Candida Isolates Research Articles

Antifungal susceptibility and virulence determinants profile of candida species isolated from patients with candidemia

Candida is the most prevalent fungal bloodstream infection (BSI) with a high mortality rate among hospitalized patients. Another concern facing physicians is rising global incidence of drug-resistant Candida. This study aimed to characterize the prevalence, antifungal susceptibility, biofilm formation, and virulence genes (HWP1, ALS1, SAP2) of different Candida spp. isolated from patients with candidemia. 52 isolates of Candida spp. were identified from blood cultures by chromogenic Candida agar and confirmed by the VITEK 2 system. Isolates were tested for antifungal susceptibility by disk diffusion and VITEK 2 system. Biofilm formation and investigated genes were detected by the Congo red method and conventional PCR, respectively. Candida spp. caused 2.3% of detected BSIs, of which 32.7% were caused by Candida albicans (C. albicans) and 67.3% by non-albicans Candida (NAC), with the predominance of C. tropicalis (25%), followed by C. parapsilosis (17.3%), and C. krusei (13.5%). The susceptibility rates to fluconazole, voriconazole, caspofungin, micafungin, amphotericin B, and flucytosine were 64.7%, 76.5%, 100.0%, 100%, 100.0%, and 100.0% in C. albicans, while 53.6%, 71.4%, 91.4%, 91.4%, 94.3%, and 94.3% in NAC, respectively. Biofilm production, HWP1, ALS1, and SAP2 were detected in 70.6%, 82.4%, 76.5%, and 52.9% of C. albicans and 74.3%, 85.7%, 80.0%, and 48.6% of NAC, respectively. There is remarkable shift to NAC BSIs and high azole resistance. Antifungal stewardship and analysis of risk factors associated with this shift are needed.

A Mini-Review of In Vitro Data for Candida Species, Including C. auris, Isolated during Clinical Trials of Three New Antifungals: Fosmanogepix, Ibrexafungerp, and Rezafungin.

This mini-review summarizes the clinical outcomes and antifungal susceptibility results, where available, for three new antifungals, including fosmanogepix, ibrexafungerp, and rezafungin, against Candida isolates cultured from patients in clinical trials. When reported, most of the data were generated by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method or by both the CLSI and European Committee on Antimicrobial Susceptibility Testing (EUCAST) methodologies. For fosmanogepix, we summarize the in vitro data for C. auris isolates from 9 patients and for Candida spp. cultured from 20 patients in two clinical trials. Ibrexafungerp has also been evaluated in several clinical trials. From conference proceedings, a total of 176 Candida isolates were evaluated in the FURI and CARES studies, including 18 C. auris isolates (CARES study). However, MIC data are not available for all clinical isolates. Results from the ReSTORE rezafungin phase 3 clinical study also included in vitro results against Candida spp., but no patients with C. auris infections were included. In conclusion, this mini-review summarizes insights regarding clinical outcomes and the in vitro activity of three new antifungals against Candida spp. cultured from patients in clinical trials.

Novel aza-bicyclic 2-isoxazoline acylhydrazone hybrids and their synergistic potential with fluconazole against a drug-resistant Candida albicans strain.

As the prevalence of drug-resistant Candida isolates continues to rise, the imperative for identifying novel compounds to enhance the arsenal of antifungal drugs becomes increasingly critical. Consequently, exploring new treatment strategies, including synthesizing molecular hybrids and applying combination therapy, is essential. For this reason, this study evaluated the efficacy of ten molecular hybrids of aza-bicyclic 2-isoxazoline-acylhydrazone belonging to two series 90 and 91 as possible anti-Candida agents. In addition, we also investigated the interaction between the hybrids and fluconazole, a commonly used antifungal drug. We evaluated the antifungal effect of aza-bicyclic 2-isoxazoline-acylhydrazone hybrid compounds against six Candida spp. strains that target planktonic cells. However, none of these new molecules were inhibitory active at the tested concentrations (2 to 1,024µg/mL). Moreover, we analyzed the interaction between the ten new hybrid molecules and fluconazole using the checkerboard assay, employing two different methodologies for reading the plate. For this, one isolate fluconazole-resistant was selected. We observed that only one combination, 6-(4-tert-butylbenzoil)-4,5,6,6a-tetrahydro-3a-H-pirrole[3,2-d]isoxazole-3-carboxylic(furan-2-metilidene)-hydrazide (91e) and fluconazole, exhibited a synergistic interaction (FICI range 0.0781 to 0.4739). The combination successfully inhibited the growth of C. albicans CA2 fluconazole-resistant, and no interaction was observed in an isolate susceptible to fluconazole. Additionally, these results emphasize the continued need for research into new compounds and the importance of using combined approaches to increase their activity.

