scholarly journals Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bhuvan Saud ◽  
Prajuna Bajgain ◽  
Govinda Paudel ◽  
Vikram Shrestha ◽  
Dipendra Bajracharya ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Candida Species ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Organ Damage ◽  
Multiple Organ ◽  
Hair Shaft ◽  
Yeast Cells ◽  
Aspergillus Species ◽  
The Status

Background. Low immunity, comorbid clinical conditions, and metabolic disorders may be the underlying factors that determine the severity of infection. Diabetes increases the risk of infection and multiple organ damage. In Nepal, the actual burden of fungal infections has not been estimated or is in a limited progress. This study aimed to investigate the status of fungal infection in diabetic and nondiabetic individuals in Bhaktapur, Nepal. Materials and Methods. A total of 670 samples were collected from 134 participants. From each participant, five samples were collected from different sites like an oral wash, toe swab, midstream urine, hair shaft, and nail scrapings. All samples were cultured on Sabouraud dextrose agar. Gram stain was used to observe yeast cells and lactophenol cotton blue stain was used for hyphae. Chlamydospore production by Candida species was observed in cornmeal agar medium by Dalmau Plate method. Candida species isolated were characterized by germ-tube test and differentiated using CHROM agar Candida medium. Candida species isolates were tested for antibiotic susceptibility. Results. Overall, 19.4% of the samples showed fungal growth. The prevalence of fungal infection was higher in diabetic (34.0%) than nondiabetic individuals (4.7%). Fungal growth was found to be higher in oral wash followed by toe, urine, hair, and nail samples. Predominant fungi were Candida species (57.5%), Aspergillus species (28.4%), and Trichophyton species (10.7%). Oral wash, toe, and urine samples in diabetics had a significantly higher fungal prevalence when compared between both groups, p value < 0.05. In Candida isolates, higher resistance was seen against fluconazole 36.8% and ketoconazole 28.9%, whereas other drugs showed low resistance. Conclusion. Diabetic participants are more susceptible to fungal infection than the nondiabetics. Overall, Candida species and Aspergillus species are highly predominant fungi. Candida species are highly resistant to fluconazole and ketoconazole.

scholarly journals Rapidly dissolving microneedle patch of amphotericin B for intracorneal fungal infections

2021 ◽  
Author(s):  
Alyaa A. Albadr ◽  
Ismaiel A. Tekko ◽  
Lalitkumar K. Vora ◽  
Ahlam A. Ali ◽  
Garry Laverty ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Amphotericin B ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Significant Inhibition ◽  
Corneal Tissue ◽  
Biodegradable Poly ◽  
Invasive Method ◽  
Poorly Soluble ◽  
Microneedle Patch

AbstractChronic fungal infection of the cornea could lead to blindness if not treated properly. Topical amphotericin B (AMP-B) is considered the first treatment of choice for ocular fungal infection. However, factors related to its poor solubility and penetration through intact cornea lead to poor bioavailability. Microneedles (MNs) are emerging as a minimally invasive method to enhance ocular drug delivery. This study aims to investigate the potential use of biodegradable poly(vinylpyrrolidone) (PVP) and hyaluronic acid (HA)–based rapidly dissolving MNs for delivery of AMP-B to treat fungal infection. The data obtained illustrates PVP/HA MN arrays’ reproducibility, good mechanical strength, and faster dissolution with 100% drug recovery. Multiphoton microscopic results revealed that MNs successfully penetrate the corneal tissue and enhance AMP-B permeation through corneal layers. Furthermore, PVP/HA MN arrays showed high solubility. Both PVP and HA successfully decreased AMP-B cytotoxicity when compared to free drug. More interestingly, the biocompatible MN formulations preserved the antifungal activity of AMP-B, as demonstrated by significant inhibition of fungal growth. Therefore, this study shows the feasibility of ocular delivery of the poorly soluble AMP-B using a fast-dissolving MN patch. Graphical abstract

scholarly journals Denture Stomatitis: Report of a Case with Rarely Used Treatment Modality and Review of Literature

