Candida Culture Research Articles

Fluconazole for Preventing Radiation-Induced Oral Mucositis: A Randomized Controlled Trial.

This study evaluated the efficacy of fluconazole prophylaxis in reducing radiation-induced oral mucositis (RIOM) and Candida carriage in head and neck cancer (HNC) patients undergoing concurrent chemoradiotherapy (CCRT). A prospective, double-blinded, randomized controlled trial was conducted with 78 HNC patients receiving either fluconazole (100 mg daily) or placebo during CCRT. The primary outcome was the incidence of grade 2 or higher RIOM. Secondary outcomes included positive Candida cultures and colony-forming units (CFUs). Mixed-effects ordinal logistic regression and logistic regression were used for analysis. Fluconazole significantly reduced the incidence of grade 2 or higher RIOM at week 7 (p = 0.039), positive Candida carriage at week 4 (p = 0.024) and week 7 (p = 0.029), and median CFUs at week 7 (p = 0.050). Fluconazole significantly reduces RIOM severity and Candida colonization in HNC patients undergoing CCRT, suggesting its efficacy as a prophylactic treatment.

In vitro activity of amphotericin B in combination with imipenem/colistin against mixed cultures of Candida spp. and Gram-negative bacteria.

A new direction of research was established due to biofilms' infections caused by a mixture of fungal and bacterial species. Diagnosis of these infections becomes more difficult and high doses of drugs are used in treatment, especially in critically ill patients. The aim of the current study was to examine the effects of amphotericin B, in combination with imipenem or colistin against Candida albicans - Acinetobacter baumannii- Proteus mirabilis and Candida tropicalis - Acinetobacter baumannii -Proteus mirabilis polymicrobial biofilms. According to the microdilution method of the Clinical Laboratory Standards Institute (CLSI) published in documents M27-A3 (2008) and M07-A10 (2015) respectively, the susceptibility of the clinical isolates Candida yeasts to amphotericin B and Gram-negative bacteria to imipenem and colistin was determined. A Checkerboard assay was employed to evaluate the efficacy of drugs combinations. The 3- (4,5-dimethylthiazol-2-yl) -2,5-diphenyl tetrazolium bromide (MTT) reduction assay was used to quantify the biofilms. The combination amphotericin B/colistin and amphotericin B/imipenem did not produce obvious effects against the polymicrobial biofilms formed for 48 hours. Whereas colistin alone produced strong effects against Candida albicans-Acinetobacter baumannii and Candida albicans - Acinetobacter baumannii -Proteus mirabilis compared to Candida tropicalis - Acinetobacter baumannii and Candida tropicalis - Acinetobacter baumannii - Proteus mirabilis polymicrobial biofilms. For mixed Candida spp. bacterial biofilms, these results point to the difficulties in eradicating these biofilms, as well as in preventing their development.

Species distribution and antifungal susceptibility patterns of Candida involvement in pediatric solid organ transplant recipients: A cross-sectional study from a single transplant center

The epidemiology and resistance patterns of Candida infections in pediatric kidney/liver recipients has not been well characterized, recently. In this study, all patients ≤ 18 years old who underwent liver/kidney transplant surgery between September 2021 and 2022 were included. Species identification of isolates recovered from clinical specimens was performed by DNA-sequencing method following amplification of the ITS1–5.8S–ITS2 regions. Antifungal susceptibility patterns of isolates were performed using the micro broth dilution method documented by Clinical & Laboratory Standards Institute (CLSI) guidelines. Of the 117 pediatric recipients enrolled, 16 recipients (13.7 %) had at least one positive Candida culture. Candidemia was detected in 5/89 (5.6 %) of liver and 1/28 (3.6 %) of kidney transplant recipients. Invasive candidiasis was observed in 6/89 (6.7 %) of liver and 2/28 (7.1 %) of kidney transplant recipients. The predominant species was Candida (C.) albicans recovered from 12 of 16 recipients (75 %). In addition to the Pichia kudriavzevii species with inherent resistance to fluconazole, one of C. albicans isolates and one C. tropicalis isolate were also identified as fluconazole-resistant (3/29:10.3 %). Moreover, our findings revealed 13.8 % and 6.8 % resistance to itraconazole and voriconazole, respectively. All Candida spp. were susceptible to caspofungin. Collectively, this study provides valuable insights into the epidemiology and resistance patterns of Candida infections in pediatric kidney and liver recipients. The study also highlights the emergence of fluconazole-resistant strains, which has significant implications for antifungal stewardship efforts in pediatric transplant populations.

