Exploring the Relationship between Candida Spp. And Periodontitis: A Review of the Literature

AimTo determine the minimum inhibitory concentrations (MICs) of voriconazole and natamycin, alone and in combination, against the clinical isolates of Fungus and to evaluate the synergy between the drugs in...

To determine in vitro susceptibility patterns of fungi associated with keratomycosis in horses in the northeastern United States and compare those patterns with results of studies from other geographic regions. Retrospective case series. 68 horses with keratomycosis. Medical records of horses with a clinical diagnosis of keratomycosis, positive results of corneal fungal cultures, and susceptibility data were reviewed from the years 1987 to 2006. Fungal identification and in vitro antifungal susceptibility test results were recorded. The percentage of susceptible isolates was compared among antifungals for all isolates together and for the most common genera individually. 74 fungal isolates from 68 horses that met inclusion criteria were identified. Aspergillus, Candida, and Fusarium spp were the most frequent isolates. Grouped isolates had the highest percentage of susceptibility to nystatin (87.7%), natamycin (87.5%), and clotrimazole (80.6%). Grouped isolates had the lowest percentage of susceptibility to fluconazole (15.8%) and miconazole (27.5%). Aspergillus spp (> or = 81.0%) were most susceptible to nystatin, clotrimazole, itraconazole, and natamycin. Candida spp (100%) were most susceptible to ketaconazole, natamycin, and nystatin. Fusarium spp (100%) were only consistently susceptible to natamycin. On the basis of in vitro susceptibility testing, nystatin, natamycin, or clotrimazole is recommended for initial topical treatment of keratomycosis in horses from the northeastern United States. Contrary to results of studies of ocular fungal isolates of horses from other regions, Candida spp were identified more frequently and miconazole had lower in vitro efficacy in the present study.

AimsTo evaluate the contribution of light microscopy to detecting Candida spp infection in patients with complicated intra-abdominal infections (IAIs) admitted for acute abdomen to a quality assurance (QA)-certified surgical emergency...

Although there are some studies evaluating CIE incidence and associated risk factors, none assessed mortality several months after the Candida spp. BSI episode. We aimed to assess risk factors for CIE and outcomes, including 1-year mortality, in patients with Candida spp. BSI in a public tertiary-care teaching hospital in Brazil. Retrospective case-control, followed by a cohort study, with adult patients who presented a Candida spp. BSI. Participants were eligible if they had at least one echocardiogram performed no longer than 3 days before Candida spp. BSI diagnosis and thereafter during the respective hospital admission. CIE diagnosis was defined by the presence of two major Duke criteria. We studied 164 patients (median age: 57.6 years) with a median Charlson comorbidity index of 3 points. Most patients were female (54.9%), were on haemodialysis (54.9%), and 4.6% had a preexisting moderate/severe heart valve disease. C. albicans (36.2%) and C. parapsilosis complex (34.4%) were the most frequent Candida species identified. CIE was detected in 10 patients (6.1%; 95% CI: 2.4%-9.8%). In the multivariable analysis, age and C. parapsilosis complex remained as independent predictors of CIE. There was no significant difference between CIE and no CIE groups in 1-year mortality after Candida spp. BSI diagnosis and hospital discharge. Considering the low costs and hazards associated with an echocardiogram, performing it systematically in all patients with Candida spp. BSI might improve CIE diagnosis and ultimately survival rates.

