API 20C AUX System Research Articles

Efficacy of gel-based artificial saliva on Candida colonization and saliva properties in xerostomic post-radiotherapy head and neck cancer patients: a randomized controlled trial

ObjectiveTo evaluate the efficacy of an edible artificial saliva gel, oral moisturizing jelly (OMJ), and a topical commercial gel (GC dry mouth gel) on Candida colonization and saliva properties.Materials and methodsThis study was a secondary analysis of a single-blinded randomized controlled trial conducted in xerostomic post-radiotherapy head and neck cancer patients. Candida colonization, stimulated salivary flow rate (SSFR), saliva pH, and buffering capacity (BC) were measured at 0, 1, and 2 months after each intervention. Candida colonization was quantified by colony counts and species identified by Candida Chromagar, polymerase chain reaction, and API 20C AUX system. Statistical significance level was 0.05.ResultsA total of 56 participants in OMJ (N = 30) and GC (N = 26) groups completed the study. OMJ significantly increased saliva pH (p = 0.042) and BC (p = 0.013) after 1-month use, while GC only improved saliva pH (p = 0.027). Both interventions tended to increase SSFR but only GC had a significant increase at 2 months (p = 0.015). GC and OMJ significantly decreased the number of Candida species at 1 and 2 months, respectively. Both groups tended to reduce Candida counts but not significant.ConclusionsBoth OMJ and GC saliva gels could improve saliva pH and decrease the number of Candida species. OMJ is superior to GC in its buffering capacity, while GC may better improve salivary flow rate. Long-term and large-scale study is warranted to test the efficacy of artificial saliva in oral health improvement.Clinical relevanceOMJ and GC gel could decrease the number of Candida species and improve saliva properties in post-radiation xerostomic patients.Trial registration numberClinicaltrials.gov NCT03035825. Date of registration: 25th January 2017.

Oral Candida colonization in xerostomic postradiotherapy head and neck cancer patients.

To evaluate (a) oral colonization of Candida species, especially for non-albicans Candida species (NACS), in xerostomic postradiotherapy head and neck cancer patients and (b) risk factors affecting their colonization. Subjective and objective dry mouth scores, stimulated salivary flow rates, pH and buffering capacity were measured in 72 xerostomic postradiotherapy head and neck cancer patients. Candida counts and species identification were performed using oral rinse samples cultured in Candida Chromagar, followed by polymerase chain reaction and API 20C AUX system. Candida colonization was observed in 87.5% of subjects, with 80.6% and 48.6% of study population colonized by C.albicans and NACS, respectively. NACS was associated with high objective dry mouth scores, denture use, and females (p=.006, .009, and .036, respectively). In addition, Candidaglabrata was detected more in females (p=.018) and denture wearers (p=.026), while Candidatropicalis was associated with high objective dry mouth scores (p=.022) and females (p=.027). Quantity of Candida colonization correlated positively with objective dry mouth scores (r=0.599, p<.001) and negatively with salivary flow rates (r=-0.258, p=.041) and pH (r=-0.290, p=.022). NACS colonization was common in xerostomic head and neck cancer patients. Increased signs of dry mouth, female and dental prostheses may promote NACS colonization.

Antifungal Effects of Silybum marianum Extract Individually and in Combination with Fluconazole on Clinical Candida Isolates in Northern Iran

