Isolates Of Candida Species Research Articles

Prevalence and species distribution of Candida bloodstream infection in children and adults in two teaching university hospitals in Egypt: first report of Candida kefyr

BackgroundCandidemia is a pervasive problem associated with significant morbidity and mortality in health care settings. This study aimed to determine the changing distribution of Candida species and the emergence of uncommon species.MethodsThis was a cross-sectional study performed in two Cairo University hospitals between 2019 and 2020. All Candida species isolates recovered from blood cultures of adults and pediatrics patients admitted to the hospitals were included. Candida isolates were identified by chromogenic Candida agar and Vitek2 YST identification card. Candida kefyr was confirmed by chip array.ResultsCandida species were responsible for 1.6% of bloodstream infections in adults and 10.8% in pediatric patients. C. albicans was the most prevalent species representing 27.8% in adults and 48.3% in pediatrics. Non-albicans species (NAC) represented the most isolated Candida species among adults and pediatrics (72.2% and 51.6%, respectively) with the predominance of C. tropicalis (27.8% and 22.5%, respectively) followed by C. parapsilosis (16.7% and 10.8%, respectively). The uncommon Candida, which is Candida species other than C. albicans, C. parapsilosis, C. tropicalis, C. glabrata, and C. krusei, represents 16.6% and 14% of all candidemia in adults and pediatrics, respectively. Only one of each of C. lusitaniae, C. utilis, and C. kefyr were detected in adults. C. lusitaniae was the most frequently recovered uncommon Candida among pediatrics resulting in 6.4% of candidemia followed by C. famata (4.3%), C. utilis (2.2%), and C. kefyr (1.1%).ConclusionsC. albicans is still the primary species isolated from pediatrics and adults with candidemia despite the considerable shift to the non-albicans species. C. tropicalis and C. parapsilosis are the most prevalent NAC. The increased prevalence of uncommon Candida species is alarming and necessitates a prompt stewardship program.

ABNORMAL VAGINAL DISCHARGE IN REPRODUCTIVE AGE GROUP WOMEN WITH SPECIAL IMPLICATION TO ANTIFUNGAL SUSCEPTIBILITY OF CANDIDA SPECIES

Introduction And Background: Vaginal discharge is a common complaint in reproductive age group women2. Vaginal discharge is one of the common reasons in women of reproductive age group seeking gynecological consultation. It is the second most common clinical problem after menstrual disorders. Globally, it is estimated that one in ten women will present with vaginal discharge in the course of one year and approximately, ten million office visits each year are attributed to vaginal discharge complaints. The prevalence of vaginal discharge in India is estimated to be 30%3. Ÿ Abnormal vaginal discharge predisposes to significant morbidity to the women in the form of pelvic inflammatory disease, infertility, endometriosis, cuff cellulitis, urethral syndrome, pregnancy loss, and preterm labour.5 Ÿ Certain conditions such as prolonged use of combined oral contraceptive, pregnancy, malnutrition, diabetes, neutropenia, prolonged antibiotic therapy, candida become pathogenic and causes candidiasis.8 Ÿ Isolation, identification, characterization, and susceptibility of candida species became critical management of fungal infections.9 Need For The Study: The study was done to emphasize the role of laboratory investigations in patients with vaginitis, as presumptive clinical diagnosis alone can lead to false interpretation and treatment mismanagement. TheMethods: present study is a cross sectional observational study conducted from January 2019 to February 2020 for about a period of one year among 300 women aged 15-49 years with vaginal discharge attending gynecology OPD, Government Maternity Hospital, Tirupati. This study included 300 subjects with a mean age of 30.4 ± 7.26 years. Nearly halfResults: of (49.33%) our study population was aged between 25 to 34years, a majority (47%) of women had bacterial vaginosis, followed by Candida in 39.33%, trichomonas vaginalis in 14.33%, mixed infections in 6.67% and 6% with no organisms. Among Candida species, 48.31% of participants had candida albicans, 23.73% had candida tropicalis, 19.49% had candida krusei, and 8.47% had candida glabrata, and of them 38.33% participants had voriconazole sensitivity, 32.33% participants had ketoconazole sensitivity, 26% participants had clotrimazole sensitivity, and 21.33% participants had fluconazole sensitivity. Among 118 candida infected 106 (89.83%) participants came for follow-up, of which symptoms subsided in 90 (84.91%) participants. In conclusion, our study with 300 women patients complaining ofConclusion: vaginal discharge found a majority of them belonging to the sexually active age group. Vaginal discharge was more prevalent in lower economic status and rural areas. Bacterial vaginosis was the most common and frequent etiology, followed by Candida. TV was the least common etiology for vaginal discharge.

