scholarly journals Molecular Identification and Antifungal Susceptibility Patterns of Candida Species Isolated from Candidemia Patients in Yasuj, Southwestern Iran

2021 ◽  
Vol 14 (7) ◽  
Author(s):  
Shaghayegh Rostami Yasuj ◽  
Maral Gharaghani ◽  
Seyed Sajjad Khoramrooz ◽  
Marjan Salahi ◽  
Ali Keshtkari ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Amphotericin B ◽  
Molecular Identification ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Hospitalized Patients ◽  
Susceptibility Tests ◽  
In Vitro Antifungal Susceptibility ◽  
Susceptibility Patterns

Background: Candidemia is the most common systemic infection in hospitalized patients causing high mortality. Hence, the diagnosis of this infection in the early stage with appropriate antifungal therapy is paramount. Objectives: The study aimed at molecular identification of Candida species isolated from candidemia patients and evaluation of the in vitro antifungal susceptibility patterns of these strains to fluconazole, amphotericin B, and caspofungin. Methods: In the present study, 800 hospitalized patients who were suspected to have candidemia were sampled. Candida species were isolated and identified based on morphological characteristics and PCR-sequencing of the ITS1-5.8S-ITS2 region. Antifungal susceptibility tests for fluconazole, amphotericin B, and caspofungin were performed according to the Clinical and Laboratory Standards Institute protocol M27-A3. Also, clinical data were recorded from the patients' records. Results: Twenty-seven patients among the sample of hospitalized patients were found to have candidemia. A total of 33.3% of candidemia patients were treated with amphotericin B, in which case the mortality rate was 14.8%. The majority of patients (59%) were from the neonatal intensive care unit, and premature birth was the most common underlying condition. Candida albicans (n = 18; 66.6%) was the most common species isolated from blood cultures, followed by C. parapsilosis (n = 7; 25.9%), C. pelliculosa (n = 1; 3.7%), and C. tropicalis (n = 1; 3.7%). Only one C. albicans isolate resistant to fluconazole (minimum inhibitory concentration = 32 µg/mL). Conclusions: Generally, C. albicans has been the most frequent causative agent of candidemia. Resistance to antifungal drugs among candidemia agents was rare. Also, the identification of Candida isolates at the species level with in vitro antifungal susceptibility tests helps manage candidemia patients better and decrease the mortality rate among them.

Molecular Identification, And Antifungal Susceptibility Patterns of Candida Species Isolated From Candidemia Patients in Yasuj, Southwestern Iran

2021 ◽  
Author(s):  
Shaghayegh Rostami Yasuj ◽  
Seyed Sajad Khoramrooz ◽  
Marjan Salahi ◽  
Ali Keshtkari ◽  
Jabar Taghavi ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Amphotericin B ◽  
Molecular Identification ◽  
Antifungal Susceptibility ◽  
Hospitalized Patients ◽  
Antifungal Drugs ◽  
Its2 Region ◽  
Susceptibility Tests ◽  
Susceptibility Patterns

Abstract Candidemia is the most common systemic infection in hospitalized patients and causing high mortality. Hence, the diagnosis of this infection in the early-stage with appropriate antifungal therapy has been attributed to the lowest mortality. The aims of this study are molecular identification of Candida species isolated from candidemia patients and evaluated the in vitro antifungal susceptibility patterns of these strains to fluconazole, amphotericin B, and caspofungin. In the present study, 800 hospitalized patients who suspected candidemia were sampled. Candida species were isolated and identified based on morphological and PCR-sequencing of the ITS1-5.8S-ITS2 region. Antifungal susceptibility tests for fluconazole, amphotericin B, and caspofungin was performed according to the Clinical and Laboratory Standards Institute M27-A3. Also, clinical data were recorded from patient's records. Overall, 27 candidemia patients were detected among hospitalized patients. 33.3% of candidemia patients were treated with amphotericin B, however, the mortality rate was 14.8%. The majority of patients (59%) were from the neonatal intensive care unit and premature born was the most underlying condition. C. albicans (n = 18; 66.6%) was the most common species isolated from blood cultures, followed by C.parapsilosis (n = 7; 25.9%), C.pelliculosa ( n = 1;3.7% ) and C.tropicalis (n = 1;3.7%). Only one C. albicans isolate were resistance to fluconazole (MIC = 32 µg/mL). Generally, C. albicans has been the most frequent causative agent of candidemia. Resistance to antifungal drugs among candidemia agents was rare. Also, the identification of Candida isolates at the species level with in-vitro antifungal susceptibility tests can manage and decrease the mortality rate among candidemia patients.