BackgroundMicafungin is one of three currently available echinocandin for treatment of candidiasis and candidemia.MethodsChildren who were treated for micafungin for possible or proven invasive Candidia infection between May 2017 and October 2019 were included.ResultsIn this cross-sectional study, totally 78 children with a median age of 3 months (8 days -17 years), 50 (64.1%, F/M: 0.56) male were included. Thirty four (43.6%) patients were neonate, 26 (76 %) of them were premature. Thirty seven patients (47.4%) received micafungin for candidemia and 41 (52.6%) patients received micafungin empirically for IC. Twelve (32.4%) Candida spp cultured were C. albicans, the rest twenty five (67.6%) Candida spp were non-albicans Candida spp. The most commonly cultured Candida spp was Candida parapsilosis (C. parapsilosis) (n=13) followed by C. albicans (n=12), C. glabrata (n=3), C. tropicalis (n=3), C. guilliermondii (n=3), C. krusei (n=2) respectively. Resistance rate of C. parapsilosis (n=13) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 66.7%, 100%, 69.2%, 90.9%, 37.5% respectively. Resistance rate of C. albicans (n=11) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 50%, 50%, 12.5%, 42.9%, 0% respectively. None of the C. tropicalis, C. guilliermondii and C. krusei isolates were resistant to micafungin. Culture negativity could not be achieved at the end of 14th day of micafungin treatment in the 15 (16.9%) candidemia episodes. The most commonly isolated Candida spp in patients with treatment failure was C. parapsilosis (n=7), the other species were; C. albicans (n=5), C. guilliermondii (n=1), C. tropicalis (n=1) and C. tropicalis and C. guilliermondii coinfection (n=1) respectively. Median serum AST, ALT and creatinin levels didn’t increase during and at the end of micafungin therapy. None of these patients had experienced an anormal kidney or liver function tests due to micafungin usage.Characteristics of patients who received micafungin.and cultured Candida sppAntifungal resistance patterns of Candida spp.Laboratory change before and after micafungin treatmentConclusionIncrease in fluconazole resistant Candida spp makes micafungin a reasonable and effective choice for suspected or proven invasive candidiasisDisclosuresAll Authors: No reported disclosures

Candida ssp are of medical importance because they are the most common opportunistic mycosis worldwide, a common cause of nosocomial urinary tract infections (UTIs), oral candidiasis and genitourinary candidiasis. The development of Candida spp infection depends on several factors such as age, sex, and immunity of the host-pathogen relationship. They are resistance to one or more antifungal. The purpose of these studies to isolation and identification of Candida spp from urine sample and investigation of susceptibility of these strains to Amphotericin B andFluconazole. There are 105 Urine sample of the renal failure were collected using a sterile urinary cap, different diagnostic techniques were used for characterization of Candida spp. Culture characteristic, gram stain, Germ tube, CHROM agar candida and scanning electronic microscopic. Results showed 40% urine sample positive also Different Candida spp isolated, C. albicans (20%), C. parapsilisos (20%), C. glabrata (32.72%) , and C. krusei (27.27%). The antibiotic susceptibility test of the isolates was determined by the Kirby-Bauer disk diffusion method. Candida spp sensitivity to 6µg/ml Amphotericin B but Fluconazole was ineffective against Candida spp. The most common pathogen in Urinary tract system is Candida spp both Albicans and non- Albicans are unusual causes of urinary tract infections in healthy individuals also Candida spp resistance to Fluconazole but sensitivity to low concentration Amphitericin B.

Early childhood caries, an ecological disease, and obesity are related to dietary habits. We previously found an association among nutritional status (NS), prevalence of caries and microbiology composition of dental biofilm, that leads to a negative relationship between obesity and caries risk. Candida spp is a frequent commensal yeast of the oral microbiota; however, in the pediatric population is associated with presence of caries.The aim of the present study was to determine the association between NS, Candida spp, and caries in preschool children. Fifty one children aged 3 to 6 years were were classified in adequate (A), overweight (OW) or obese (Ob) with Anthro software. Presence/absence of caries lesions, and Candida spp in the dental plaque were determined. Dental plaque samples were collected and seeded in selective medium CHROMagar Candida®.ResultsNS showed 49% of A, 29.4% OW and 21.6% Ob. Candida spp strains were isolated from dental plaque of (% and CI95%): 52 (32‐72) of A, 33 (12‐62) OW and 0(0‐28) Ob children (Fisher's test, p=0.0107), regardless the presence of caries. Althoug 36% of Ob children presented caries, we did not isolated Candida spp in dental plaque.ConclusionColonization of dental plaque biofilm by Candida spp is related with nutritional status of preschoolers.UBACyT 20720130100017BA.