Antifungal activity of eugenol and clove leaf essential oil (Syzygium aromaticum L.) against clinical isolates of candida species

Candida species are causative microorganisms of oropharyngeal, vulvovaginal, and skin infections. Clove (Syzygium aromaticum L.) and eugenol oil have considerable antifungal activity against human pathogenic fungi, including Candida species. The anticandidal action of the studied oils is significantly dependent on the concentration of eugenol and further main and minor constituents of the oils with well-known antifungal effects must have additional and synergistic activities. This study was conducted to compare the antifungal activity of clove leaf essential oil (Syzygium aromaticum L.) and eugenol to determine the role of the content other than eugenol in clove leaf essential oil as an antifungal against Candida species isolates from HIV-AIDS patients. Methods: This study is an in vitro test using the disk diffusion method to determine the zone of inhibition of clove leaf essential oil (Syzygium aromaticum L.) concentrations of 5%, 10%, and 15% as well as eugenol which was equivalent to the concentration of eugenol in clove leaf essential oil at concentrations of 5%, 10% and 15% in 40 isolates of Candida species.

Comparison of antifungal activity of fluconazole and clove leaf essential oil on Candida species isolate in HIV/AIDS patients with oral candidiasis

Current treatment guidelines include fluconazole as the main therapeutic option for treating oral candidiasis infection in HIV/AIDS patients, but resistance increases. Several in vitro studies have shown that clove leaf essential oil with the main content of eugenol can be an alternative therapy for oral candidiasis that is resistant to fluconazole. This study was conducted to determine the zone of inhibition of clove leaf essential oil and fluconazole against Candida isolates species that cause oral candidiasis in HIV/AIDS patients. This study showed that the average fluconazole disk 25 μg/mL inhibition zone in 20 isolates of Candida albicans species was larger than non-albicans Candida species. The zone of inhibition of clove leaf essential oil was significantly lower than that of fluconazole (p < 0.05), except at a concentration of 15% against non-albicans Candida isolates. Clove leaf essential oil has an antifungal effect that can inhibit the growth of Candida species, so it can be considered an alternative antifungal therapy. Clove leaf essential oil concentration of 15% showed no significant difference in antifungal activity with the standard drug fluconazole in isolates of non-albicans Candida species.

Comparison of simulated candidemia detection during prophylactic antifungal therapy

BackgroundWe investigated the neutralization performance of various automated blood culture systems for antifungal agents with regard to the most commonly isolated Candida species. MethodsIn this study, we evaluated the time to detection (TTD) of simulated candidemia for 6 Candida spp. (C. albicans, C. auris, C. glabrata, C. krusei, C. parapsilosis, and C. tropicalis) in 3 automated blood culture systems (BACTEC™ FX, BACT/ALERT® 3D, and BACT/ALERT® VIRTUO®), with or without trough and peak levels of eight antifungal agents (amphotericin B, anidulafungin, caspofungin, fluconazole, itraconazole, micafungin, posaconazole, and voriconazole). ResultsCaspofungin and micafungin significantly prolonged the TTDs for most of the tested strains in the 3 blood culture instruments, especially at peak concentrations. ConclusionPeak concentrations of caspofungin and micafungin influence the performance of blood culture detection systems. Therefore, one should be careful about the possibility of prolonged TTDs for candidemia when using the abovementioned antifungal agents.

Prevalence, antifungal susceptibility and etiology of vulvovaginal candidiasis in sub-Saharan Africa: a systematic review with meta-analysis and meta-regression.

