Albicans In Patients Research Articles

Fungal Infection of the Oral Cavity by Candida Albicans in Patients Wearing a Removable Dental Prosthesis

Permanent wearing of a removable prosthesis can be a source of mechanical irritation, which will lead to the appearance of pathological conditions. These conditions can be of several types but the most common are oral candidiasis with Candida albicans. As part of the scientific research, we have begun a practical study that aims to establish the relationship between the wearing of a removable denture and the colonization of the oral cavity by Candida albicans. This study was carried out in collaboration with the central laboratory of parasitology –mycology of the Ibn Sina University Hospital Center of Rabat (CHU) and assistant prosthesis department of the clinic of the Faculty of Dentistry of Rabat. The present study was carried out on 45 specimens from the oral cavity in subjects with a removable prosthesis. We observed that most subjects affected by oral candidiasis had inflammation in the oral cavity and these subjects did not have adequate oral hygiene. 30% of these subjects had chronic diseases and 20% of male subjects were smokers. Most subjects with prostheses older than 10 years were the most affected. Mycological examination of the samples made allowed us to note 35.5% of fungal infection by the genus Candida and 27% by the species Candida Albicans. C. albicans was the most isolated yeast representing 75% of the yeasts isolated in this study, followed by C. famata, after C.tropicalis with a lower frequency and finally C.dubluensis with the lowest frequency. We also observed a relationship between the nocturnal use of the prosthesis and the presence of Candida albicans, indeed most subjects affected by oral candidiasis kept their prostheses during the night.

Activation of CD4+CD25+CD45+ T-lymphocytes by Candida albicans in vitro in patients with leukoplakia associated with candidal stomatitis

The mechanisms and patterns of T-lymphocyte activation in response to the effects of Candida albicans are currently insufficiently studied. Therefore, the study of of lymphocytes expressing CD4, CD25, CD45 against the background of precancer and cancer of the oral mucosa is very relevant. The purpose of the study was to study the in vitro effect of Candida albicans on the expression of CD4+CD25+CD45+ T-lymphocytes in the blood of patients with candidal stomatitis with and without leukoplakia. Material and methods. The study involved 93 patients with candidal stomatitis (with and without leukoplakia) aged from 36 to 79 years with chronic and recurrent candidiasis. 30 patients with leukoplakia without candidal stomatitis aged from 38 to 71 years old. The control group consisted of 30 patients aged from 34 to 75 years without candidal stomatitis and leukoplakia. Leukocytes from peripheral blood patients were incubated for 24 hours at 37°C with 2.5 μl of Candida albicans (experimental sample) and with 2.5 μl of buffered saline (control sample). The cells were then phenotyped with CD4+CD25+CD45+ monoclonal antibodies. Conclusions. In the control sample, CD25 expression was higher in the groups of patients with candidiasis (with and without leukoplakia). The expression of activation markers – CD25+-increased on patient lymphocytes in the experimental sample. There were more activated T lymphocytes in response to stimulation by fungi of the genus Candida albicans (p<0.05), compared to lymphocytes in the control sample. The main increase was observed in the group of patients with leukoplakia, candidal stomatitis and endothelial dysplasia, in which Treg lymphocytes were determined. These data confirm the presence of a pronounced response of CD4+ T lymphocytes to fungi of the genus Candida albicans in patients with candidal stomatitis.

Ophthalmia " Adultorum" Secondary to Cytomegalovirus and Candida albicans Isolates from Right Eye Ulcer of an Alcoholic: The Benin City Experience

