Incidence Of Candidiasis Research Articles

Increased vulvovaginal candidiasis incidence risk in various gestational ages at a private midwifery practice in Surabaya, Indonesia

HIGHLIGHTS 1. Hormonal changes during pregnancy lead to the presence of vulvovaginal candidiasis.2. Increased incidence of vulvovaginal candidiasis in different pregnancy trimesters were analyzed.3. Frequency of vulvovaginal candidiasis tends to increase along with the gestational age. ABSTRACT Objectives: This study aimed to analyze whether there was an increase in the incidence risk of vulvovaginal candidiasis at various gestational ages. Materials and Methods: A study examined vaginal smears of pregnant women at a private midwifery practice Farida Hadjri, Surabaya, Indonesia. A total sample of 96 patients was taken by the consecutive sampling method, consisting of 32 patients each from the 1st, 2nd, and 3rd trimester of pregnancy.y The smear was examined using Gram stain at Balai Besar Laboratorium Kesehatan Daerah Jawa Timur to detect the presence of fungi elements. Data were analyzed using Chi-square test with 95% confidence interval to investigate whether there was an increased risk of vulvovaginal candidiasis and gestational age. Results: There was an increased risk of vulvovaginal candidiasis and increased gestational age (p < 0.05). This result was related to the hormonal status of pregnant women. An increase in estrogen level during pregnancy leads to an increase in glycogen production by vaginal epithelial cells, which cause the vaginal environment to become more susceptible to fungal growth. Conclusion: There was increased vulvovaginal candidiasis incidence risk along with gestational age. Pregnancy is one of the predisposing factors for candida infection.

Current situation of fungal diseases in Eritrea.

The epidemiology of fungal infections in Eritrea is unknown. Most cases are under‐reported due to a lack of diagnostics. This study estimates the burden of serious fungal infections and highlights treatment and diagnostic gaps in the country. All publications related to fungal infections were identified by searches using PubMed/Medline and Google Scholar. Where no data were available, data from neighbouring countries, then sub‐Saharan African countries, then other parts of the world were considered for deriving estimates. The Eritrea population was 3,546,427 in 2020. In 2020, HIV/AIDS patients numbered 1400 and TB incidence were 2875. The five‐year adult prevalence of asthma (2016–2020) was 41,390, and the total prevalence estimate of chronic obstructive pulmonary disease (COPD) was 308,328. The annual incidence of cryptococcal meningitis and Pneumocystis jirovecii pneumonia in AIDS patients was estimated at 96 and 205 cases. Oesophageal candidiasis incidence is 715 HIV‐infected patients. Chronic pulmonary aspergillosis prevalence, including post‐tuberculosis cases, was estimated at 1399 (39/100,000). Fungal asthma has a prevalence of 1035 and 1366 in adults. The estimated prevalence of recurrent vulvovaginal candidiasis and tinea capitis is 59,391 and 342,585, respectively. There are no data on candidaemia, but it is estimated at 5/100,000 (177 cases annually). Invasive aspergillosis in leukaemia, lung cancer, COPD and HIV is estimated at 540 cases and fungal keratitis in 514 cases annually. Serious fungal infections are prevalent in Eritrea with approximately 408,164 people (11.5%) affected annually. Studies on fungal diseases to improve diagnosis and treatment are required with the implementation of a national surveillance program.

Evaluation of clotrimazole prophylaxis on tacrolimus trough concentrations in kidney transplant recipients.