The overarching aim of this study was to comprehensively investigate the prevalence, antifungal susceptibility, and causative species of vulvovaginal candidiasis (VVC) in sub-Saharan Africa (SSA). A detailed search of studies was conducted to retrieve eligible observational studies published 'between' January 1, 2000, to July 31, 2021. From the 41 selected studies including 15 723 participants, VVC was found in 33% of the participants. The chances of diagnosing VVC was 40% higher in symptomatic patients compared to the general study population. In 71.7% of the cases, C. albicans was the causative species of VVC. We conclude that about one-third of women in SSA have VVC, mainly caused by C. albicans.

Evaluation of the Distribution of Candida Species in Patients with Dysplastic and Nondysplastic Oral Lichen Planus Lesions.

Objectives This study is aimed at identifying and determining the distribution of isolated Candida species in patients with dysplastic and nondysplastic oral lichen planus (OLP) lesions in comparison with those of healthy controls. Material and Methods. This study includes patients with OLP, aged (more than 18 years old), who have had informed consent. Samples of the oral, tongue, and buccal mucus by rubbing with a sterile swab and sterilely next to the lamp flame. Demographic information was obtained using patient records to determine the species of Candida in both groups, and two tests of fertile tube production by Candida albicans and dye production in the dye medium were used. A biopsy from OLP lesions has been taken from each patient after swab sampling and was sent to the pathology department for further histopathological analysis. In the end p value, less than 0/05 was considered significant. Result In this study, 40 lichen planus patients were compared with 32 control patients. The female/male ratio in OLP and healthy groups was 22/18 and 17/15, respectively. Among the OLP patients, 23 cases (56%) were dysplastic, and the other 17 (44%) patients were nondysplastic. The mean (±standard deviation (SD)) age of patients was 48.83 (±9.34) years, and the mean age of the control group was 40.21 (±10.32). There were no significant differences based on age (p > 0.05). The highest frequency was related to tongue in both groups (22 (55%)) and buccal mucosa was the least common. There was a significant relationship between the location of the lesion and OLP (p = 0.05). 18 (45%) were erosive, and 22 (55%) were nonerosive. However, no significant difference was observed between erosive and nonerosive types in the OLP group (p = 0/07). Regarding the type of Candida, all cases in the patient's group were related to Candida albicans [40 (100%)], and the correlation was not found in this regard (p > 0/05). About colony count, the mean for the case and control groups was 26.68 and 23.25, respectively. Also, no significant relationship was found between colony count and groups in this study (p = 0.3). There was no significant difference between gender and dysplastic or nondysplastic (p > 0.05). Conclusion According to the statistical studies performed in this study, the presence of Candida in patients with dysplastic and nondysplastic lichen planus is not significantly different, and this rate is not higher than healthy individuals and in cases where the results are positive. The predominant species of Candida is the Candida albicans. In this study, the highest frequency was related to tongue in both groups. There was only a significant relationship between the location of the lesion and OLP.

Prevalence of Oral Candidiasis among Children Caused by Different Candida Species

Introduction: Oral candidiasis, which is caused by Candida species by the involvement of hard and soft palates, tongue, buccal mucosa, and floor of the mouth, is becoming a very common threat to oral health. Although in the majority of the cases, this infection is caused by Candida albicans which is a normal commensal organism in humans, however, it might be also caused by other Candida species, such as C. glabrata, C. tropicalis, and C. krusei. Objectives: This study aimed to evaluate the prevalence of oral candidiasis among children and to compare the type of causative candida species among them. Materials and Methods: This prospective observational study was conducted in the Shishu Hospital, Shamoly, Dhaka, spanned January 2016 through December 2016. A total of 286 oral swab samples were collected, and three methods including direct wet mount smear, staining, and culture were used for laboratory investigation of Candida infections. Results: Among 286 respondents, 161 (56.29%) were culturally and microscopically confirmed to have oral candidiasis. Among all of the detected species, C. Albicans was by far the highest species with 139(86.34%) followed by C. tropicalis with 14 (8.68%). Whereas 05(3.12%) cases were infected by C. krusei. On the other hand, the least detected species were C. glabrata and C. guilliermondii with 01(0.62%) and 02(1.24%) respectively. Conclusion: These days accurate and prompt identification of the infectious candida strains is crucial because isolates of Candida species differ extremely, both in their ability to produce infection and also in their susceptibility to antifungal agents. Medicine Today 2022 Vol.34(1): 57-60

Isolation Frequency of Fluconazole-Resistant Candida Species From Cockroaches: A Cross-Sectional Study From a National Hospital in Dar es Salaam, Tanzania.

