scholarly journals Recent Exposure to Caspofungin or Fluconazole Influences the Epidemiology of Candidemia: a Prospective Multicenter Study Involving 2,441 Patients

2010 ◽  
Vol 55 (2) ◽  
pp. 532-538 ◽  
Author(s):  
Olivier Lortholary ◽  
Marie Desnos-Ollivier ◽  
Karine Sitbon ◽  
Arnaud Fontanet ◽  
Stéphane Bretagne ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Odds Ratio ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Bloodstream Infections ◽  
Antifungal Drugs ◽  
Surveillance Program ◽  
Prospective Multicenter Study ◽  
Recent Exposure ◽  
Adults And Children

ABSTRACTA prospective multicenter surveillance program on yeast bloodstream infections was implemented in the Paris, France, area without restrictions on ward of hospitalization (intensive care unit, hematology, and surgery) or age (adults and children). The present analysis concerns 2,618 isolates collected over 7 years from 2,441 patients. Centralized species identification and antifungal susceptibility testing using the EUCAST methodology were performed. Almost 10% (232/2,441) of the patients had recently (≤30 days) been treated with antifungal drugs. We analyzed the effect of recent exposure to fluconazole (n= 159) or caspofungin (n= 61) on the proportions of the five majorCandidaspecies. For both drugs, preexposure was associated with a decreased prevalence ofCandida albicansin favor of less drug-susceptible species (C. glabrataandC. kruseifor the former andC. parapsilosisand, to a lesser extent,C. glabrataandC. kruseifor the latter;P= 0.001). In the multivariate analysis, the risk of being infected with an isolate with decreased susceptibility to fluconazole was independently associated with an age of ≥15 years (odds ratio [OR] = 2.45; 95% confidence interval [CI] = 1.39 to 4.31;P= 0.002) and with recent exposure to fluconazole (OR = 2.17; 95% CI = 1.51 to 3.13;P< 0.001), while the risk of being infected with an isolate with decreased susceptibility to caspofungin was independently associated with an age <15 years (OR = 2.53; 95% CI = 1.43 to 4.48;P= 0.001) and with recent exposure to caspofungin (OR = 4.79; 95% CI = 2.47 to 9.28;P< 0.001). These findings could influence future recommendations for the management of candidemia.

scholarly journals Species distribution and antifungal susceptibility profile of Candida isolates from bloodstream infections in Lima, Peru

2014 ◽  
Vol 63 (6) ◽  
pp. 855-860 ◽  
Author(s):  
B. Bustamante ◽  
M. A. Martins ◽  
L. X. Bonfietti ◽  
M. W. Szeszs ◽  
J. Jacobs ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Latin American ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Bloodstream Infections ◽  
Antifungal Drugs ◽  
Latin American Region ◽  
Pcr Rflp ◽  
A3 Method

Yeast identification and in vitro susceptibility testing provide helpful information for appropriate administration of antifungal treatments; however, few reports from the Latin American region have been published. The aim of this study was to identify the species present in isolates from bloodstream infections diagnosed in nine hospitals in Lima, Peru and to determine their in vitro susceptibility to four antifungal drugs. We tested and identified 153 isolates collected between October 2009 and August 2011 using standard methods. PCR and PCR-RFLP assays were performed to distinguish Candida albicans from Candida dubliniensis and to identify species of the Candida parapsilosis and Candida glabrata complexes. Antifungal susceptibility testing for fluconazole, anidulafungin and voriconazole was performed using the CSLI M27-A3 method, and amphotericin B susceptibility was determined using the Etest method. The most frequently isolated species were: C. albicans (61; 39.9 %), C. parapsilosis (43; 28.1 %), C. tropicalis (36; 23.5%) and C. glabrata (8; 5.2 %). The overall susceptibility rates were 98.0 %, 98.7 %, 98.0 % and 97.4 % for amphotericin B, fluconazole, voriconazole and anidulafungin, respectively. No isolate was resistant to more than one drug. These results showed that the rate of resistance to four antifungal drugs was low among Candida bloodstream isolates in Lima, Peru.

scholarly journals Frequency of candida infection among intensive care unit patients and their susceptibility profile

