Candidiasis Research Articles

Clinical Features of Candida Catheter-related Bloodstream Infections and Persistent Infections Associated with Early Catheter Reinsertion: A 6-year Retrospective Study.

Catheter-related persistent Candida infections (CRPCI) may develop after Candida catheter-related bloodstream infections (CRBSI) due to colonization of the newly inserted catheter. However, the optimal timing for new catheter insertion remains controversial. The aim of this study was to determine the clinical features of CRBSI due to Candida species and CRPCI. This was a retrospective study conducted in a teaching hospital in Japan. We retrospectively collected clinical information on hospitalized patients diagnosed with Candida CRBSIs by catheter tip culture from 2015 to 2020. CRPCI was defined as the growth of the same Candida species from the tip culture of a newly inserted catheter after the onset of a Candida CRBSI. The Chi-squared and Fisher's exact tests were used to compare differences between the case and control groups. Sixty-three cases of Candida CRBSI were collected. Fifty-four (85.7%) received total parenteral nutrition. CRPCI developed in 12 (48%) patients of the 25 in whom cultures of newly inserted catheters were performed. Despite antifungal therapy in these patients, persistent fungemia incidence was significantly higher (50.0% vs. 9.1%, odds ratio = 10.0, P = 0.033). The mean number of days from removal of infected catheter to reinsertion was significantly shorter for patients with CRPCI (0.27 days vs. 3.08 days, P = 0.038). Total parenteral nutrition may be a major risk factor in the development of Candida CRBSI. CRPCI often leads to persistent fungemia. Early insertion of a new catheter after removal of an infected catheter may be a risk factor for CRPCI.

Invasive Candida Infections in Neonatal Intensive Care Units: Risk Factors and New Insights in Prevention.

Invasive Candida infections represent a significant cause of morbidity and mortality in neonatal intensive care units (NICUs), with a particular impact on preterm and low-birth-weight neonates. In addition to prematurity, several predisposing factors for Candida colonization and dissemination during NICU hospitalization have been identified, including prolonged exposure to broad-spectrum antibiotics, central venous catheters, parenteral nutrition, corticosteroids, H2 antagonist administration, and poor adherence to infection control measures. According to the literature, the implementation of antifungal prophylaxis, mainly fluconazole, in high-risk populations has proven to be an effective strategy in reducing the incidence of fungal infections. This review aims to provide an overview of risk factors for invasive Candida infections and current perspectives regarding antifungal prophylaxis use. Recognizing and reducing people's exposure to these modifiable risk factors, in conjunction with the administration of antifungal prophylaxis, has been demonstrated to be an effective method for preventing invasive candidiasis in susceptible neonatal populations.

In vitro determination of antifungal susceptibility and virulence factors in Candida species causing candidemia in North India Region

Candidiasis is the most incessant fungal disease affecting human population worldwide. In this research work, we explored the characteristics contributing to pathogenicity of Candida infections, from serious bloodstream conditions like candidemia. Candida spp. were isolated from the blood of 120 suspected patients and assessed their susceptibility to antifungal treatments via MIC measurements. Enzyme activities (phospholipase, proteinase, hemolysin, and esterase) were examined alongside biofilm formation, with surface analysis conducted via SEM. Statistical analysis, facilitated by GraphPad Prism 8.4.2, identified correlations among data points. Results reveal that non-albicans spp. like Candida auris heightened resistance to antifungal treatments compared to Candida albicans. Candida tropicalis exhibited no phospholipase activity but shows activity to proteinase and esterase. Conversely, C. albicans show a case of elevated hemolysin activity. Non-albicans Candida i.e. C. tropicalis and Candida krusei were isolated as high biofilm formers in comparison to C. albicans. Statistical analysis yielded a highly significant p-value (< 0.001), affirming the robustness of our results. In conclusion, non-albicans species exhibit a broader spectrum of resistance mechanisms compared to C. albicans in pathogenicity. This investigation sheds light on diverse virulence strategies employed by different Candida species, informing future treatment approaches.