Background: Cockroaches are common pests in homes and hospitals. They cause allergic reactions in some individuals and are potential vectors for various infectious pathogens. The study investigated the extent to which hospital cockroaches act as vectors and reservoirs of medically important fungal pathogens on their external surfaces.Methods: Cockroaches were captured from the selected hospital locations including the burn unit, adult surgical wards, pediatric oncology wards, intern hostel kitchen, and the central kitchen of a national referral teaching hospital in Tanzania. Normal saline washings from the external surface of cockroaches were cultured on standard mycological media to facilitate isolation and identification of medically important molds and yeasts. The susceptibility of Candida species isolates to fluconazole was tested using the Clinical and Laboratory Standards Institute (CLSI) M27-A3 microdilution method.Results: A total of 69 cockroaches were captured from various hospital sites between February and April 2017. All cockroaches captured were shown to carry medically important fungi. A total of 956 medically important fungi were isolated; 554 (57.9%) were of Candida species, 222 (23.2%) were of Aspergillus species, 30 (3.1%) were of​​​​​​​ Cladosporium species, 17 (1.8%) were of​​​​​​​ Rhizopus species, 11 (1.2%) were of​​​​​​​ Geotrichum species, nine (0.9%) were of​​​​​​​ Penicillium species, seven (0.7%) were of​​​​​​​ Alternaria species, six (0.6%) were of​​​​​​​ Fusarium species, three (0.3%) were of​​​​​​​ Mucor species, and 97 (10.1%) were of other species. Of the Aspergillus species, Aspergillus fumigatus (111, 50.0%) was the most commonly isolated, followed by Aspergillus niger (35, 15.8%) among the Aspergillus isolates. Out of the 103 selected isolates, 18 (17.5%) of the Candida isolates normally not intrinsically resistant to fluconazole demonstrated resistance to this drug. Resistance was most frequently found in Candida parapsilosis (3, 30%), Candida pseudotropicalis (10, 23.8%), and Candida glabrata (2, 18.2%). The isolates with the least proportion of resistance to fluconazole were Candida albicans (2, 6.3%).Conclusion: Cockroaches from this hospital may act as reservoirs of medically important opportunistic fungi exhibiting resistance to fluconazole.

Isolation and Identification of Various Candida Species in Potentially Malignant Disorders of Oral Cavity: A Retrospective Study

Aim: The aim of this study was to find and compare various Candida species in the normal and ‘potentially malignant disorders’ of oral cavity.
 Study Design: Retrospective cross-sectional study.
 Materials and Methods: 110 subjects were selected for the study comprising of 55 normal healthy individuals (control group) and 55 patients with ‘‘potentially malignant disorders’’ (test group). A saliva swab was taken from the normal healthy individuals and patients with ‘potentially malignant disorders’ to check the presence of Candida on Sabouraud’s Dextrose Agar (SDA) media. A wedge shaped tissue sample from the representative site was surgically excised and sent for routine tissue processing for histopathological diagnosis. All the fungal colonies from SDA were subjected to further microbiological tests to check for the presence of various species of Candida.
 Results: No fungus growth was found in the saliva of healthy patients. Out of 55 patients with ‘potentially malignant disorders’, Candida growth was isolated by using the culture method, 30 patients (54.5%) showed positive growth on Sabouraud’s Dextrose Agar (SDA) media, of which 23 were diagnosed cases of leukoplakia and 7 oral submucous fibrosis. No fungus growth was seen in patients with oral lichen planus. There is positive association between the potentially malignant lesions and Candida and the p-value (.006) is statistically significant.
 Conclusion: The results of the study showed that a positive association exists between the ‘potentially malignant disorders’ and various Candida species and the p-value (.006) is statistically significant. The most prevalent Candida species was Candida albicans followed by Candida tropicalis, Candida glabrata, Candida Krusei.