Virulence factors, antifungal susceptibility and molecular profile in Candida species isolated from the hands of health professionals before and after cleaning with 70% ethyl alcohol-based gel

Fungal infections in neonatal intensive care units (NICU) are mainly related to Candida species, with high mortality rates. They are predominantly of endogenous origin, however, cross-infection transmitted by healthcare professionals' hands has occurred. The aim of this study was to identify Candida species isolated from the hands of healthcare professionals in a NICU before and after hygiene with 70% ethanol-based gel and evaluate virulence factors DNase, phospholipase, proteinase, hemolysin, biofilm biomass production, and metabolic activity. In vitro antifungal susceptibility testing and similarity by random amplified polymorphic DNA (RAPD) were also performed. C. parapsilosis complex was the most frequent species (57.1%); all isolates presented at least one virulence factor; three isolates (Candida parapsilosis complex) were resistant to amphotericin B, two (Candida famata [currently Debaryomyces hansenii] and Candida guilliermondii [currently Meyerozyma guilliermondii]) was resistant to micafungin, and six (Candida parapsilosis complex, Candida guilliermondii [=Meyerozyma guilliermondii], Candida viswanathi, Candida catenulata [currently Diutina catenulata] and Candida lusitaniae [currently Clavispora lusitaniae]) were resistant to fluconazole. Molecular analysis by RAPD revealed two clusters of identical strains that were in the hands of distinct professionals. Candida spp. were isolated even after hygiene with 70% ethanol-based gel, highlighting the importance of stricter basic measures for hospital infection control to prevent nosocomial transmission.

Synthesis, Physicochemical and Antimicrobial Studies of Schiff base derived from 2, 4-dinitrophenyl hydrazine with Salicyldehyde and its Co (II) and Ni (II) Complexes

A Schiff base ligand derived from salicylaldehyde and 2, 4-dinitrophenylhydrazine was synthesized, along with its Co(II) and Ni(II) complexes (CoL2 and NiL2). These compounds were characterized by melting point/decomposition temperature, solubility, molar conductance, magnetic susceptibility, infrared analysis, and UV-visible spectrophotometry. The metal-ligand ratio in the complexes is 1:2. All complexes exhibited low molar conductance values (5.2-11.0), indicating their non-electrolytic nature. The synthesized ligand and its metal (II) complexes were evaluated for antibacterial activity against five bacterial isolates (Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus) and three fungal isolates (Fusarium solani, Aspergillus fumigatus, and Candida albicans) using the well diffusion method. The results demonstrated that the metal complexes exhibited greater antimicrobial activity compared to the Schiff base ligand. Keywords: Isolates, Conductance value, Synthesis, Non-electrolytic, Fusarium solani

SPECIES DISTRIBUTION AND ANTIFUNGAL SUSCEPTIBILITY OF VAGINAL <i>CANDIDA</i> ISOLATES

Introduction: Vulvovaginal candidiasis (VVC) is the most common Candida infection in females of reproductive age. Data concerning the species identification and antifungal susceptibility of vaginal Candida isolates are of great importance for the infection management. Aim: The aim of the present study was to determine the species distribution and antifungal susceptibility of Candida isolates obtained from vaginal samples of women with VVC. Material and methods: A total of 125 vaginal Candida isolates were collected and tested. The definitive species identification was performed by VITEC2 Compact (Bio Merieux, France) using YST ID cards. The minimum inhibitory concentrations (MICs) of nine antifungal agents were determined by the commercial system Micronaut-AM (Merlin Diagnostika GmbH, Germany). Results: Overall, 8 Candida species were established among the vaginal yeast isolates. The most common was C. albicans (77.6%), followed by C. glabrata (12%), C. krusei (4%), C. kefyr (2.4%), C. spherica (1.6%), C. lusitaniae, C. utilis, and C. sake (each one 0.8%). All C. albicans and 20 non-albicans Candida (NAC) were susceptible to nine antifungal agents. In the group of NAC, 8 isolates were resistant to fluconazole – 5 C. krusei with intrinsic resistance, 2 C. spherica, and 1 C. sake. The fluconazole MICs of C. spherica and C. sake were 32 - 128 μg/mL, and 16 μg/mL, respectively. Conclusions: C. albicans was the main causative agent of VVC. Among NAC, C. glabrata was the predominant species. In general, vaginal C. albicans and non-albicans Candida were susceptible to azoles as well as echinocandins, amphotericin B and 5-fluorocytosine. Of particular interest was the detection of rare non-albicans Candida isolates with acquired resistance to azoles.