The therapeutic effects of Juglans regia Linn (Walnut) extracts on oral Candida infection

The difficulties associated with oral Candida infection management necessitate the development of novel antifungal medicines in order to widen the spectrum of activity against Candida albicans. The aim of this work is to study the oral anticandidal activity of Juglans regia L. cultivated in Algeria. This plant was chosen due to its traditional use for the treatment of oral infections. Methanolic, ethanolic, butanolic, ethylic acetate and acetonic extracts of the bark of J. regia L. were extracted in a Soxhlet device and screened for in vitro activity against C. albicans. Plant preparations were screened for antifungal activity using a standard agar well diffusion assay. Following a study of the antimicrobial activity of plant extracts, their minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) values were determined using a broth microdilution assay. Among J. regia L. extracts, ethylic acetate extract had potent antifungal activity against Candida strain with diameters of inhibition ranging from 15.16±0.76 to 20.83±0.76 mm, followed by acetonic extract with diameters of inhibition ranging from 14.83±0.76 to 19.33±0.28 mm. The J. regia L. demonstrated MIC values ranging from 0.46875 to 3.75 mg mL-1 and the lowest MIC was recorded for ethylic acetate, acetonic extracts and AMB at 0.46875 mg mL-1. The ethylic acetate extract showed the lowest MFC value (0.9375 mg mL-1), followed by butanolic extract (3.125 mg mL-1). These results indicate that J. regia L. bark extracts can contain compounds with therapeutic potential against oral C. albicans and, hence, their possible use as therapeutic agents for oral candidiasis.

Cytokine profiles and their roles in development of provoked vulvodynia

Provoked, localized, vulvodynia (PVD) is the main subtype of vulvodynia. Although the etiology of PVD is still a topic of debate, inflammation caused by cytokines responding to a dysregulated microbiome is one of the leading proposed theories. Therefore, the purpose of our study is to further explore the cytokine profiles in the study group with PVD using multiplex immunoassays based on electrochemiluminescence. We compared a panel of 26 distinct cytokines levels in the study group with PVD (n = 23) to the control group (n = 18) and cytokine concentrations were measured using MESO QuickPlex SQ 120 instrument with 5 different multiplex assays. Statistical analysis used the Mann-Whitney U test, two-sided p-values, and a significance level of α = 0.05. Differences in cytokine concentrations are described as negligible, small, medium, or large based on Cliff’s δ. Concentrations of three cytokines were significantly lower in the PVD group: a large difference in IP-10 (p = 0.029*) and medium differences in IL-1RA44Cytokine abbreviations: bFGF; Basic Fibroblast Growth Factor, G-CSF; Granulocyte colony stimulating factor, GM-CSF; Granulocyte-Macrophage Colony-Stimulating Factor, IFN; interferon, IL; Interleukin, IP; Interferon-gamma Inducible Protein, MCP; Monocyte Chemoattractant Protein, MIP; Macrophage Inflammatory Protein, PGDF-BB; Platelet Derived Growth Factor Subunit B, RA; Receptor antagonist, TNF; Tumor Necrosis Factor, VEGF; Vascular Endothelial Growth Factor (p = 0.030*) and IL-12 (p = 0.034*). One cytokine level was significantly higher in the PVD group: a medium difference for IL-6 (p = 0.037*). Due to the lack of consistency in elevation of inflammatory profiles, it is not enough to support persistent inflammation as the etiology behind PVD. However, these findings may indicate there is a possible immune response deficiency in some patients who have PVD. The resemblance of cytokine profile in our study to cytokine profile of people with chronic yeast infection further support this proposed mechanism behind PVD. Future studies involving history and testing for yeast infection are necessary to explore this possibility further.

Evaluation of Candidemia Cases Developed in the Intensive Care Unit: A Ten-Year Analysis

Objective: Fungal infections have been a major health problem for many years. They constitute a major cause of increased mortality and morbidity, especially in immunocompromised patients and intensive care unit (ICU) patients. In this study, we aimed to evaluate the epidemiologic characteristics, mortality and causative agent distribution of cases of healthcare-associated candidemia (HCA) in intensive care units of our hospital and to contribute to the literature. Methods: Our study included patients diagnosed with healthcare-associated candidemia who were hospitalized in 3rd level ICUs with various complaints between November 2011 and August 2021 in Meram State Hospital. Results: In our study, the mean age of patients who developed candida infection during intensive care unit hospitalization was 67.2±20.5 years. Of these patients, 59.5% (n:103) were men and 40.5% (n:70) women. Mean duration of hospitalization in the intensive care unit was 38.2±29.5 (min:1, max:231) days. Grouping of candida related HCAIs developed in patients according to Centers for Disease Control and Prevention (CDC) criteria shows that the most common candida related healthcare-associated infection (HCAI) was central line-associated bloodstream infection (CLABSI) at 52% and the second most common was laboratory-confirmed bloodstream infection (LCBI) at 31.2%. Cumulatively, candidemia are significantly higher to other candida related HCAIs. Conclusion: To prevent and empirically treat candidemia, which has a very high mortality rate, the causative agent distribution of the center should be well understood. Large-scale, high-quality studies using various biomarkers in addition to clinical findings for the correct antifungal selection and to reduce mortality due to invasive candidiasis in line with these selections are warranted.