Infective Endocarditis in the Young, Risk Profile, Patient Demographics and Hospital Outcome during Hospital Stay. Registry among Ain Shams University Hospitals

Abstract Background Infective endocarditis (IEC) is a serious and potentially life-threatening condition if left untreated. Objective To identify demographics, risk profile and hospital outcome during hospital stay of young patients with infective endocarditis admitted to Ain Shams University Hospitals. Patients and Methods We developed a registry to describe patient demographics, risk factors, clinical features, and hospital outcomes for all cases of infective endocarditis diagnosed using modified Duke's criteria referred to Ain Shams University in Egypt over a six-month period. Results We collected 72 confirmed cases of infective endocarditis that presented to Ain Shams University hospitals over a six-month period (from August 2023 to January 2024). We observed that the mean age was 35 years [(87.5 %) males and (12.5%) females]. Among them, (70.8%) were smokers, (68.1%) were IV drug users. Three main substances that were used were opioids, heroin and cocaine. Only two patients were diabetic, five were hypertensive and one was diagnosed with chronic kidney disease before admission. The most common predisposing factors were IV drug use in (65%), rheumatic heart disease in (22%), followed by patients that had underwent an invasive procedure (16.7%), those who had a recent dental procedure (16.7%), and lastly patients born with congenital heart defects (11.1%). Positive blood cultures were encountered in (95.8%) of patients, with the most common organism being Staphylococcus Aureus in (52.8%) of cases. Three patients had positive fungal cultures for Candida. Most common antibiotics that were used were vancomycin (47.2%), gentamycin (50%), line (27.8%), ampicillin and sulbactam (18.1%), teicoplanin (8%). The three patients that had positive fungal cultures for Candida showed sensitivity for fluconazole. Concerning our echocardiographic findings, we noticed that at least one vegetation was present in every patient. Most patients had only one vegetation (72.2%), the rest had two vegetations. 62 patients (83.3%) had vegetations over 10mm. Native valve affection was present in 63 patients (87.5%) while prosthetic valve affection was in 4 patients representing (5.6%) of patients, VSD related vegetation was in (4.2%) and CIED vegetations represented (2.8%) of all studied patients. Two patients experienced valvular complications, one patient had a mitral valve perforation and the other had a paravalvular leak after recent valve replacement. Pericardial effusion was present in (8.3%) of the studied patients, it was mild in (4.2%), moderate in (2.8%) and severe in (1.4%) of cases All patients had elevated CRP and ESR on admission. Regarding viral markers, (48.6%) were negative for HBV, HCV and HIV. However, (40.3%) had positive viral markers from which 29 were HCV only positive, 2 were HBV only positive, 2 were HIV only positive and 4 were positive for both HBV and HCV. Concerning the outcome of the patients, (81.9%) of patients continued their course of treatment and discharged while in-hospital mortality represented (18.1%). Conclusion Our study revealed that the first cause of infective endocarditis in the studied young population was IV addiction. Also, it revealed that the most common organism was staphylococcus aures.

Bridging Echinocandin With Azole Antifungal Therapy on Prevention of Invasive Candidiasis Post-Lung Transplantation.