BackgroundClotrimazole troches are used as prophylaxis against oropharyngeal candidiasis post‐transplant and have limited systemic absorption. Following several occurrences of tacrolimus concentration fluctuations after clotrimazole discontinuation, its use as prophylaxis was discontinued post‐kidney transplant.MethodsWe conducted a retrospective cohort study to evaluate the effect of clotrimazole prophylaxis on tacrolimus trough concentrations post‐kidney transplant. The study included adult patients who received a kidney transplant at Cleveland Clinic Main Campus from August 1, 2019 to July 1, 2020 and were maintained on per‐protocol, standard‐dose tacrolimus through 90 days post‐transplant. Patients were excluded if they received cyclosporine, systemic antifungals, strong CYP3A4 inhibitors or inducers, or a simultaneous multiorgan transplant. The primary objective was to compare tacrolimus trough concentrations before and after completion of clotrimazole prophylaxis. Secondary objectives were to compare the time to first post‐transplant goal tacrolimus trough concentration, the rate of for‐cause allograft biopsies within 90 days after transplant, and the incidence and type of candidiasis within 30 days after transplant, pre‐ and post‐protocol change.ResultsFollowing clotrimazole discontinuation, the median tacrolimus trough concentration decreased from 10.5 ng/ml (IQR 8.4–12.2) to 6.6 ng/ml (IQR 5–8.7, p < 0.0001). No statistically significant differences in the rate of for‐cause allograft biopsies (4.9% vs. 9.7%, p = 0.264) or incidence of candidiasis (1.2% vs. 5.4%, p = 0.217) were observed between those who received clotrimazole and those who did not receive clotrimazole.ConclusionsOur study provides further evidence of a significant drug–drug interaction between tacrolimus and clotrimazole among kidney transplant recipients that can potentially lead to negative allograft outcomes.

Antifungi Test of Red Spinning Extract (Amaranthus tricolor L.) on The Growth of Candida albicans

Candidiasis is starting to increase globally in line with the increase in the immunocompromised population such as people with HIV (Human Immunodeficiency Virus), diabetes mellitus, antibiotic consumption, and pregnant women. The incidence of candidiasis in pregnant women increased by 40%. Candidiasis is caused by a Candida yeast infection such as Candida albicans. Red spinach (Amaranthus tricolor L.) is a plant that has antifungal effects because it contains alkaloids, tannins, saponins, and flavonoids. The research was conducted in a laboratory experimental manner using the disc diffusion method to determine the effectiveness of red spinach (Amaranthus tricolor L.) as an antifungal against Candida albicans in vitro. Analysis of the data used is Anova One Way and Pearson correlation. Based on the results of the study, the highest inhibition zone was at a concentration of 100%, namely 16.4 mm, this means that red spinach (Amaranthus tricolor L.) has strong antifungal power to inhibit the growth of Candida albicans. Researchers hope that these results can be a general reference material for further research to prevent candidiasis so as to improve maternal health rates.

Incidence of Oral Candidiasis in Patients with Asthma Using Inhaled Corticosteroids by Various Inhaler Devices

Objective: The aim of this study was to do the comparison of the incidence of oral candidiasis in individuals with inhaled corticosteroids by Rota caps via Revolizer and metered dose inhalers via spacer. Place and Duration: This Cross-sectional study was held in the Pulmonology department of Gulab Devi Hospital, Lahore for six-months duration from March 2021 to August 2021. Methods: Patients with asthma who were referred to chest clinics and used MDI inhaled corticosteroid with spacer or Rota cap with Revolizer for minimum two-months were alienated into 2 groups. The A Group included patients using metered dose inhalers with spacer and inhaled steroids and group B patients using Rota cps with Revolizer. The treating physician examined all patients for oropharyngeal candidiasis, and a thorough throat examination in patients was done who reported dysphonia or throat ache. Results: Of 120 patients (group A: 60 and group B: 60) who participated in the analysis, 72 (60%) were female and 48 (40%) were male. Their ages fluctuated from 15 to 75 (mean 43.2). 89 patients (74.2%) were encompassed in the analysis with moderate asthma and severe asthma was noted in 31 patients (25.8%). 39 patients (32.5%) described throat ache; 81 patients (67.5%) did not have such symptoms. The oral candidiasis incidence was noted in 18 (15%) in group B patients who used Rotacaps encompassing 6mcg and Formeterol Fumerate 400 mcg Budesonide and 12 (10%) in group A patients using MDI containing Salmeterol xinafoate 25 and Fluticasone propionate 250 mcg with spacer device. It was advanced in B group patients than A group (p &lt;0.05). The oral candidiasis incidence in individuals over 50 years was also higher than patients under 50 years. Conclusion: This analysis exhibited a high proportion of oral candidiasis among individuals using Rota caps containing formoterol and Budesonide by Revolizer in comparison to metered dose inhalers with spacer. Keywords: Oral candidiasis; Asthma; Inhaled corticosteroids