2021 ◽  
Vol 7 (3) ◽  
pp. 133-136
Author(s):  
Umar Farooq ◽  
Ayushi Jain ◽  
Sudhir Singh ◽  
Vasundhara Sharma ◽  
Shweta R Sharma ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Central Line ◽  
Antifungal Susceptibility Testing ◽  
Clinical Samples ◽  
Human Beings ◽  
High Susceptibility ◽  
Vitek 2 ◽  
Isolated Species

species are responsible for causing many health care associated and central line associated infections. They are responsible for causing opportunistic infection in human beings. Genus of is composed of a heterogeneous group of organsims.Invasive infections of mainly caused by , , & . The main objective of this study was to isolates and Non- albicans and their antifungal susceptibility testing.Thestudy was carried out in the Department of Microbiology, in Tmu Hospital Moradabad. Total numbers of 806 clinical samples were processed in which 206 isolates were taken for . Isolation and antifungal susceptibility testing done by Vitek-2 system.Out of 206 samples 77(37%) were and 129(63%) were Non-albicans (NAC). Maximum isolated species were 77(37%), followed by 70(34%), 24(12%), C. glabrata 19(9%), 12(6%), C. krusei 3(1%), C.african 1(1%).Infection caused by NAC species have increased. was the most common isolated species. ,and were shown high susceptibility to fluconazole and voriconazole. Amphotericin B, Caspofungin, Micafungin and Flucytosine shows high susceptibility towards other candida species.

scholarly journals Identification of Fungal Pathogens in Otomycosis and Their Drug Sensitivity: Our Experience

2018 ◽  
Vol 22 (04) ◽  
pp. 400-403 ◽  
Author(s):  
Khaled Ali ◽  
Mahmood Hamed ◽  
Hameda Hassan ◽  
Amira Esmail ◽  
Abeer Sheneef
Keyword(s):  
Enzymatic Activity ◽  
Candida Species ◽  
Fungal Pathogens ◽  
Antifungal Agents ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Antifungal Susceptibility Testing ◽  
Antifungal Drugs ◽  
High Recurrence Rate ◽  
Fungal Culture

Introduction Otomycosis is a common problem in otolaryngology practice. However, we usually encounter some difficulties in its treatment because many patients show resistance to antifungal agents, and present high recurrence rate. Objectives To determine the fungal pathogens that cause otomycosis as well as their susceptibility to the commonly used antifungal agents. Additionally, to discover the main reasons for antifungal resistance. Methods We conducted an experimental descriptive study on 122 patients clinically diagnosed with otomycosis from April 2016 to April 2017. Aural discharge specimens were collected for direct microscopic examination and fungal culture. In vitro antifungal susceptibility testing was performed against the commonly used antifungal drugs. We tested the isolated fungi for their enzymatic activity. Results Positive fungal infection was found in 102 samples. The most common fungal pathogens were Aspergillus and Candida species, with Aspergillus niger being the predominant isolate (51%). The antifungal susceptibility testing showed that mold isolates had the highest sensitivity to voriconazole (93.48%), while the highest resistance was to fluconazole (100%). For yeast, the highest sensitivity was to nystatin (88.24%), followed by amphotericin B (82.35%), and the highest resistance was to terbinafine (100%), followed by Itraconazole (94.12%). Filamentous fungi expressed a high enzymatic ability, making them more virulent. Conclusion The Aspergillus and Candida species are the most common fungal isolates in otomycosis. Voriconazole and Nystatin are the medications of choice for the treatment of otomycosis in our community. The high virulence of fungal pathogens is owed to their high enzymatic activity. Empirical use of antifungals should be discouraged.

scholarly journals Candida antifungal drug resistance in sub-Saharan African populations: A systematic review

F1000Research ◽  
2017 ◽  
Vol 5 ◽  
pp. 2832 ◽  
Author(s):  
Charlene Wilma Joyce Africa ◽  
Pedro Miguel dos Santos Abrantes
Keyword(s):  
Drug Resistance ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Antifungal Drugs ◽  
Antifungal Drug ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Antifungal Drug Resistance ◽  
Resistance Patterns ◽  
Sub Saharan