Background: Eye injuries are more common and have more severe effects when they occur in developing countries. The factors reponsible for these eye injuries can be linked to socioeconomic status, insufficient safety precautions, a lack of ideal treatment facilities, the use of conventional eye medication, and low levels of education. Ocular trauma has been identified in studies from Nigeria and other African countries as a major contributing factor to monocular blindness.
 In neonates, conjunctivitis within the first 28 days of life is termed “Ophthalmia neonatorium”. Conjunctivitis arising from either viral, bacteria or fungal causes in an Adult is what we termed as “Ophthalmia Adultorum".
 In our study the individual was a chronic alcoholic who was already immunosuppressed from his large alcohol intake. This study therefore is case report of a traumatic innoculation causing Ophthalmia Adultorum in a male alcoholic, a university of Benin Teaching Hospital experience.
 Methods: This is a case report.
 Results: A 57 year old man who was admitted on 25 September, 2023, as a case of Cytomegalovirus (CMV ) and Candida albicans associated Conjunctivitis ,after a traumatic sandball inoculation to his right eye . Conjunctiva swab for microscopy and culture was sent to the medical microbiology laboratory. Gram stain showed yeasts cells, while 10%giemsa staining of the eye swab showed ztanck cells. Culture yielded Candida albicans.
 He was placed on chloramphenicol eye drop, steroid eye drops, Acyclovir (patient could not afford gangcyclovir the specific antiviral drug due to high cost) and fluconazole eye drops. Patient was managed by the ophthalmologists and the Medical Microbiology team.
 Patient was discharged home on the 5th day and was asked to come for follow up after one week .On follow up visit , previous symptoms had resolved and right and left eyes were both normal on examination.
 Conclusion: We are unaware of any previous reports of Ophthalmia Adultorium involving Cytomegalovirus and Candida albicans in patients with sandball eye accidents. Patients with sandball injuries should be assessed quickly and antibiotic and antifungal therapy should be considered if cultures are positive.

Activity Test of Kedondong Leaf Juice Extract (Spondias dulcis) as Anti-Candida albicans in Patients with Diabetes Mellitus

Diabetes is a disease characterized by high blood glucose levels which can stimulate the growth of the Candida albicans. Indonesia is the second highest country in the world with biodiversity which allows the creation of new compounds that can be used as medicine. One type of plant that has medicinal properties is kedondong leaves (Spondias dulcis) which can be used as herbal medicine, and can also act as an anti-fungal, because it has anti-fungal substances such as flavonoids, alkaloids, saponins and tannins. This compound can prevent fungal growth. The aim of this research was to determine the inhibitory ability of kedondong (Spondias dulcis) leaf extract in inhibiting the growth of Candida albicans using the Kirby Bauer method. The type of research used in this research is laboratory experiments. The results of the inhibition test in this study were the concentration inhibition zone results of 25%, 50%, 75%, 100%, the results were 0 mm, indicating that these 4 concentrations could not inhibit the growth of Candida albicans. Meanwhile, the positive control showed that there was a clear zone with an average of 28.8 mm, which indicated that antibiotics inhibited the growth of Candida albicans, while the negative control showed that no clear zone was formed. Therefore, the results of this study can be concluded that squeezed kedondong (Spondias dulcis) leaf extract cannot inhibit the growth of Candida albicans isolated from diabetes mellitus sufferers

EVALUATING CHANGES IN SALIVARY FLOW RATE, PH & MICROBIAL COUNT DURING FIXED ORTHODONTIC TREATMENT - AN IN VIVO STUDY

Aim of the study: Aim of this study is to assess the changes in salivary flow rate, salivary pH, plaque index, Streptococcus mutans, Lactobacillus, and Candida albicans in patients undergoing fixed orthodontic treatment, before and after placement of fixed orthodontic appliances. Materials and Method: In present study salivary samples from 60 patients (30 Males and 30 Females) with age group of 14-25 years would be undergoing fixed orthodontic treatment at the department of orthodontics. Salivary flow rate, pH, plaque index and microbial colony count were measured. Streptococcus mutans, Lactobacillus and Candida albicans colony counts were measured using mitis salivarius agar, rogosa agar and sabouraud dextrose agar respectively. Saliva collected for 5 mins and measured in ml/min. salivary pH measured with digital pH meter. Salivary samples obtained from the same patients at intervals of 8 weeks and 16 weeks after commencement of orthodontic treatment and evaluated for the same. Result: This study showed fixed orthodontic appliances increases salivary flow rate (p=0.0001), decreases salivary pH (p=0.03), increases plaque index (p=0.0001), also increases Streptococcus mutans, Lactobacillus and Candida albicans colony count (p=0.0003, p=0.0001and p=0.019 respectively). Independent t test reported salivary flow rate significantly increases more in male patients at 16 weeks interval (p=0.03). Conclusion: The results of this study confirmed that after placement of fixed orthodontic appliances plaque retention increases, which sequentially decrease the salivary pH and decreased salivary pH promote the growth of microbiota.