Fluticasone Propionate Orally Disintegrating Tablet (APT-1011) for Eosinophilic Esophagitis: Randomized Controlled Trial

Topical steroids are effective treatments for eosinophilic esophagitis (EoE). The FLUTE (Fluticasone in EoE) trial evaluated safety and efficacy of APT-1011 (fluticasone propionate oral disintegrating tablet) vs placebo for treatment of EoE. In this randomized, double-blind, placebo-controlled, dose-finding, phase 2b trial, 106 adults with EoE received 1 of 4 APT-1011 doses or placebo for a 12-week induction period and 40 weeks of maintenance. Primary outcome was histologic response (≤6 eosinophils per high-power field) at Week 12. Secondary outcomes included endoscopic features and dysphagia frequency. Histologic response rates were 0% for placebo, 80% for APT-1011 3 mg twice daily (BID), 67% for 3 mg at bedtime (HS), 86% for 1.5 mg BID, 48% for 1.5 mg HS (P &lt; .001 for all groups vs placebo). At Week 12, mean Edema/Rings/Exudates/Furrows/Strictures (EoE Endoscopic Reference Score) total score (max, 9.0) improved from 4.5 to 2.3 for 3 mg BID, 5.3 to 2.1 for 3 mg HS, 4.6 to 1.7 for 1.5 mg BID, 5.3 to 2.9 for 1.5 mg HS vs 5.2 to 4.5 for placebo. Mean dysphagia frequency over 14 days improved from baseline to Week 12 with all active groups improving more than placebo. Improvements were sustained to Week 52. APT-1011 was safe and well-tolerated, with higher incidence of candidiasis noted at the higher twice daily doses. APT-1011 dosing regimens were superior for histologic and endoscopic responses, and for reduction in dysphagia frequency vs placebo. Based on the symptom improvement and assessment of adverse events together with the histologic response rate, 3 mg once daily at bedtime dose showed the most favorable risk-benefit profile. gov, Number: NCT03191864.

Oral Fungal Infections: Past, Present, and Future.

Oral fungal infections have afflicted humans for millennia. Hippocrates (ca. 460-370 BCE) described two cases of oral aphthae associated with severe underlying diseases that could well have been oral candidiasis. While oral infections caused by other fungi such as cryptococcosis, aspergillosis, mucormycosis, histoplasmosis, blastomycosis, and coccidioidomycosis occur infrequently, oral candidiasis came to the fore during the AIDS epidemic as a sentinel opportunistic infection signaling the transition from HIV infection to AIDS. The incidence of candidiasis in immunocompromised AIDS patients highlighted the importance of host defenses in preventing oral fungal infections. A greater understanding of the nuances of human immune systems has revealed that mucosal immunity in the mouth delivers a unique response to fungal pathogens. Oral fungal infection does not depend solely on the fungus and the host, however, and attention has now focussed on interactions with other members of the oral microbiome. It is evident that there is inter-kingdom signaling that affects microbial pathogenicity. The last decade has seen significant advances in the rapid qualitative and quantitative analysis of oral microbiomes and in the simultaneous quantification of immune cells and cytokines. The time is ripe for the application of machine learning and artificial intelligence to integrate more refined analyses of oral microbiome composition (including fungi, bacteria, archaea, protozoa and viruses—including SARS-CoV-2 that causes COVID-19). This analysis should incorporate the quantification of immune cells, cytokines, and microbial cell signaling molecules with signs of oral fungal infections in order to better diagnose and predict susceptibility to oral fungal disease.

Risk of candidiasis associated with interleukin-17 inhibitors: A real-world observational study of multiple independent sources.