Invasive candidiasis (IC) is a significant factor for lung transplant recipient (LTR) mortality, especially in the immediate postoperative phase. Receipt of antifungal prophylaxis has demonstrated lower all-cause mortality. This was a single-center, retrospective cohort study of LTRs between August 2017 and August 2020. Included patients were adult LTRs with positive Candida cultures preoperatively (donor or recipient) or within 6 weeks postoperatively. Patients were divided into 2 cohorts-bridged and unbridged. The bridged cohort received micafungin in the postoperative period until therapeutic azole concentrations were achieved or up to 2 weeks, whichever was sooner. The primary outcome was a composite of proven or probable invasive candidiasis. A total of 117 patients were included in the study, with 68 in the unbridged cohort and 49 in the bridged cohort. There were more cases of IC in the bridged cohort than in the unbridged cohort (P = .011). In combination with an azole antifungal, micafungin did not prevent IC in postoperative LTRs with cultures positive for Candida species in this cohort. Larger prospective studies are needed to determine the ideal combination and duration of antifungal prophylaxis.

Treatment Outcomes Among Patients With a Positive Candida Culture Close to Randomization Receiving Rezafungin or Caspofungin in the ReSTORE Study.

Rezafungin, a novel, once-weekly echinocandin for the treatment of candidemia and/or invasive candidiasis (IC) was noninferior to caspofungin for day 30 all-cause mortality (ACM) and day 14 global cure in the phase 3 ReSTORE trial (NCT03667690). We conducted preplanned subgroup analyses for patients with a positive culture close to randomization in ReSTORE. ReSTORE was a multicenter, double-blind, double-dummy, randomized trial in patients aged ≥18 years with candidemia and/or IC treated with once-weekly intravenous rezafungin (400 mg/200 mg) or once-daily intravenous caspofungin (70 mg/50 mg). This analysis comprised patients with a positive blood culture drawn between 12 hours before and 72 hours after randomization or a positive culture from another normally sterile site sampled between 48 hours before and 72 hours after randomization. Efficacy endpoints included day 30 ACM, day 14 global cure rate, and day 5 and 14 mycological response. Adverse events were evaluated. This analysis included 38 patients randomized to rezafungin and 46 to caspofungin. In the rezafungin and caspofungin groups, respectively, day 30 ACM was 26.3% and 21.7% (between-group difference [95% confidence interval], 4.6% [-13.7%, 23.5%]), day 14 global response was 55.3% and 50.0% (between-group difference, 5.3% [-16.1%, 26.0%]), and day 5 mycological eradication was 71.1% and 50.0% (between-group difference, 21.1% [-0.2%, 40.2%]). Safety was comparable between treatments. These findings support the efficacy and safety of rezafungin compared with caspofungin for the treatment of candidemia and/or IC in patients with a positive culture close to randomization, with potential early treatment benefits for rezafungin.

Risk factors for the development of candidemia in patients with positive urine surveillance culture for Candida spp.

The objective of the study was to characterize candiduria in patients admitted to a tertiary hospital and establish the risk factors associated with the development of candidemia. To this end, a laboratory and clinical surveillance study was carried out with samples of Candida spp. previously isolated from urine surveillance cultures of patients admitted to the Intensive Care Unit, during the period from 2019 to 2020. It was demonstrated that the incidence of candidemia in patients with positive urine cultures for Candida spp. it was 17.7 per 1000 admissions and 80% of patients who developed candidemia died. The chance of developing candidemia was eight times greater in patients who had diseases of the digestive system that caused hospitalization and 26 times greater in those who had Coronary Artery Disease (CAD), compared to patients who did not have the comorbidity. We concluded that the possibility of developing candidemia from candiduria is 4.5%, however, the onset of candidemia, regardless of the source, worsens the patient's prognosis.

Guideline Adherence and Outcomes of Patients with Candidemia in Brazil.