Background: Candidiasis is a spectrum of opportunistic fungal diseases. The resistance of Candida to antibiotics is unfortunately increasing. Silybum marianum, which belongs to the Asteraceae family, is a wild plant growing in most parts of Iran. Objectives: The present study was conducted to investigate the effect of Silybum marianum extract, both individually and in combination with fluconazole, on the growth of drug-resistant clinical Candida isolates. Methods: Candida species isolated from 85 patients suspected of Candidisis was identified and cultured on CHROMagar Candida and API 20CAUX system. The test of susceptibility to fluconazole was performed using broth microdilution. The minimum inhibitory concentration (MIC) of Silybum marianum extract and its antagonistic effects were determined using the microdilution assay. Results: The highest resistance to fluconazole was reported in Candida glabrata (81.8%) and Candida albicans (72.9%). Variations in the MIC of the aqueous extract of Silybum marianum in a range of 4096 - 8 μL/mL showed that 77.8% of C. glabrata isolates and 88.6% of C. albicans isolates were resistant to fluconazole, and did not grow at a concentration of 2048 μL/mL; nevertheless, in the case of Silybum marianum extracts in combination with fluconazole, 89% of C. glabreta and 94.3% of C. albicans isolates were resistant to fluconazole, and stopped growing at concentrations of at least 128 μL/mL (P < 0.01). Conclusions: The aqueous extract of Silybum marianum seeds found to present proper inhibitory effects on clinical fluconazole-resistant Candida isolates at high concentrations. Silybum marianum extract in combination with fluconazole was found to have a more potent in-vitro activity than the extract and drug individually.

Genetic Diversity Among Candida albicans Isolated from Humans and Cattle with Respiratory Distress in Egypt.

As human populaces develop, they are progressively squeezed into higher living densities. The same is true for horticulture and animals expected to bolster these communities. Despite the high potential for zoonotic transmission, connections among humans and cattle have been understudied; however, Candida albicans remains the most important medical mycosis. The genesis of the mycobiome can vary, and interactions between humans and cattle are progressively being perceived as a key interface for disease transmission. αINT1 is a unique gene from Candida albicans; hence, it has been used for detection as well as intraspecific and interspecific phylogenetic analysis of C. albicans collected from human patients and cattle with pulmonary distress in urban-rural populations. A total of 1,921 specimens were examined by direct microscopy and culture to recover yeast associated with human infection. Identification was performed by micromorphology using an API 20C AUX system. The fungal species identified in bovine nasal specimens were Alternaria species (15%), Penicillium species, and C. albicans (6.7%). Other fungal species, such as Aspergillus niger, Torulopsis species, Mucor species (5%), Aspergillus flavus, Fusarium species, Trichosporon species (3.3%), C. rugosa, C. tropical, and Saccharomyces species (1.7%), were also isolated. In human sputum specimens, C. albicans (20%) and C. parapsilosis (2.7%) were the only reported yeast species in our samples. The four identified C. albicans species (two human and two cattle) were subjected to αINT1 gene sequence analysis, which confirmed major phylogenetic relationships among human and cattle isolates. This finding highlights the public health importance of bovines as a potential source for C. albicans zoonotic transmission to humans in an urban-rural community. Additionally, the close relationship between circulating C. albicans strains recorded in Egypt and the United States indicates the possible cross-species transmission of C. albicans between imported foreign and native cattle breeds.

Increasing incidence of candidaemia and shifting epidemiology in favor of Candida non-albicans in a 9-year period (2009–2017) in a university Greek hospital

The aim of the present study was to analyze candidaemia's epidemiology (incidence, species distribution, and susceptibility rates) and antifungal consumption during a 9-year period. All candidaemias recorded at The University General Hospital of Patras, Greece, between 2009 and 2017 were included. Candida isolates were identified using the germ tube test, API 20C AUX System, and/or Vitek-2 YST card. Antifungal susceptibility was determined by the gradient method according to CLSI. During the study period, 505 episodes of candidaemia were observed with an overall incidence of 1.5 episodes per 1000 hospital admissions (1.1 episodes in 2009 to 1.9 in 2017: P 0.038, r 0.694). C. albicans was the leading cause (200 cases; 39.6%), followed by C. parapsilosis (185; 36.6%), C. glabrata (56; 11.1%), C. tropicalis (50; 9.9%), C. krusei (8; 0.2%), C. lusitaniae (5; < 0.1%), and C. guilliermondii (1; < 0.1%). Overall resistance to fluconazole, voriconazole, anidulafungin, caspofungin, and micafungin (according to CLSI) were 11.6%, 4.1%, 2.0%, 6.0%, and 0.8%, respectively. The overall consumption of antifungal drugs was stable, with a significant reduction of fluconazole's use in favor of echinocandins. An increase in the incidence of candidaemia and a predominance of Candida non-albicans due to decreasing use of fluconazole in favor of more potent antifungals, such as echinocandins, are reported in this study.