SummaryBackgroundBiologics directed against the T-helper (Th)-17 pathway have been approved for several inflammatory diseases. Interleukin (IL)-17 is involved in anti-Candida host defense, and clinical trials suggested increased candidiasis incidence during IL-17 inhibitor therapy. We describe the worldwide epidemiology of candidiasis during Th17 inhibitor therapy, and immunological mechanisms involved in candidiasis susceptibility.MethodsA comprehensive analysis of multiple independent sources reporting Candida adverse events during biologics inhibiting the Th17 pathway was performed. Association between Th17 inhibitors and candidiasis was assessed using safety reports of (1) WHO and (2) EMA, (3) a population-based prescriptions registry, and (4) a psoriasis cohort. In a cohort of psoriasis patients experiencing candidiasis during Th17 inhibitors, Candida killing by immune cells and serum inflammatory proteome were analyzed.FindingsA strong association between IL-17 inhibitors and candidiasis (ROR 10·20) was found in the WHO database, particularly for cutaneous (ROR 12·28), oropharyngeal (ROR 19·18), and esophageal candidiasis (ROR 21·20). Risk was higher relative to TNF-α inhibitors (4–10-fold, depending on candidiasis type), confirmed by EMA reports (16–33-fold), prescriptions registry (2–42-fold), and a psoriasis cohort (3–25-fold). After start of IL-17 inhibitors, patients’ risk of candidiasis requiring antifungals increased 2–16 fold. In the psoriasis cohort, 58% of IL-17 treatment episodes were associated with candidiasis. In Th17 inhibitor recipients, proteins involved in anti-Candida immunity and Candida killing by mononuclear leukocytes were impaired.InterpretationIL-17 inhibitors are associated with an increased risk of oropharyngeal, esophageal, and cutaneous candidiasis, posing a significant disease burden for IL-17 inhibitor recipients.FundingRadboudUMC.

Evaluation of the antifungal activity of Lactobacillus reuteri against Candida species

BackgroundCandidiasis is a variety of diseases, including cutaneous, mucosal, and disseminated organ infections caused by members of the genus Candida. The incidence of candidiasis is increasing in immunocompromised patients. Probiotics are microorganisms that have health benefits when used properly. The present study aimed to assess the inhibitory activity of Lactobacillus reuteri against five different Candida species isolated from the oral cavity of Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) patients. MethodsThe inhibitory effect of L. reuteri versus oral Candida species was studied with broth microdilution (BMD), agar overlay interference, and co-aggregation assays. ResultsBoth cells and cell free supernatant (CFS) of L. reuteri had antifungal effects versus the five oral Candida species. In this study, Minimum inhibitory concentration (MIC) and Minimum fungicidal concentration (MFC) amounts for CFS of L. reuteri ranged from 6.25 to 25 μl/ml and 50 to 200 μl/ml, respectively. C. tropicalis and C. krusei were shown to be the most susceptible to CFS of L. reuteri. At 1010 and 108 colony forming unit (CFU/ml) of L. reuteri, no colonies of Candida species grew, and growth of all studied Candida species were completely inhibited. L. reuteri showed the most significant co-aggregation percentage for C. tropicalis (96%) followed by C. parapsilosis (95%). The ranking of the co-aggregation of L. reuteri with the five Candida species was C. tropicalis > C. parapsilosis > C. glabrata > C. krusei > C. albicans. ConclusionToday, the increasing resistance of antifungal drugs to infectious agents of Candida species has caused concern around the world. Hence, the role of probiotic, especially lactobacilli such as L. reuteri may be a suitable solution to inhibit candidiasis.