Ketoconazole: A Re-emerging choice for Oral candidiasis in patients with human immunodeficiency virus infection/acquired Immunodeficiency Syndrome

Background: The long term use of antifungals for oral candidiasis (OC) in patients with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) causes some strains to be resistant to certain antifungals. HIV/AIDS are currently most common in men. Aim: To evaluate ketoconazole sensitivity on Candida species in male HIV/AIDS patients with OC. Method: This is an observational descriptive study at the Outpatient Unit and Inpatient Installation of the Infectious Disease Intermediate Care Unit (UPIPI) Dr. Soetomo, Surabaya. Samples were taken from HIV/AIDS male patients with OC using sterile swabs. The smear was cultured in CHROMagar Candida incubated at 37°C for 48-72 hours, and Sabouraud Dextrose Agar media for 48 hours at 28°C. Species identification were done using carbohydrate and Cornmeal test. Resistance test was done by disk diffusion method. Results: There were 23 research subjects with 40 isolates of Candida species growing in culture. The most common species was C. albicans in 23(57.5%) isolates, while Candida non-albicans were found in 17(42.5%) isolates. The sensitivity test results showed that 34 (85%) isolates were sensitive, while 2(5%) isolates were resistant to ketoconazole. All C. albicans (23 [100%]) and most Candida non-albicans species (11 [64%]) were sensitive to ketoconazole. Conclusion: Ketoconazole can be recommended as a treatment option for OC patients with HIV/AIDS due to the high sensitivity of both C. albicans and non-albicans to this drug.

Could Frequency of Candida spp. Be Different on Various Parts of Tongue in Denture and Non-denture Wearers?

Background & Objectives: Oral Candidiasis is the most common opportunistic fungal infection that could affect the oral mucosa. Studies to date did not compare the colony count of candida of the anterior and posterior surfaces of the tongue. This study makes an attempt to compare the Candida spp. on the anterior and posterior surfaces of tongue among healthy denture and non-denture wearers.
 Materials & Methods: Participants of the current cross-sectional study were 26 healthy denture wearers (DW) and 10 healthy non-denture wearers (NDW). Oral specimens were collected from anterior and posterior tongue dorsa by swabbing for mycological examination. After 48 h incubation on Sabouraud dextrose agar (S) and chloramphenicol (SC) and chloramphenicol and Cycloheximide (SCC) ™ medium, C. Albicans and non-Albicans were identified by Germ Tube test. Isolated colonies were evaluated. Obtained data were analyzed by SPSS software version 17. Chi-square, Mann-Whitney and Wilcoxon tests were used for statistical comparison of data due to non-compliance with normal distribution.
 Results: The higher rate of isolated colonies was seen in DW group compared to NDW group (P-Value = 0.03). There was a significant difference between candida colonization of anterior and posterior surface of tongue (P-Value = 0.006). C. Albicans was the most common isolated candida species.
 Conclusions: Mycological findings of this study revealed that the presence of denture can increase colonization of candida on the posterior surface of the tongue. It could be an important role in choosing the best form for medical management of oral candidiasis.

Detection and Molecular Identification of Eight Candida Species in Clinical Samples by Simplex PCR.