Multi-state evaluation of Candida infections in burn patients.

Burn patients are at high risk of developing secondary invasive fungal infections due to their compromised skin barrier, extensive use of antibiotics, and immunosuppression. We investigated demographic characteristics and clinical factors associated with Candida infections in intensive care unit (ICU) burn patients, and the invitro antifungal susceptibility of species of isolates. A total of 353 burn patients admitted to three major ICUs of burn centers in Iran were evaluated between 2021 and 2023. Patients were considered as colonisation and candidemia. Demographic characteristics, burn-related factors, and clinical conditions were compared among the groups. Furthermore, we identified fungi at the species level and performed antifungal susceptibility testing according to CLSI guidelines. Overall, 46.2% of patients were colonised with a Candida species, leading to candidemia in 15.3%. The most frequently isolated species from candidemia and burn wound colonisation were Candida parapsilosis (37.0%) and Candida albicans (31.9%), respectively. Risk factors linked to candidemia included larger total body surface area (TBSA) (>50%), older patients, indwelling catheters, diabetes, and an extended ICU stay. Mortality rate was higher among candidemia patients (82.5%) compared to colonised patients (7.3%). The resistance rate of the strains isolated from candidemia to fluconazole and voriconazole was 28% and 18.2%, respectively. We found that a higher percentage of TBSA burn injuries, longer hospital stays, and catheterization are important predictors of candidemia. The mortality rate was significantly higher in people infected with non-albicans Candida species. Prevention and treatment strategies for candidemia should be based on updated, regional epidemiological data.

Transcriptional, biochemical, and histochemical response of resistant and susceptible cultivars of Brassica juncea against Albugo candida infection.

White rust disease caused by a biotrophic oomycete Albugo candida is one of the most serious impediments in realizing the production potential of Brassica juncea. Due to the obligate nature of the pathogen, R-gene-based resistance is unstable as the newer virulent races emerge quickly. For this, a deep understanding of the molecular basis of resistance is essential for developing durable resistant varieties. In this study, we selected one susceptible cultivar, 'Pusa Jaikisan' and its single R gene based resistant NIL, 'Pusa Jaikisan WRR as the source of understanding the defense mechanism in B. juncea against A. candida. Comparative histochemical analysis at 12 dpi showed higher callose deposition in the resistant cultivar than in the susceptible which hints towards its possible role in defense mechanism. Based on the biochemical markers observation, total protein was found to have a negative correlation with the resistance. The antioxidant enzymes (POX, CAT, and SOD) and non-enzymatic ROS scavenging compounds such as polyphenols and proline showed a positive correlation with the white rust resistance. Polyphenol Oxidase (PPO) total chlorophyll and total carotenoids were also found to be more abundant in the 'Pusa Jaikisan WRR'. Based on the heat map analysis, PAL was identified to be the comparatively most induced enzyme involved in the defense mechanism. The polyphenol oxidase, total chlorophyll and total carotenoids were also found to show higher activity in the 'Pusa Jaikisan WRR'. Furthermore, to study the defense response of 'Pusa Jaikisan WRR' compared to 'Pusa Jaikisan' against A. candida infection, the gene expression analyses of salicylic acid (SA)-marker PR protein genes (PR1 and PR2) and jasmonic acid (JA)-marker PR protein genes (PR3 and PR12) were done by qRT-PCR. Based on the results, PR2 emerged as the best possible gene for defense against A. candida followed by PR1. PR3 and PR12 also showed positive correlation with the disease resistance which may be due to the JA pathway acting complementary to the SA pathway in case of B. juncea-A. candida interaction. This provides evidence for the JA-SA hormonal crosstalk to be synergistic in case of the white rust resistance.