The Inhibitory Effect of Probiotic Bacteria against Drug - Resistant Candida Species Isolated from the Oral Cavity of the Elderly

Background: Candidiasis includes a range of opportunistic fungal diseases that appear in various forms such as oral thrush and stomatitis in the elderly. Recently, the resistance of Candida species to antibiotics selected to treat oral infections has increased significantly. Objectives: This study aimed to determine the antagonistic effects of probiotics on oral candidiasis in the elderly. Patients and Methods: Swab samples from the saliva and mouth of 72 elders residing in the elderly care centers in Gorgan were cultured in Sabouraud dextrose agar (SDA). The Candida spp. and Candida albicans were identified by culturing in CHROMagar Candida medium and using a PCR identification kit and API 20CAUX system. The broth microdilution method was used to determine the minimum inhibitory concentration (MIC) of nystatin and itraconazole based on the CLSI document. The well - diffusion method and the modified agar method were applied to separate dairy - isolated probiotics from cultures in MRS and M17 media and to study their antimicrobial effect. Results: Overall, 47 Candia isolates in seven different species were diagnosed. The MICs of itraconazole and nystatin were within the range of 0.03 - 16 and 0.03 - 8 µg/mL and the rates of resistance were 87.23% and 74.46%, respectively. The study on dairies showed that most isolated strains belonged to Lactobacilli. It was also revealed that the probiotic bacteria were able to prevent the growth of Candida species. The highest inhibitory effect was seen in Lactobacillus plantarum. Moreover, desirable antifungal effects were observed in preventing the growth of C. albicans as well as non - albicans species, particularly C. glabrata. Conclusions: Concerning the high resistance of Candida isolates to antifungal agents and the inhibitory effects of lactic bacteria, especially Lactobacillus plantarum, it is recommended to use its metabolites directly in the diet of the elderly or to use them in the form of supplements in order to control oral candidiasis.

The Relative Frequency and Susceptibility Patterns of Candida Species Isolated from Blood and Urine of Children with Malignancy

Background: Systemic candidiasis has been on the rise in recent years due to the increasing number of patients with malignancies and use of immunosuppressants. The present study seeks to identify the distribution of Candida species isolated from malignant patients and determine in vitro antifungal susceptibility patterns of the isolates to promote their effective management. Methods: Blood and urine samples from 385 patients with malignancies were cultured. Identification and susceptibility patterns of the Candida isolates from clinical samples to antifungal drugs were done using API 20C AUX system and microdilution methods. Results: From 90/385 patients (23.4%), 102 Candida spp. were isolated. The most prevalent species was Candida albicans with sensitivity rates of 91%, 96%, 100%, 96%, and 60% to fluconazole, amphotericin B, caspofungin, voriconazole, and itraconazole, respectively. Epidemiological cutoff values for amphotericin B and voriconazole were 0.064 and 0.032, respectively. All the isolated species were of wild-type for all antifungal agents except 4% of Candida albicans, which were non-wild type to amphotericin B and voriconazole and 6% to itraconazole. No relationship was seen between the rate of isolated species and sex, age, and the type of malignancy; but the relationship between the use of antibacterial agents and Candida isolation was significant (P < 0.05). Conclusions: Mutations in drug sensitivity were found in some species (non-wild type). As there was a relationship between the use of antibacterial agents and the isolation of Candida species from immunocompromised patients, accurate diagnosis of Candida species isolated and their antifungal susceptibility patterns are needed for the management of such patients.