2020 ◽  
Vol 4 (5) ◽  
pp. 116-119
Author(s):  
Parul Uppal Malhotra ◽  
Neera Ohri ◽  
Yagyeshwar Malhotra ◽  
Anindita Mallik
Keyword(s):  
Candida Albicans ◽  
Candida Species ◽  
Fungal Infections ◽  
Bacterial Colonization ◽  
Oral Candidiasis ◽  
Clinical Signs ◽  
Fungal Growth ◽  
Dimorphic Fungus ◽  
Denture Stomatitis ◽  
Microbial Invasion

Candida albicans is the most common Candida species isolated from the oral cavity both in healthy and diseased. Candida albicans is a dimorphic fungus existing both in blastopore phase (yeast phase) and the hyphal or mycelial phase. Although these organisms typically colonize mucocutaneous surfaces, the latter can be portals of entry into deeper tissues when host defences are compromised. Denture stomatitis is a common form of oral candidiasis that manifests as a diffuse inflammation of the maxillary denture bearing areas & is associated with angular cheilitis. At least 70% of individuals with clinical signs of denture stomatitis exhibit fungal growth & these conditions most likely result from yeast colonization of the oral mucosa combined with Bacterial colonization. Candida species act as an endogenous infecting agent on tissue predisposed by chronic trauma to microbial invasion. At one time, oral fungal infections were rare findings in general dentist's office. They were more commonly seen in hospitalized and severely debilitated patients. However with enhanced medical and pharmaceutical technology, increasing numbers of ambulatory immunosuppressed individuals with oral fungal infections are seeking out general dentists for diagnosis and treatment of these lesions.

scholarly journals The The Effects of Cinnamaldehyde (Cinnamon Derivatives) and Nystatin on Candida Albicans and Candida Glabrata

2019 ◽  
Vol 7 (7) ◽  
pp. 1067-1070 ◽  
Author(s):  
Sedigheh Bakhtiari ◽  
Soudeh Jafari ◽  
Jamileh Bigom Taheri ◽  
Tahereh Sadat Jafarzadeh Kashi ◽  
Zahra Namazi ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Minimum Inhibitory Concentration ◽  
Candida Species ◽  
Candida Glabrata ◽  
Inhibitory Concentration ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Minimum Fungicidal Concentration ◽  
Microdilution Method

BACKGROUND: Candida species are the most common opportunistic fungal infections. Today, cinnamon plants have been considered for anti-Candida properties. AIM: This study aimed to investigate the effectiveness of cinnamaldehyde extract (from cinnamon derivatives) on Candida albicans and Candida glabrata species and comparison with nystatin. MATERIAL AND METHODS: In this study, cinnamaldehyde and nystatin were used. The specimens included Candida albicans and Candida glabrata. Minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) were measured for each one by the microdilution method. This experiment was repeated three times. RESULTS: Cinnamaldehyde extract at a concentration of 62.5 μl/ml was able to prevent the growth of Candida albicans, at a concentration of 93.7 μl/ml, causing Candida albicans to disappear, at 48.8 μl/ml, to prevent the growth of Candida glabrata, and in the concentration of 62.5 μl/ml, causes the loss of Candida glabrata. In comparison, nystatin at 0.5 μg/ml concentration prevented the growth of Candida albicans, at concentrations of 1 μg/ml causing Candida albicans to be destroyed, at 4 μg/ml concentration to prevent the growth of Candida glabrata, and at a concentration of 8 μg/ml causes the loss of Candida glabrata. The results were the same every three times. CONCLUSIONS: Although cinnamaldehyde extract had an effect on fungal growth in both Candida albicans and Candida glabrata with a fatal effect; the effect on these two species was lower than nystatin.

