scholarly journals Correlation between antifungal consumption and distribution of Candida spp. in different departments of a Lebanese hospital

2018 ◽  
Vol 12 (02.1) ◽  
pp. 33S
Author(s):  
Lyn Awad ◽  
Hani Tamim ◽  
Ahmad Ibrahim ◽  
Dania Abdallah ◽  
Mohammad Salameh ◽  
...  
Keyword(s):  
Candida Species ◽  
Candida Glabrata ◽  
Fungal Infections ◽  
Statistical Significance ◽  
Candida Spp ◽  
Antifungal Stewardship ◽  
Days Of Therapy ◽  
Major Shift ◽  
The Difference ◽  
Antifungal Consumption

Introduction: Recently there has been a significant increase in the incidence of fungal infections attributed to Candida species worldwide, with a major shift toward non-albicans Candida (NAC). Herein, we described the distribution of Candida species among different departments in a Lebanese hospital and calculated the antifungal consumption in this facility. We, then, correlated the consumption of antifungals and the prevalence of Candida species. Methodology: This was a retrospective study of Candida isolates recovered from the hospital microbiology laboratory database between 2010 and 2015. Data on antifungal consumption between 2008 and 2015 were extracted from the hospital pharmacy database. Spearman's coefficient was employed to find a correlation between Candida species distribution and antifungal consumption. Results: The highest antifungal consumption was seen in the haematology/oncology department (days of therapy/1000 patient days = 348.12 ± 85.41), and the lowest in the obstetrics department (1.36 ± 0.47). The difference in antifungal consumption among various departments was statistically significant (p < 0.0001). Azoles were the most common first-line antifungals. A non-homologous distribution of albicans vs. non-albicans was noted among different departments (p = 0.02). The most commonly isolated NAC was Candida glabrata, representing 14% of total isolates and 59% of NAC. The total antifungal consumption correlated positively with the emergence of NAC. The use of azoles correlated positively with Candida glabrata, while amphotericin B formulations correlated negatively with it. None of these correlations reached statistical significance. Conclusion: Different Candida species were unequally distributed among different hospital departments, and this correlated with consumption of antifungals in respective departments, highlighting the need for antifungal stewardship.

scholarly journals 2114. Correlation Between Antifungal Consumption and the Distribution of Candida Species in a Hospital in Colombia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S715-S716
Author(s):  
Harold T Arboleda ◽  
German A Moreno ◽  
Karen M Ordonez Diaz
Keyword(s):  
Candida Species ◽  
Statistical Significance ◽  
General Ward ◽  
Medical Surgery ◽  
Contributing Factors ◽  
Candida Spp ◽  
Defined Daily Doses ◽  
Cross Transmission ◽  
Antifungal Consumption ◽  
Oncology Unit

Abstract Background In recent years, a shift toward non albicans Candida infections has been described. An increase in the prescription of antifungals has been attributed as the cause of this change, but this issue has not been evaluated in Colombia. Methods The distribution of Candida spp. over an 11-year period 2007–2018 were extracted of the software WHONET 5.6. Antifungal drug consumption was measured as the number of defined daily doses (DDD)/100 patient-days over a 6-year period 2012–2018. Spearman’s coefficient was performed to find a correlation between antifungal consumption and distribution of Candida species. Results A total of 811 non-duplicate isolates of Candida spp. were included. An increase in the frequency of isolates was observed in the period 2013–2016 (Figure 1). The highest number of isolates were collected from the intensive care unit (ICU) (35.6%) followed of medical ward (22%). Non albicans Candida predominated (58%) in the period evaluated. The shift toward non albicans Candida was presented in 2015 (Figure 2). A non-homologous distribution of albicans vs. non-albicans was noted between ICU and general ward (P = 0.026). 152 (18.7%) isolates were recovered from blood. C. parapsilosis was the most commonly species identified in the blood cultures of ICU in contrast to C. albicans in general ward (Figures 3 and 4). Intravenous fluconazole was the main antifungal prescribed in ICU (mean 0.094 DDD/100 PD). Oral fluconazole was the principal antifungal prescribed in a medical-surgery ward (mean 0.021 DDD/100 PD) and oncology unit (mean 0.429DDD/100 PD). None of the correlations between antifungal consumption and recovery of non albicans species reached a statistical significance. Conclusion The shift toward non albicans Candida is possible even in the presence of a low consumption of antifungals. This finding suggests the possibility of other contributing factors such as cross transmission and microbiome alteration. Disclosures All authors: No reported disclosures.