Antifungal activity of propolis extract against Candida albicans in patients with vulvovaginal candidiasis

Background: The aim was to evaluate the antifungal activity of propolis extract against Candida albicans (or C. albicans) in patients with vulvovaginal candidiasis. Methods: The research presents a quantitative approach with an experimental design, with a population of C. albicans strains isolated from patients diagnosed with vulvovaginal candidiasis who were admitted to the Gynecology Service of the Maria del Socorro Clinic, district of Ate, Lima; a sample of 34 strains was chosen in total, considering three repetitions per strain, obtaining 102 experimental units. The antifungal susceptibility test was carried out by the disc diffusion plate method using a single concentration of propolis extract, with fluconazole as a positive control. Results: Propolis extract was shown to inhibit all strains of C. albicans, as was fluconazole, with the effect of the latter being significantly greater than that of the product under investigation. Conclusions: The conclusion is that propolis extract does show antifungal activity against C. albicans in patients with vulvovaginal candidiasis.

A comparative study on the production of extracellular hydrolytic enzymes of C. albicans and non-albicans Candida species isolated from HIV+/AIDS patients and healthy individuals.

Oropharyngeal candidiasis is the most prevalent opportunistic fungal infection in patients with human immunodeficiency virus (HIV) as well as other immunodeficiency disorders, which is caused by various Candida species, mostly Candida albicans. Studies have shown that Candida isolates differ in their pathogenicity. These variations are attributed to virulence factors, host characteristics, and the target tissue. This study aimed to determine and compare the secretion of hydrolytic enzymes in C. albicans and non-albicans Candida species isolated from HIV+/AIDS patients and healthy individuals. Samples were taken from 201 patients with HIV and 118 healthy individuals. The samples were identified by macroscopic, phenotypic, and molecular methods, and virulence factors were subsequently measured. Statistical differences in enzymatic activity of various Candida isolates were calculated (P<0.0001). In total, 95 samples (47.20%) from patients and 46 samples (38.90%) from healthy individuals were positive for the growth of different Candida species. There were 39 (41.10%) and 36 (78.30%) C. albicans in patients and healthy individuals, respectively, as well as 56 (58.90%) and 10 (21.70%) non-albicans species in patients and healthy subjects, respectively. All the enzymes produced by Candida species enzymes were at low, medium, and high levels. Hemolysin activity in Candida species isolated from patients was significantly higher, compared to healthy individuals. Moreover, the activity of all C. albicans enzymes in patients was significantly higher than other Candida species. The C. albicans isolated from HIV-positive individuals secreted higher amounts of exoenzymes, and can cause oropharyngeal candidiasis and become a source of candidiasis for the host.

Epidemiological factors associated with Candida albicans in patients using complete denture: a scoping review

Objective: This study undertakes a scoping review of research on epidemiological factors of Candida albicans in patients using complete denture (CD). Methods: PubMed, LILACS, Embase, SciELO, Web of Science, and Scopus databases were used. Searches were conducted in December 2020. Keywords used in this search were Candida albicans, Complete Denture, Mouth, and Microbiology. Results: Initially, 89 articles were identified; 19 of these comprised the final sample after applying the exclusion/inclusion criteria. There was a greater tendency for females to use DC. In addition, among all samples evaluating the incidence of the fungus (n = 2,724), approximately 44.7% (n = 1,218) had C. albicans-associated prosthetic stomatitis. Conclusion: Prosthetic stomatitis is a condition that mainly affects women aged 50–70 years and has a multifactorial predisposition. Also, Newton's classification proposed in 1962 is the most used for the clinical diagnosis of oral candidiasis. The CD's hygiene status is a crucial factor for the progression of candidosis, in the same way that the C. albicans fungus plays an important role in the progression of this pathogenesis in the host.