Background:Candidainfections are responsible for increased morbidity and mortality rates in at-risk patients, especially in developing countries where there is limited access to antifungal drugs and a high burden of HIV co-infection. Objectives:This study aimed to identify antifungal drug resistance patterns within the subcontinent of Africa. Methods: A literature search was conducted on published studies that employed antifungal susceptibility testing on clinicalCandidaisolates from sub-Saharan African countries using Pubmed and Google Scholar. Results: A total of 21 studies from 8 countries constituted this review. Only studies conducted in sub-Saharan Africa and employing antifungal drug susceptibility testing were included. Regional differences inCandidaspecies prevalence and resistance patterns were identified. Discussion: The outcomes of this review highlight the need for a revision of antifungal therapy guidelines in regions most affected byCandidadrug resistance.  Better controls in antimicrobial drug distribution and the implementation of regional antimicrobial susceptibility surveillance programmes are required in order to reduce the highCandidadrug resistance levels seen to be emerging in sub-Saharan Africa.

scholarly journals A one-year survey of candidemia in Belgium in 2002

2004 ◽  
Vol 132 (6) ◽  
pp. 1175-1180 ◽  
Author(s):  
D. SWINNE ◽  
M. WATELLE ◽  
C. SUETENS ◽  
K. MERTENS ◽  
P.-A. FONTEYNE ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Susceptibility Testing ◽  
The Elderly ◽  
Surveillance Program ◽  
National Surveillance ◽  
Intravascular Catheter ◽  
Predisposing Factor ◽  
One Year

A total of 211 episodes of bloodstream yeast infections in 207 patients, hospitalized in 28 Belgian hospitals participating in a National Surveillance Program, were evaluated. A total of 81% of the patients were more than 50 years of age. Candida albicans was the cause of infections in 55% of patients, 22% were due to C. glabrata and 13% to C. parapsilosis. The most common predisposing factors were antibacterial therapy (42%), residence in an intensive care unit (32·9%) and presence of an intravascular catheter (29·7%). Most patients had more than one predisposing factor. Fluconazole alone or in association with another antifungal agent was the treatment of choice for 89·7% of the cases. In vitro susceptibility testing of the isolates revealed that 99% were susceptible to amphotericin B, 95% to 5-fluorocytosine, 82% to fluconazole and 69% to itraconazole. Resistance to azoles was more common among C. glabrata isolates in the elderly. We conclude that the frequency of C. albicans infection is decreasing in Belgium and this is associated with the emergence of other species, most notably, C. glabrata.

scholarly journals Molecular differentiation and antifungal susceptibilities of Candida parapsilosis isolated from patients with bloodstream infections

2009 ◽  
Vol 58 (2) ◽  
pp. 185-191 ◽  
Author(s):  
Sun Tee Tay ◽  
Shiang Ling Na ◽  
Jennifer Chong
Keyword(s):  
Candida Parapsilosis ◽  
Susceptibility Testing ◽  
Rapd Analysis ◽  
Antifungal Susceptibility ◽  
Bloodstream Infections ◽  
Candida Metapsilosis ◽  
Significant Difference ◽  
Its Gene ◽  
Candida Orthopsilosis ◽  
Susceptibility Patterns

The genetic heterogeneity and antifungal susceptibility patterns of Candida parapsilosis isolated from blood cultures of patients were investigated in this study. Randomly amplified polymorphic DNA (RAPD) analysis generated 5 unique profiles from 42 isolates. Based on the major DNA fragments of the RAPD profiles, the isolates were identified as RAPD type P1 (29 isolates), P2 (6 isolates), P3 (4 isolates), P4 (2 isolates) and P5 (1 isolate). Sequence analysis of the internal transcribed spacer (ITS) gene of the isolates identified RAPD type P1 as C. parapsilosis, P2 and P3 as Candida orthopsilosis, P4 as Candida metapsilosis, and P5 as Lodderomyces elongisporus. Nucleotide variations in ITS gene sequences of C. orthopsilosis and C. metapsilosis were detected. Antifungal susceptibility testing using Etests showed that all isolates tested in this study were susceptible to amphotericin B, fluconazole, ketoconazole, itraconazole and voriconazole. C. parapsilosis isolates exhibited higher MIC50 values than those of C. orthopsilosis for all of the drugs tested in this study; however, no significant difference in the MICs for these two Candida species was observed. The fact that C. orthopsilosis and C. metapsilosis were responsible for 23.8 and 4.8 % of the cases attributed to C. parapsilosis bloodstream infections, respectively, indicates the clinical relevance of these newly described yeasts. Further investigations of the ecological niche, mode of transmission and virulence of these species are thus essential.