scholarly journals Impact of the SARS-CoV-2 Pandemic in Candidaemia, Invasive Aspergillosis and Antifungal Consumption in a Tertiary Hospital

2021 ◽  
Vol 7 (6) ◽  
pp. 440
Author(s):  
Juan Vicente Mulet Bayona ◽  
Nuria Tormo Palop ◽  
Carme Salvador García ◽  
Begoña Fuster Escrivá ◽  
Mercedes Chanzá Aviñó ◽  
...  
Keyword(s):  
Candida Species ◽  
Great Increase ◽  
Fungal Infections ◽  
Invasive Pulmonary Aspergillosis ◽  
Tertiary Hospital ◽  
Third Wave ◽  
Candida Auris ◽  
The Third ◽  
Antifungal Consumption ◽  
Hospital General

In addition to the increase in fungal infections that has been observed in the last few decades, it has been reported that severe clinical COVID-19 can increase the risk of invasive fungal infections. The main objective of this study was to evaluate if there had been an increase in candidaemia and invasive pulmonary aspergillosis (IPA) cases since the onset of the SARS-CoV-2 pandemic. Data were retrospectively collected from April 2019 to March 2021, from patients admitted to Consorcio Hospital General Universitario de Valencia (Spain). A total of 152 candidaemia cases (56 of which were due to Candida auris) and 108 possible IPA cases were detected. A great increase in candidaemia cases was produced during the first and the third epidemic waves of the SARS-CoV-2 pandemic (June 2020, and January 2021, respectively), while an increase in IPA cases was produced during the third wave. The 28-day mortality rates in patients affected by candidaemia and IPA increased in 2020 and 2021. C. auris has displaced the other Candida species, becoming the most isolated Candida species in blood cultures since the onset of the SARS-CoV-2 pandemic. Antifungal consumption increased in 2020 when compared to 2019, especially echinocandins, voriconazole and isavuconazole.

scholarly journals The The Effects of Cinnamaldehyde (Cinnamon Derivatives) and Nystatin on Candida Albicans and Candida Glabrata

2019 ◽  
Vol 7 (7) ◽  
pp. 1067-1070 ◽  
Author(s):  
Sedigheh Bakhtiari ◽  
Soudeh Jafari ◽  
Jamileh Bigom Taheri ◽  
Tahereh Sadat Jafarzadeh Kashi ◽  
Zahra Namazi ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Minimum Inhibitory Concentration ◽  
Candida Species ◽  
Candida Glabrata ◽  
Inhibitory Concentration ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Minimum Fungicidal Concentration ◽  
Microdilution Method

BACKGROUND: Candida species are the most common opportunistic fungal infections. Today, cinnamon plants have been considered for anti-Candida properties. AIM: This study aimed to investigate the effectiveness of cinnamaldehyde extract (from cinnamon derivatives) on Candida albicans and Candida glabrata species and comparison with nystatin. MATERIAL AND METHODS: In this study, cinnamaldehyde and nystatin were used. The specimens included Candida albicans and Candida glabrata. Minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) were measured for each one by the microdilution method. This experiment was repeated three times. RESULTS: Cinnamaldehyde extract at a concentration of 62.5 μl/ml was able to prevent the growth of Candida albicans, at a concentration of 93.7 μl/ml, causing Candida albicans to disappear, at 48.8 μl/ml, to prevent the growth of Candida glabrata, and in the concentration of 62.5 μl/ml, causes the loss of Candida glabrata. In comparison, nystatin at 0.5 μg/ml concentration prevented the growth of Candida albicans, at concentrations of 1 μg/ml causing Candida albicans to be destroyed, at 4 μg/ml concentration to prevent the growth of Candida glabrata, and at a concentration of 8 μg/ml causes the loss of Candida glabrata. The results were the same every three times. CONCLUSIONS: Although cinnamaldehyde extract had an effect on fungal growth in both Candida albicans and Candida glabrata with a fatal effect; the effect on these two species was lower than nystatin.