Antibiofilm Activity of Nystatin, Aspirin and EDTA Against Candida albicans Isolated from Iraqi Women with Vulvovaginitis

The vulvovaginitis candidiasis is often associated with biofilm formation by Candida albicans and using ofantifungal agents against C. albicans biofilms is urgently needed. Microtiter plate assay using crystal violetwas used for detection the ability of Candida albicans to form biofilm and the microtiter broth dilutionmethod was used for determination the minimum inhibitory concentrations (MICs). Out of 42 Candidaalbicans isolated from vulvovaginitis, 37 (88%) can produce biofilm at the varying degrees. Twenty-eight(75.7%) isolates could form a strong biofilm. The results of minimum inhibitory concentrations (MICs) ofNystatin, Aspirin and EDTA (Ethylenediaminetetraacetic acid) against 28 C. albicans isolates which formedthe strong biofilm, revealed that range of concentrations of Nystatin were (6.25-100 µg/ml), while the MICsof aspirin and EDTA were more than 1000 µg/ml. It was obvious that the Nystatin had the inhibitory activityat the concentrations 6.25 and 12.5 µg/ml. The highest antibiofilm activity by Nystatin were demonstratedat the subinhibitory concentration 50 ?g/ml with biofilm eradication percent (75.80%), while the lowestantifungal effect (2.86-10.70%) was at very low concentrations (3.125-6.25 ?g/ml). Also, there was anobvious biofilm eradication of Aspirin and EDTA at the concentrations 500 and 1000 ?g/ml but the effectof aspirin at the concentration 1000 ?g/ml (70.51%) is more than EDTA (60.12%) in contrast with theconcentration 500 ?g/ml, it was found that the effect of EDTA (51.29%) is more than aspirin (34.25%). Inconclusion, the present study highlights the role of Aspirin and EDTA as antibiofilm agents when used withNystatin which have the ability to inhibit the growth of C. albicans in patients with vulvovaginitis.

The First Evidence of a Disturbed Immune Response toward Candida Albicans in Patients with Sars-Cov-2 and Co-Morbility. A Novel Case Report

The First Evidence of a Disturbed Immune Response toward Candida Albicans in Patients with Sars-Cov-2 and Co-Morbility. A Novel Case Report

The First Evidence of a Disturbed Immune Response toward Candida Albicans in Patients with Sars-Cov-2 and Co-Morbility. A Novel Case Report

The First Evidence of a Disturbed Immune Response toward Candida Albicans in Patients with Sars-Cov-2 and Co-Morbility. A Novel Case Report

EPIDEMIOLOGY OF NOSOCOMIAL INFECTION COMPLICATIONS IN A SURGICAL CLINIC

The analysis of the data of literary sources of domestic and foreign researchers on the problem of the occurrence and development of nosocomial infections in general and in the surgical departments in particular is carried out. The relevance of the study is confirmed by the following data: the spread of nosocomial infections in the Russian Federation is 2.5 million annually; the minimum damage inflicted by them in Russia alone is approximately 6-7 million rubles. The data of foreign scientists have been studied, suggesting that infections in the field of hirirurgic intervention were recorded in 13% of cases after performing clean operations, in 16% after and in 29% after . In St. Petersburg, with selective studies, the frequency of infections in the field of surgical intervention revealed 9% of patients among 1,500 operated It was revealed that the number of potential causative agents of nosocomial infections increases every year due to opportunistic bacteria that differ in biological characteristics from hospital strains and have multiple drug antibiotic resistance. A retrospective and prospective analysis of the frequency of occurrence of microorganisms in patients of the surgical department of 2008-2019 was carried out. The microbial spectrum and prevalence of nosocomial infection pathogens in the surgical department were investigated. An epidemiological analysis of the causative agents of nosocomial infection in patients with pneumonia, infections in the surgical field and urinary tract, as well as with generalized infections, was carried out. The analysis of the bacterial flora of the clinical microbiological culture of the wound discharge, sputum, urine and blood was carried out. The following microorganisms were most prevalent in these samples: Staphylococcus aureus, Acinetobacter baumannii, Candida albicans, Klebsiella pneumonia. A tendency to increase the proportion of Candida albicans in patients of the surgical department, as well as a high prevalence of Staphylococcus epidermidis in blood cultures, was revealed.