Risk factors and predictors of mortality of candidaemia among critically ill patients: role of antifungal prophylaxis in its development and in selection of non-albicans species.

The aim of the present study is to identify risk factors for development and predictors of mortality of candidaemia among critically ill patients. A 1:7 case-control study was conducted during a 4-year period (2012-2015) in a Greek Intensive Care Unit (ICU). Candidaemia was confirmed by positive blood cultures. All yeasts were identified using API 20C AUX System or Vitek 2 Advanced Expert System. Epidemiologic data were collected from the ICU computerized database and patients' chart reviews. Fifty-three patients developed candidaemia with non-albicans species being the predominant ones (33 patients, 62.3%). Multivariate analysis found that prior emergency surgery, malignancy, hospitalization during summer months, prior septic shock by KPC-producing Klebsiella pneumoniae and number of antibiotics administered were independently associated with candidaemia, while, prior administration of azole was a protective factor. Non-albicans candidaemia was associated with number of antibiotics administered and prior administration of echinocandin. Mortality of 14 days was 28.3% (15 patients) and was associated with SOFA score upon infection onset and septic shock, while, appropriate empirical antifungal treatment was associated with better survival. Prophylactic azole administration prevents development of candidaemia, while, echinocandin administration predisposes to non-albicans candidaemia. Empirical administration of an appropriate antifungal agent is associated with better survival.

Isolation and Identification of Fungi and Fungus-like Organisms from Sewage Water and soil edge sewage water in the Erbil City

Abstract This study was carried out in Mycological –Laboratory Department of Biology –College of science during spring and autumn season in 2012. This study aims to survey fungi and fungus –like organisms from Sewage water and edge soil sewage water, in Erbil city. Certain physico-chemical parameters of water were performed following standard methods. Five sites at different locations along sewage waterway for 25km distance were chosen for this study. They baiting technique was used by (seed) and dilution method to the soil for isolation of fungi, used API 20C AUX and VITEK2 system to identifying yeasts. During spring (27) species isolated were belong to (14) genera, the most frequents isolated fungi were Geotrichium spp , Verticillium sp., and Fusarium spp . While during autumn isolate (34) species belong to the (17) genus, Most frequently fungi isolated were Fusarium spp , Trichoderma sp, Rhizopus sp, and Aspergillus sp. present results indicated the diversity of fungi and fungus –like organisms which isolated from edge soil of sewage water by dilution method during both seasons, (107) species belong to (37) Genera isolated, among these which they Aspergillus spp (70 x1000) cfu\g.soil Fusarium spp (94x 1000)cfu\g.soil, Geotrichium spp (65x1000)cfu g.soil , the minimum isolated fungi were Torula sp. , Archnophora sp. , Aristatoma sp. ,Bahnsakala sp. Harpographium sp., Phialophora sp. , Arthrospora sp ., Aureobasidium sp. , Myrothecium sp. , Pythium sp. and Xylohyph sp. for each (1 x1000)cfu \g.soil .

Effectiveness of convective drying to conserve indigenous yeasts with high volatile profile isolated from algerian fermented raw bovine milk (Rayeb)

Yeasts Candida tropicalis, Yarrowia lipolytica, Wickerhamomyces anomalus, Issatchenkia orientalis, Kluyveromyces marxianus, Saprochaete suaveolens and Trichosporon coremiiforme were isolated and identified by physiological, biochemical tests with API 20C AUX system and molecular methods by restriction fragment analysis of PCR-amplified 28S-rRNA from Algerian fermented raw bovine milk (Rayeb). Selected yeasts S. suaveolens, I. orientalis, K. marxianus and W. anomalus produced esters and higher esters which can exert a pertinent influence on the sensory characteristics of Rayeb. Viability of S. suaveolens and W. anomalus using three methods of drying (freeze-drying, convective drying, and spray-drying) and during 4 months of storage at 4 °C and 25 °C in the darkness was studied. Immediately after each drying method, high survival was obtained using freeze-drying followed by convective drying in rice cakes and spray-drying respectively. During storage at 4 °C, convective drying provided better survival of yeast cultures of S. suaveolens and W. anomalus than freeze-drying. At 25 °C of storage, convective and freeze-dried yeast cultures showed no significant loss of viable cells up to 2 months of storage. Spray-dried yeast cultures had the greatest loss of viable count during the 3 months of storage at 25 °C.