Effect of Virgin Coconut Oil in The Treatment of Leucorrhea Caused by Candida Albicans Infection on Pregnant Women at Hospitals in Padang

Introduction : According to WHO, the prevalence of reproductive health problems in women has reached 33% from all types of diseases. One of the most frequent reproductive health problems is fluor albus. The incidence of candidiasis in pregnant women has doubly increased, especially at third trimester, compared to women who were not pregnant. Candida should be considered a dangerous pathogen in early pregnancy.Objective : This study compared the number of colonies before and after the administration of virgin coconut oil (VCO) to address vaginal discharge caused by C. albicans infection in pregnant women.Material and methods : This is an experimental study on 36 pregnant women. Examination of fluor albus is done by applying vaginal swab before and after administration of 1 tablespoon of VCO orally three times a day dan 5cc of VCO was applied on the vagina and vulva for intervention group, meanwhile the control group was not given anything. Statistical analysis to test the significance is done by using T-test.Results : There was a difference on average number of colonies with higher number of colonies prior to administration (137.17 ± 16.35 vs 122.17 ± 14.42). The average number of colonies at the first examination was 96.06 ± 8.85 colonies and increased at the second examination to 112.89 ± 12.49 colonies.Conclusion : There was an effect of VCO administration on decreasing the number of colonies in the intervention group (p=0.000), while in control group, there was increasing average number of colonies in the second examination (p=0.000).Keywords: Candida albicans, fluor albus, pregnant women, virgin coconut oil

Effect of Virgin Coconut Oil in The Treatment of Leucorrhea Caused by Candida Albicans Infection on Pregnant Women at Hospitals in Padang

Introduction : According to WHO, the prevalence of reproductive health problems in women has reached 33% from all types of diseases. One of the most frequent reproductive health problems is fluor albus. The incidence of candidiasis in pregnant women has doubly increased, especially at third trimester, compared to women who were not pregnant. Candida should be considered a dangerous pathogen in early pregnancy.Objective : This study compared the number of colonies before and after the administration of virgin coconut oil (VCO) to address vaginal discharge caused by C. albicans infection in pregnant women.Material and methods : This is an experimental study on 36 pregnant women. Examination of fluor albus is done by applying vaginal swab before and after administration of 1 tablespoon of VCO orally three times a day dan 5cc of VCO was applied on the vagina and vulva for intervention group, meanwhile the control group was not given anything. Statistical analysis to test the significance is done by using T-test.Results : There was a difference on average number of colonies with higher number of colonies prior to administration (137.17 ± 16.35 vs 122.17 ± 14.42). The average number of colonies at the first examination was 96.06 ± 8.85 colonies and increased at the second examination to 112.89 ± 12.49 colonies.Conclusion : There was an effect of VCO administration on decreasing the number of colonies in the intervention group (p=0.000), while in control group, there was increasing average number of colonies in the second examination (p=0.000).Keywords: Candida albicans, fluor albus, pregnant women, virgin coconut oil

Prevalence of superficial-cutaneous fungal infections in Shiraz, Iran: A five-year retrospective study (2015-2019).

BackgroundSuperficial and cutaneous fungal infections are common in tropical areas. The aim of this study was to provide a basic database of superficial and cutaneous mycoses and the most common etiological agents among patients.MethodsBetween 2015 and 2019, a total of 1807 patients suspected of superficial and cutaneous mycosis referring to the mycology laboratory of Shiraz medical school, Fars, Iran were evaluated. Specimens were taken from the patients’ affected area, and clinical samples were examined by direct microscopy and culture. The epidemiological profile of the patients was collected.ResultsA total of 750 patients were confirmed with mycoses. Positive samples totaled 750 cases consisting of the nail (373/49.7%), skin (323/43%), head (47/6.26%), and mucosal membrane (4/0.5%). The yeasts group included 304 Candida spp. (70.3%), 123 Malassezia spp. (28.47%), and 5 Rhodotorula spp. (1.1%). The filamentous fungi were distributed as 34.8% dermatophytes and 7.5% non‐dermatophyte. The clinical types of dermatophytosis were tinea unguium (110/261), tinea capitis (50/261), tinea pedis (48/261), tinea corporis (37/261), and tinea cruris (16/261). Non‐dermatophyte molds included A. flavus 17, A. niger 4, Aspergillus spp. 15, Penicillium. 10, Fusarium 6, Mucor 2, Stemphylium 1, and Alternaria 1.ConclusionThis study provides useful data for the study trends of superficial and cutaneous fungal infections in a specific area. The mycological data confirmed higher incidence of candidiasis (mainly onychomycosis) and dermatophytosis in patients affected by fungal pathogens, which helped to better understand the epidemiological aspects of these mycoses.