Effect of celery leaves extract on the growth of Candida albicans in patients wearing removable orthodontic appliances

Background: Maintaining the cleanliness of removable orthodontic appliances is often overlooked so it can lead to changes in Candida albicans into the pathogenic form. Celery leaves are one of the natural ingredients that have active compounds as antimicrobial. Objective: To determine the effects of celery leaf extract in inhibiting the growth of C.albicans found on re-movable orthodontic appliances. Methods: Laboratory experimental studies were conducted with post test only control group design involving 5 samples of removable orthodontic appliances, which were swabbed to obtain C.albicans. Samples were divided into 5 groups, 1 control group and 4 treatment groups with 10%, 30%, 50%, and 70% extract concentration and the inhibitory test was performed. Result: The greater the concentration of celery leaf extract, the greater the diameter of the inhibi-tory zone formed. Conclusion: Celery leaf extract has the effect in inhibiting the growth of C.albicans found on removable or-thodontic appliances.

Effect of binahong leaf extract on the growth of Candida albicans in patients using removable orthodontic appliances

Background: In the oral cavity there are countless microorganisms, about 40% of which are Candida albicans as normal flora. The use of removable orthodontic appliances in the oral cavity greatly inhibits cleanliness and increases the number of retentive areas in the oral cavity resulting in risk factors of increased C.albicans. Binahong leaves contain many active compounds that are antimicrobial. Objective: To determine the effect of binahong leaf extract in inhibiting the growth of C.albicans in patients using removable orthodontic appliances. Method: Laboratory experimental research was conducted with the design of the posttest only control group design involving 5 samples of removable orthodontic appliances which were swabbed to obtain C.albicans, then each tested with binahong leaf extract concentrations of 10%, 30%, 50%, 70% and the control group. Next is the inhibitory test. Results: The greater concentration of the Binahong leaf extract, the greater the diameter of the resistance. Conclusion: Binahong leaf extract has an effect on inhibiting the growth of C.albicans in patients using removable orthodontic appliances.

THE EVALUATION OF THE COLONIZATION AND BIOFILM FORMATION CAPACITY OF THE CANDIDA SPECIES ISOLATED FROM DENTURE WEARER PATIENTS

Aim: C Aim: Candida species, although being a member of the oral flora, may exhibit pathological features under certain conditions. The aim of this study was to determine the distribution and biofilm production of Candida species that were isolated from denture related stomatitis (DRS) patients and to compare with healthy subjects. andida species, although being a member of the oral flora, may exhibit pathological features under certain conditions. The aim of this study was to determine the distribution and biofilm production of Candida species that were isolated from denture related stomatitis (DRS) patients and to compare with healthy subjects. Materials and Methods: The 56 non-smoker, systemically healthy, maxillary removable denture wearer subjects included in this study and diagnosed as DRS(N=27) and healthy(N=29) . Samples from the palatal mucosal surface of patients were collected by sterile swabs during 20 seconds. Cultivation and selective isolation of Candida species were performed on CHROMagar (CHROMagar ® Candida, CHROMagar, Paris, France) at 37ºC for 2 days. Isolated Candida species were identified with API ID 32 C (bioMérieux ® , France). Biofilm formation by Candida species were determined by a visual tube method. Results: The prevalence of the yeasts in the healthy group was found to be 37.94%, while in the DRS group it was 100% (p<0.001). The isolation rate of C. albicans in patients with DRS significantly higher (p<0.001). Biofilm formation was observed in a total of 37 oral yeast isolates, 9 isolates from healthy denture wearers and 28 isolates from DRS patients. The number of C. albicans and C. glabrata isolates showing biofilm formation ability in the DRS group was significantly higher than the healthy group (p<0.05). Conclusions: Within the limitations of this study, our results suggest that Candida species play a major role on the development of DRS. While C. albicans was the most isolated species in DRS, C. glabrata was as important as C. albicans on the pathogenesis of DRS. keywords: Biofilms , Candida, denture stomatitis, mycology, oral pathology HAREKETLİ PROTEZ KULLANAN HASTALARDA KANDİDA TÜRLERİNİN KOLONİZASYONUNUN VE BİYOFİLM OLUŞTURMA KAPASİTELERİNİN DEĞERLENDİRİLMESİ Öz Amaç: Candida türleri, oral floranın doğal üyesi olmakla birlikte, belirli koşullar altında patolojik özellikler sergileyebilir. Bu çalışmanın amacı, protez stomatiti (PS) olan hastalardan ve protez kullanan sağlıklı bireylerden elde edilen Candida türlerinin dağılımını ve biyofilm üretime kapasitelerini karşılaştırmaktır Gereç ve Yöntem: Sigara içmeyen, sistemik olarak sağlıklı, maksiller tam damak protez kullanan 56 kişi bu çalışmaya dahil edildi. Katılımcılar PS (N = 27) ve sağlıklı (N = 29) olmak üzere gruplandırıldı. Hastaların palatal mukoza yüzeyinde 20 saniye boyunca steril swablar gezdirilerek sürüntü örnekleri elde edildi. Candida türlerinin kültivasyon ve seçici izolasyonu 2 gün boyunca 37 ° C'de CHROMagar (CHROMagar® Candida, CHROMagar, Paris, Fransa) besiyerinde gerçekleştirildi. İzole edilen Candida türlerinin identifikasyonu API ID 32 C (bioMérieux®, Fransa) ile gerçekleştirildi. Candida türlerinin biyofilm oluşturma potansiyelleri görsel tüp yöntemi ile saptandı Bulgular: Sağlıklı gruptaki mayaların prevalansı % 37.94 iken, PS grubunda % 100'dü ( p <0.001). PS'li hastalarda C. albicans 'ın izolasyon oranı anlamlı derecede daha yüksekti ( p <0.001). Sağlıklı katılımcılardaki 9 PS katılımcılardaki 28 izolatta biyofilm oluşumu gözlendi. PS grubunda biyofilm oluşumunu gösteren C. albicans ve C. glabrata izolatlarının sayısı sağlıklı gruba göre anlamlı olarak yüksekti ( p <0.05). Sonuç: Bu çalışmanın sınırları dahilinde, sonuçlarımız Candida türlerinin PS'nin gelişiminde önemli bir rol oynadığını göstermektedir. C. albicans , PS'de en sık izole edilen tür olsa da C. glabrata da PS'nin patogenezinde C. albicans kadar önemlidir. Anahtar Kelimeler: Biyofilm , Kandida, protez stomatitisi, mikoloji, oral patoloji