Candidemia is a significant cause of mortality among hospitalized patients, both worldwide and in Brazil. Prompt and appropriate treatment are essential to mitigate mortality, and clinical practice guidelines aim to optimize patient care based on the best scientific evidence. This study aims to examine the management of candidemia, assessing adherence to the guidelines of the Brazilian Society of Infectious Diseases in a single center located at São Paulo, Brazil. All adult patients hospitalized from 2016 to 2018 who presented one positive blood culture for Candida spp. were included. Electronic medical records were retrospectively reviewed to collect information relevant to the treatment for candidemia, in order to assess the adherence to the Brazilian guideline for the management of candidemia in relation to nine defined outcomes, and we correlated those findings with 30-day mortality by using uni- and multivariate analyses. A total of 115 patients were included; 68 patients (59.1%) were male, with a mean age of 55 years. C. albicans, C. tropicalis and C. glabrata were the most prevalent species. In total, 80 patients (69.5%) received antifungal treatment. The adherence to Brazilian guideline recommendations was determined as described in the following: initial treatment with echinocandin in 48 (60%); step-down to fluconazole in 21 (26.2%); collection of first control blood culture in 43 (58.9%); collection of second control blood culture, if the first one had been positive, in 14 (73.6%); treatment for 14 days after the first negative blood culture in 53 (65.4%); central venous catheter (CVC) removal in 66 (82.5%); CVC removal if the first control blood culture had been positive in 17 (89.4%); performance of a transthoracic echocardiogram in 51 (63.7%) and performance of a fundoscopy in 59 (73.7%). Univariate analysis showed that CVC removal and initial echinocandin therapy were more prevalent in the surviving group, but with no statistically significant difference. On the other hand, step-down to fluconazole demonstrated higher survival rate in the multivariate analysis OR 0.15 (95% CI 0.03-0.8); p = 0.02. The analysis of these nine recommendations demonstrates that it is necessary to improve adherence to specific recommendations and also disseminate strategies of the initial use of echinocandin as the drug of choice and addressing length of treatment and follow-up and complementary exams. Our study provides reassurance that the step-down to fluconazole is safe and may be recommended, if the preexisting conditions are present.

Prediction of candidemia in pediatric patients based on central venous catheter: Real world evidence to guide antifungal empirical prescription

Background: Candida is one of the main etiological agents of bloodstream nosocomial infections, and is associated with high morbidity/mortality in children. High use of empirical antifungals incurs in higher health care costs and concerns on emergent resistant Candida spp. Therefore, a prediction model should optimize prescribing empirical antifungals in pediatrics. Objective: Based on real-world evidence data, we aimed at assessing how accurate is a regression model for predicting central venous catheter (CVC) candidemia in pediatric patients. We also explored how this prediction model might be useful for prescribing antifungals empirically. Methods: A case-control study was conducted based on 144 patients with positive and negative blood cultures for Candida spp.. A model for predicting Candida spp. was developed through univariate and multivariate analyses (logistic regression). Data were reported as odds ratio (OR) and p-value less than 0.05 was considered statistically significant. Results: Candidemia was predicted by the presence of CVC (OR 2.561, p=0.0042). For this model, an area under the curve (AUC) of 0.550 (p=0.314) was estimated, representing the Receiver Operating Characteristic curve of the present study, with a sensitivity of 86% and a specificity of 24%. Conclusion: Our study demonstrated that CVC is a fragile predictor for candidemia, however, its clinical significance and low specificity obtained in the ROC curve suggests that other covariates rather than those investigated should be considered to assess its impact on a prediction model for pediatric patients.

In - Vitro Study on Anti Fungal Activity of Various Potencies of Sepia Against Candida Albicans

In this study , we have tested the ability of Sepia to limit the growth of a Candida culture. The current study's objective is to evaluate the effects of this drug on the fungus at various potencies. For almost two decades, homoeopaths have worked to establish the existence of the miraculous potential of little doses. The overall purpose of all of this research is to demonstrate, through in-vitro modifications, how Sepia acts on Candida fungus. The disc diffusion assay was used to evaluate the antifungal activity. Using a micropipette, a known volume of 10 μL of sepia of potency 200 C and 1M was loaded over small, circular, sterile paper discs (6mm in diameter) that had been impregnated in SDA plates. The plates were left at room temperature so that the sample could be absorbed into the medium before being incubated there for 24 to 48 hours. In order to assess the antifungal activity, the diameter of inhibition zone is measured. Itraconazole is used as positive control and ethanol as negative control.