Systemic candidiasis is a frequent opportunistic mycosis that can be life-threatening. Its main etiological agent is Candida albicans; however, the isolation of non-albicans Candida species has been increasing. Some of these species exhibit greater resistance to antifungals, so the rapid and specific identification of yeasts is crucial for a timely diagnosis and optimal treatment of patients. Multiple molecular assays have been developed, based mainly on polymerase chain reaction (PCR), showing high specificity and sensitivity to detect and identify Candida spp. Nevertheless, its application in diagnosis has been limited due to specialized infrastructure or methodological complexity. The objective of this study was to develop a PCR assay that detects and identifies some of the most common pathogenic Candida species and evaluate their diagnostic utility in blood samples and bronchial lavage. A pair of oligonucleotides was designed, CandF and CandR, based on sequence analysis of the 18S-ITS1-5.8S-ITS2-28S region of the rDNA of Candida spp., deposited in GenBank. The designed oligonucleotides identified C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, C. krusei/Pichia kudriazevii, C. guilliermondii/Meyerozyma guilliermondii, C. lusitaniae/Clavispora lusitaniae, and C. dubliniensis using simplex PCR based on the amplicon size, showing a detection limit of 10 pg/μL of DNA or 103 yeasts/mL. Based on cultures as the gold standard, it was determined that the sensitivity (73.9%), specificity (96.3%), and the positive (94.4%) and negative (81.2%) predictive values of the PCR assay with the designed oligonucleotides justify their reliable use in diagnosis.

In Vitro evaluation of antimycotic activity of oregano essential oil on candida species from isolation of patient with chronic periodontitis

Background: Candida albicans is an opportunistic fungi mainly causing mucosal and opportunistic infections in immunocompromised people. Origanum vulgare is an herbal plant that has been used as a food flavouring agent in many countries . It has strong antiseptic and antimicrobial activity due to the presence of carvacrol and thymol, which directly inhibit germination and hyphal formation in candida. Periodontitis is one of the first diseases to be related to mixed-species biofilms in humans. C. albicans produces virulence factors that may play a role in the incidence of periodontal disease, such as penetrating ability, colonisation and growth of candida species in the oral mucosa and periodontal pocket. AIM: Is to evaluate the antimycotic activity of oregano essential oil on candida species isolated from patient with chronic periodontitis Materials And Methods: The study was conducted at Saveetha dental college .Ethical clearance for the study was obtained from the Institutional Ethical Committee. Swabs were obtained from the subgingival plaque tooth surface of patients who had clinical symptoms of chronic periodontitis. For the isolation of Candida from the clinical samples, the obtained samples were plated onto candida chromagar. The isolated species of candida is then investigated for antimycotic activity. The antimycotic activity of oregano essential oil on Candida species isolates was examined using an agar well diffusion assay. Result And Discussion : Antimycotic activity of the Oregano essential oil against clinical isolates of Candida albicans are shown in the table. The findings reveal that oregano essential oils showed a zone of inhibition of 21 mm against Candida albicans at concentration of 100μL compared to the standard ketoconazole which shows a zone of inhibition of 25 mm. As the concentration of the extract increases the zone of inhibition increases . Conclusion: Based on the results presented , it is possible to conclude that the essential oil extracted from Oregano may represent a good alternative for the treatment of candidiasis due to its appreciable antifungal action against Candida spp in vitro.

Estimation of Invitro Antifungal Activity of Ethanolic Crude Extract of Punicagranatum peel and Woodfordiafruticosa Leaves on Isolates of Candida Species

Introduction: The Candida species which are opportunistic fungi especially the species of C. albicans, C. glabrata, C. tropicalis have been causing oral candidiasis. Due to resistance of conventional antifungal agents, the scientists are in verge of exploring novel antifungal drugs such as traditional medicinal plants. Hence we aimed in studying the antifungal effect of Woodfordia fruiticosa and Punicagranatum which are plants of Lythraceae on Candida species. Materials and Methods: The ethanolic extracts of both the plants were prepared using soxhlet extraction method and the obtained metabolites were confirmed by Thin Layer Chromatography. The Paper discs were prepared by Whatman filter paper No. 1 The disc was moistened with 10 μL from the prepared stock solution. Were kept at 4°C for 3 hours for diffusion and incubated for 48 hours. Then the diameters of the circular inhibition zones were measured. Results: The obtained data was expressed as mean and standard deviation. Chloroform fraction of Woodfordia fruticosa showed superior antifungal effect when compared to Punicagranatum peel. Conclusion: The invitro antimicrobial activity of Woodfordia leaf depicted superior antifungal activity against Candida isolates with effective anticandidal effect when compared to Punica peel. In future both of these plants could serve as basis for the new anti-candidal agents.