scholarly journals COVID-19 and Fungal Infection

2020 ◽  
pp. 47-50
Author(s):  
Ji Hyun Lee ◽  
Hwa Jung Yook
Keyword(s):  
Fungal Infection ◽  
Multiple Organ Failure ◽  
World Health Organization ◽  
Organ Failure ◽  
Fungal Infections ◽  
Severe Disease ◽  
Multiple Organ ◽  
World Health ◽  
The World ◽  
Health Organization

In November 2019, the coronavirus disease-2019 (COVID-19) outbreak was first reported. The infection of COVID-19 has rapidly spread worldwide. Some have unapparent or mild symptoms, but some patients have fatal forms including respiratory or multiple organ failure. In March 2020, the World Health Organization announced COVID-19 as pandemic disease. The COVID-19 pandemic is a sudden, difficult-to-control, and severe disease that can also appear to patients in dermatology. However, understanding disease and experience with it is still insufficient. Therefore, we would like to review patients with fungal infections in the COVID-19 pandemic era.

scholarly journals 267. Fungal Culture Diagnostic Stewardship: An Avenue for Antimicrobial Stewardship in the Immunocompromised Host

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S148-S148
Author(s):  
Pooja Gurram ◽  
Kirtivardhan Vashistha ◽  
John C O’Horo ◽  
Aditya Shah
Keyword(s):  
Antimicrobial Stewardship ◽  
Candida Species ◽  
Fungal Infections ◽  
Immunocompromised Host ◽  
Common Species ◽  
Aspergillus Species ◽  
Fungal Culture ◽  
Penicillium Species ◽  
Fungal Organisms ◽  
Disseminated Disease

Abstract Background Bronchoalveolar lavage (BAL) is a widely used procedure in the diagnosis of pneumonia in critically ill and immunocompromised hosts. Fungal smears and cultures are commonly performed on these samples. We evaluated the yield of various fungi, including but not limited to Candida species, Aspergillus species, Penicillium species, isolated from BAL specimens at our institution to determine the yield of this test and its impact on decision making. Methods We identified adult immunocompromised patients who underwent “Bronchoscopy with Immunocompromised Host Protocol (ICH),” which consists of an exhaustive list of diagnostic tests for various pathogenic organisms, over a one year period from January 1, 2017 to December 31, 2017. We reviewed if positive fungal cultures led to a change in management and if this was appropriate. Results 582 patients underwent bronchoscopy with ICH protocol. There were 285/582 (48.9%) positive fungal cultures of which 177 (62%) grew Candida species. The most common species was Candida albicans (142/177, 80%). 53(18%) were Aspergillus species of which Aspergillus fumigatus was the most common (26/53). 16/285 (5.6%) patients underwent intervention based on the results, 14(87.5%) of which were appropriate. 176/177 (99.4%) patients with Candida species in BAL cultures were not treated.10/53 (18. 8%) patients with Aspergillus species in BAL cultures were treated of which 80% were appropriate interventions based on proven/probable invasive fungal infections criteria as were rest of the 6/16 patients with other fungal organisms (Table 4). Patients with Aspergillus species in BAL cultures are 8 times more likely to have an intervention (OR: 8. 7, P = < 0. 0001) while patients with Candida species in BAL cultures are not likely to be intervened upon (OR: 0. 26, P = 0. 0098) (Table 3). Conclusion Although Candida species is commonly isolated in BAL cultures its clinical significance is minimal in the absence of disseminated disease even in immunosuppressed hosts. Evaluating the way that Candida cultures are communicated for respiratory specimens, along with diagnostic stewardship may be a route for antimicrobial stewardship. Consulting ID service early on is essential in assessing the significance of fungal culture data thereby resulting in appropriate changes in management. Disclosures All authors: No reported disclosures.

scholarly journals Nitric Oxide-Releasing Macromolecule Exhibits Broad-Spectrum Antifungal Activity and Utility as a Topical Treatment for Superficial Fungal Infections