scholarly journals 2106. Evaluation of Isavuconazole for the Prophylaxis and Treatment of Invasive Fungal Infections at a Large Academic Medical Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S712-S713
Author(s):  
Christine Vu ◽  
Meenakshi Rana ◽  
Patricia Saunders-Hao
Keyword(s):  
Fungal Infections ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Invasive Fungal Infections ◽  
Prescribing Practices ◽  
Candida Spp ◽  
Antifungal Stewardship ◽  
Hospital Formulary

Abstract Background Isavuconazole is an azole antifungal with in vitro activity against various fungi, including Candida spp, Aspergillus, and Mucormycetes. Currently, isavuconazole is FDA approved for the treatment of invasive aspergillosis and mucormycosis; however, there remains limited data to support prophylaxis use. Compared with other first-line azoles, isavuconazole’s broad spectrum of activity, favorable safety profile, and oral bioavailability makes it an attractive antifungal option. In July 2017, isavuconazole was added to our hospital formulary as a restricted antimicrobial. Since then, we have seen increased use for both prophylaxis and treatment of invasive fungal infections. Methods A single-center, retrospective chart review was conducted on adult patients who received at least 1 dose of isavuconazole at The Mount Sinai Hospital between July 1, 2017 and December 31, 2018. The electronic medical record was utilized to collect information on therapeutic indication, dosing, formulation, duration, reasons for switching to isavuconazole, prior antifungals, and proven or probable breakthrough invasive fungal infections (bIFIs) based on EORTG/MTG definitions. Results 54 patients received 61 courses of isavuconazole. Reasons for switching to isavuconazole are described in Table 1. Eleven patients received inappropriate intravenous formulations and 14% of orders were prescribed isavuconazole without a loading dose (Table 2). We identified 4 proven/probable bIFIs, representing 7.4% of patients and 6.6% of courses (Table 3). All patients died within 60 days of bIFI onset. Conclusion Since its addition to hospital formulary, we have observed varying isavuconazole prescribing practices, highlighting the need for improved antifungal stewardship. Rates of bIFIs on isavuconazole were lower than previously reported studies. Additional studies are needed to provide guidance on isavuconazole use and determine its role as prophylaxis therapy. Disclosures All authors: No reported disclosures.

scholarly journals The Trends in the Distribution of Candida species Causing Candidemia at a Community Hospital in 2005 and 2014

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S87-S87
Author(s):  
Celestine Ishiekwene ◽  
Maxine Seales Kasangana ◽  
Monica Ghitan ◽  
Margaret Kuhn-Basti ◽  
Edward Chapnick ◽  
...  
Keyword(s):  
New York ◽  
Antifungal Therapy ◽  
Candida Species ◽  
Fungal Infections ◽  
Medical Center ◽  
Retrospective Chart Review ◽  
Common Species ◽  
Published Data ◽  
Candida Spp ◽  
Common Cause

Abstract Background Candida remains the most common cause of invasive fungal infections, with an attributable morality of 15–35%. Although five Candida species (C. albicans, C. tropicalis, C. parapsilosis, C. glabrata, and C. krusei) account for 92% of cases of candidemia, Candida albicans remains the most common cause of candidemia. However, recent studies report that the frequency of non albicans species are increasing globally and the distribution of Candida spp. varies significantly among different geographic regions and hospitals units. Objective We determine the distribution of Candida species causing candidemia at an adult level 1 Trauma Center in Brooklyn, New York and compared the trends of Candida species between 2005 and 2014. The results were compared with trends of US data collected in 2004 and 2012. Knowledge of the frequency of causative species would facilitate appropriate selection of empiric antifungal therapy. Methods We performed a retrospective chart review of patients with candidemia who were admitted in 2005 and 2014. We determined the frequency of Candida species and compared 2005 data with those in 2014. Results In total, 226 and 109 patients with candidemia were admitted to our hospital in 2005 and 2014, respectively. Although, C. albicans was the most common species (43% of candidemia in 2005), its frequency decreased to 33% in 2014. The frequencies of C. glabrata and C. parapsilosis increased in 2014 compared with those in 2005 (24% vs. 16% and 33% vs. 26%, respectively). Figure 1 compared the proportion of Candida species in Maimonides Medical Center to National data. Conclusion Our finding of an increase in non-albicans spp. causing candidemia is consistent with published reports. We saw more cases of C. parapsilosis compared with published data. Our results may be used to inform empiric antifungal therapy. Disclosures All authors: No reported disclosures.

scholarly journals Presumptive Identification of Candida spp. from Clinical Isolates and Anticandidal Effect of Essential Oils