Navigating the Microbial Landscape: Understanding Dysbiosis in Human Genital Tracts and Its Impact on Fertility.

Dysbiosis, an imbalance in microbial communities, significantly impacts the health and functionality of the human genital tract, with profound implications for fertility and reproductive health. This review explores the intricate relationship between genital tract microbiota and reproductive outcomes, highlighting the composition and dynamics of these microbial communities in both females and males. In females, the vaginal microbiota, primarily dominated by Lactobacillus species, is essential for maintaining a healthy vaginal environment, preventing infections, and supporting reproductive functions. In males, the genital microbiota influences sperm quality and reproductive health. Dysbiosis in the genital tract, manifesting as bacterial vaginosis, yeast infections, urethritis, or prostatitis, disrupts these microbial communities, leading to adverse reproductive outcomes such as infertility, pregnancy, and increased susceptibility to sexually transmitted infections. This review delves into the mechanisms through which dysbiosis affects fertility, including alterations in vaginal pH, mucosal immunity, inflammation, sperm viability, and motility. It also evaluates diagnostic methods, clinical implications, and management strategies, including probiotics, prebiotics, antibiotics, antifungal treatments, lifestyle interventions, and emerging therapeutic approaches. By understanding the microbial landscape of the genital tract and its impact on fertility, this review aims to inform targeted interventions that restore microbial balance and enhance reproductive health, ultimately improving fertility outcomes and the potential for healthy pregnancies.

Liposomal Fba and Met6 peptide vaccination protects mice from disseminated candidiasis.

This study introduces a promising vaccine strategy against invasive candidiasis, a severe fungal infection, by targeting specific peptides on the surface of Candida. Using a novel approach called spontaneous nanoliposome antigen particle (SNAP), we combined peptides from two key Candida proteins, Fba and Met6, into a vaccine. This vaccine induced robust immune responses in mice, including the production of protective antibodies and the activation of immune cells. Importantly, mice vaccinated with SNAP were shielded from disseminated candidiasis in experiments. These findings highlight a potential avenue for developing a broad-spectrum vaccine against Candida infections, which could significantly improve outcomes for patients at risk of these often deadly fungal diseases.

The Characterization of the Th1/Th2 Ratio in Multiple Sclerosis Patients and its Response to a Dietary Supplement Regimen

Introduction Multiple sclerosis (MS) is a debilitating neurodegenerative disease affecting the central nervous system, causing disability and life-threatening complications. The interplay between immune cells and signaling pathways is a topic for investigating novel therapies. Past research has shown how the Th1/Th2 ratio plays a key role in the pathogenesis of MS lesions. Modulating the Th1/Th2 ratios with an efficacious dietary supplement may improve some of the consequences of MS. Methods Participants (n = 15) diagnosed with MS for an average of 12.4 years (standard deviation = 7.4; range = 2, 25) were enrolled in a clinical trial in which they consumed a dietary supplement regimen daily for 12 months. Venous blood was drawn at baseline and 12-month follow-up and peripheral blood mononuclear cells, cytokines, and growth factors were quantified. Infections, physical functioning, and quality of life were also assessed at baseline and 12 months. Results The IL-2/IL-10 and IFN-γ/IL-10 ratios were significantly higher than those of the healthy adults, and while only IFN-γ/IL-10 increased significantly at 12 months, all ratios other than IFN-γ/TNF-α increased over the course of the intervention. The decrease in yeast infections was inversely correlated with IL-2/TNF-α and IFN-γ/TNF-α. Significant improvements in physical functioning and quality of life correlated with changes in the Th1/Th2 ratios in response to the dietary supplement regimen. Conclusions The results show that dietary supplementation somewhat impacted the Th1/Th2 ratios over the course of the intervention (toward more Th1 dominance), and those changes were related to various clinical improvements of the participants’ symptoms in cognitive, motor, and psychosocial dimensions.

Bridging Diagnostic Gaps: Utilising HiCrome Agar and Tetrazolium Reduction Medium for the Rapid and Presumptive Identification and Speciation of Candida Species in Vulvovaginal Candidiasis in Low-Resource Environments.

