation of standard guidelines and protocol, meticulous research must be conducted on effect of antifungals and derive at universally implementable guidelines.

scholarly journals Epidemiological profile and antifungal susceptibility pattern of Trichosporon species in a tertiary care hospital in Chandigarh, India

2021 ◽  
Author(s):  
Vibha Mehta ◽  
Jagdish Chander ◽  
Neelam Gulati ◽  
Nidhi Singla ◽  
Hena Vasdeva ◽  
...  
Keyword(s):  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
North India ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Trichosporon Species ◽  
Epidemiological Profile ◽  
Associated Risk Factors

Background and Purpose: Trichosporon species are ubiquitous in nature which are associated with fatal opportunistic invasive infections, especially in immunocompromised patients. The present study aimed to evaluate the epidemiological and clinical details, as well as the antifungal susceptibility pattern of the patients with Trichosporon infections. Materials and Methods: In total, 50 clinical isolates of Trichosporon species from various samples were included in this study. The samples were isolated over a period of 18 months from patients in a tertiary hospital in North India. The isolates were characterised phenotypically with Vitek MS (bioMérieux, France). Trichosporon spp. were isolated from urine (30%), nail (30%), tissue (16%), pleural fluid (14%), and sputum (5%). In total, majority of the isolates were of Trichosporon asahii (92%),followed by Trichosporon mucoides (6%), and Trichosporon ovoides (2%). It is noteworthy that most of the reported cases were from intensive care unit (34%). Results: Intravenous catheters, antibiotics, and antifungal uptake were significantly associated risk factors with Trichosporon infection. All invasive isolates were observed to be resistant in vitro to caspofungin and exhibited high minimum inhibitory concentration (MIC) values against amphotericin B, fluconazole, and 5-flucytosine. The MICs for voriconazole and posaconazole were low. Conclusion: Trichosporonosis is being increasingly reported all around the world,including India. The results of this study highlighted the importance of early detection and treatment for this emerging yeast and also added to the ongoing surveillance for the antifungal susuceptibility pattern for this fungus.

scholarly journals Antifungal Susceptibility of Non-albicans Candida Species in A Tertiary Care Hospital, Bulgaria

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Hristina Yotova Hitkova ◽  
Diana Simeonova Georgieva ◽  
Preslava Mihailova Hristova ◽  
Teodora Vasileva Marinova-Bulgaranova ◽  
Biser Kirilov Borisov ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Antifungal Agents ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Acquired Resistance ◽  
Multidrug Resistant ◽  
Antifungal Drugs ◽  
Care Hospital ◽  
And Control

Background: Emerging non-albicans Candida (NAC) species are a major threat because of their intrinsic or acquired resistance to routinely applied antifungal agents. Objectives: The purpose of our study was to reveal in vitro activity of nine antifungal agents against NAC isolates. Methods: A total of 67 NAC (27 Candida glabrata, 10 C. tropicalis, 6 C. krusei, 6 C. parapsilosis, 4 C. lusitaniae, 4 C. lipolytica, etc.) were identified and tested. The antifungal susceptibility was estimated on the basis of minimum inhibitory concentrations (MIC). Results: Overall, 13 species were determined, of which C. glabrata was the most common (40.3%), followed by C. tropicalis (14.9%), C. krusei, and C. parapsilosis (8.9 % each). Forty-nine NAC isolates (73.13%) demonstrated decreased susceptibility to one or more antifungals, and 18 of them were resistant to all azoles. Out of 27 C. glabrata, 12 (44.4%) were resistant to fluconazole with MICs: 32 - >128 µg/mL and 15 (55.6%) were intermediate with MICs: 8 - 16 µg/mL Non-albicans Candida revealed a good susceptibility to echinocandins. Amphotericin B resistance was found in 5.97% of the isolates. Of particular interest was the detection of 6 (8.95%) multidrug-resistant NAC, which expressed resistance to azoles and echinocandins and/or amphotericin B. Conclusions: About one-fourth of the studied NAC were resistant to all azoles. These findings as well as the detection of several multidrug-resistant isolates determine the necessity of susceptibility testing of clinically important yeast isolates and control of the antifungal drugs in our hospital.

scholarly journals Isolation of Candida africana in oral candidiasis: First report among cancer patients in Iran

2020 ◽  
Author(s):  
Ensieh Lotfali ◽  
Masoud Mardani ◽  
Sara Abolghasemi ◽  
David Darvishnia ◽  
Mohammad Mahdi Rabiei ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Amphotericin B ◽  
Oral Candidiasis ◽  
Antifungal Susceptibility ◽  
Empirical Therapy ◽  
Antifungal Prophylaxis ◽  
In Vitro Susceptibility ◽  
Molecular Tests ◽  
In Vitro Antifungal Susceptibility