The Prevalence of Non-albicans Candida and Candida Mixed-species in Vulvovaginal Candidiasis in Northeast Iran

Background: Vulvovaginal candidiasis (VVC) is a prevalent infectious disease that affects the majority of women. While Candida albicans is the most common cause of VVC, the prevalence of non-albicans species is increasing, and mixed infections have made treatment more challenging. This study aimed to identify Candida species and detect mixed infections in women with VVC in a tropical region of northeastern Iran, employing the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Methods: In the prospective study, a total of 270 specimens of vaginal discharge were collected using sterile swabs from patients suspected of having VVC. After extracting DNA from Candida colonies, the genome was amplified using PCR with specific primers. Species identification was conducted through PCR-RFLP analysis of the ribosomal DNA internal transcribed spacer (ITS) regions, using the MspI restriction enzyme. Results: Out of the 270 specimens suspected of VVC, 167 tested positive for Candida cultures. Among these positive Candida cultures, Candida species were identified in 150 specimens, with 44 (29.3%) showing evidence of mixed Candida infections. The species of Candida in 17 specimens were not identified. Out of the 190 identified Candida isolates included, the distribution was as follows: 85 (44.8%) C. albicans, 39 (20.5%) C. glabrata, 28 (14.7%) C. guilliermondii, 11 (5.8%) C. kefyr, 11 (5.8%) C. parapsilosis, 8 (4.2%) C. tropicalis, and 8 (4.2%) C. krusei. The mixed Candida species combinations observed were as follows: C. albicans/C. guilliermondii 26 (65%), C. albicans/C. kefyr 4 (10%), C. parapsilosis/C. glabrata 4 (10%), C. parapsilosis/C. tropicalis 4 (10%), C. krusei/C. tropicalis 2 (5%), C. albicans/C. parapsilosis 1 (2.5%), C. albicans/C. krusei 1 (2.5%), C. glabrata/C. guilliermondii 1 (2.5%), and C. kefyr/C. tropicalis 1 (2.5%). Conclusions: In women with VVC in the tropical region of northeastern Iran, the prevalence of clinical non-albicans species is higher than that of C. albicans. Furthermore, there is a notable high prevalence of clinical specimens containing mixed Candida infections.

Role of source control in critically ill candidemic patients: a multicenter retrospective study

PurposeCandidemia is associated with high mortality especially in critically ill patients. Our aim was to identify predictors of mortality among critically ill patients with candidemia with a focus on early interventions that can improve prognosis.MethodsMulticenter retrospective study.SettingThis retrospective study was conducted in Intensive Care Units from three European university hospitals from 2015 to 2021. Adult patients with at least one positive blood culture for Candida spp. were included. Patients who did not require source control were excluded. Primary outcome was 14-day mortality.ResultsA total of 409 episodes of candidemia were included. Most candidemias were catheter related (173; 41%), followed by unknown origin (170; 40%). Septic shock developed in 43% episodes. Overall, 14-day mortality rate was 29%. In Cox proportional hazards regression model, septic shock (P 0.001; HR 2.20, CI 1.38–3.50), SOFA score ≥ 10 points (P 0.008; HR 1.83, CI 1.18–2.86), and prior SARS-CoV-2 infection (P 0.003; HR 1.87, CI 1.23–2.85) were associated with 14-day mortality, while combined early appropriate antifungal treatment and source control (P < 0.001; HR 0.15, CI 0.08–0.28), and early source control without appropriate antifungal treatment (P < 0.001; HR 0.23, CI 0.12–0.47) were associated with better survival compared to those without neither early appropriate antifungal treatment nor source control.ConclusionEarly source control was associated with better outcome among candidemic critically ill patients.

Red/Orange Autofluorescence in Selected Candida Strains Exposed to 405 nm Laser Light.