Background Vulvovaginal candidiasis (VVC) is a common fungal infection caused by an overgrowth of Candida species, primarily Candida albicans (C. albicans). Using HiCrome agar and tetrazolium reduction medium offers cost-effectiveness in Candida detection by eliminating the need for additional tests, reducing equipment costs compared to automated systems, and simplifying workflow with direct species identification while maintaining high specificity. They expedite detection by directly identifying Candida species based on colony colour, bypassing the multiple steps of phenotypic methods. This efficiency saves time in the laboratory, providing rapid results without the extended processing times associated with automated systems and facilitating prompt diagnosis and treatment decisions. These diagnostic tools are especially valuable in low-resource environments where a quick and accurate diagnosis of VVC is crucial for effective treatment and management of antifungal resistance. Aims and objectives This study aims to evaluate the efficacy of HiCrome agar and tetrazolium reduction medium's efficacy in speciating Candida species in VVC cases. Materials and methods A cross-sectional observational study was conducted at Saveetha Medical College and Hospitals, Chennai, India, over six months. High vaginal swabs from 126 patients suspected of VVC were collected and plated on Sabouraud dextrose agar (SDA), HiCrome Candida differential agar (Himedia, Mumbai, India), and tetrazolium reduction medium. The results were compared with those obtained from the VITEK2 compact system (bioMérieux, Marcy-l'Étoile, France). Results Of the 126 samples, 74.6% showed single yeast infections, 7.9% displayed mixed yeast infections, and 17.5% showed no growth. A total of 114 Candida isolates were identified. Both HiCrome agar and tetrazolium reduction medium accurately identified all isolates, with complete concordance with the VITEK2 compact system. The most commonly isolated species were C. albicans (55.2%), Candida tropicalis (32.4%), Candida glabrata (8.8%), and Candida parapsilosis (3.6%). Both media provided rapid and accurate presumptive identification in low-resource settings. Conclusions HiCrome agar and tetrazolium reduction medium demonstrated high sensitivity and specificity in identifying Candida species. These methods are reliable for rapid and accurate diagnosis, particularly in resource-limited settings. However, they may require supplementary tests for definitive species identification. The adoption of these diagnostic tools represents a significant advancement in clinical microbiology, improving VVC management and addressing antifungal resistance.

The Relationship between Candida Infections and Atherosclerotic Heart Disease

The Relationship between Candida Infections and Atherosclerotic Heart Disease

The sunflower jacalin Helja: biological and structural insights of its antifungal activity against Candida albicans.

The limited availability of efficient treatments for Candida infections and the increased emergence of antifungal-resistant strains stimulates the search for new antifungal agents. We have previously isolated a sunflower mannose-binding lectin (Helja) with antifungal activity against Candida albicans, capable of binding mannose-bearing oligosaccharides exposed on the cell surface. This work aimed to investigate the biological and biophysical basis of Helja's binding to C. albicans cell wall mannans and its influence on the fungicidal activity of the lectin. We evaluated the interaction of Helja with the cell wall mannans extracted from the isogenic parental strain (WT) and a glycosylation-defective C. albicans with altered cell wall phosphomannosylation (mnn4∆ null mutants) and investigated its antifungal effect. Helja exhibited stronger antifungal activity on the mutant strain, showing greater inhibition of fungal growth, loss of cell viability, morphological alteration, and formation of clusters with agglutinated cells. This differential biological activity of Helja was correlated with the biophysical parameters determined by solid phase assays and isothermal titration calorimetry, which demonstrated that the lectin established stronger interactions with the cell wall mannans of the mnn4∆ null mutant than with the WT strain. In conclusion, our results provide new evidence on the nature of the Helja molecular interactions with cell wall components, i.e. phosphomannan, and its impact on the antifungal activity. This study highlights the relevance of plant lectins in the design of effective antifungal therapies.