Background and Purpose: Oropharyngeal candidiasis (OPC) is a fungal infection of the oral cavity caused by the members of C. albicans complex. Although C. africana, as a part of the complex, is considered to be mostly responsible for the development of vulvovaginal candidiasis, it may be associated with a wider clinical spectrum. Case report: This report described two cases diagnosed with oral candidiasis during the receipt of treatment for malignancies. Conventional and molecular tests were performed on the samples collected from the patients’ oral cavities. The test results revealed C. africana as the causative agent of oral candidiasis. Furthermore, in vitro antifungal susceptibility test indicated the full susceptibility of all C. africana isolates to caspofungin. However, the data were also suggestive of the resistance against fluconazole and amphotericin B. Caspofungin was used as the main antifungal agent for the treatment of oral candidiasis, resulting in the improvement of thrush in patients. The resistance of C. africana to fluconazole and amphotericin B suggests the necessity of performing in vitro susceptibility testing on the isolates for the selection of appropriate antifungal agents. Conclusion: As the findings indicated, the achievement of knowledge regarding C. africana as an emerging non-albicans Candida species and its antifungal susceptibility profile is crucial to select antifungal prophylaxis and empirical therapy for oral candidiasis in cancer patients undergoing chemotherapy.

Conventional PCR as a reliable method for diagnosing invasive mucormycosis in resource-limited settings

2021 ◽  
Vol 70 (5) ◽  
Author(s):  
Mragnayani Pandey ◽  
Immaculata Xess ◽  
Gagandeep Singh ◽  
Rakesh Kumar ◽  
Manoranjan Mahapatra ◽  
...  
Keyword(s):  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Care Hospital ◽  
Direct Microscopy ◽  
Specific Pcr ◽  
Resource Limited ◽  
Valuable Adjunct ◽  
Panfungal Pcr ◽  
A Prospective Study

Introduction. Invasive mucormycosis (IM) is a life-threatening infection caused by fungi belonging to the order Mucorales. Histopathology, culture and radiology are the mainstay of diagnosis but lack sensitivity, leading to a delay in timely diagnosis and intervention. Recently, PCR-based approaches have been shown to be a promising method in diagnosing IM. Hypothesis/Gap Statement. Molecular-based approaches may be a valuable adjunct to standard conventional methods for diagnosing IM, especially among culture negatives and patients on antifungal therapy. Aim. In the present study we aimed to evaluate the clinical utility of panfungal and Mucorales-specific PCR for diagnosing IM from various clinical specimens. Methodology. This was a prospective study in which 239 clinically suspected cases of IM attending our tertiary care hospital from August 2015 to March 2018 were enrolled. All the cases were defined as ‘proven’, ‘probable’ or ‘possible’ based on EORTC/MSGERC guidelines. In addition to conventional diagnostics (KOH-calcofluor stain and culture), panfungal and Mucorales-specific PCR assays were also performed. The amplified products were sequenced for species identification. In vitro antifungal susceptibility was performed on all the culture-positive isolates. Results. Among 239 clinically suspected cases of IM, only 140 cases were diagnosed by the demonstration of aseptate ribbon-like hyphae on direct microscopy. Culture was positive in 35.7 % (54/140) of direct microscopy-positive samples. Among the proven cases (n=11), the sensitivity for both Mucorales-specific nested PCR and panfungal PCR was 100 %, but specificity was 91.9 and 73.7% respectively. In probable cases (n=129), the sensitivity of both the PCRs was 98.5 % and specificity for panfungal PCR was 73.7 and 91.9 % for Mucorales-specific PCR. Conclusion. Pan fungal PCR in combination with Mucorales-specific PCR, followed by sequencing, may play a significant role in IM diagnosis especially among those negative for both direct microscopy and culture.

scholarly journals Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis

2020 ◽  
Vol 18 (1) ◽  
pp. 28-36
Author(s):  
Apurva Kaushal ◽  
Pratik Gahalaut ◽  
R K Goyal ◽  
Neni Agarwal ◽  
Nitin Mishra ◽  
...  
Keyword(s):  
Candida Species ◽  
Plant Pathogens ◽  
Fusarium Species ◽  
Antifungal Susceptibility ◽  
Aspergillus Species ◽  
Dilution Method ◽  
Susceptibility Pattern ◽  
Cross Sectional ◽  
Anti Fungal