Antifungal Activity of 3-Hydrazinoquinoxaline-2-Thiol, a Novel Quinoxaline Derivative against Candida Species

Candida ranks as among the most frequently encountered fungal infections that associated with high morbidity and mortality. Quinoxaline derivatives are a group of small molecules that showed a promising antimicrobial activity. This study aimed to investigate the fungicidal effects of 3-hydrazinoquinoxaline-2-thiol against Candida in comparison with Amphotericin B in vitro as a reference. Also, we aim to assess the efficacy of 3-hydrazinoquinoxaline-2-thiol in vivo using mice oral candidiasis model. Fifty-six Candida isolates were subjected to susceptibility testing by broth microdilution method for 3-hydrazinoquinoxaline-2-thiol and Amphotericin B. Therefore, Minimal inhibitory concentrations (MIC) were assessed and compared. The oral candidiasis mice model was used to evaluate the activity of 3-hydrazinoquinoxaline-2-thiol in vivo. Microbiological evaluation of progression and ELISA were used in this study. 3-hydrazinoquinoxaline-2-thiol was more effective than Amphotericin B against most clinical isolates of Candida albicans. Higher effectiveness was seen against Candida glabrata and Candida parapsilosis isolates. However, the efficiency against Candida tropicalis isolates varies. 3-hydrazinoquinoxaline-2-thiol was also effective against Pichia kudriavzevii and Clavispora lusitaniae. 3-hydrazinoquinoxaline-2-thiol showed a good efficacy in mice model against C. albicans cells ATCC 10231. 3-hydrazinoquinoxaline-2-thiol has shown promising antifungal and anti-inflammatory activity against different Candida species. More tests and experiments are needed.

Evaluation Study of Petroselinum Crispum Extract Toward Pathogenic Isolates of candida

Objectives: The aim of this study was to isolation and identify the isolated genetically if candida species from candidiasis infection and study the activity of bioactive compounds. Methods: Samples were obtained from 28 patients from the mouth of patients with oral candidiasis. Samples were collected from the Child Specialized Hospital, Al-Faiha General Hospital Dermatologist Dr. Laith Globe Lazim Al-Kinani (Master of Dermatology, PhD in Dermatology, Iraqi Ministry of Health, Al-Fayhaa Teaching Hospital) aided in the diagnosis of clinical cases and molecular analysis then tested the activity of the mint plant extract on it and compared it with the antifungal nystatin. Results: Mint leaf extract showed activity against Candida isolates. The extract was non-toxic, and C. albicans was the most common Candida. Conclusions: The methanolic extract of Petroselinum crispum in this study showed good inhibition activity against the isolated Candida species.

Bioactive Lyocell Fibers with Inherent Antibacterial, Antiviral and Antifungal Properties.

Functional Lyocell fibers gain interest in garments and technical textiles, especially when equipped with inherently bioactive features. In this study, Lyocell fibers are modified with an ion exchange resin and subsequently loaded with copper (Cu) ions. The modified Lyocell process enables high amounts of the resin additive (>10%) through intensive dispersion and subsequently, high uptake of 2.7% Cu throughout the whole cross-section of the fiber. Fixation by Na2CO3 increases the washing and dyeing resistance considerably. Cu content after dyeing compared to the original fiber value amounts to approx. 65% for reactive, 75% for direct, and 77% for HT dyeing, respectively. Even after 50 household washes, a recovery of 43% for reactive, 47% for direct and 26% for HT dyeing is proved. XRD measurements reveal ionic bonding of Cu fixation inside the cellulose/ion exchange resin composite. A combination of the fixation process with a change in Cu valence state by glucose/NaOH leads to the formation of Cu2O crystallites, which is proved by XRD. Cu fiber shows a strong antibacterial effect against Staphylococcus aureus and Klebsiella pneumonia bacteria, even after 50 household washing cycles of both >5 log CFU. In nonwoven blends with a share of only 6% Cu fiber, a strong antimicrobial (CFU > log 5) and full antiviral effectiveness (>log 4) was received even after 50 washing cycles. Time-dependent measurements already show strong antiviral behavior after 30 s. Further, the fibers show an increased die off of the fungal isolate Candida auris with CFU log 4.4, and nonwovens made from 6% Cu fiber share a CFU log of 1.7. Findings of the study predestines the fiber for advanced textile processing and applications in areas with high germ loads.