Characteristics of fungemia in a peruvian referral center: 5-year retrospective analysis.

Retrospective descriptive study carried out to determine the characteristics of fungemia in 285 cancer patients hospitalized from 2012 to 2016 at the Instituto Nacional de Enfermedades Neoplásicas (INEN). Demographic, clinical and microbiological information was evaluated. Fungemia by C. albicans predominated in patients with solid tumors and without neutropenia, while those caused by C. tropicalis predominated in patients with hematological neoplasia and neutropenia. C. tropicalis was the agent isolated in most cases (47.0%). Fungemia increased over time in patients without neutropenia. Fungemia caused by C. albicans increases with age in patients with solid tumors without neutropenia. It is concluded that fungemia are mainly caused by C. tropicalis in patients with hematological neoplasia with neutropenia and by C. albicans in patients with solid tumors without neutropenia. In addition, fungemia in patients without neutropenia increases over time; and those caused by C. albicans increase with age in patients with solid tumors without neutropenia.

A pilot study: a possible implication of Candida as an etiologically endogenous pathogen for oral lichen planus

BackgroundThe aim of this study was to investigate the prevalence and genotypic profiles of Candida albicans in patients with oral lichen planus (OLP).Materials and methodsPositive rates and genotypic profiles of Candida albicans strains from OLP patients and healthy controls were analyzed. Random amplified polymorphic DNA and internal transcribed spacer of ribosome DNA polymerase chain reactions were used to sequence the DNA of these strains, and then their genetic similarity was measured using BLAST, UIV Band, and Vector NTI Suite Sequence Analyses Software.ResultsThe prevalence of C. albicans strains detected from erosive-OLP, non-erosive OLP, and normal individuals was 18.87, 18.75, and 7.92%, respectively. Four different genotypes were revealed by the two methods. To be specific, type I was found only in the healthy subjects; type II a and II b were found in non-erosive OLP, and type III was identified in erosive OLP. Intragroup similarity coefficients, i.e. SAB were 100%, and inter-groups similarity coefficients, i.e. SAB were less than 30%.ConclusionsThe genotypic results of C. albicans in OLP revealed an endogenous rather than exogenous infection of C. albicans. In addition, a possible pathogenic role of C. albicans in OLP, with the etiologic sense contributing to a more proper recognition on the pathogenesis, development, and progression of OLP, as well as some strategies for its diagnosis and treatment were identified.

