Expect the unexpected: fungemia caused by uncommon Candida species in a Turkish University Hospital

Candida species are opportunistic yeasts affecting the genitourinary tract which causes the vulvovaginal candidiasis in the most female especially in developing countries. This study aims to determine the prevalence of vulvovaginal candidiasis caused by Candida species causing among pregnant women in Sana'a City, Yemen. This study was carried out at the department of microbiology of AL-Kuwait University Hospital. 250 vaginal swabs were collected and cultured on Sabouraud dextrose agar. Candida species identification and antifungal susceptibility testing were determined according to standard microbiological methods. The results showed that out of 250 samples, 63(25.2%) were positive for Candida species. It was found that the C. albicans (68.3%) was the most common species isolated followed by non-albicans species that are C. tropicalis (20.6%), C. glabrata (6.3%), and C. kefyr (4.8%). Also, it was recorded that the highest prevalence of Candida species was within group aged of 36-46 year. Susceptibility tests revealed that the most isolated species of C. andida were sensitive to nystatin (95%). miconazole was the next effective drug with 64% sensitive followed by amphotericin B (29%) and clotrimazole (24%). But only 6% of the isolates were sensitive to fluconazole. It can be concluded that the vulvovaginal candidiasis are quite common in Yemen country with a high prevalence. Also, the nystatin remains the effective agent against all isolated of Candida species. In contrast, the increase resistance of Candida species to fluconazole that commonly used antifungal is an alarming increase of vaginal candidiasis caused by antifungal-resistant Candida species. Peer Review History: UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Name: Dr. Hassan A.H. Al-Shamahy Affiliation: Sana'a University, Yemen E-mail: [email protected] Name: Dr. Tamer Mohamed Ali El Habibi Affiliation: Suez Canal University, Egypt. E-mail: [email protected] Name: Rola Jadallah Affiliation: Arab American University, Palestine E-mail: [email protected] Comments of reviewer(s): Similar Articles: AN EXHAUSTIVE STATISTIC ON CURRENT MUCOADHESIVE INTRAVAGINAL DRUG DELIVERY METHODOLOGIES TETANUS IMMUNIZATION AMONG PREGNANT WOMEN: COVERAGE RATE AND RATE OF PROTECTION AT TIME OF DELIVERY

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An alarming rise of non-albicans Candida species and uncommon yeasts in the clinical samples; a combination of various molecular techniques for identification of etiologic agents

10.21203/rs.2.15836/v1 ◽

2019 ◽

Author(s):

Mohireh Taei ◽

Mostafa Chadeganipour ◽

Rasoul Mohammadi

Keyword(s):

Molecular Identification ◽

Candida Species ◽

Fungal Infections ◽

Antifungal Susceptibility ◽

Etiologic Agent ◽

Molecular Techniques ◽

University Hospital ◽

Medical Mycology ◽

Clinical Samples ◽

Pcr Multiplex

Abstract Objective: Yeasts are opportunistic microorganisms can cause human fungal infection among immunocompromised patients. This study aimed to identify Candida species and uncommon yeasts obtained from clinical specimens in Kashani university hospital and Shefa Lab as a referral medical mycology laboratory, in Isfahan, Iran, by combination of various molecular techniques. Results: A total of 202 yeast strains were isolated from 341 clinical samples between February 2017 to May 2019. All clinical isolates were identified using phenotypic and molecular tests. PCR-RFLP, duplex-PCR, multiplex-PCR, and PCR-sequencing were applied for molecular identification of yeasts. The most clinical samples were obtained from urine (66.8%), nail (9.4%), bronchoalveolar lavage (5.9%), sore (4.4%), and blood (3.9%). One hundred and twenty-one Candida species were identified as non- albicans against 76 Candida albicans. Trichosporon asahii, and Pichia terricola were uncommon non- Candida yeasts isolated from urine samples. For the first time, we isolated P. terricola as etiologic agent of urinary tract infection in a pregnant female. Since non- albicans Candida species and non- Candida yeasts have various virulence factors and antifungal susceptibility profile, precise molecular identification can help us to reach to the advantageous strategies for treatment of these fungal infections.

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P268 Trends in species distribution and antifungal susceptibilities of Candida species isolated from urine at the University Hospital

International Journal of Antimicrobial Agents ◽

10.1016/s0924-8579(13)70509-0 ◽

2013 ◽

Vol 42 ◽

pp. S127

Author(s):

T. Sho ◽

R. Hamasuna ◽

M. Honda ◽

T. Muratani ◽

N. Fujimoto ◽

...

Keyword(s):

Species Distribution ◽

Candida Species ◽

University Hospital ◽

The University

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The resistance to fluconazole in patients with esophageal candidiasis

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032009000100011 ◽

2009 ◽

Vol 46 (1) ◽

pp. 32-37 ◽

Cited By ~ 3

Author(s):

Ana Botler Wilheim ◽

Demócrito de Barros Miranda-Filho ◽

Rodrigo Albuquerque Nogueira ◽

Rossana Sette de Melo Rêgo ◽

Kedma de Magalhães Lima ◽

...

