Incidence Of Candidiasis Research Articles

Neonatal candidiasis: prophylaxis and treatment

The incidence of candidiasis has risen in neonatal intensive care units as advances in medical therapy have allowed for increased survival of extremely preterm neonates. The mortality of candidiasis has been reported to be 20% by several multi-centre studies. Definitive guidance for prophylaxis and treatment is hindered by lack of large, multi-centre, randomised controlled trials. Systemic prophylaxis is currently not recommended for any neonatal population, and amphotericin B deoxycholate continues to be used as first-line therapy for the treatment of invasive disease.

The Role of Corticosteroids in Chronic Obstructive Pulmonary Disease

Oral corticosteroids are powerful relatively nonspecific antiinflammatory agents with a range of well-characterized side effects. There is good evidence to show that they accelerate the rate of resolution of exacerbations of COPD and relapse is less likely if patients receive these drugs. Maintenance therapy with oral preparations is associated with worse mortality and skeletal muscle myopathy is a particular problem. Corticosteroids have little effect on biopsy proven inflammation or its surrogates in COPD and did not change the rate of decline of FEV (1) over a range of spirometric disease severity in a number of trials each lasting 3 years. However, meta-analysis of the data suggests that a small effect (up to 10 ml /year) might be present. There is more consistent evidence for an effect on postbronchodilator FEV (1) with both fluticasone propionate and budesonide. In patients with a postbronchodilator FEV (1) < 50% predicted where self-reported exacerbations become more common, inhaled corticosteroids can reduce the number of attacks. This effect is the major factor accounting for the reduction in deterioration in health status seen in patients who receive inhaled corticosteroids. Inhaled corticosteroids are much safer than oral therapy, although they do have a predictably higher incidence of candidiasis and hoarseness of the voice. Skin bruising is seen in patients with better lung function who use these drugs. Triamcinolone use is associated with reduction in bone density but this was not seen with budesonide. Combining an inhaled corticosteroid and a long-acting beta-agonist in the same inhaler increases the efficacy of the latte drug in COPD patients, with a significantly larger improvement in FEV (1), a larger reduction in reported breathlessness, and a reduction in exacerbation numbers in those with severe disease where beta-agonists appear to be less effective. Inhaled corticosteroids are not suitable for monotherapy in COPD but can be helpfully combined with an inhaled bronchodilator in patients with symptomatic disease.

Incidence of Oral Lesions in HIV-1-infected Women: Reduction with HAART

Few studies assess the effectiveness of HAART on reducing the incidence and recurrence of oral lesions. We investigated such changes among 503 HIV+ women over six years in the Women's Interagency HIV Study. The incidence of erythematous candidiasis (EC), pseudomembranous candidiasis (PC), hairy leukoplakia (HL), and warts was computed over follow-up visits after HAART initiation compared with before HAART initiation. Analysis of our data demonstrates a strong decrease in candidiasis after HAART initiation. The incidence of EC fell to 2.99% from 5.48% (RR 0.545); PC fell to 2.85% from 6.70% (RR 0.425); and EC or PC fell to 3.43% from 7.35% (RR 0.466). No changes were seen in HL or warts. Higher HIV-RNA was associated with greater incidence of candidiasis and HL, but not warts. Analysis of these data indicates that recurrence and incidence of candidiasis are reduced by HAART, and that recurrence is reduced independently of CD4 and HIV-RNA.