2018 ◽  
Vol 62 (7) ◽  
Author(s):  
Nathan Stasko ◽  
Kimberly McHale ◽  
Stanley J. Hollenbach ◽  
Megan Martin ◽  
Ryan Doxey
Keyword(s):  
Nitric Oxide ◽  
Fungal Infection ◽  
Topical Application ◽  
Fungal Infections ◽  
Drug Product ◽  
Nail Plate ◽  
Fungal Growth ◽  
Content Type ◽  
Nitric Oxide Releasing

ABSTRACTCutaneous and superficial fungal infections affecting the skin, nails, and hair of humans are caused primarily by dermatophytes of the generaTrichophytonandEpidermophytonor by yeasts of the generaCandidaandMalassezia.Onychomycosis is a common fungal infection of the nail that frequently coexists with tinea pedis, the most prevalent mycotic skin infection. Efficacy rates for current topical onychomycosis therapies are hampered by low drug penetration across the nail plate, which is theoretically obviated with nitric oxide (NO)-based topical therapies. The Nitricil technology platform is comprised of polysiloxane-based macromolecules that stably release therapeutic levels of NO. In the reported studies, NVN1000, the lead candidate of the platform, was assessed for its spectrum ofin vitroactivity against a broad range of filamentous fungi and yeast species commonly associated with cutaneous fungal infections. Time-kill assays demonstrated that NVN1000 exhibited fungicidal activity as early as 4 h. Additionally, the penetration of several unique NVN1000 NO-releasing drug product formulations (gel, cream, and lacquer) was evaluated following a single topical application in anin vitroinfected human nail assay, with all formulations showing similar inhibition of fungal growth. Repeated topical application in this model demonstrated that a lower-strength dose of NO could achieve the same efficacy as a higher-strength dose after 7 days. Together, thesein vitroresults demonstrate that NO-releasing treatments rapidly penetrate the nail plate and eradicate the fungal infection, representing promising novel topical therapies for the treatment of onychomycosis and other cutaneous fungal infections.

scholarly journals Rapidly Dissolving Microneedle Patch of Amphotericin-B for Intracorneal Fungal Infections.

2021 ◽  
Author(s):  
Alyaa A. Albadr ◽  
Ismaiel A. Tekko ◽  
Lalitkumar K. Vora ◽  
Ahlam A. Ali ◽  
Garry Laverty ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Significant Inhibition ◽  
Corneal Tissue ◽  
Biodegradable Poly ◽  
Invasive Method ◽  
Poorly Soluble ◽  
Microneedle Patch ◽  
Potential Use

Abstract Chronic fungal infection of the cornea could lead to blindness if not treated properly. Topical AMP-B is considered the first treatment of choice for ocular fungal infection. However, factors related to its poor solubility and penetration through intact cornea leads to poor bioavailability. Microneedles (MNs) are emerging as a minimally-invasive method to enhance ocular drug delivery. Therefore, this study aims to investigate the potential use of biodegradable poly(vinylpyrrolidone) (PVP) and hyaluronic acid (HA) based rapidly dissolving MNs for delivery of AMP-B to treat fungal infection. The data obtained illustrates PVP/HA MN arrays' reproducibility, good mechanical strength, and faster dissolution with 100% drug recovery. Multiphoton microscopic results revealed that MNs as microdevice successfully penetrate the corneal tissue and enhance AMP-B permeation through corneal layers. Furthermore, PVP/HA MNs arrays showed high solubility. Both PVP and HA successfully decreased AMP-B cytotoxicity when compared to free drug. More interestingly, the biocompatible MN formulations preserved the antifungal activity of AMP-B, as demonstrated by significant inhibition of fungal growth. Therefore, this study shows the feasibility of ocular delivery of the poorly soluble AMP-B using a fast-dissolving MN patch.

scholarly journals COVID - 19 Presenting with Fungal Infections - The Hidden Pandemic within Pandemic?