YMER Digital ◽  
2021 ◽  
Vol 20 (11) ◽  
pp. 254-261
Author(s):  
S S Khandare ◽  
◽  
A P Moon ◽  
M G Ingale ◽  
◽  
...  
Keyword(s):  
Essential Oils ◽  
Candida Species ◽  
Candida Glabrata ◽  
Candida Parapsilosis ◽  
Biochemical Characterization ◽  
Morphological Characterization ◽  
Candida Krusei ◽  
Clinical Samples ◽  
Candida Spp ◽  
Life Threatening

Candida is normal flora of human skin, mouth, vagina, colon and causes mycosis worldwide. Candida causes oral thrush, vaginitis and other potentially life-threatening diseases. This study assesses anticandidal potential of essential oils against Candida species isolated from clinical samples obtained from Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra. On the basis of morphological characterization on Sabouraud dextrose agar, CHROMagar, Germ tube test and biochemical characterization, Candida species identified as Candida albicans, Candida krusei, Candida glabrata, Candida parapsilosis. Clove, thyme, cinnamon and eucalyptus essential oils with concentrations of 6.2, 12.5, 25, 50 and 100 μg/ml were used to study their anticandidal activity. C. albicans demonstrated zone of inhibition (ZOI) 29, 20, 32, 29 mm, Candida krusei 25, 25, 30, 21 mm, Candida glabrata 24, 22, 31, 32mm,Candida parapsilosis 33,31,33, 29mm towards clove, thyme, cinnamon and eucalyptus oil (each at 100 μg/ml) respectively which are highest ZOI as compared with antifungal agent Amphotericin-B, which showed 16, 13, 12, 8 mm against C. albicans, C. krusei, C.glabrata and C. parapsilosis respectively. All Candida spp. produced biofilms and enzyme lipase. This study will facilitate the development of novel broad-spectrum key molecules against a range of Candida species.

scholarly journals Identification of Candida Species Circulating in Dakar using Multiplex Nested PCR

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Aida Badiane
Keyword(s):  
Nested Pcr ◽  
Candida Species ◽  
Fungal Infections ◽  
Test Tube ◽  
Species Level ◽  
Storage Medium ◽  
Group I ◽  
Vaginal Swabs ◽  
Identification Of Fungi ◽  
The Difference

Background: In most developing countries, laboratory identification of Fungi belonging to the genus Candida is often problematic. The germ test tube known as Blastese test, which is the most used has the limitation that it only differentiates the C. albicans complex from other Candida complexes. Not only it is important to know the involvement of other species in the occurrence of fungal infections, but also the difference in sensitivity to the azoles used in the treatment of these fungal infections makes it necessary to identify the Fungi at the species level. The objective of this study was to identify by multiplex nested PCR the Candida species isolated in the laboratory of Parasitology and Mycology of Aristide Le Dantec Hospital, Senegal. Methodology: Candida isolates were obtained from patients who were admitted to the laboratory of Parasitology and Mycology with suspected fungal infections. After identification by conventional methods, isolates were preserved in a storage medium and kept at -20°C. Species identification was performed by nested PCR. Results: A total of 42 yeast isolates were collected after culture on Sabouraud medium, among which 10 (24%) from vaginal swabs and 32 (76%) from patients suffering from superficial mycoses (skin and nails). C. albicans represented 68% and nonCandida albicans (NAC) species 32%. The distribution of the NAC species was as follows: C. parapsilosis (group I and II) 17% (8), C. tropicalis 8.5% (4), C. kefyr 4.25% (2) and C. lusitaniae 2.15% (1). Mixed infection with two species represented 17.39% of the isolates. Conclusion: This study shows that other Candida species are common in Dakar, although their identification is not routinely performed in most laboratories. Thus, it is necessary to improve the technical facilities in these diagnostic laboratories.

scholarly journals First report on echinocandin resistant Polish Candida isolates

2019 ◽  
Author(s):  
Martyna Mroczyńska ◽  
Anna Brillowska-Dabrowska
Keyword(s):  
Candida Species ◽  
Susceptibility Testing ◽  
Fungal Infections ◽  
Candida Spp ◽  
Causative Agents ◽  
Echinocandin Resistance ◽  
Human Infections ◽  
Very High ◽  
Line Drug ◽  
Microdilution Broth