Treatment of candidemia caused by Candida albicans and Candida non - albicans in patients with hematological malignancies

To study the risk factors, symptoms and outcomes of candidemia caused by C. albicans and C. non - albicans in patients with hematological malignancies. The study included patients with hematological malignancies and candidemia. The diagnosis of candidemia was established according to the single isolation of Candida spp. from blood culture and the presence of symptoms of infection. Over 12 years (2006-2017), candidemia was diagnosed in 75 patients aged 17 to 77 years (median 48 years). The causative agents of candidemia were C. albicans in 34.7% of patients, C. non - albicans - in 65.3%. Candidemia caused by C. albicans prevailed in patients of the older age group (median 56.5 years, p=0.04) and in patients with lymphoma (61.5%, p=0.01) with colonization of the gut by the same species of Candida (88.5%, p=0.002). Isolation of C. non - albicans from blood culture was more common in patients with acute leukemia (51%, p=0.01) and in recipients of allogeneic hematopoietic stem cells (22.5%, p=0.01). The ability to form biofilms was observed more frequently among C. non - albicans (59.2%) than C. albicans (19.2%, p=0.001). The clinical symptoms of candidemia were non - specific (fever was in 97%). Septic shock developed in 25 (33%) patients with comparable frequency in both groups. Concomitant infections was also comparable (73% vs. 73.5%). Overall 30-day survival in patients with candidemia caused by C. albicans and C. non - albicans was 61.2% and 61.5%. Treatment with echinocandin was associated with increase of survival compared to other antifungal agents among patients with C. albicans candidaemia (88.9% versus 40%, p=0.02) and among C. non - albicans (77.3% versus 47.8%). C. non - albicans constituted a high proportion among causative agents of candidemia. High mortality rate was observed in both groups. Initial therapy with echinocandin was associated with increase of survival.

Modulation of the Oral Microbiome to Improve Oral Health and Reduce BSI from Oral Flora in Pediatric Hematopoietic Stem Cell Transplant Recipients: A Randomized Controlled Trial