Identification of phytochemicals as potential inhibitors of Candida albicans SAP3: An in-silico approach

Background: Candida albicans is a major threat to human health, causing a variety of diseases. Candida albicans can overgrow and trigger infections like thrush, diaper rash, and vaginal yeast infections. Therefore, finding potential inhibitors of C. albicans from plant sources has become important, recently.Methods: This study investigated the interaction of natural compounds (N = 450) from the ZINC database with the C. albicans SAP3 protein. PyRx tools were used to conduct molecular docking analyses, which included ligand and target receptor preparation, data analysis, and visualization.Result: The binding energies between the natural compounds and SAP3 ranged from -8.8 to -7.8 kcal/mol, indicating that the interactions were predominantly strong. Among the compounds screened, ZINC000252509014, ZINC000252509722, ZINC000253389136, ZINC000251981944, and ZINC000252480871 were extensively explored in this study because they were found to be the best among others. Furthermore, these compounds showed favorable drug-like properties.Conclusion: These findings lay the groundwork for future research aimed at developing potent SAP3 inhibitors to treat C. albicans infections.Keywords: Candida albicans; SAP3 protein; Natural compounds; Virtual screening; Drug-likeness

Anticandidal effect of cinnamic acid characterized from Cinnamomum cassia bark against the fluconazole resistant strains of Candida.

Candida spp., causes invasive fungal infections, especially in immune-compromised patients and the propensity of antifungal resistance against azole-based drugs need to be addressed. This study is thus aimed to characterize the anticandidal effect of the cinnamic acid extracted from the barks of Cinnamomum cassia. Five species of Fluconazole-resistant Candida sp. were retrieved from the department repertoire. The extraction of CA was performed by three different methods followed by silica gel column chromatography. Eluant was subjected to FTIR and XRD analysis for confirmation. The anticandidal activity of the CA was checked by the agar disc diffusion method and the MIC and MFC were determined. The anti-biofilm effect of CA was assessed using the CLSM technique followed by the biocompatibility check using MTT assay in normal HGF cell lines. CA was best extracted with the hot maceration method using ethanol with a maximum yield of 6.73mg. Purification by column chromatography was achieved using benzene, acetic acid, and water (6:7:3) mobile phase. CA was confirmed by FTIR with absorption peaks and by XDR based on strong intensity. CA was found to possess promising anticandidal activity at 8µg/mL with MIC and MFC values determined as 0.8µg/mL and 0.08µg/mL respectively. Antibiofilm activity by CLSM analysis revealed biofilm inhibition and was biocompatible at 8.5µg/ml concentrations in HGF cell lines until 24h. The study findings conclude that CA is the best alternative to treat candidal infection warranting further experimental preclinical studies.

Oral Colonization by Different Candida Species: First Comparative Study between Denture and Nondenture Wearers in Tunisia.

This study aimed to compare different Candida species present in patients with and without removable dentures to identify alterations in biofilm composition following denture wear within a Tunisian population. A cross-sectional study was conducted, comprising a group of patients wearing removable dentures (test group) and a control group without dentures. In the test group, two mycological samples were obtained: one from the prosthetic intaglio and another from the osteomucosal area bearing the denture. For the control group, mycological samples were collected from the oral mucosa. The collected swabs were cultured on CHROMagar Candida medium, and yeast counts were quantified as colony forming units (CFUs). Candida species were identified through chromogenic analysis. The normality of quantitative variables was evaluated using the Kolmogorov-Smirnov's test. To compare means and ranks between the test and control groups, the independent samples t-test and the Mann-Whitney's U test were employed, respectively. Qualitative variables were compared using Fisher's exact test. Statistical significance was determined at a critical uncertainty value of p < 0.05. A total of 150 participants were involved in this study, with 75 patients in each group. Wearing an acrylic removable denture was found to increase the number of detected Candida species (p < 0.001) and significantly increases the overall growth of Candida spp. (p = 0.001). Specifically, the numbers of CFUs of Candida tropicalis and Candida glabrata were elevated in denture wearers (p < 0.001). Findings stemming from this study indicate that removable dentures promote the growth of Candida species. This can be a predisposing factor for Candida-associated denture stomatitis in cases of poor oral hygiene or compromised immunity. Therefore, it is imperative to emphasize the fabrication of high-quality dentures and the implementation of rigorous postdenture maintenance protocols to prevent or limit Candida infection.

In vitro activity of Western Australian honeys and Manuka honey against clinically important yeasts.