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.

scholarly journals Fungal Infections among Psoriatic Patients: Etiologic Agents, Comorbidities, and Vulnerable Population

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mostafa Chadeganipour ◽  
Shahla Shadzi ◽  
Rasoul Mohammadi
Keyword(s):  
Candida Species ◽  
Fungal Pathogens ◽  
Fungal Infections ◽  
Fungal Species ◽  
High Rate ◽  
Clinical Samples ◽  
Inflammatory Disorder ◽  
Candida Spp ◽  
Chronic Inflammatory Disorder ◽  
Malassezia Species

Background. Psoriasis is a chronic inflammatory disorder of the skin and joint, affecting nearly 2-3% of the general population. It is assumed that imbalance between the types of natural microflora can accelerate the onset of the disease. Some fungi can play the role of superantigens and prolong chronic inflammation in the skin of psoriatic patients. The aim of the present investigation was to identify fungal species isolated from patients with psoriasis. Methods. From March 2016 to May 2019, 289 patients with prior diagnosis of psoriasis were included in this survey. Direct microscopy with potassium hydroxide (KOH 10%), culture, urea hydrolysis, hair perforation test, and growth on rice grains were used to identify clinical isolates, phenotypically. For molecular identification of Candida species and Malassezia species, PCR-RFLP and PCR-sequencing were used, respectively. Results. Forty-six out of 289 psoriatic patients had fungal infections (15.9%). Dermatophytes (54.3%), Candida spp. (19.5%), Malassezia spp. (15.2%), Aspergillus spp. (6.5%), and Fusarium spp. (4.3%) were the causative agents of fungal infections. Among Malassezia and Candida species, M. restricta (10.8%) and C. glabrata (8.7%) were the most prevalent species, respectively. Conclusion. Our findings suggested that fungal pathogens, particularly dermatophytes, may play an important role in the pathogenicity of psoriasis. Also, due to the high rate of yeast colonization in the clinical samples of psoriatic patients, concomitant use of anti-inflammatory drugs and antifungals may represent an effective therapeutic approach for better management of chronic lesions among these patients. Mycological tests should be applied to indicate the incidence of fungal diseases in psoriatic patients.

scholarly journals Oral Candidiasis in Hematological Malignancy Patients: Identification and Antifungal Susceptibility Patterns of Isolates

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Masoud Mardani ◽  
Sara Abolghasemi ◽  
David Darvishnia ◽  
Ensieh Lotfali ◽  
Reza Ghasemi ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Candida Species ◽  
Hematological Malignancy ◽  
Fungal Infections ◽  
Oral Candidiasis ◽  
Antifungal Susceptibility ◽  
Fungal Culture ◽  
Oropharyngeal Candidiasis ◽  
Candida Spp ◽  
Susceptibility Patterns

Background: Oropharyngeal candidiasis is a fungal infection in the mouth caused by Candida species. Oropharyngeal candidiasis is a major problem among hematologic malignancy patients. Objectives: The present study was designed to identify and evaluate antifungal susceptibility patterns of Candida spp. isolated from hematological malignancy patients with oral candidiasis. Methods: Samples were collected from the oral cavity of 138 patients and confirmed for oropharyngeal candidiasis by microscopic examination and fungal culture. Isolated Candida strains were identified by ITS-PCR. Hyphal wall protein 1 (HWP1) was amplified to differentiate the Candida albicans complex. In vitro antifungal susceptibility tests against fluconazole, amphotericin B, and caspofungin were performed according to CLSI M27-A3/S4. Results: The study enrolled 120 patients, including 74 (61.66%) females and 46 (38.33%) males. The mean age of affliction by fungal infections was 42 ± 8 years. Patients with acute myeloid leukemia (44%) comprised the majority of cases. The most commonly isolated species among patients were C. albicans (n = 110; 91.6%), C. glabrata (n = 8; 6.6%), and C. africana (n = 2; 2.8%). The overall resistance of C. albicans was 2.7% to fluconazole, and 1.8% to amphotericin B. Candida glabrata showed 12.5% resistance to amphotericin B. All Candida spp. isolates from patients were susceptible to caspofungin. Conclusions: Local information about the increasing resistance to fluconazole in both C. albicans and non albicans Candida species and their antifungal susceptibility is useful for deciding on antifungal prophylaxis and selecting the empirical therapy of cancer patients.

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