scholarly journals Antifungal Susceptibility In Vitro Determined by the Etest(r) for Candida Obtained from the Oral Cavity of Irradiated and Elderly Individuals

2015 ◽  
Vol 26 (2) ◽  
pp. 99-104 ◽  
Author(s):  
Edimilson Martins de Freitas ◽  
Larissa Cavalcanti Monteiro ◽  
Michelle Bonfim da Silva Fernandes ◽  
Hercílio Martelli Junior ◽  
Paulo Rogério Ferreti Bonan ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Culture Collection ◽  
Morphological Criteria ◽  
Group 2 ◽  
In Vitro Antifungal Susceptibility ◽  
Mic Minimum Inhibitory Concentration ◽  
Dose Dependent

This study aimed to evaluate the in vitro antifungal susceptibility of Candida species of head-and-neck-irradiated patients (Group 1), non-institutionalized (Group 2) and institutionalized elders (Group 3) using Etest(r) methodology. Candida was isolated from saliva and presumptively identified by CHROMagar Candida(r), confirmed by morphological criteria, carbohydrate assimilation (API 20C AUX(r)) and genetic typing (OPE 18). The collection was made from 29, 34 and 29 individuals (Groups 1, 2 and 3, respectively) with 67 isolates. Etest(r) strips (ketoconazole, itraconazole, fluconazole, amphotericin B and flucytosine) on RPMI (Roswell Park Memorial Institute) agar, on duplicate, were used to evaluate susceptibility. ATTC (American Type Culture Collection) 10231 (Candida albicans) was used as quality control. Among the 67 isolates of Candida species, most were susceptible to azoles, flucytosine and amphotericin B. None of the isolates showed resistance and dose-dependent susceptibility to amphotericin B. There were nine strains resistant to itraconazole, six to fluconazole and two to ketoconazole and ten dose-dependent, mainly to flucytocine. The highest MIC (minimum inhibitory concentration) to C. albicans, C. tropicalis, C. parapsilosis was 2.671 μg.mL-1, 8.104 μg.mL-1, 4.429 μg.mL-1, all for flucytosine. C. krusei and C. glabrata were associated with higher MIC for azoles and C. glabrata with higher MIC to flucytosine. In summary, susceptibility to all tested antifungal agents was evident. The isolates were more resistant to itraconazole and dose-dependent to flucytosine. A comparison of C. albicans in the three groups showed no outliers. Higher MIC was associated with C. krusei and C. glabrata.

scholarly journals 146. antifungal Susceptibility Patterns of candida Parapsilosis Bloodstream Isolates in the US, 2008–2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S203-S203
Author(s):  
Brenda L Tesini ◽  
Meghan Lyman ◽  
Brendan R Jackson ◽  
Anita Gellert ◽  
William Schaffner ◽  
...  
Keyword(s):  
Candida Species ◽  
Regional Variation ◽  
Antifungal Susceptibility ◽  
Bloodstream Infections ◽  
Emerging Infections ◽  
In Vitro Susceptibility ◽  
Fluconazole Resistance ◽  
The Us ◽  
Susceptibility Patterns