With the steady rise in antifungal resistance amongst clinically important yeasts, antifungal drug discovery remains of the utmost importance. To determine the potential of some honeys as alternative antifungal agents, we quantified the antifungal activity of 12 Western Australian honey samples, two Manuka honey samples and an artificial honey against 10 yeast isolates including clinical and reference strains. Results showed that the tested honeys varied in activity, and yeasts species also differed in susceptibility, with minimum inhibitory concentrations (MICs) determined by broth microdilution ranging from 8% to >44% w/v honey. Honeys with the highest overall activity were derived from Blackbutt (Eucalyptus patens), Jarrah (E. marginata), and Karri (E. diversicolor). The optical density of each MIC microtitre plate was determined after incubation and showed that at relatively low concentrations of honey the growth of all yeasts was enhanced compared to the untreated control, whereas at and above approximately 12% w/v, honeys exerted a dose-dependent growth inhibitory effect, the extent of which varied by honey type. Time-kill studies with 64% w/v honey showed that all eight of the natural honeys tested had greater fungicidal activity than the comparator artificial honey. Our findings suggest that the specific nectar-derived phytochemicals present within each honey play an important role in antifungal activity, and support the notion that activity is due to a combination of factors including osmotic activity, hydrogen peroxide and phytochemical compounds. These data indicate that honey is worthy of further investigation as a potential therapeutic agent for superficial yeast infections.

Candidiasis in Choloepus sp.-A Review of New Advances on the Disease.

Candidiasis is a significant fungal infection caused by various species of the genus Candida, posing health challenges to a wide range of animals, including Choloepus species (two-toed sloths). This review article aims to provide a comprehensive understanding of candidiasis in Choloepus sp., highlighting the etiology, epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention strategies. This article begins by examining the causative agents, primarily focusing on Candida albicans, which is the most commonly implicated species in candidiasis. The epidemiological aspects are discussed, emphasizing the prevalence of candidiasis in wild and captive Choloepus populations and identifying predisposing factors, such as immunosuppression, stress, poor nutrition, and environmental conditions. Pathogenesis is explored, detailing the mechanisms through which Candida species invade host tissues and evade immune responses. Clinical manifestations in Choloepus sp. are described, including oral thrush, cutaneous lesions, and gastrointestinal infections, and their impact on the health and behavior of affected individuals. Diagnostic methods, including culture techniques, histopathology, and molecular assays, are reviewed to highlight their roles in accurately identifying Candida infections. This article also covers treatment options, focusing on antifungal therapies and supportive care tailored to the unique physiology of Choloepus sp. Finally, prevention and management strategies are discussed, emphasizing the importance of maintaining optimal husbandry practices, regular health monitoring, and early intervention to reduce the incidence and impact of candidiasis in Choloepus populations. This review underscores the need for further research to enhance our understanding of candidiasis and improve health outcomes for these unique and vulnerable animals.

Clinical features and risk factors for Sjogren’s syndrome patients suffering from oral candidiasis in Shanxi, China

ObjectivesTo investigate the clinical features and risk factors of Sjogren’s Syndrome (SS) patients suffering from oral candidiasis and to provide a foundation for the prevention and treatment of oral candidiasis in SS patients.MethodsThe medical records of 479 SS patients admitted to the Second Hospital of Shanxi Medical University from 2018 to 2020 were analysed to determine the clinical characteristics and risk factors that influence the occurrence of oral candidiasis infection in SS patients.ResultsPatients with oral candidiasis were older than those without oral candidiasis (P < 0.05). Male SS patients had greater oral candidiasis rates (P < 0.05). Unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were both shown to be adversely associated with oral Candida infections (P < 0.001). Logistic regression revealed that a low UWS was an independent risk factor for oral Candida infections in SS patients (OR: 0.004, P = 0.023). Greater WBC counts (OR: 1.22, P < 0.001), lower haemoglobin levels (OR: 0.97, P = 0.007), lower serum albumin levels (OR: 0.88, P < 0.001), lower IgG levels (OR: 0.91, P = 0.011), lower IgA levels (OR: 0.75, P = 0.011), and lower IgM levels (OR: 0.91, P = 0.015) were found in patients with oral Candida infections. Patients on immunosuppressive medications (OR: 0.32, P = 0.011), particularly rapamycin (P < 0.001), had a decreased rate of oral Candida infections.ConclusionsPatients with oral candidiasis were older than those without oral candidiasis. Male SS patients are more likely to have oral candidiasis. Individuals with lower UWS and SWS are more susceptible to oral Candida infection. Oral Candida infections in SS patients depend on their immunological status. Rapamycin may increase the abundance of Treg cells to reduce oral Candida infection in SS patients.