PERIODONTAL THERAPY AFFECTS ORAL COLONIZATION OF CANDIDA SPP AND HIV INFECTION STATUS IN PATIENTS WITH PERIODONTITIS

Invasive fungal infections in infants admitted to the neonatal intensive care unit are common and often fatal. The mainstay of therapy against invasive fungal infections is antifungal agents. Over the last two decades, the development and approval of these drugs evolved tremendously, and the azole class emerged as important agents in the treatment and prevention of invasive fungal infections. Among the azoles, fluconazole has been used extensively due to its favorable pharmacokinetics, excellent activity against Candida spp, and safety profile. This drug has been well studied in children, but data for its use in infants are largely limited to Candida prophylaxis studies. Voriconazole, a second generation triazole, has excellent activity against Candida and Aspergillus spp. However, data on its use in neonates are extremely limited. Posaconazole and ravuconazole are the newest agents of the triazole family. The antimicrobial spectrum of posaconazole is similar to voriconazole, but with additional activity against zygomycetes. Experience with posaconazole in children is very limited, and there are no reports of its use in infants. Ravuconazole is not approved for use by the FDA, but studies in animals and humans show that it is often fungicidal and has favorable pharmacokinetics. In conclusion, the management of invasive fungal infections has progressed greatly over the last two decades with the azole antifungals playing a significant role. Related to this class, future research is needed in order to better assess dosing, safety, schedules and areas of use of these agents in infants admitted to the neonatal intensive care unit.

Clinical Utility of Routine Use of Fungal Blood Cultures

This study investigated whether sphingosine is effective as prophylaxis against Aspergillus spp. and Candida spp. In vitro experiments showed that sphingosine is very efficacious against A. fumigatus and Nakeomyces glabrataa (formerly named C. glabrata). A mouse model of invasive aspergillosis showed that sphingosine exerts a prophylactic effect and that sphingosine-treated animals exhibit a strong survival advantage after infection. Furthermore, mechanistic studies showed that treatment with sphingosine leads to the early depolarization of the mitochondrial membrane potential (Δψm) and the generation of mitochondrial reactive oxygen species and to a release of cytochrome C within minutes, thereby presumably initiating apoptosis. Because of its very good tolerability and ease of application, inhaled sphingosine should be further developed as a possible prophylactic agent against pulmonary aspergillosis among severely immunocompromised patients.

Echinocandins

Anidulafungin (Vicuron Pharmaceuticals) is a new echinocandin antifungal with potent activity against Aspergillus and Candida spp. Anidulafungin is a noncompetitive inhibitor of (1,3)-β-d-glucan synthase within fungal cells. The drug is rapidly distributed and steady-state concentrations are achieved after the first dose, when a loading dose of twice the daily maintenance dose is given on day 1. Drug biotransformation occurs via chemical degradation, with no hepatic metabolism or renal elimination. A favorable pharmacokinetic profile and lack of significant drug interactions suggest that patients can receive anidulafungin without dosage adjustments. These characteristics, in addition to comparable efficacy to fluconazole (Diflucan®, Pfizer Ltd) in the treatment of esophageal candidiasis, support further investigation of its use in the treatment of systemic fungal infections caused by Candida and Aspergillus spp.

Fungal Isolation in Respiratory Tract After Lung Transplantation: Epidemiology, Clinical Consequences, and Associated Factors

Background: Earlier the fungal infection spectrum was considered to be only restricted to mucocutaneous and cutaneous tissues. However, this consideration has now changed. The threatening rise in the incidence of invasive mycosis is seen recently. Despite advancements in diagnostic and therapeutic modalities, high mortality rates are linked to invasive mycosis. The most common cause of bloodstream infections is Candida spp. Among candida genus, the most pathogenic species is C. Albicans, recent literature data has shown the emergence of treatment-resistant, relatively uncommon, and unusual nonalbicans Candida (NAC) spp. Aim: The present study was conducted to assess the antifungal susceptibility profile and virulence factors of non-Albicans candida species obtained from the infection of the bloodstream. Material and methods: The present study included blood culture isolates of nonalbicans Candida (NAC) spp. which were identified to species level using the standard mycological protocol. This NAC spp. were screened for virulence factors production including biofilm formation, hemolysin, and extracellular hydrolytic enzymes. Ezy MIC strip was used for assessing the antifungal susceptibility profile of these isolates. Results: 100% (n=1) C. rugosa NAC spp. showed hemolysin production. In C. gulliermondii, 50% (n=1) subject showed phospholipase production and biofilm formation each.