Prevalence and Species Distribution of Candida Clinical Isolates in a Tertiary Care Hospital in Ecuador Tested from January 2019 to February 2020.

The incidence of candidemia in healthcare centers is associated with high morbidity and mortality. Frequency varies significantly among regions, with some species being more prevalent than others in Latin America. In this study, 191 clinical Candida isolates were collected from a major hospital in Ecuador from January 2019 to February 2020 aiming to assess their prevalence and distribution. After data processing, 168 isolates characterized by the VITEK 2 system were subsequently identified by ITS sequencing. Results showed diverse Candida species distributions, with C. albicans and C. tropicalis being the most prevalent across different clinical sources. In hospitalized individuals, C. tropicalis (38%) and C. albicans (37%) were the most prevalent, followed by, C. parapsilosis (16%), C. glabrata (5%), and other non-Candida albicans (NCA) species (6%). Conversely, C. parapsilosis (48%), C. albicans (20%), and C. glabrata (14%), associated with candidemia, were the most common in blood and CSF. Additionally, uncommon NCA species such as C. haemulonii, C. kefyr, and C. pelliculosa were identified in Ecuador for the first time. Discrepancies in species identification were observed between the VITEK 2 system and ITS sequencing, coinciding at 85%. This highlights the need for ongoing surveillance and identification efforts in Ecuador's clinical and epidemiological settings.

Identification and assessment of antifungal susceptibility of Candida species based on bronchoalveolar lavage in immunocompromised and critically ill patients

Background and Objectives: The presence of fungi in the respiratory tract as mycobiome, particularly Candida species (spp.), remains a serious problem due to increasing numbers of immunocompromised patients. The confirmed reliable ex- istence of these pathogens due to frequent colonization is essential. This investigation aimed to recognize Candida spp. among isolates from bronchoalveolar lavage of immunocompromised and critically ill patients and to evaluate their suscep- tibility to antimycotic drugs. Materials and Methods: Bronchoalveolar lavage fluid was collected from 161 hospitalized patients presenting with sus- pected respiratory fungal infection /colonization. The specimens were examined by standard molecular and mycological assays. Candida spp. were recognized with sequence assessment of the D1-D2 section of the large subunit ribosomal DNA. The susceptibility of Candida isolates to common antimycotic drugs was distinguished by standard broth microdilution. Results: Seventy-one clinical isolates of Candida spp. were recognized. Candida albicans was the most frequent, followed by C. glabrata, C. krusei (Pichia kudriavzevii), C. dubliniensis, C. parapsilosis, and C. tropicalis. We found 5.1% of C. albi- cans isolates and 8% of C. glabrata isolates to show resistance to fluconazole. The whole of the Candida spp. were sensitive to amphotericin B and caspofungin. Conclusion: This study demonstrated that C. albicans and C. glabrata are the most common isolates of bronchoalveolar lavage fluid in patients, and the drug susceptibility screening confirmed that amphotericin B and caspofungin are effective against Candida spp. but some C. glabrata and C. albicans isolates showed resistance to fluconazole.