Keyword(s):

Candida Species ◽

Predisposing Factors ◽

University Hospital ◽

Hiv Positive ◽

Digestive Endoscopy ◽

Esophageal Candidiasis ◽

Endoscopic Findings ◽

Endoscopy Unit ◽

Therapeutic Choice ◽

Hiv Negative

CONTEXT: Esophageal candidiasis is often observed in patients with risk factors for its development and fluconazole is the therapeutic choice for the treatment of this disease. OBJECTIVES: To determine its frequency, by performing upper digestive endoscopy; to determine Candida species involved in its pathogenesis and verify their distribution according with the predisposing factors and to determine susceptibility to fluconazole in the samples. METHODS: From March 2006 to April 2007, all patients submitted to esophagogastroduodenoscopy at the Digestive Endoscopy Unit in the Oswaldo Cruz University Hospital, Recife, PE, Brazil, were eligible for the study. Samples were collected from patients who presented lesions consistent with esophageal candidiasis in order to identify Candida species and verify their susceptibility to fluconazole. The predisposing factors for the occurrence of esophageal candidiasis were described. RESULTS: Of 2,672 patients referred to upper endoscopy at the Digestive Endoscopy Unit, 40 (1.5%) had endoscopic findings compatible with esophageal candidiasis. The average age was 49.1 years. Twenty one patients (52.5%) were less than 50 years old, of which 82.6% were infected with HIV. Most of them (52.5%) were males and 65.0% were inpatients. Diseases were identified in 90% of the patients and 21 (52.5%) were HIV positive. Concerning endoscopic findings, severe forms of esophagitis were found in 50% of the patients with CD4 count <200. Non-albicans Candida species were isolated in 22.7% of HIV positive and in 45% HIV negative patients. A total of 6 (14.28%) samples were resistant to fluconazole, while 2 (4.76%) samples had dose depending susceptibility to this drug. CONCLUSIONS: Esophageal candidiasis prevalence was low, although within the results described by other authors. Male and inpatients were the most affected. The species isolated varied according to the characteristics of each group studied. Both, resistance and dose-depending susceptibility to fluconazole were considered high.

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Antifungal susceptibility trend and analysis of resistance mechanism for Candida species isolated from bloodstream at a Japanese university hospital

Journal of Infection and Chemotherapy ◽

10.1016/j.jiac.2018.10.007 ◽

2019 ◽

Vol 25 (1) ◽

pp. 34-40 ◽

Cited By ~ 8

Author(s):

Toru Sakagami ◽

Takaki Kawano ◽

Kohei Yamashita ◽

Eio Yamada ◽

Noritomo Fujino ◽

...

Keyword(s):

Candida Species ◽

Antifungal Susceptibility ◽

Resistance Mechanism ◽

University Hospital ◽

Japanese University

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Antifungal Susceptibility of Candida Species Causing Candidemia in Kurume University Hospital and Shaiseikai Hutukaichi Hospital

Kansenshogaku zasshi ◽

10.11150/kansenshogakuzasshi1970.79.20 ◽

2005 ◽

Vol 79 (1) ◽

pp. 20-24

Author(s):

Toru RIKIMARU ◽

Junko YONEMITU ◽

Akiko SHIMADA ◽

Ako KOGA ◽

Mamoru NISHIYAMA ◽

...

Keyword(s):

Candida Species ◽

Antifungal Susceptibility ◽

University Hospital

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Comparison of risk factors and outcomes of Candida auris candidemia with non-Candida auris candidemia: A retrospective study from Pakistan

Medical Mycology ◽

10.1093/mmy/myz112 ◽

2019 ◽

Vol 58 (6) ◽

pp. 721-729 ◽

Cited By ~ 2

Author(s):

Muneeba Ahsan Sayeed ◽

Joveria Farooqi ◽

Kauser Jabeen ◽

Syed Faisal Mahmood

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Hospital Stay ◽

Candida Species ◽

Antifungal Susceptibility ◽

Positive Culture ◽

University Hospital ◽

Prior History ◽

P Value ◽

Candida Auris

Abstract Candida auris has emerged as a nosocomial multi-drug resistant pathogen. This study aimed to compare the risk factors and outcomes of C. auris candidemia patients with non-C. auris candidemia, at a single center in Pakistan. A retrospective study compared 38 C. auris with 101 non-C. auris (36 C. albicans, 38 C. tropicalis, and 27 C. parapsilosis) candidemia patients between September 2014 and March 2017 at the Aga Khan University Hospital, Pakistan. Demographics, clinical history, management and outcomes were studied. Prior history of surgery (adjusted odds ratio [aOR] 4.9, 95% confidence interval [CI]: 1.4–17.5), antifungals exposure (aOR 38.3, 95% CI: 4.1–356) and prior MDR bacteria isolation (aOR 5.09, 95% CI: 1.6–15.9) were associated with C. auris candidemia. On survival analysis both groups of patients had similar outcome in terms of mortality (62.6% vs. 52.54%, hazard ratio [HR] 1.45, 95% CI: 0.84–2.4, P-value = .17) and microbiological failure rates (42.3% vs. 32.2%, HR 0.65, 95% CI: 0.35–1.2, P-value = .17) however, C. auris patients had a higher mean hospital stay (36.32 days vs. 14.8 days, P-value = <.001) and higher >15-day in-hospital stay from positive culture (HR 2.68, 95% CI: 1.1–6.3, P-value = .025). Antifungal susceptibility was different, with C. auris more often resistant to voriconazole (29.6% vs. 0%) and amphotericin (3.7 vs. 0%); though no echinocandin resistance was detected in either group. As opposed to other Candida species, C. auris candidemia occurred after nosocomial exposure, and its source was most commonly an indwelling line. Although these patients had a higher in-hospital stay, but there was no excess mortality when compared to other Candida species.

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