BackgroundBlood stream infections (BSI) in hematopoietic stem cell transplant (HSCT) patients with central venous catheters may arise from translocation of bacteria through a non-intact gastrointestinal mucosa and are known as mucosal barrier injury–laboratory confirmed blood stream infections (MBI-LCBI). Central venous catheter maintenance care doesn't prevent MBI-LCB and currently there are no proven strategies to prevent bacteremia secondary to mucosal barrier injury. Gingivitis and periodontitis are features of the mucosal toxicity seen post-HSCT and are associated with BSI frequency. Xylitol is a non-fermentable polysaccharide that reduces dental caries, plaque accumulation, and oral disease progression by inhibiting bacterial growth and community development. We hypothesized that daily dental xylitol, in addition to current oral care practice, is effective at reducing gingivitis, periodontitis and BSI from oral organisms.MethodsWe performed a prospective randomized controlled trial to test our hypothesis. All patients received standard oral care and half were randomized to additionally receive daily xylitol. Oral exams were performed at baseline and at intervals for the first 28 days post-HSCT. Metagenomic shotgun sequencing of gingival samples was performed at these same intervals. For patients who develop BSI, whole genome sequencing of bacterial isolates is being performed to assess for genetic relatedness to corresponding strains present within the patient's oral microbiome preceding the infection.ResultsWe enrolled 35 patients, 17 cases and 18 controls before ending the study early for efficacy. Five patients withdrew from the study (3 cases, 2 controls). Patients who received xylitol had a significantly lower rate of gingivitis, oral plaque and oral ulcers greater than 10 mm. There was a significant decrease in BSI from oral organisms in the first 30 days post HSCT in the xylitol group, 0/14 (0%) vs 5/16 (31%) (p = 0.04). Preliminary microbiome analysis showed decrease relative abundance of Candida albicans in patients receiving xylitol and individual patient analysis shows that xylitol may also impede Streptococcus mitis/oralis dominance in the oral microbiome. Additionally, we found that Staphylococcus aureus, a common cause of Central Line Associated Blood Stream Infection (CLABSI), was prominent in several gingival samples, suggesting BSI with Staphylococcus aureus may indeed be related to mucosal barrier injury.ConclusionsThe addition of xylitol to oral standard care appears to decrease BSI secondary to oral organisms, dental plaque, gingivitis and oral ulcerations in patients undergoing SCT. Blood stream infections (BSI) in hematopoietic stem cell transplant (HSCT) patients with central venous catheters may arise from translocation of bacteria through a non-intact gastrointestinal mucosa and are known as mucosal barrier injury–laboratory confirmed blood stream infections (MBI-LCBI). Central venous catheter maintenance care doesn't prevent MBI-LCB and currently there are no proven strategies to prevent bacteremia secondary to mucosal barrier injury. Gingivitis and periodontitis are features of the mucosal toxicity seen post-HSCT and are associated with BSI frequency. Xylitol is a non-fermentable polysaccharide that reduces dental caries, plaque accumulation, and oral disease progression by inhibiting bacterial growth and community development. We hypothesized that daily dental xylitol, in addition to current oral care practice, is effective at reducing gingivitis, periodontitis and BSI from oral organisms. We performed a prospective randomized controlled trial to test our hypothesis. All patients received standard oral care and half were randomized to additionally receive daily xylitol. Oral exams were performed at baseline and at intervals for the first 28 days post-HSCT. Metagenomic shotgun sequencing of gingival samples was performed at these same intervals. For patients who develop BSI, whole genome sequencing of bacterial isolates is being performed to assess for genetic relatedness to corresponding strains present within the patient's oral microbiome preceding the infection. We enrolled 35 patients, 17 cases and 18 controls before ending the study early for efficacy. Five patients withdrew from the study (3 cases, 2 controls). Patients who received xylitol had a significantly lower rate of gingivitis, oral plaque and oral ulcers greater than 10 mm. There was a significant decrease in BSI from oral organisms in the first 30 days post HSCT in the xylitol group, 0/14 (0%) vs 5/16 (31%) (p = 0.04). Preliminary microbiome analysis showed decrease relative abundance of Candida albicans in patients receiving xylitol and individual patient analysis shows that xylitol may also impede Streptococcus mitis/oralis dominance in the oral microbiome. Additionally, we found that Staphylococcus aureus, a common cause of Central Line Associated Blood Stream Infection (CLABSI), was prominent in several gingival samples, suggesting BSI with Staphylococcus aureus may indeed be related to mucosal barrier injury. The addition of xylitol to oral standard care appears to decrease BSI secondary to oral organisms, dental plaque, gingivitis and oral ulcerations in patients undergoing SCT.

Autoimmunity and intestinal colonization by Candida albicans in patients with type 1 diabetes at the time of the diagnosis

Purpose Type 1 diabetes mellitus (T1DM) is a chronic and immune-mediated disease, which is characterized by the progressive destruction of pancreatic beta cells. T1DM precipitates in genetically susceptible individuals through environmental factors. In this study, we aimed to evaluate the impact of autoimmunity and intestinal colonization of Candida albicans on the development of T1DM.Methods Forty-two patients newly diagnosed with T1DM and 42 healthy subjects were included in this monocentric study. The basic and clinical characteristics of the patients were recorded. T1DM-, thyroid-, and celiac-associated antibodies were evaluated. Stool cultures for C. albicans were performed to assess whether or not gut integrity was impaired in patients with T1DM.Results The evaluation of T1DM- and thyroid-associated antibodies showed that the prevalences of islet cell antibodies and antithyroperoxidase positivity were higher in the study patients than in the patients in the control group. Furthermore, the direct examination and culture of fresh stool samples revealed that 50% of the patients with T1DM and 23.8% of the control subjects had fungi (C. albicans).Conclusion Through this study, we suggest that the presence of intestinal C. albicans colonization at the time of the diagnosis of T1DM may indicate impairment of normal intestinal microbiota. We also suggest that there may be a tendency of T1DM in patients with a high prevalence of intestinal C. albicans.