Time to positivity of blood cultures causing candidemia and its relation to mortality

Background and Objectives: Early diagnosis of candidemia is of vital importance in reducing mortality and morbidity. The main objective of the study was to determine the TTP (Time to Positivity) of different species of Candida causing blood- stream infection and to see whether TTP can help differentiate Candida glabrata which is frequently fluconazole resistant from Fluconazole sensitive Candida. Materials and Methods: TTP (Time to positivity) and AAT (Appropriate Antifungal therapy) were noted for Blood cultures becoming positive for Candida. Presence of Risk factors for candidemia like prolonged ICU stay, neutropenia, Total Paren- teral Nutrition (TPN), use of steroids , broad spectrum antibiotics, use of Central Venous Catheter, Foleys catheter were also analyzed. Results: The most frequent isolates were Candida parapsilosis, Candida tropicalis and Candida albicans. The median TTP for all Candida isolates in our study was 34 hours. The diagnostic sensitivity of TTP for detecting C. glabrata and C. tropicalis in patients with candidemia was 88% and 85% respectively. TTP showed that there was no difference in survival between TTP <24 hrs. and > 24hrs. Initiation of antifungal therapy <24 hours and > 24hrs after onset of candidemia had no association with survival. Conclusion: Longer TTP maybe predictive of C. glabrata while shorter TTP may be predictive of C. tropicalis. In our study we found that fluconazole resistant Candida causing blood stream infection is quite unlikely if the TTP of the isolate is <48hrs.

Prevalence and Antibiotic Susceptibility of Urinary Tract Infections in Diabetic and Non Diabetic Individuals: A Prospective Study

Background & Objectives: Diabetes mellitus is increasingly recognized as a major health concern worldwide, particularly in developing countries like India. Diabetic individuals are known to have a higher susceptibility to urinary tract infections (UTIs), compounded by the emergence of drug-resistant uropathogens. This study aims to determine the prevalence and etiology of UTIs in diabetic patients. Materials and Methods: A cross-sectional prospective study involving 220 individuals was conducted from March to April 2023 to assess the spectrum of pathogens causing UTIs and their antibiotic susceptibility. Primary cultures were performed on McConkey agar and sheep blood agar, followed by identification and antimicrobial susceptibility testing (AST) using the Vitek2 system and Kirby Bauer's disc diffusion method on Mueller-Hinton agar. Results: Of the 220 samples tested, 150 exhibited significant bacteriuria, with 36 (75%) of 48 diabetic individuals testing positive for UTIs. Gram-negative bacilli (GNB) accounted for 135 (61.4%) isolates, with Escherichia coli (E. coli) being the most prevalent pathogen (52.7%), followed by Klebsiella spp. (25.3%). Among gram-positive organisms, Enterococcus spp. (5.3%) were predominant, with Candida isolates detected in 3 cases (2%). Meropenem (87.6%) exhibited the highest susceptibility against GNB, followed by Netilmycin (87.6%) and Imipenem (82.5%). For gram-positive organisms, Imipenem and Nitrofurantoin demonstrated high susceptibility. Conclusion: E. coli emerged as the predominant pathogen in both diabetic and non-diabetic populations. High sensitivity to meropenem, imipenem, amikacin, and fosfomycin was observed in both groups, suggesting their potential for empirical treatment. Regular surveillance of drug resistance patterns is crucial for identifying evolving resistance trends and optimizing treatment strategies.

Comparison of Candida colonization in intensive care unit patients with and without COVID-19: First prospective cohort study from Turkey.

Candida species are the primary cause of fungal infections in intensive care units (ICUs). Despite the increasing prevalence of Candida-related infections, monitoring the progression of these infections from colonization in COVID-19 ICU patients lacks sufficient information. This study aims prospectively to compare 62 COVID-19 and 60 non-COVID-19 ICU patients from admission to discharge in terms of colonization development, rates, isolated Candida species, risk factors, and Candida infections during hospitalization. A total of 1464 samples were collected at specific time intervals from various body sites [mouth, skin (axilla), rectal, and urine]. All samples were inoculated onto CHROMagar Candida and CHROMagar Candida Plus media, and isolates identified using MALDI-TOF MS. COVID-19 patients exhibited significantly higher colonization rates in oral, rectal, and urine samples compared to non-COVID-19 patients, (p<0.05). Among the Candida species, non-albicans Candida was more frequently detected in COVID-19 patients, particularly in oral (75.8%-25%; p<0.001) and rectal regions (74.19% - 46.66%; p<0.05). Colonization with mixed Candida species was also more prevalent in the oropharyngeal region (p<0.05). Mechanical ventilation and corticosteroid use emerged as elevated risk factors among COVID-19 patients (p<0.05). Despite the colonization prevalence, both COVID-19-positive and negative patients exhibited low incidences of Candida infections, with rates of 9.67% (n=6/62) and 6.67% (n=3/60), respectively. Consequently, although Candida colonization rates were higher in COVID-19 ICU patients, there was no significant difference in Candida infection development compared to the non-COVID-19 group. However, the elevated rate of non-albicans Candida isolates highlights potential future infections, particularly given their intrinsic resistance in prophylactic or empirical treatments if needed. Additionally, the high rate of mixed colonization emphasizes the importance of using chromogenic media for routine evaluation.