Candida albicans and similar species are significant pathogens in immunocompromised and hospitalized individuals, known for mucosal colonization and bloodstream/organ invasion. Many pathogenic fungi, including these species, exhibit autofluorescence (R/OF) under specific light conditions, a feature crucial for their detection. We investigated the use of a 405 nm diode laser for the direct observation of red/orange autofluorescence of Candida spp., common in the oral cavity, exploring its potential in health screenings. This study utilized cultures of Candida spp. on Sabouraud dextrose agar with Qdot 655 and 685 for fluorescence benchmarking, illuminated using a 405 nm diode laser (continuous wave, power 250 mW, 0.0425 J/cm² fluence, 0.0014 W/cm² power density). Images were captured using a yellow-filter camera at set intervals (48 to 144 h). Visual and computational analyses evaluated the R/OF in terms of presence, intensity, coloration, and intra-colony variation. Most Candida strains displayed red/orange autofluorescence at all observation times, characterized by varied coloration and intra-colony distribution. Initially, there was an increase in R/OF intensity, which then stabilized in the later stages of observation. The majority of the Candida strains tested are capable of emitting R/OF under 405 nm laser light. This finding opens up new possibilities for integrating R/OF detection into routine dental screenings for Candida spp.

Burden of Candida-related vascular graft infection: a nested-case control study.

We aimed to assess risk factors of candida-related Vascular Graft Infections (VGIs). We did a case-control study (1:4) matched by age and year of infection, nested in a cohort of patient with a history of VGIs. Cases were defined by a positive culture for Candida spp. in biological samples and controls were defined by a positive culture for bacterial strains only in biological samples. Risk factors for Candida-related VGIs were investigated using multivariate logistic regression. Mortality were compared using survival analysis. 16 Candida-related VGIs were matched to 64 bacterial-related VGIs. The two groups were comparable regarding medical history and clinical presentation. Candida-related VGIs were associated with bacterial strains in 88% (14/16). Gas/fluid-containing collection on abdominal CT scan and the presence of an aortic endoprosthesis were risk factors for Candida spp.-related VGIs [RRa 10.43 [1.81-60.21] p = 0.009 RRa and 6.46 [1.17-35.73] p = 0.03, respectively]. Candida-related VGIs were associated with a higher mortality when compared to bacterial-related VGIs (p = 0.002). Candida-related VGIs are severe. Early markers of Candida spp. infection are needed to improve their outcome. The suspicion of aortic endoprosthesis infection may necessitate probabilistic treatment with antifungal agents.

Endogenous Fungal Endophthalmitis: A Single-Center Retrospective Study and Review of the Literature

To evaluate factors that inform systemic antifungal choices in patients with endogenous fungal endophthalmitis (EFE). Single-institution retrospective case series. Charts of EFE patients from 2010 to 2023 were reviewed. Patients treated systemically for EFE with a minimum of 14 days of follow-up were included. Outcome measures included time to improvement in vitritis or chorioretinitis, systemic therapy modification, and need for surgical intervention. A total of 20 eyes of 16 patients were included. Candida species were most common (43.8%), followed by culture-negative EFE (37.5%) and Aspergillus species (18.8%). In all, 90% of eyes had vitritis and/or macula-involving chorioretinitis. The majority of Candida infections (60%) or culture-negative EFE (75%) were treated initially with oral antifungals. Patients with a history of immune compromise, positive fungal culture, or positive Fungitell assay were more likely to be treated with early intravenous (IV) antifungal therapy. Two patients required systemic antifungal therapy modification because of worsening chorioretinitis, in 1 case due to voriconazole-resistant Aspergillosis that demonstrated chorioretinal lesion growth despite intravitreal amphotericin B injections and systemic voriconazole, and in the second case due to worsening chorioretinitis from Candida dubliniensis infection that regressed upon switch from oral to IV fluconazole. Initial systemic treatment decisions in patients with EFE were driven by systemic culture positivity, systemic symptoms, or comorbidities. Intravitreal antifungal therapy may be insufficient to arrest progression of chorioretinal lesions in some cases. Larger studies are needed to determine whether visible end-organ damage in the form of chorioretinitis may be useful for guiding systemic therapy changes.

Oral Findings, Salivary Copper, Magnesium, and Leptin in Type II Diabetic Patients in Relation to Oral Candida Species.