Isolation, Identification and Antifungal Susceptibility Testing of Candida Species: A Cross-sectional Study from Manipur, India

ABSTRACT Introduction: Candidiasis is an opportunistic infection which occurs due to indiscriminate and prolonged use of broadspectrum antimicrobials, corticosteroids, immunosuppressive agents, diabetes mellitus, Human Immunodeficiency Virus (HIV), chronic renal failure, haemodialysis, renal transplantation or indwelling urinary catheter. Recently, Non-albicans Candida (NAC) species have replaced Candida albicans and emerged as an important opportunistic pathogens exhibiting decreased susceptibility to commonly used antifungal agents. Early speciation of Candida isolates along with their antifungal susceptibility testing not only will restrict the empirical use of antifungal agent but also greatly influence the treatment options for the clinicians. Aim: To speciate Candida isolates from various clinical specimens and to determine their antifungal susceptibility pattern. Materials and Methods: This study was a cross-sectional study carried out in the Mycology Section, Department of Microbiology, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur, India, from September 2016-August 2018. Candida isolates were identified using standard microbiological procedures, and speciation was done following conventional and HiCrome differential media. Antifungal susceptibility testing was determined by using Clinical and Laboratory Standards Institute (CLSI) disk diffusion method. Data analysis was done using descriptive statistics and Chi-square test. Results: A total of 100 isolates were identified from different clinical specimens, which included 43 (43%) from sputum, 34 (34%) from urine, in majority. Highest age was 92 years and lowest age was one year from whom the isolates were detected and females (57%) outnumbered males (43%) patients. Predominant Candida isolates were Candida albicans (44%), Candida tropicalis (32%). Among the azoles, the most sensitive agent was voriconazole (86%) and least was ketoconazole (56%), 81% of the total isolates were found sensitive to amphotericin B. Conclusion: The present study demonstrated that NAC spp. have surpassed Candida albicans and there is an increase in the resistance of the Candida isolates to commonly used antifungal agents. Therefore, this study highlights the need for speciation of Candida isolates upto species level and to determine the antifungal susceptibility pattern to decrease the morbidity and mortality of the patients.

Candida species isolation, identification from Diabetics and their Antifungal Susceptibility Pattern

Background and Objectives: The Candida infection has increased over the past two decades among diabetes patients. The specific Candida species isolated from diabetes patient and its antifungal susceptibility patterns are important factor which helps for establishment of empirical treatment protocol, however very limited institutional data are available on Candida infection from Nepali diabetes patients. Material and Methods: In the current cross sectional research, different clinical samples from Nepali diabetes patients were selectively taken. The Candida species were isolated, identified and using Corn meal agar, HiChrom agar, sugar assimilation and fermentation tests and performed antifungal susceptibility test of Candida species isolated from different diabetes patients by disc diffusion method as per CLSI guide line given in document (M44-A). Results: There were 321 Candida spp. isolated and identified with different Hi-Chrom media and sugar assimilation and fermentation tests. The highest number of Candida spp. were obtained from urine sample 201(37.6%) and least isolates were from nail infection 5(0.9%). Out of 321 Candida isolates, C. albicans was 88(27.4%) and non albicans Candida group were 233(72.6%). Candida tropicalis 122(38.0%) and C. albicans 88(27.4%) were the most common Candida spp. causing infections in patients. Candida albicans and non albicans Candida sp. which was 2nd highest isolates showed (100%) sensitive to amphotericin B and nyastatin. Whereas, resistance pattern was highest seen with fluconazole, ketoconazole and itraconazole, which was 13.6%, 22.7% and 21.6% respectively. C. spherica 8 (2.8%) showed (100%) sensitive to all the antifungal agents. Unidentified Candida species 11(3.4%) also exhibited similar resistance patterns to azole drug but they all were 100% sensitive to amphetericin B and nyastatin drugs. Conclusions: Our findings show that non albicans Candida is the emerging fungal infection among diabetes patients followed by C. albicans. The rate of resistance is also increasing to azole group of antifungal drugs especially in Candida species isolates from Nepali diabetes patients.

A prospective study on vulvovaginal candidiasis: multicentre molecular epidemiology of pathogenic yeasts in China.