scholarly journals Comparative Evaluation of a New Fluorescent Carboxyfluorescein Diacetate-Modified Microdilution Method for Antifungal Susceptibility Testing of Candida albicans Isolates

2002 ◽  
Vol 46 (10) ◽  
pp. 3236-3242 ◽  
Author(s):  
Robert S. Liao ◽  
Robert P. Rennie ◽  
James A. Talbot
Keyword(s):  
Candida Albicans ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Antifungal Drugs ◽  
Alamar Blue ◽  
Broth Microdilution ◽  
Modified Method ◽  
Microdilution Method ◽  
Growth Phenomenon ◽  
Broth Microdilution Method

ABSTRACT This report presents a fluorescent carboxyfluorescein diacetate (CFDA)-modified microdilution method used for the susceptibility testing of Candida albicans to amphotericin B, fluconazole, ketoconazole, itraconazole, voriconazole, and flucytosine. Four different broth microdilution susceptibility testing methods were simultaneously evaluated at 24 and 48 h. The MICs determined using the CFDA-modified method (MICcfda) were compared to those obtained by the standard broth microdilution method (MICvisual) and a procedure employing the indicator Alamar blue (MICalamar). The reference MIC was determined visually as recommended by the NCCLS M27-A protocol, and then quantified spectrophotometrically following agitation (MICspec). The CFDA-modified microdilution method was demonstrated to effectively determine the MICs for all the antifungal drugs tested at both 24 and 48 h. The results from both the MICspec and MICcfda methods yielded >80% agreement within ±1 dilution and >90% agreement within ±2 dilutions at 24 h in comparison to the reference MICvisual method, respectively. The trailing growth phenomenon that occurs with azole antifungal drugs and many strains of C. albicans did not inhibit the effectiveness of the MICspec and MICcfda methods. The MICspec and MICcfda methods shared 92.8% agreement within ±1 dilution at 24 h and 87.6% agreement within ±1 dilution at 48 h.

scholarly journals Speciation of Candida using CHROMagar from various clinical specimens and their antifungal susceptibility pattern at a tertiary care hospital.

2020 ◽  
Vol 16 (2) ◽  
pp. 107-111
Author(s):  
Sanjana Raj Kumari ◽  
Neetu Adhikaree
Keyword(s):  
Candida Albicans ◽  
Candida Species ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Antifungal Susceptibility Testing ◽  
Antifungal Drugs ◽  
Care Hospital ◽  
Clinical Specimens

Background: Candida albicans remains the most common and are responsible for various clinical infections ranging from mucocutaneous infection to life threatening invasive diseases. But recent epidemiological data shift from C.albicans to non albicans Candida species and also increased resistance to antifungal drugs made the scenario a serious concern. Methods: A total of 156 Candida isolates from various clinical specimens received in the department of Microbiology were taken up for the study over a period of one year i.e. from March 2019 to February 2020. The Candida were grown on Sabouraud dextrose agar to be  evaluated for colony  appearance, macroscopic examination, Gram staining, germ tube, urea hydrolysis etc. The Candida isolates were speciated by using CHROMagar medium. Antifungal susceptibility testing was performed as recommended by Clinical and Laboratory Standards Institute (CLSI) M44-A document. Results: The isolation of non albicans Candida (54.5%) predominated over Candida albicans (45.5%). Non albicans Candida isolated were Candida tropcalis 40(25.6%), Candida krusei 21(13.4%), Candida glabrata 17(10.8%) and Candida dublinensis 07(4.4%) each. Candida species were all susceptible to Amphotericin B, followed by fluconazole (67.4%), miconazole (51.9%) and ketoconazole (22.5%). Conclusions: The accurate species identification of Candida is important for the treatment because not all species respond to the same treatment and also because of the increasing antifungal resistance. CHROMagar is a convenient and rapid method of identification of Candida species specially in resource limited poor settings.   Keywords: antifungal susceptibility testing; Candida albicans; CHROMagar; non albicans Candida

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