Susceptibility pattern of Candida albicans isolated from Iranian patients to antifungal agents.

Background and Purpose:Candidiasis is a major fungal infection, and Candida albicans is the major cause of infections in humans. The Clinical and Laboratory Standards Institute (CLSI) developed new breakpoints for antifungal agents against C. albicans. In this multi-center study, we aimed to determine the drug susceptibility profile of C. albicans, isolated from Iranian population according to new species-specific CLSI.Materials and Methods:Clinical samples were cultured on Sabouraud dextrose agar and were incubated at room temperature for seven days. The isolates were transferred to Professor Alborzi Clinical Microbiology Research Center, Shiraz, Iran. C. albicans were identified by using API 20C AUX system. Broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) of amphotericin B, caspofungin, voriconazole, fluconazole, posaconazole, itraconazole, and ketoconazole, based on CLSI document M27-S4 and new breakpoints for some azoles and caspofungin.Results:Overall, 397 C. albicans were isolated from patients admitted to ten university hospitals in Iran. The MIC90 of the isolates to amphotericin B, caspofungin, voriconazole, fluconazole, posaconazole, itraconazole, and ketoconazole were 0.125, 0.125, 0.125, 1, 0.064, 0.5, and 0.125 µg/ml, and rates of resistance were 0.5%, 0.3%, 3.8%, 2.8%, and 2.5% for amphotericin B, caspofungin, voriconazole, fluconazole, and itraconazole, respectively.Conclusion:According to our data, fluconazole is the drug of choice for management of patients at risk for systemic candidiasis throughout the region, since it is cost-effective with low side effects.

Raman spectroscopy and determination of soil yeasts

In this paper, two isolates of yeasts, members of the genus Candida, have been examined using Raman spectroscopy. The yeasts were isolated from soils sampled at the town park in Tivat (Montenegro) and experimental farm Radmilovac (Serbia), by the accumulation method. The pure cultures of yeasts were identified by the API 20C AUX system. The presence of Candida guilliermondii and Candida utilis was noted. The Raman spectra, originating from lipids, amides, proteins, carbohydrates, aromatic amino acids and the nucleotide bases, were analyzed in the wide range of the wave numbers from 500 to 3200 cm-1. It was noticed that peaks which correspond to the lipid fraction were more pronounced in the case of Candida guilliermondii compared to Candida utilis. This may represent a specific response of the yeast species to stress conditions.

Evaluation of the BD Phoenix ID Yeast System for the Species Identificationof Clinical Yeast-Like Organisms

Most fungi isolated from patients with deep-seated mycosis are yeast-like organisms such as Candida and Cryptococcus. As their respective susceptibilities to antifungal agents can vary depending on the species, rapid identification is important for the administration of appropriate antifungal therapy. The aim of this study was to evaluate the performance of a new automated identification panel, Phoenix Yeast ID (Becton, Dickinson Diagnostics, USA) as well as the time required for identification. The identification results of 106 isolates generated by this system were then compared with those of the API 20C AUX system (SYSMEX bioMérieux Co., Ltd. Japan). Among the 106 isolates, the identification agreement between the two yeast panels was 97/106 (91.5%). Of the 9 (8.5%) discrepant identifications, 5 identification using the Phoenix Yeast ID system and 1 identification using the API 20C AUX system agreed with the genotypic identification. Genotypic identification did not agree with the Phoenix Yeast ID or API 20C AUX findings for the remaining 3 discrepant identifications. Approximately 60% of the C. albicans, C. tropicalis, and C. parapsilosis isolates were identified within 4 hours. In total, about 90% of the 4 major Candida sp. (C. albicans, C. tropicalis and C. glabrata) were identified within 8 hours. In conclusion, the Phoenix Yeast ID findings agreed well with the API 20C AUX findings. Genotypic identification of the discrepant identifications confirmed most of the Phoenix Yeast ID panel identifications. As approximately 80% of the major Candida sp. could be identified within 8 hours using the Phoenix Yeast ID identification system, our results suggest that this system is a clinically useful addition to commercially available yeast identification panels. The Phoenix Yeast ID system showed excellent concordance with genotypic identification for the classification of organisms with discrepant API 20C AUX findings.