2021 ◽  
Vol 10 (44) ◽  
pp. 3810-3814
Author(s):  
Vidyashree S. Hulkoti ◽  
Samarth Shukla ◽  
Sourya Acharya ◽  
Dhruv Talwar ◽  
Aditi Goyal
Keyword(s):  
Fungal Infection ◽  
Fungal Infections ◽  
Organ Damage ◽  
High Rate ◽  
Treatment Modalities ◽  
Medical Attention ◽  
Current State ◽  
Increasing Trend ◽  
Cellular Immunodeficiency ◽  
Immunocompetent Patients

As the pandemic continues to spread vigorously, it is being noted that the COVID 19 virus is associated with various complications during the disease and also a great deal of post disease sequel.1 These gruelling complications are integrated with the overwhelming infection caused by the cytokine storm produced by the virus. While the treatment modalities are still under trial, glucocorticoids seem to have played a pivotal role in putting a check to the inflammation caused by the virus and have forbidden the organ damage caused thereafter. However, the aftermath of glucocorticoids usage has its own benefits and risks. Glucocorticoids cause cellular immunodeficiency and thus have immunosuppressive effects, additionally the use of immunomodulators such as tocilizumab alters the immune system and it subsequently predisposes the host to various secondary opportunistic infective agents. In the current state, as the pandemic abstains from fading away, an increasing trend of secondary fungal infections has been seen with COVID-19, resulting in an outbreak of fungal infections such as mucormycosis and candidiasis. Mucormycosis refers to any infection caused by the fungi of the Order Mucorales. Mucormycosis has been documented in the literature to be associated with a high rate of mortality due to its potential to spread drastically.2 Altered immunity is an important risk factor for mucormycosis. Additionally, diabetes has been noted to be critical for the development of mucormycosis in immunocompetent patients. Candidiasis is an infection caused by the candida species due to the immunosuppressed state developed by the use of glucocorticoids, which results in secondary fungal infection requiring urgent medical attention. The objective of this case report is to highlight the impending secondary fungal infection outbreak in COVID-19 and the need to contain this emerging spread of fungal infections under the blanket of this deadly pandemic.

scholarly journals Opportunistic Fungal Infection in HIV Positive Patients Attending a Tertiary care Hospital in Eastern Nepal

2018 ◽  
Vol 1 (2) ◽  
pp. 81-87
Author(s):  
Rinku Sah ◽  
R. Gurung ◽  
N. Poudyal ◽  
R. Baral ◽  
S. Rijal ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Cryptococcus Neoformans ◽  
Candida Species ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Aspergillus Species ◽  
Hiv Positive ◽  
Care Hospital ◽  
Isolation And Identification ◽  
Major Health Problem

Background: HIV infection continues to be a major health problem with more than millions of AIDS related death annually. The risk of opportunistic infections increases with the depletion of CD4+ count in HIV positive patients which are responsible for the high mortality and morbidity. The spectrum of opportunistic infection (OIs) varies from one region to another. This study was carried out to see the occurrence of opportunistic fungal infection among the HIV positive patients in Eastern Nepal. Method: This was a hospital based descriptive study carried out in Microbiology laboratory, BPKIHS, Dharan, Nepal over a period of one year (15th May 2013 to 14th May 2014). Total 60 HIV positive patients with CD4+ count ≤200 cells/mm3 and suspected of having fungal infections were included. Samples were collected after taking an informed written consent from the patient. Isolation and identification was done as per standard Microbiological procedure. Result: Opportunistic fungal infection was identified in 51.66% patients. The most common fungi isolated were Candida species, Cryptococcus neoformans, Aspergillus species and Dermatophytes respectively being 33.3% (n= 20), 10% (n= 6), 3.3% (n= 2) and 8.3% (n= 5). Candida species comprised 60%, Cryptococcus neoformans 20%, Aspergillus species 5.7% and dermatophytes 14.3% of total fungal isolates. Conclusion: The common fungus isolated were Candida species, Cryptococcus neoformans, Aspergillus species and Dermatophytes in HIV positive patients in this hospital of Eastern Nepal.

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