Abstract Background Multidrug resistant Candida is an increasing concern. C. parapsilosis in particular has decreased in vitro susceptibility to echinocandins. As a result, fluconazole had been favored for C. parapsilosis treatment. However, there is growing concern about increasing azole resistance among Candida species. We report on antifungal susceptibility patterns of C. parapsilosis in the US from 2008 through 2018. Methods Active, population-based surveillance for candidemia through the Centers for Disease Control and Prevention’s (CDC) Emerging Infections Program was conducted between 2008–2018, eventually encompassing 9 states (GA, MD,OR, TN, NY, CA, CO, MN, NM). Each incident isolate was sent to the CDC for species confirmation and antifungal susceptibility testing (AFST). Frequency of resistance was calculated and stratified by year and state using SAS 9.4 Results Of the 8,704 incident candidemia isolates identified, 1,471 (15%) were C. parapsilosis; the third most common species after C. albicans and C. glabrata. AFST results were available for 1,340 C. parapsilosis isolates. No resistance was detected to caspofungin (MIC50 0.25) or micafungin (MIC50 1.00) with only one (< 1%) isolate resistant to anidulafungin (MIC50 1.00). In contrast, 84 (6.3%) isolates were resistant to fluconazole and another 44 (3.3%) isolates had dose-dependent susceptibility to fluconazole (MIC50 1.00). Fluconazole resistance increased sharply from an average of 4% during 2008–2014 to a peak of 14% in 2016 with a subsequent decline to 6% in 2018 (see figure). Regional variation is also observed with fluconazole resistance ranging from 0% (CO, MN, NM) to 42% (NY) of isolates by site. Conclusion The recent marked increase in fluconazole resistance among C. parapsilosis highlights this pathogen as an emerging drug resistant pathogen of concern and the need for ongoing antifungal resistance surveillance among Candida species. Our data support the empiric use of echinocandins for C. parapsilosis bloodstream infections and underscore the need to obtain AFST prior to fluconazole treatment. Furthermore, regional variation in fluconazole resistance emphasizes the importance of understanding local Candida susceptibility patterns. Disclosures Lee Harrison, MD, GSK (Consultant)Merck (Consultant)Pfizer (Consultant)Sanofi Pasteur (Consultant)

scholarly journals In Vitro Azole and Amphotericin B Susceptibilities of Malassezia furfur from Bloodstream Infections Using E-Test and CLSI Broth Microdilution Methods

Antibiotics ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 361 ◽  
Author(s):  
Wafa Rhimi ◽  
Chioma Inyang Aneke ◽  
Adriana Mosca ◽  
Domenico Otranto ◽  
Claudia Cafarchia
Keyword(s):  
Amphotericin B ◽  
Reading Time ◽  
Antifungal Susceptibility ◽  
Bloodstream Infections ◽  
Hospitalized Patients ◽  
Malassezia Furfur ◽  
Broth Microdilution ◽  
Test Procedures ◽  
The Media

The number of reports of Malassezia furfur bloodstream infections is constantly increasing and there is a need for more simple antifungal susceptibility methods for their management. In this study, a total of 39 M. furfur isolates collected from hospitalized patients with fungemia were screened for antifungal susceptibility to azole and amphotericin B (AmB) using Clinical and Laboratory Standards Institute broth microdilution (CLSI BMD) and E-test in Sabouraud dextrose agar + 1% Tween80 (SDAt) and mDixon agar (DIX). Essential agreement (EA) and discrepancies between the two methods were evaluated after 48 h and 72 h reading times. Itraconazole (ITZ) and posaconazole (POS) displayed the lowest MIC values whereas fluconazole (FLZ) and AmB the highest, regardless of the methods and the reading time. The EA between BMD was >95% for FLZ and voriconazole (VOR) regardless of the media in the E-tests and reading time. The EA between BMD with E-test for AmB was >97% only when E-test in SDAt was used. The EA between BMD and E-test for ITZ and POS varied according to the media in E-test procedures and the reading time and was higher than 66.6% (POS) or 72% (ITZ) only when SABt was used. Substantial discrepancies for ITZ and POS were >5.1% regardless of the media and the reading time. This study suggests that the E-test in SABt represents an alternative method to CLSI BMD to evaluate the susceptibility of M. furfur to FLZ, VOR and AmB and not for ITZ and POS.

Molecular Identification and In Vitro Antifungal Susceptibility of Aspergillus Isolates Recovered from Otomycosis Patients in Western China

2020 ◽  
Vol 185 (3) ◽  
pp. 527-535
Author(s):  
LiLi Zhang ◽  
Xiaodong Wang ◽  
Jos Houbraken ◽  
Huan Mei ◽  
Wanqing Liao ◽  
...  
Keyword(s):  
Molecular Identification ◽  
Antifungal Susceptibility ◽  
Western China ◽  
In Vitro Antifungal Susceptibility

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.

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