Introduction: Non-dermatophytic molds (NDM) are filamentous fungi or yeast, commonly found in nature as saprophytes and plant pathogens. The incidence of onychomycosis due to NDM is 1.45 – 16.6%. NDMs are usually resistant to conventional antifungal treatment. Objective: To know the anti-fungal susceptibility pattern of non-dermatophyte fungi causing onychomycosis.  Materials and Methods: A prospective hospital based cross-sectional study was done on non - dermatophytic isolates from patients with clinical suspicion of onychomycosis. All non – dermatophytic isolates were subjected to anti-fungal susceptibility against terbinafine, itraconazole, fluconazole and griseofulvin by micro broth dilution method.  Results: NDM were isolated in 20.2% cases of clinically suspected onychomycosis, among which Fusarium species was the most common followed by Aspergillus species and Candida species. MIC50 (Mean Inhibitory Concentration) for overall non - dermatophytic isolates for terbinafine, itraconazole, fluconazole and griseofulvin was 0.25μg/mL, 0.5μg/mL, 32μg/mL and 2μg/mL respectively and the order of sensitivity was Itraconazole (74.7%) > terbinafine (68%) > Fluconazole (60%) > Griseofulvin (51.6%) of the study samples. For Fusarium species, the  sensitivity for terbinafine was (73.5%) > itraconazole (67.6%) > fluconazole (64.7%) and griseofulvin (64.7%). For Aspergillus species, the sensitivity for itraconazole was 79.1% > fluconazole (58.3%) > terbinafine (54.1%) > griseofulvin (50%). For Candida species, the sensitivity was fluconazole (83.3%) > itraconazole (75%) > terbinafine (41.6%), while no candida species was found sensitive to griseofulvin.  Conclusion: Non-dermatophytes play a significant role in onychomycosis. On in vitro estimation, Itraconazole was the most sensitive drug, followed by terbinafine, fluconazole and griseofulvin.

scholarly journals Relationship between the Antifungal Susceptibility Profile and the Production of Virulence-Related Hydrolytic Enzymes in Brazilian Clinical Strains ofCandida glabrata

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Maria Helena Galdino Figueiredo-Carvalho ◽  
Lívia de Souza Ramos ◽  
Leonardo Silva Barbedo ◽  
Jean Carlos Almeida de Oliveira ◽  
André Luis Souza dos Santos ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Antifungal Susceptibility ◽  
Hydrolytic Enzymes ◽  
Antifungal Drug ◽  
Clinical Strains ◽  
Antifungal Drug Resistance ◽  
Opportunistic Fungal Pathogen ◽  
Esterase Production ◽  
In Vitro Antifungal Susceptibility

Candida glabratais a facultative intracellular opportunistic fungal pathogen in human infections. Several virulence-associated attributes are involved in its pathogenesis, host-pathogen interactions, modulation of host immune defenses, and regulation of antifungal drug resistance. This study evaluated the in vitro antifungal susceptibility profile to five antifungal agents, the production of seven hydrolytic enzymes related to virulence, and the relationship between these phenotypes in 91 clinical strains ofC. glabrata. AllC. glabratastrains were susceptible to flucytosine. However, some of these strains showed resistance to amphotericin B (9.9%), fluconazole (15.4%), itraconazole (5.5%), or micafungin (15.4%). Overall,C. glabratastrains were good producers of catalase, aspartic protease, esterase, phytase, and hemolysin. However, caseinase and phospholipase in vitro activities were not detected. Statistically significant correlations were identified between micafungin minimum inhibitory concentration (MIC) and esterase production, between fluconazole and micafungin MIC and hemolytic activity, and between amphotericin B MIC and phytase production. These results contribute to clarify some of theC. glabratamechanisms of pathogenicity. Moreover, the association between some virulence attributes and the regulation of antifungal resistance encourage the development of new therapeutic strategies involving virulence mechanisms as potential targets for effective antifungal drug development for the treatment ofC. glabratainfections.

scholarly journals Antifungal susceptibility of Candida albicans isolated from oral mucosa of patients with cancer

1999 ◽  
Vol 13 (3) ◽  
pp. 219-223 ◽  
Author(s):  
Lino João da COSTA ◽  
Esther Goldenberg BIRMAN ◽  
Sidney Hartz ALVES ◽  
Arlete Emily CURY
Keyword(s):  
Candida Albicans ◽  
Cancer Patients ◽  
Amphotericin B ◽  
Oral Mucosa ◽  
Antifungal Susceptibility ◽  
New Drugs ◽  
Local Conditions ◽  
Opportunistic Fungi ◽  
Sabouraud Agar

The increasing number of oral infections due to opportunistic fungi in immunocompromised patients, needs a new evaluation of the drugs in use. The susceptibility in vitro of Candida albicans strains from the oral mucosa of cancer patients to amphotericin B, ketoconazole, miconazole, fluconazole and itraconazole were evaluated. A dilution technique in YNB agar or subculture on Sabouraud agar was utilised for MIC or MFC determinations. With this methodology, the best fungicidal drug for C.albicans collected from the oral mucosa of 40 cancer patients, divided in two groups: one treated by radiotherapy and the other not, the best results were obtained with amphotericin B, presenting low values of MIC compared to azoles and MFC values. However it is important to take into consideration the utilisation in vivo of this polyenic antibiotic and the possible toxic levels necessary to achieve good results. The coexistence of other fungi and the local conditions must also be pondered with these patients, who are mostly undergoing radiotherapy. In order to achieve better results without undesirable consequences, higher levels of MIC are expected with the daily clinical use of new drugs.

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