Virulence Factors and Antifungal Susceptibility Profile of C. tropicalis Isolated from Various Clinical Specimens in Alexandria, Egypt

Background: The incidence of candidiasis caused by non-albicans Candida (NAC) species is increasing. Candida tropicalis has emerged as one of the most important NAC species. This study aims to examine the antifungal susceptibility profile and some virulence factors of C. tropicalis isolated from various clinical specimens. Methods: A total of 71 C. tropicalis isolates from various clinical specimens (69.01%, 18.31%, 9.86%, and 2.82% of isolates were collected from urine, respiratory samples, blood, and skin and soft tissue infections, respectively) from ICU patients in Alexandria, Egypt. The isolates were identified at species level by CHROMagar Candida and VITEK 2 compact system. Furthermore, the antifungal susceptibility was determined using the VITEK 2 system AST-YS07 card containing different antifungals. Hemolysin, phospholipase, and proteinase activity and biofilm formation were also tested as virulence factors. Results: Only 30 isolates (42.25%) were non-susceptible (MIC ≥ 4 µg/mL) to fluconazole, of which 28 isolates showed non-susceptibility (MIC ≥ 0.25 µg/mL) to voriconazole. All isolates showed both hemolysin and proteinase activities, while only 9 isolates (12.68%) showed phospholipase production and 70 isolates (98.59%) demonstrated biofilm formation. Strong biofilm production was observed among the blood culture isolates (85.71%), followed by the respiratory and urinary isolates (61.54% and 46.94%, respectively). Conclusions: This study sought to provide useful data on the antifungal susceptibility of C. tropicalis isolates from ICU patients suffering from invasive infections with an increased trend towards elevated MICs levels of both fluconazole and voriconazole. Due to the high incidence of systemic candidiasis and antifungal resistance, C. tropicalis is emerging as a serious root of infections. Therefore, early and accurate identification of Candida species along with susceptibility testing is of utmost importance.

Relationship Between Tight Pants Use and The Incidence of Flour Albus Pathology in Women of Childbearing Age

Women who have not had a marital relationship, vaginal discharge can also occur, but the cause of leucorrhoea can occur because of using tight pants, wearing a towel together, the lack of maintaining the cleanliness of the vaginal area. This study aims to determine the association of the vulva higiene with vulvovaginal candidiasis on fertile age in Public Health Center (PHC) Cipayung districts. This study aim to know the relationship of the use of tight pants with the incident flour albus pathology in women of childbearing age at the PHC Cipayung. The analytic study method with study design was cross sectional approach and chi square test would be used. The research using purposive sampling by through 36 women of childbearing. This data used is primary data. The result showed that there is a significant association between tight pants use with flour albus pathology incidence in women of childbearing age at the PHC Cipayung (P-value = 0.009; α = 0.05). There is a relationship between vulva hygiene and vulvovaginal candidiasis at Cipayung PHC due to lack of vaginal hygiene on woman of childbearing age, which increased the incidence of candidiasis.

Non Candida albicans Candida (NCAC) of oral cavity in head and neck cancer patients under cancer therapy: Prevalance, species identification and antimycotic sensitivity pattern