Prolonged fluconazole prophylaxis is associated with persistent protection against candidiasis-related death in allogeneic marrow transplant recipients: long-term follow-up of a randomized, placebo-controlled trial

AbstractTwo randomized, placebo-controlled trials previously showed that fluconazole (400 mg/d) administered prophylactically decreases the incidence of candidiasis in blood and marrow transplant (BMT) recipients. However, there exists conflicting data regarding the optimal duration of fluconazole administration, specifically whether prophylaxis through acute graft-versus-host disease (GVHD) results in improved survival in allograft recipients. Reported here are the results of long-term follow-up and a detailed analysis of invasive candidiasis and candidiasis-related death in 300 patients who received fluconazole (400 mg/d) or placebo for 75 days after BMT at the Fred Hutchinson Cancer Research Center. Patients in both treatment arms were compared for survival, causes of death, and the incidence of invasive fungal infections early (less than 110 days) and late (more than 110 days) after BMT. After 8 years of follow-up, survival is significantly better in fluconazole recipients compared with placebo recipients (68 of 152 vs 41 of 148,P = .0001). The overall incidence of invasive candidiasis was increased in patients who received placebo compared with fluconazole (30 of 148 vs 4 of 152, P < .001). More patients who received placebo died with candidiasis early (13 of 148 vs 1 of 152, P = .001) and late (8 of 96 vs 1 of 121,P = .0068) after BMT. The incidence of severe GVHD involving the gut was higher in patients who did not receive fluconazole (20 of 143 vs 8 of 145, P = .02), and fewer patients who received fluconazole died with this complication. Thus, administration of fluconazole (400 mg/d) for 75 days after BMT appears to be associated with decreased gut GVHD, a persistent protection against disseminated candidal infections and candidiasis-related death, resulting in an overall survival benefit in allogeneic BMT recipients.

Prolonged fluconazole prophylaxis is associated with persistent protection against candidiasis-related death in allogeneic marrow transplant recipients: long-term follow-up of a randomized, placebo-controlled trial

Two randomized, placebo-controlled trials previously showed that fluconazole (400 mg/d) administered prophylactically decreases the incidence of candidiasis in blood and marrow transplant (BMT) recipients. However, there exists conflicting data regarding the optimal duration of fluconazole administration, specifically whether prophylaxis through acute graft-versus-host disease (GVHD) results in improved survival in allograft recipients. Reported here are the results of long-term follow-up and a detailed analysis of invasive candidiasis and candidiasis-related death in 300 patients who received fluconazole (400 mg/d) or placebo for 75 days after BMT at the Fred Hutchinson Cancer Research Center. Patients in both treatment arms were compared for survival, causes of death, and the incidence of invasive fungal infections early (less than 110 days) and late (more than 110 days) after BMT. After 8 years of follow-up, survival is significantly better in fluconazole recipients compared with placebo recipients (68 of 152 vs 41 of 148,P = .0001). The overall incidence of invasive candidiasis was increased in patients who received placebo compared with fluconazole (30 of 148 vs 4 of 152, P &lt; .001). More patients who received placebo died with candidiasis early (13 of 148 vs 1 of 152, P = .001) and late (8 of 96 vs 1 of 121,P = .0068) after BMT. The incidence of severe GVHD involving the gut was higher in patients who did not receive fluconazole (20 of 143 vs 8 of 145, P = .02), and fewer patients who received fluconazole died with this complication. Thus, administration of fluconazole (400 mg/d) for 75 days after BMT appears to be associated with decreased gut GVHD, a persistent protection against disseminated candidal infections and candidiasis-related death, resulting in an overall survival benefit in allogeneic BMT recipients.

Epidemiology of vaginitis

Vaginitis is one of the most common problems in clinical medicine, and it is the reason cited most often for visits to obstetricians and gynecologists. This article reviews the epidemiology in the United States and Scandinavia for the three major causes of vaginitis: candidiasis, trichomoniasis, and bacterial vaginosis. The incidence of candidiasis has increased dramatically during the past decade, with an increase in the percentage of non-albicans Candida strains. However, in Scandinavia the incidence of candidiasis has been relatively stable, between 10% and 30%, during the past 5 years. The incidence of Trichomonas has decreased dramatically in both the United States and Scandinavia during the past 15 years, partly attributable to the advent of metronidazole. In the United States bacterial vaginosis continues to be the leading variety of vaginal infection, affecting a broader spectrum of women than gonorrhea. The prevalence of bacterial vaginosis in Scandinavia is about 30%, and this percentage increases with age according to studies of patients at sexually transmitted disease clinics.