Yeast fungi in the etiology of animal mycoses

760 samples of biological material from various regions of the Russian Federation were studied, 320 isolates of yeast fungi were isolated, which amounted to 42.10% of the total number of samples. Of the 760 samples, 29.0% belonged to cattle, 11.8% to small cattle, 13.0% to horses, 1.6% to camels, 7.2% to cats and 17.5% to dogs, 1.8% to raw milk and 0.8% to environmental objects (OVS). Most of the isolated isolates (240) of yeast fungi belonged to fungi of the genus Candida, which amounted to 75%. The species diversity of fungi of the genus Candida is represented by 15 species. The largest number of isolates belong to the species Candida albicans, Candida catenulata, Candida kefyr Candida krusei, Candida membranifaciens, Candida pararugosa and Candida tropicals. These species of fungi of the genus Candida are known as pathogens of fungal infections in humans and animals. The species diversity of species not belonging to the genus Candida is limited to 7 species in 5 genera – Geotrichum, Malassezia, Rhodotorula, Saccharomyces and Trichosporon. The fact of the development of resistance of some yeast species to the most commonly used antifungal drugs (fluconazole and voriconazole) has been established. It was revealed that 30% of the studied isolates of the genus Candida are resistant to fluconazole, 32% are dose–dependent, 38% are sensitive, 28% are resistant to voriconazole, 30% are dose–dependent, 42% are sensitive. Isolates not belonging to the genus Candida showed resistance to fluconazole 19%, 38% - dose–dependent, 43% - sensitive, voriconazole – 23% – resistant, 18% – dose–dependent and 59% - sensitive. The proportion of isolates of yeast fungi resistant to fluconazole and voriconazole isolated from animals is quite large, in some cases it is up to 50% (C. tropicalis). A high level of resistance was found in isolates of Candida albicans, Candida catenulata, Candida rugosa and Candida pararugosa, which can significantly complicate the treatment of infections caused by them and contribute to the worldwide problem of antibiotic resistance.

Approaches for identifying and measuring heteroresistance in azole-susceptible Candida isolates.

Heteroresistance to antifungal agents poses a significant challenge in the treatment of fungal infections. Currently, the absence of established methods for detecting and measuring heteroresistance impedes progress in understanding this phenomenon in fungal pathogens. In response to this gap, we present a comprehensive set of new and optimized methods designed to detect and quantify azole heteroresistance in Candida albicans. Here, we define two primary assays for measuring heteroresistance: population analysis profiling, based on growth on solid medium, and single-cell assays, based on growth in liquid culture. We observe good correlations between the measurements obtained with liquid and solid assays, validating their utility for studying azole heteroresistance. We also highlight that disk diffusion assays could serve as an additional tool for the rapid detection of heteroresistance. These methods collectively provide a versatile toolkit for researchers seeking to assess heteroresistance in C. albicans. They also serve as a critical step forward in the characterization of antifungal heteroresistance, providing a framework for investigating this phenomenon in diverse fungal species and in the context of other antifungal agents. Ultimately, these advancements will enhance our ability to effectively measure antifungal drug responses and combat fungal infections.IMPORTANCEHeteroresistance involves varying antimicrobial susceptibility within a clonal population. This phenomenon allows the survival of rare resistant subpopulations during drug treatment, significantly complicating the effective management of infections. However, the absence of established detection methods hampers progress in understanding this phenomenon in human fungal pathogens. We propose a comprehensive toolkit to address this gap in the yeast Candida albicans, encompassing population analysis profiling, single-cell assays, and disk diffusion assays. By providing robust and correlated measurements through both solid and liquid assays, this work will provide a framework for broader applications across clinically relevant Candida species. These methods will enhance our ability to understand this phenomenon and the failure of antifungal therapy.