Introduction: Cancer patients remain at risk for developing serious infections due to oropharyngeal Candida colonisation as the incidence of Candidiasis continues to rise after chemotherapy (CT), Radiochemotherapy (RCT) or Radiotherapy (RT) for head and neck cancer. So, accurate and rapid identification of candida species is very important in clinical laboratory. Objective: To study the prevalance, species identification and antimycotic sensitivity pattern of Candida spp. of oral cavity in patients of head & neck cancer undergoing chemotherapy (CT) & Radiochemotherapy (RCT) and compare with control group. Materials and Methods: This is prospective cross sectional and case control analysis including 110 patient in study group; chemotherapy (CT)-55 patient, Radiochemotherapy (RCT)-55 patients and 50 healthy individuals as control. Candida isolates identified by standrad methods using morphological, biochemical & chromogenic property of different Candida spp. and antimycotic sensitivity applied by disc diffusion method. Results: Prevalence of Candida spp. colonization seen in 50% patients of study and 20% in control group (p value- 0.004) ; patients on RCT (63.6%) have higher prevelance as compare to CT (36.4%), (p 0.007). C. tropicalis was most common (38%) species followed by C. albicans (11%) & C. glabrata (11%); most of isolates were sensitive to Amphotericin B and Nystatin and least sensitive to Fluconazole. Conclusion: High prevalence of Candidal carriage and the species variation and changing pattern of antifungal susceptibility of Candida spp in patients undergoing chemotherapy and radiation therapy require isolation and speciation of the causative Candida sp. and prophylaxis is needed to prevent infection among these patients. Keywords: Candida species, Non Candida albicans Candida (NCAC), Oral cavity, Head & neck cancer, Radiochemotherapy.

In vivo and in vitro Pathogenesis and Virulence Factors of Candida albicans Strains Isolated from Cutaneous Candidiasis.

Background:The Candida albicans is one of the most important global opportunistic pathogens, and the incidence of candidiasis has increased over the past few decades. Despite the established role of skin in defense against fungal invasion, little has been documented about the pathogenesis of Candida species when changing from normal flora to pathogens of vaginal and gastrointestinal epithelia. This study was carried out to determine the in vivo and in vitro pathogenesis of clinical C. albicans strains isolated from skin lesions. Methods:In this study, association of in vivo and in vitro pathogenesis of C. albicans isolates with different evolutionary origins was investigated. Oral and systemic experimental candidiasis was established in BALB/C mice. The expression levels of SAP1-3 genes, morphological transformation, and biofilm-forming ability of C. albicans were evaluated. Results:All the strains showed in vitro and in vivo pathogenicity by various extents. The SAP1, SAP2, and SAP3 genes were expressed in 50%, 100%, and 75% of the strains, respectively. The biofilm formation ability was negative in 12% of the strains, while it was considerable in 38% of the strains. Fifty percent of the strains had no phospholipase activity, and no one demonstrated high level of this pathogenesis factor. Relatively all the strains had very low potency to form pseudohyphae. Conclusion:Our findings demonstrated that Candida albicans strains isolated from cutaneous candidiasis were able to cause oral and systemic infections in mice, so they could be considered as the potential agents of life-threatening nosocomial candidiasis in susceptible populations.

Plant-Derived Substances in the Fight Against Infections Caused by Candida Species.

Yeast-like fungi from the Candida genus are predominantly harmless commensals that colonize human skin and mucosal surfaces, but under conditions of impaired host immune system change into dangerous pathogens. The pathogenicity of these fungi is typically accompanied by increased adhesion and formation of complex biofilms, making candidal infections challenging to treat. Although a variety of antifungal drugs have been developed that preferably attack the fungal cell wall and plasma membrane, these pathogens have acquired novel defense mechanisms that make them resistant to standard treatment. This causes an increase in the incidence of candidiasis and enforces the urgent need for an intensified search for new specifics that could be helpful, alone or synergistically with traditional drugs, for controlling Candida pathogenicity. Currently, numerous reports have indicated the effectiveness of plant metabolites as potent antifungal agents. These substances have been shown to inhibit growth and to alter the virulence of different Candida species in both the planktonic and hyphal form and during the biofilm formation. This review focuses on the most recent findings that provide evidence of decreasing candidal pathogenicity by different substances of plant origin, with a special emphasis on the mechanisms of their action. This is a particularly important issue in the light of the currently increasing frequency of emerging Candida strains and species resistant to standard antifungal treatment.