Comparative Evaluation of the BD Phoenix Yeast ID Panel and Remel RapID Yeast Plus System for Yeast Identification.

Becton Dickinson Phoenix Yeast ID Panel was compared to the Remel RapID Yeast Plus System using 150 recent clinical yeast isolates and the API 20C AUX system to resolve discrepant results. The concordance rate between the Yeast ID Panel and the RapID Yeast Plus System (without arbitration) was 93.3% with 97.3% (146/150) and 95.3% (143/150) of the isolates correctly identified by the Becton Dickinson Phoenix and the Remel RapID, respectively, with arbitration.

Candida profiles and antifungal resistance evolution over a decade in Lebanon.

Infection with and antifungal resistance of Candida species have been on the rise globally. Relevant data on these pathogens are relatively few in our region, including Lebanon, thus warranting this study. This retrospective study of Candida spp. profiles and their in vitro antifungal susceptibility was based on analysis requests for 186 Candida non-albicans and 61 C. albicans during three periods (2005-2007, 2009-2011, and 2012-2014) over the span of the last 10 years at the American University of Beirut Medical Center (AUBMC), a major tertiary care center in Lebanon. Identification of Candida was done using the API 20C AUX system, and the E-test was used to determine the minimum inhibitory concentrations (MICs) of antifungal agents. Among the 1,300-1,500 Candida isolates recovered yearly, C. albicans rates decreased from 86% in 2005 to around 60% in 2014. Simultaneously, the non-albicans rates increased from 14% in 2005 to around 40% in 2014, revealing 11 species, the most frequent of which were C. tropicalis, C. glabrata, and C. parapsilosis. All these demonstrated high resistance (35%-79%) against itraconazole, but remained uniformly susceptible (100%) to amphotericin B. Though C. albicans and the other species maintained high susceptibility against fluconazole and voriconazole, their MIC90 showed an elevated trend over time, and C. glabrata had the highest resistance rates. The observed rise in resistance among Candida spp. in Lebanon mandates the need for close surveillance and monitoring of antifungal drug resistance for both epidemiologic and treatment purposes.

Characterisation of Yeasts Isolated from 'Nduja of Spilinga.

The ‘Nduja of Spilinga protected geographical indication (PGI) is a spreadable italian salami, obtained by using fat (50%), lean of pork (25%), chili pepper (25%) and NaCl, stuffed into natural pork casing. Its predominant flora is represented by yeasts, reaching at the end of seasoning values of 6 log CFU/g. Considering the need to enhance and protect traditional local products, it seemed interesting to carry out a characterisation of yeasts of the ‘Nduja of Spilinga PGI. A total of 127 strains of yeast isolated from samples of ‘Nduja of Spilinga PGI (79 strains from samples at different days of curing and 48 from samples of commerce) was subjected to morphological identification, hydrolysis of urea, lipolytic activity and identification with API 20C AUX, ID 32C and simplified identification systems. One hundred twenty three (96.8%) strains were attributable to the phylum Ascomycetes (urease-negative), the remaining 4 strains (3.2%) were Basidiomycetes (urease-positive). Debaryomyces hansenii and its anamorph shape, Candida famata, represented the most prevalent species (61.42 and 17.32% respectively), followed by Candida glabrata (8.66%), Pichia (Candida) guilliermondii (5.17%), Candida parapsilosis and Rhodotorula glutinis (1.57%). Candida catenulata, Criptococcus uniguttulatus, Rhodotorula minuta, Candida zeylanoides and Candida utilis were observed with 0.79%. The lipolytic activity was observed only in 10 strains of D. hansenii and in one of C. zeylanoides. Further investigation will contribute to the selection of indigenous strains that could be used for the creation of specific starter, useful to improve the process of characterisation of the ‘Nduja of Spilinga and also to guarantee its safety.