Clinical Distribution and Drug Susceptibility Characterization of Invasive Candida Isolates in a Tertiary Hospital of Xinjiang Province.

This study aims to investigate the clinical distribution characteristics and drug susceptibility profiles of invasive Candida isolates in a tertiary hospital in Urumqi. The examination was conducted on samples obtained from patients who were clinically diagnosed with invasive candidiasis in this hospital. A total of 109 strains of Candida strains were identified through the use of internal transcribed spacer (ITS) sequencing and fungal cultivation methods.The clinical distribution of the strains was analyzed. Antifungal drug susceptibility tests were performed using the Sensititre YO10 fungal drug susceptibility plate based on the micro-broth dilution method. Candida albicans had the highest percentage (51.38%) among 109 Candida isolates, followed by C. glabrata (18.35%) and C. tropicalis (15.60%). The isolates were predominantly found in the respiratory department (41.28%), intensive care unit (ICU) (31.19%), and infection department (9.17%).The results of drug susceptibility tests indicated that amphotericin B, 5-fluorocytosine, and echinocandins exhibited good in vitro antifungal activity, with a susceptibility rate of over 96%. However, the azoles demonstrated low antifungal activity, especially posaconazole and voriconazole, which had high resistance rates of 64.71% for C. tropicalis and 70% for C. glabrata, respectively. In our hospital, Candida albicans was identified as the primary causal agent of invasive candidiasis. In terms of in vitro antifungal activity, echinocandins, amphotericin B, and 5-fluorocytosine demonstrated efficacy against invasive Candida infections. However, it was important to note that C. glabrata and C. tropicalis exhibited low susceptibility to azoles.

الكشف عن بعض عوامل الضراوة بين المبيضات المعزولة من المرضى وانتشار جين candidalysin ECE1

المبيضات البيضاء هي مسبب شائع لعدوى الجهاز التنفسي وداء المبيضات الفموي لدى الناس ، ومسببات أمراض الخميرة الانتهازية والأسباب الرئيسية للمرض والوفيات لدى الأشخاص الذين يعانون من نقص المناعة وتسبب التهابات سطحية على الأسطح المخاطية التي تصيب ملايين الأشخاص في جميع أنحاء العالم. كان الهدف الرئيسي من هذه الدراسة هو التحقق من انتشار بعض عوامل الضراوة التي لها القدرة على تكوين الأغشية الحيوية (Biofilm)، والبروتينيز (Proteinase)، وإنتاج الهيمولايسين( Hymolysine) بين عزلات C. albicans التي تشمل انتشار جين Candidalysin (ECE1). تم جمع العينات خلال الفترة من ايار 2022 الى اب 2022 من 280 عينة (مسحة) لمرضى عراقيين من مختلف الاعمار والاجناس غير مكررين كانوا يعانون من داء المبيضات الفموي وامراض الجهاز التنفسي في مستشفيات بغداد (مستشفى مدينه الطب و مستشفى اليرموك التعليمي ومستشفى مدينه الامامين الطبية التعليمية). تم زراعة العينات التي تم جمعها على وسط اكار السابرويد دكستروز (SDA) مضاف اليه كلورامفينيكول كمضاد للبكتيريا بتركيز 10 ميكجم / مل ، وتم حضن الاطباق الملقحة على وسط SDA عند 37 درجة مئوية لمدة تتراوح بين 24-48 ساعة.أظهرت نتائج الاستنبات أن 102 عينة كانت موجبه، منها58 (56.86%) من تجويف الفم و 44 (43.14%) من الجهاز التنفسي، بينما 178 منها كانت سالبة , تم الكشف عن عزلات المبيضات باستخدام الطرق التقليدية والتي تشمل (النمو على وسط HiCrome Candida ، إنتاج الأنبوب الجرثومي Germ tube ، تكوين الابواغ الكلاميديه Clamydospore وتم تأكيد نتئج التعريف باستخدام نضام VITEK-2 بينت النتائج ان من بين 102 عزلة C. albicans هي الاكثر شيوعا بين الانواع بنسبة 68.63 % ثم تلتها C. tropicalis بنسبة %10.78 ثم C. kruzei %5.88 وC. kefyr %5.88 C. parapsilosis % 4.9 بينما كانت C. glabrata % 3.9 وتمثل النسبة الاقل بين الانواع . تم فحص حساسية عزلات المبيضات للأدوية المضادة للفطريات بطريقة انتشار القرص ، والتي أجريت على النحو الموصى به بواسطة(CLSI) M44-A -وثيقة . أظهرت العزلات درجة عالية من الحساسية للأمفوتريسين-ب 93.14% وكلوتريمازول 90.20% ونسياتين 85.92% ،تم التحقق من انتشار جينCandidalysin (ECE1) بين 70 عزلة من C. albicans باستخدام تقنية تفاعل البلمرة المتسلسل PCR ، وأظهرت النتائج أن 41 58.57% تحتوي على جين Ece1 في تجويف الفم والجهاز التنفسي. و 34 عزلة 48.57% من C. albicans كانت منتجة قوية للغشاء الحيوي, بينما 30 عزلة 42.86% عزلة انتجت بروتيناز و 20 عزلة 28.57% عزلة لديها القدرة على تحلل الدم.