Vulvovaginal candidiasis (VVC) is frequent in women of reproductive age, but very limited data are available on the epidemiology in cases of VVC in China. The current study has been conducted to reveal the prevalence, species distribution of yeast causing VVC and molecular genetics of Candida albicans in China. Vaginal swabs were collected from 543 VVC outpatients recruited in 12 hospitals in China between September 2017 and March 2018. They were preliminarily incubated on Sabouraud dextrose agar and then positive subjects of which were then transmitted to our institute for further identification. CHROMagar™ was used to isolate Candida species, and all isolates were finally identified by DNA sequencing. Multilocus sequence typing (MLST) was used to analyse phylogenetic relationships of the various C. albicans isolates. Eleven different yeast species were identified in 543 isolates, among which C. albicans (84.7%) was the most frequent, followed by C. glabrata (8.7%). We obtained 117 unique diploid sequence types from 451 clinical C. albicans isolates and 92 isolates (20.4%) belonged to a New Clade. All the strains appearing in the New Clade were from northern China and they were isolated from non-recurrent VVC. Our findings suggest that C. albicans are still the main cause of VVC in China and the majority of C. albicans isolates belongs to Clade 1 with DST 79 and DST 45 being two most common. Moreover, the New Clade revealed in our study seems to be specific to northern China.

Investigation of the zinc uptake system of the human fungal pathogen Candida parapsilosis

Candida parapsilosis is the second or third most commonly isolated Candida species from blood cultures and is frequently associated with infections in neonatal intensive care units. Candida species have several virulence factors enabling them to adapt to host environmental conditions and cause infections. These factors include adhesion, biofilm formation, and secretion of hydrolytic enzymes, such as acidic proteinases and lipases. Candida species also obtain heavy metal ions from their environment, such as zinc. Zinc is a cofactor of several proteins and a vital element in cellular mechanisms of the fungi. On the one hand, the host niche represents a zinc-limited environment, that indirectly inhibits microbial growth. In order to survive in such an environment, these pathogens have evolved a zinc transport system that allows them to access bound zinc ions during infection. On the other hand, high zinc ion concentration within the host can also be toxic to microbes e.g. in the phagosomes of Mycobacterium tuberculosis infected macrophages. In case of C. albicans, zinc acquisition processes are intensively studied, but we lack information of the zinc uptake, transfer and homeostasis mechanisms in C. parapsilosis. Here, predicted potential zinc transporters in C. parapsilosis using in silico analyses, generated homozygous knock out mutants and performed their phenotypical characterization by exposing them to various types of stressors and zinc limiting conditions. Furthermore, we analyzed their virulence traits by examining kinetics of fungal cell uptake by macrophages, their killing efficiency and also investigated zinc ion levels in the phagolysosome during in vitro infections

Speciation of candida species isolated in clinical samples in a tertiary health care centre in Northern India

The purpose of this study is to isolate, identify and specification of various the Candida species from various clinical samples in a tertiary care hospital, and to characterize various the isolated Candida species. A study was conducted on people of different age groups from January 2019 to December 2019. Candida species isolated from different patients by using Potassium Hydroxide mount and processed by BacTalert 3D (Biomerieux) automated blood culture system. Further culture identification of Candida species were done on Sabouraud dextrose agar (SDA). Speciation of Candida was done using Germ tube test, CHROM agar Candida Medium, Cornmeal agar, Sugar Fermentation test and Sugar Assimilation test.In our study was the most common species isolated, among non albicans Candida i.e. 21 (38.9%); 19(35.2%) of was the most common followed by 9(16.7%) ofand 5(9.3%) of . Maximum number of Candida isolates were obtained from NICU i.e. 27(50.0%) followed by 11 from Med (20.3%), 7 from E/W (13.0%), 2 from BICU (3.7%), 2 from Skin (3.7%), 1 from PICU (1.9%), and 1 from R/R (1.9%).Our study showed that is the most common isolates species. Among , was found to be the most common isolate followed by . Children less than 1 year are most affected with maximum number of Candida species were obtained from NICU department. HiChrom Candida is proven to be more useful as differential agar.