Phylogenetic analysis and characterization of an alkane-degrading yeast strain isolated from oil-polluted soil

The isolation and phylogenetic analysis of new yeast strains represent an important basis for the development of practical applications in biotechnology, industry, and bioremediation. The yeast strain RG1 was isolated from oil-polluted soil and characterized using morphological observations and the API 20C AUX system. The amplified ITS1-5.8S rDNA-ITS2 region had 653 bp and the restriction profiles obtained with Cfo I, Dde I, Hae III, Hinf I, and Hpa II endonucleases showed high similarities with those from Rhodotorula glutinis reference strains. The phylogenetic tree based on the Cfo I patterns confirmed the classification of the strain RG1 as belonging to the R. glutinis species. The studies performed during the present work indicate the existence of different mechanisms of n-alkane assimilation and biodegradation in the RG1 cells and their correlation with the production of biosurfactants. An evaluation of the emulsifying activity revealed that biosurfactant-mediated assimilation of n-alkanes decreases in the order n-decane > n-tetradecane > n-hexadecane. Biodegradation and emulsification assays using culture media supplemented with 1% n-alkanes as the sole carbon source showed that n-tetradecane represented the optimal hydrocarbon substrate for the growth of the strain RG1 over 14 days and for obtaining biosurfactants at stable rates.

Asymptomatic oral yeast carriage and antifungal susceptibility profile of HIV-infected patients in Kunming, Yunnan Province of China

BackgroundOral Candida colonization and its relation with predisposing factors in HIV-infected patients have received wide concerns during recent decades. In this study, we investigated asymptomatic oral Candida carriage rate, species distribution and antifungal susceptibility of 604 HIV-infected patients and 851 healthy individuals in Kunming, Yunnan Province of China.MethodsMucosal swab sampling was taken from each subject and CHROMagar Candida agar medium and API 20C AUX system were used to identify yeast isolates. In vitro antifungal susceptibility was tested by the broth microdilution method according to the M27-A2 document of the Clinical and Laboratory Standard Institute (CLSI).ResultsThe oral yeast colonization rate in HIV-infected patients (49.5%) was higher than that of healthy subjects (20.7%). Candida albicans constituted the most frequent species, accounting for 82.2% of yeast isolates. The remaining species were composed of C. glabrata, C. parapsilosis, C. krusei, C. tropicalis, C. rugosa, C. norvegensis, Pichia ohmeri and Saccharomyces cerevisiae. In HIV-infected patients, asymptomatic oral yeast colonization was associated with low CD4 cell count (<200 cells/mm3) and lack of highly active antiretroviral therapy (HAART). Different Candida species isolated from our samples presented different susceptibility to voriconazole, fluconazole and itraconazole. Amphotericin B had the best inhibiting effect for all isolates.ConclusionOral yeast colonization in Han Chinese patients with HIV from Kunming had common and unique features and was associated with CD4 cell number and HARRT. Amphotericin B should be used with first priority in controlling Candida infection in Han Chinese patients from Kunming. Our results provide first hand information on monitoring oral yeasts colonization in HIV-infected patients from Kunming, China.