Epidemiology, clinical characteristics, outcome and biofilm forming properties in candidaemia: A single-centre retrospective 4-year analysis from Hungary.

Candidaemia is a life-threatening disease that is associated with high mortality, especially in intensive care units (ICUs). The number of comprehensive studies dealing with the epidemiologic characteristics of biofilm-related properties is limited. This study evaluated the clinical characteristics of candidaemia, to assess the biofilm-forming properties of isolates, and to identify the risk factors of mortality. A total of 149 candidaemia episodes from the University of Debrecen, Clinical Centre, between January 2020 and December 2023 were investigated retrospectively. The susceptibility of Candida isolates to fluconazole, amphotericin B, anidulafungin, caspofungin, and micafungin was evaluated and compared to the susceptibility of 1-day-old biofilms. Multivariate logistic regression analysis was applied to identify the independent predictors of 30-day mortality rate. The most common Candida species was Candida albicans (41%), followed by C. parapsilosis (20%), C. glabrata (14%), C. tropicalis (13%), rare Candida species (7%), and C. krusei (5%). Sixty-six percent of Candida isolates were biofilm formers and 44% had high metabolic activity. The 30-day mortality rate was 52%, which was higher in ICUs (65%). The logistic regression analysis revealed several factors significantly influencing mortality including ICU admission (odds ratio [OR] 2.99, 95% confidence interval [CI] 1.17-8.04, p = 0.025), fluconazole treatment (OR 4.12, 95% CI 1.62-11.42, p = .004), and pneumonia (OR 0.261, 95% CI 0.1-0.67, p = .006). This comprehensive analysis supports the better characterisation of candidaemia in healthcare settings, which ultimately may reduce mortality among patients.

Epidemiology and antifungal susceptibility patterns of invasive candidiasis: A single-center study

Background: Invasive candidiasis remains a leading cause of morbidity and mortality. Despite the availability of various antifungal treatments, global reports continue to highlight resistance, treatment ineffectiveness, and outbreaks. This study aimed to analyze the epidemiology of various Candida species isolated from invasive samples and assess their antifungal susceptibility profiles. Material and Methods: The study identified and evaluated a total of 200 Candida isolates, recovered over a 6-month period from various clinical specimens. These were assessed against various antifungals according to recommendations. Results: Among the samples, blood (79%) and pus (12%) were the most commonly encountered sources of Candida isolation. Candida isolates comprised 14.5% (30) C. albicans and 85.5% (170) non-albicans species. Non-albicans species included 15% (30) C. guilliermondii, 14.5% (29) C. lusitaniae, 11.5% (22) C. tropicalis, 2.3% (4) C. auris, and 8.5% (17) C. parapsilosis. Overall, the strains showed 74% and 91% sensitivity to Fluconazole and Voriconazole, respectively, and 100% sensitivity to Caspofungin and Amphotericin B, with the exception of C. lusitaniae. Conclusion: The susceptibility profile of antifungals is evolving. This study demonstrated a low rate of resistance to four antifungals in invasive candidiasis in Pakistan. None of the isolates were resistant to more than one drug. Early and prompt treatment through the implementation of an antifungal stewardship program and strict infection control is crucial. Keywords: Invasive candidiasis (IC), Antifungal susceptibility profile, Fluconazole, Candidemia