Prevalence of Candida albicans among Female Patients in Two Selected Hospitals in Owerri Metropolis, Imo State Southeastern Nigeria

The incidence of candidiasis in the female reproductive tract is a serious threat to public health. This study assesses the prevalence of Candida albicans among female patients in the two selected hospitals in Owerri metropolis. A systematic random sampling technique was used to select 120 female patients between the ages of 16-56 years. Only patients who showed no symptoms of urinary tract infections and who were not on anti-fungal therapy at the time of the study were included in the study. A well-structured interview questionnaire was used to source information on socio-demographic characteristics of the respondents as well as the risk factors of Candida albicans infections. High Vaginal Swab (HVS) was aseptically collected from each of the patients, using a sterile swab stick. The collected samples were labeled appropriately and immediately sent to the microbiology/mycology lab for analysis. The HVS samples were respectively streaked directly into sabouraud agar plates and incubated anaerobically at 37oC for 48 hours. Yeast growth characteristics were noted. Positive colonies were sub-cultured in Macconkey agar to obtain pure isolates. The Candida albicans were properly identified and confirmed by germ tube test, gram staining and biochemical tests. The results showed that the overall prevalence of Candida albicans among the women was (53.34%). The prevalence was highest among the patients in the age group 16-25 (44.17%), lower education qualification (n=65, 54.17%) and pregnant women (n=44, 36.67%). The possible risk factors for the infection include use of antibiotics (n=85, 70.83%), use of nylon underwear (n=78, 65.00), use of public toilet (n=90, 75.00%), use of squat WC (n=59, 9.17%) and use of oral contraceptive (n=59, 49.17%). The results call for preventive measures to protect women. Therefore public health education and campaign should be adopted.

&lt;I&gt;Vulvovaginal candidasis&lt;/I&gt; among female patients attending Yusuf Dantsoho Memorial Hospital and Barau Dikko Specialist Hospital Kaduna

Vulvovaginal candidiasis (VVC) is a major cause of lower genital infections in women, especially in developing countries and cause significant morbidity and financial burden on the already weak economy. The objective was to isolate and identify Candida spp responsible for Vulvovaginitis. Two hundred (200) vaginal swabs were collected from female patients 15years and above, attending Yusuf Dantsoho Memorial Hospital (YDMH) and Barau Dikko Specialist Hospital (BDSH) all within Kaduna metropolis. The samples were analysed for the presence of Candida spp using standard procedures of microscopy, culture and biochemical identification. The overall incidence of VVC was 79.5% (159/200), with higher incidence among patients attending Yusuf Dantsoho Memorial Hospital 84.8% (117/138), than Barau Dikko Memorial Hospital 67.7% (42/62). Four (4) yeast species were isolated and identified which include Candida krusie, Candida parapsilosis and Candida glabrata. C. krusie had the highest percentage occurrence of 42.5% (39/159), while C. parapsilosis had the least percentage occurrence of 11.3% (18/159). Higher incidence was recorded among age group 40 and above 92.8% (13/14) and lowest among age group 31-40 76.5% (39/51). Highest incidence was also recorded among widow 100% (18/18) and lowest among married 76.8% (109/142). The high percentage of positive samples is an indication that there is a high incidence of candidiasis among the study population. There is need for regular screening of women for VVC and other sexually transmitted infections.&#x0D; Key words: Incidence, Vulvovaginal Candidiasis, Isolation, Kaduna.

Mekanisme Escape dan Respon Imun innate terhadap Candida albicans

Candidiasis is an infection caused by fungal Candida albicans. The incidence of candidiasis is pretty high in Indonesia. Candida albicans develop their pathogenicity by several ways so that it can invade and escape from the immune system. The host’s immune system must always be vigilant to recognized antigen through various receptors, activation of the transduction pathway and activation of various immune cells. But as organisms that struggle to survive, Candida also develops mechanisms to escape the immune response. There are so many articles have written the immune response against candidiasis, this review aims to understand more and updating information about the biological processes of pathogenicity of fungi and the mechanism of Candida albicans in escaping immune responses, the role of each innate molecule and immune cell, and clinical aspect to Candida albicans infections. We already facing the big challenges against therapy of fungal infection, so by understanding the escape mechanism of Candida albicans, it is possible to developed antifungal or Candida vaccine in the future, therefore the incidence of candidiasis can be suppressed.