Type 2 diabetes is a condition in which the body becomes resistant to the effects of insulin, leading to reduced insulin production in the pancreas. It has genetic- and family-related risk factors that cannot be changed, along with modifiable lifestyle factors. The precise genetic causes of type 2 diabetes are still unknown. However, individuals can potentially slow or stop the progression of the condition by making dietary adjustments and increasing physical activity levels. Material and Methods. Forty-five type II diabetic patients in the study included participants between 40 and 60 years old, with a minimum duration of one year, as well as 45 healthy control subjects who were matched in terms of age and sex, and had no underlying systemic diseases. Oral examination is done for the symptoms including burning sensation, candidiasis, and a reduction in the production of saliva. The rate of saliva flow (in milliliters per minute) was measured in samples of saliva that were not stimulated. The salivary trace elements and levels of adipocytokines were evaluated using colorimetric and Ethylenediaminetetraacetic acid (ELISA) testing. The quantification of Candida colony numbers, an enrichment and culture approach, was used to achieve a concentration of 100,000 colony-forming units per milliliter (CFU/ml). The ShowNovo WG1 halimeter was used to measure volatile sulfur compounds in breath. The salivary glucose oxidase assay was conducted using a colorimetric technique, while the determination of trace elements was also performed using a colorimetric assay method. The diabetic group exhibited a significant increase in the number of Candida spp colonies due to elevated levels of glucose in the saliva (p > 0.05). However, the variables being examined, such as body mass index (BMI), burning mouth syndrome (BMS), salivary flow rate (SFR), salivary leptin, salivary copper, and salivary magnesium, did not exhibit any significant variations in quantities between the diabetic and healthy groups (p > 0.05). The data collected in this research aid in the creation of a preventative program for oral fungal infections in individuals with type 2 diabetes. The program utilizes saliva and its constituents.

The Prevalence of Candida Species among HIV-Positive Women in Aluu, Nigeria: A Call for Awareness

Background: The acquired immune deficiency syndrome (AIDS), which HIV brings on, is a major public health concern. The human immunodeficiency virus (HIV) is still a pandemic. Only 2.1% of HIV cases worldwide are recorded in Nigeria. Usually, under the control of the immune system, Candida infections may be dangerous for immunocompromised people, particularly those living with HIV/AIDS.&#x0D; Aim: At the Mbodo Health Centre in Aluu, Rivers State, Nigeria, this study aimed to assess the prevalence of Candida infections and their relationship to HIV-positive patients.&#x0D; Methods: Fifty HIV-positive women were chosen at random. Self-collected oral and vaginal swabs were used to gather data. To identify Candida species, biochemical testing, culture, and microscopy were used.&#x0D; Results: Eighty percent of the 50 individuals had positive candidiasis tests. Oral and vaginal mono/co-candidiasis were found to be common, with Candida albicans being the most common specie. Based on demographic parameters, statistical analysis did not show a significant difference in the prevalence of oral candidiasis. The frequency of vaginal candidiasis was much greater in those with secondary education and aged 31-40 years. The age group of 31 to 40 years old had a considerably greater co-occurrence rate of oral and vaginal candidiasis. Adult female HIV-positive patients at Mbodo Health Centre have a significant prevalence of candidiasis.&#x0D; Conclusion: The study sheds light on the distribution of Candida species and how demographic variables relate to them. These results highlight the significance of treating candidiasis as a serious health issue in people living with HIV. To improve overall health outcomes for HIV-positive people and reduce related risk factors, further research and treatments may be required.

Development of Short-term Membrane-based Cultivation Combined with Dual-target Melting Analysis for Rapid Differentiation of Common Candida Species