Comparison of VITEK 2 YST Card and API 20C AUX system in identification of non- albicans Candida species

Amac: Bu calismada cesitli klinik orneklerden soyutlanan Candida albicans disi mayalarin tur duzeyinde tanimlan-masinda VITEK 2 YST kart (bioMerieux, Fransa) kullanilarak elde edilen sonuclarin API 20C AUX (bioMerieux, Fran-sa) sistemi ile karsilastirilmasi amaclandi. Gerec ve yontem: Yirmi sekiz idrar, 10 kan, 3 vajinal akinti orneginden soyutlanan ve germ tup testi negatif olarak bulunan 41 C.albicans disi maya izolati VITEK 2 YST kart (bioMerieux, Fransa) ile tanimlandi. Ayrica misir unu-Tween 80 agardaki mikroskobik morfoloji ve API 20C AUX (bioMerieux, Fransa) ticari kiti ile yapilan karbonhidrat asimilasyonu degerlendirildi. Bulgular: Her iki sistemle izolatlarin 34\'u (%82.9) ayni tur olarak tanimlanirken, 7\'sinde (%17.1) farkli sonuclar elde edildi. API 20C AUX sistemi ile Candida glabrata olarak tanimlanan 5 izolat VITEK 2 YST kart ile Candida tropicalis (n:2), Candida krusei, Candida lipolitica ve Candida kefyr olarak, C.tropicalis olarak tanimlanan bir baska izolat Can-dida parapsilosis olarak, C.parapsilosis olarak tanimlanan bir diger izolat ise C.tropicalis olarak tanimlandi. Sonuc: VITEK 2 YST kart sistemi ile API 20C AUX sistemi arasinda C.albicans disi mayalarin tur duzeyinde tanim-lanmasinda buyuk oranda benzerlik bulunmasina karsin, ozellikle C.glabrata, basta olmak uzere C.tropicalis ve C.parapsilosis turlerinin tanimlanmasinda dikkatli olunmasi gerektigi kanaatine varildi.

Prediction of the Clinical Outcome in Invasive Candidiasis Patients Based on Molecular Fingerprints of Five Anti-Candida Antibodies in Serum

Better prognostic predictors for invasive candidiasis (IC) are needed to tailor and individualize therapeutic decision-making and minimize its high morbidity and mortality. We investigated whether molecular profiling of IgG-antibody response to the whole soluble Candida proteome could reveal a prognostic signature that may serve to devise a clinical-outcome prediction model for IC and contribute to known IC prognostic factors. By serological proteome analysis and data-mining procedures, serum 31-IgG antibody-reactivity patterns were examined in 45 IC patients randomly split into training and test sets. Within the training cohort, unsupervised two-way hierarchical clustering and principal-component analyses segregated IC patients into two antibody-reactivity subgroups with distinct prognoses that were unbiased by traditional IC prognostic factors and other patients-related variables. Supervised discriminant analysis with leave-one-out cross-validation identified a five-IgG antibody-reactivity signature as the most simplified and accurate IC clinical-outcome predictor, from which an IC prognosis score (ICPS) was derived. Its robustness was confirmed in the test set. Multivariate logistic-regression and receiver-operating-characteristic curve analyses demonstrated that the ICPS was able to accurately discriminate IC patients at high risk for death from those at low risk and outperformed conventional IC prognostic factors. Further validation of the five-IgG antibody-reactivity signature on a multiplexed immunoassay supported the serological proteome analysis results. The five IgG antibodies incorporated in the ICPS made biologic sense and were associated either with good-prognosis and protective patterns (those to Met6p, Hsp90p, and Pgk1p, putative Candida virulence factors and antiapoptotic mediators) or with poor-prognosis and risk patterns (those to Ssb1p and Gap1p/Tdh3p, potential Candida proapoptotic mediators). We conclude that the ICPS, with additional refinement in future larger prospective cohorts, could be applicable to reliably predict patient clinical-outcome for individualized therapy of IC. Our data further provide insights into molecular mechanisms that may influence clinical outcome in IC and uncover potential targets for vaccine design and immunotherapy against IC.