The incidence of candidiasis amongst the asymptomatic female students of the University of Jos, Nigeria.

A survey was carried out on the incidence of candidiasis amongst the asymptomatic female students of University of Jos. One hundred and three students were selected at guided random. Their first stream urine samples were collected with the aid of sterile McCarthney bottles. The deposits of the centrifuged urine samples were plated out on sabouraud's dextrose agar (SDA) fortified with antibiotics (penicillin G and streptomycin). A total number of 42 positive Candida cases were obtained. This represented 40.78% of the total samples (103) examined. The Candida species isolated included C. albicans, C. glabrata, C. guilliermondi, C. parapsilosis, C. pseudotropicalis, C. stellatoidea, C. tropicalis and C. viswanathii. C. albicans and C. tropicalis were more predominant than the other species. C. albicans had 38.10% frequency of occurrence while C. tropicalis had 21.43% occurrence. The least percentage occurrence was recorded for C. viswanathii which had 2.38%. There were significant relationships between the incidence of candidiasis and the predisposing factors like drug administration (antibiotics and contraceptive pills), cases of pregnancy and previous cases of urinogenital tract infection. Neither the marital status nor the age groups of the test female students had significant effects on the incidence of this disease. The pH values of the infected urine samples had a significant effect on the incidence of the disease.

Diagnosing invasive candidiasis: The clinicians' albatross

With advances in cancer chemotherapy, organ transplantation procedures, life support systems, and broader spectrum antibacterial antibiotics, the incidence of candidiasis continues to increase. As therapeutic and technologic advances in medical care proceed, it can be expected that the upward spiral of candidal in- fections will continue. Although cognizant of the frequency and potential severity of candidal infections, clinicians remain hampered by the inability to make an early diagnosis of these infections. An early diagnosis is essential for the

The Use of a Precipitin Test to Differentiate Candida Albicans from Candida Stellatoidea

The incidence of Candidiasis (or Moniliasis) has apparently increased since the introduction and use of certain antibiotics (1). For this reason, it is important to recognize cultures of Candida albicans with speed and accuracy. These organisms are usually identified by their morphological characteristics on special agar and their ability to ferment sugars (2, 3, 4, 5). Animal pathogenicity, while helpful is too expensive and time consuming to be used routinely.

THE RECENT TREND OF DEEP CANDIDIASIS (MONILIASIS) IN OTO-RHINO-LARYNGOLOGY IN JAPAN

The research committie sponsored by Japanese ministry of education entrusted us the investigation of deep candidiasis in oto-rhino-laryngology. We collected 75 cases from the 21 medical schools and one national hospital and we added to them 26 cases which were found in literatures. Of these 101 cases the following studies were done. The incidence of candidiasis has significantly increased since 1952, 66 cases of 101 cases being discovered after 1952. The cases which were preceded by antibiotics treatment were only 13 and we conci- dered that the candidiasis in oto-rhino-laryngology might occur primarily. The affected sites were: mouth, 38 cases; pharynx, 38 cases; mouth, pharynx and larynx, 30 cases; nose and sinuses, 3 cases; bronchus, one case; external meatus, one case. The clinical pictures of candidiasis of the mucous membrane were classified into 8 types. Superficial candiasis, i. e. was excluded from present study. 1) Aphtous solitary type: 1. 2) Flat type with thin coating : 33. 3) Erosion and Plaques muqueses type: 19. 4) Irregular deep ulcer: 13. 5) Necrotic ulcer complicated with high septic fever: 13. 6) Deep ulcer with rich granulation : 8. 7) Hyperplastic and granulomatous type : 7. 8) Others : 7. For the treatment the specific effective agents have not discovered, but trichomycin (Hosoya) seemed to be most effective.