Background: Candida is the main causative agent of severe mucosal and invasive candidiasis. Different species of Candida have shown varying levels of resistance to antifungal treatments. It is estimated that each 12-hour delay in antifungal treatment is associated with a significant increase in patient mortality and treatment costs. The culture method is regarded as the gold standard for identifying Candida species, but its time-consuming process is a clear disadvantage. Objectives: This study established a method using membrane technology combined with dual-target melting analysis for rapid cultivation and identification of common Candida species. This method is expected to preserve the advantages of the conventional culture method and improve upon its weaknesses while also evaluating the practical application of the method. Methods: A microfiltration membrane-based culture followed by a color indicator method was established to rapidly cultivate Candida cultures. The 5.8S ribosomal DNA region and internal transcribed spacer 2 (ITS2) region were used as target gene regions, for which two sets of primers were employed. Melting analysis following dual-target real-time polymerase chain reaction (PCR) was conducted to distinguish among Candida albicans, C. tropicalis, C. glabrata, and C. krusei. To evaluate its practical application, the method was tested with 72 clinical isolates, and the results were compared with those obtained using the chromogenic culture method and DNA sequencing. Results: Distinctive melting temperatures in the two gene targets were detected among the four common Candida species. The entire process, from cultivation to identification, was completed within 12 hours, about 50% less time than the gold-standard method. The minimum detection limit of Candida species was 10 femtograms. The results of the identification of the clinical isolates were consistent with those of DNA sequencing. Conclusions: The short-term membrane-based cultivation combined with dual-target melting analysis can be used to rapidly, easily, and accurately identify common Candida species, thus reducing the time needed to initiate targeted treatment for patients with severe candidiasis.

Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management.

Fungal endocarditis accounts for 1% to 3% of all infective endocarditis cases, is associated with high morbidity and mortality (>70%), and presents numerous challenges during clinical care. Candida spp. are the most common causes of fungal endocarditis, implicated in over 50% of cases, followed by Aspergillus and Histoplasma spp. Important risk factors for fungal endocarditis include prosthetic valves, prior heart surgery, and injection drug use. The signs and symptoms of fungal endocarditis are nonspecific, and a high degree of clinical suspicion coupled with the judicious use of diagnostic tests is required for diagnosis. In addition to microbiological diagnostics (e.g., blood culture for Candida spp. or galactomannan testing and PCR for Aspergillus spp.), echocardiography remains critical for evaluation of potential infective endocarditis, although radionuclide imaging modalities such as 18F-fluorodeoxyglucose positron emission tomography/computed tomography are increasingly being used. A multimodal treatment approach is necessary: surgery is usually required and should be accompanied by long-term systemic antifungal therapy, such as echinocandin therapy for Candida endocarditis or voriconazole therapy for Aspergillus endocarditis.

Clinical Evaluation of Polymerase Chain Reaction Coupled with Quantum Dot Fluorescence Analysis for Diagnosis of Candida Infection in Vulvovaginal Candidiasis Practice.

Time-consuming culture methods and wet-mount microscopy (WMM) with low sensitivity have difficulties in diagnosing Vulvovaginal candidiasis (VVC). Rapid and highly sensitive polymerase chain reaction coupled with quantum dot fluorescence analysis (PCR-QDFA) for the diagnosis of VVC has not been reported to date. This study was the first to evaluate the performance of PCR-QDFA for diagnosis of Candida strains in the leukorrhea samples from patients with suspected VVC. Leukorrhea samples from all visited patients were taken from the vagina using vaginal swabs by clinicians. We evaluated patients admitted with suspected VVC who completed WMM for diagnosis and reported the diagnostic effectiveness of PCR-QDFA and Candida culture (gold standard) when testing leucorrhea samples. A total of 720 leukorrhea samples from 387 VVC-positive patients and 333 VVC-negative patients were included in this study. Of the 387 leukorrhea samples from the VVC-positive patients, 391 Candida strains were identified by culture. 99.23% (388/391) Candida strains were included in the PCR-QDFA list. The 388 Candida strains belonged to four different species of Candida, including C. albicans (n = 273, 70.36%), C. glabrata (n = 85, 21.91%), C. tropicalis (n = 16, 4.12%), and C. krusei (n = 14, 3.61%). PCR-QDFA diagnosed Candida strains in 340/384 (88.54%) of the leucorrhea samples with Candida strains infection. The sensitivity of PCR-QDFA for C. albicans, C. glabrata, C. tropicalis, and C. krusei was 89.01%, 85.88%, 81.25% and 92.86%, respectively. The specificity of PCR-QDFA for C. albicans, C. glabrata, C. tropicalis and C. krusei was 93.69%, 99.37%, 99.71%, and 99.57%, respectively. The highly sensitive and specific PCR-QDFA technique can be exploited as a rapid (approximately 4 h) diagnostic tool for common Candida strains of leucorrhea samples from patients with suspected VVC.