scholarly journals Prevalence and Antifungal Susceptibility of the Emerging Fungal Species, Candida nivariensis, Isolated in a Teaching Hospital in Poland

2019 ◽  
Vol 68 (3) ◽  
pp. 303-308 ◽  
Author(s):  
MAGDALENA SIKORA ◽  
ROBERT KUTHAN ◽  
KATARZYNA PISKORSKA-MALOLEPSZA ◽  
MARLENA GOLAS-PRADZYNSKA ◽  
DARIUSZ DOMAŃSKI ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Teaching Hospital ◽  
Antifungal Susceptibility ◽  
Sensu Stricto ◽  
Fungal Species ◽  
Clinical Samples ◽  
Global Knowledge ◽  
Identification Of Species ◽  
26S Rrna

The data on susceptibility to antifungals of new specieswithin Candida glabrata complex are limited. Our study was to enrich a global knowledge of yeast epidemiology and drug resistance. The study was focused on the identification of species within clinical isolates of the C. glabrata complex and on the determination of their resistance to antifungals. Four hundred forty-five clinical C. glabrata sensu lato strains were isolated from different clinical samples at routine mycological exams at the Infant Jesus Teaching Hospital in Warsaw. The identification of the most of tested isolates to species complex level was performed using the ID 32 C system. The identification of C. nivariensisand C. bracarensis species within the C. glabrata complex was performed by DNA sequencing. The MICs of amphotericin B, fluconazole, itraconazole, posaconazole, voriconazole, caspofungin, anidulafungin, and micafungin were determined by E-test. Twenty-four isolates did not have an ITS-1 region, characteristic of C. glabrata sensu stricto and their D1/D2 regions of the 26S rRNA were 99% homologous to C. nivariensis 26S rRNA. No strains of C. bracarensis were recovered. C. nivariensis strains were very susceptible to amphotericin B, anidulafungin, micafungin, and caspofungin. Ninety-two percent of C. nivariensis were resistant to itraconazole. The halves of the strains was resistant to posaconazole. Eighty-three percent of C. nivariensis were susceptible to voriconazole. None of the tested strains were susceptible to fluconazole. In the present study, none of the C. nivariensis strains were simultaneously resistant to azoles and echinocandins. C. nivariensis should be recognized as an emerging pathogen, resistant to azoles.

scholarly journals Species Identification andIn VitroAntifungal Susceptibility ofAspergillus terreusSpecies Complex Clinical Isolates from a French Multicenter Study

2018 ◽  
Vol 62 (5) ◽  
pp. e02315-17 ◽  
Author(s):  
S. Imbert ◽  
A. C. Normand ◽  
S. Ranque ◽  
J. M. Costa ◽  
J. Guitard ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Antifungal Susceptibility ◽  
Sensu Stricto ◽  
Antifungal Drugs ◽  
Clinical Isolates ◽  
Clinical Samples ◽  
Azole Resistance ◽  
University Hospitals ◽  
Content Type ◽  
Interesting Alternative

ABSTRACTAspergillussectionTerreiis a species complex currently comprised of 14 cryptic species whose prevalence in clinical samples as well as antifungal susceptibility are poorly known. The aims of this study were to investigateA. Terreiclinical isolates at the species level and to perform antifungal susceptibility analyses by reference and commercial methods. Eighty-two clinicalA. Terreiisolates were collected from 8 French university hospitals. Molecular identification was performed by sequencing parts of beta-tubulin and calmodulin genes. MICs or minimum effective concentrations (MECs) were determined for 8 antifungal drugs using both EUCAST broth microdilution (BMD) methods and concentration gradient strips (CGS). Among the 79A. Terreiisolates,A. terreus stricto sensu(n= 61),A. citrinoterreus(n= 13),A. hortai(n= 3), andA. alabamensis(n= 2) were identified. All strains had MICs of ≥1 mg/liter for amphotericin B, except for two isolates (bothA. hortai) that had MICs of 0.25 mg/liter. FourA. terreusisolates were resistant to at least one azole drug, including one with pan-azole resistance, yet no mutation in theCYP51Agene was found. All strains had low MECs for the three echinocandins. The essential agreements (EAs) between BMD and CGS were >90%, except for those of amphotericin B (79.7%) and itraconazole (73.4%). Isolates belonging to theA. sectionTerreiidentified in clinical samples show wider species diversity beyond the knownA. terreus sensu stricto. Azole resistance inside the sectionTerreiis uncommon and is not related to CYP51A mutations here. Finally, CGS is an interesting alternative for routine antifungal susceptibility testing.

Etest ECVs/ECOFFs for detection of resistance in prevalent and three non-prevalent Candida spp. to triazoles and amphotericin B and Aspergillus spp. to caspofungin: Further assessment of modal variability

2021 ◽  
Author(s):  
A. Espinel-Ingroff ◽  
M. Sasso ◽  
J. Turnidge ◽  
M. Arendrup ◽  
F. Botterel ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Susceptibility Testing ◽  
Clinical Laboratory ◽  
Antifungal Susceptibility ◽  
Point Mutations ◽  
Fungal Species ◽  
Candida Spp ◽  
Pichia Kudriavzevii ◽  
Routine Testing ◽  
Data Points

Susceptibility testing is an important tool in the clinical setting; its utility is based on the availability of categorical endpoints, breakpoints (BPs) or epidemiological cutoff values (ECVs/ECOFFs). CLSI and EUCAST have developed antifungal susceptibility testing, BPs and ECVs for some fungal species. Although the Concentration Gradient Strip BioMerieux Etest is useful for routine testing in the clinical laboratory, ECVs are not available for all agent/species; the lack of clinical data precludes development of BPs. We re-evaluated and consolidated Etest data points from three previous studies, and included new data. We defined ECOFFinder Etest ECVs for three sets of species/agent combinations: fluconazole, posaconazole and voriconazole and 8 Candida spp.; amphotericin B and 3 non-prevalent Candida spp.; and caspofungin and 5 Aspergillus spp. The total of Etest MICs from 23 laboratories (Europe, the Americas, South Africa) included (antifungal agent/dependent): 17,242 Candida albicans , 244 C. dubliniensis , 5,129 C. glabrata species complex (SC), 275 C. guilliermondii ( Meyerozyma guilliermondii ), 1,133 C. krusei ( Pichia kudriavzevii ), 933 C. kefyr ( Kluyveromyces marxianus ), 519 C. lusitaniae ( Clavispora lusitaniae ), 2,947 C. parapsilosis SC, 2,214 C. tropicalis , 3,212 Aspergillus fumigatus , 232 A. flavus , 181 A. niger , and 267 A. terreus SC isolates. Triazole MICs for 66 confirmed non-wild-type (non-WT) Candida isolates were available ( ERG11 point mutations). Distributions fulfilling CLSI ECV criteria were pooled and ECOFFinder Etest ECVs were established for triazoles (9 Candida spp.); amphotericin B (3 less-prevalent Candida spp.) and caspofungin (4 Aspergillus spp.). Etest fluconazole ECVs could be good detectors of Candida non-WT isolates (59/61 Non-WT: 4 of 6 species).

scholarly journals Increasing Prevalence of Multidrug-Resistant Candida haemulonii Species Complex among All Yeast Cultures Collected by a Reference Laboratory over the Past 11 Years

2020 ◽  
Vol 6 (3) ◽  
pp. 110 ◽  
Author(s):  
Soraia Lopes Lima ◽  
Elaine Cristina Francisco ◽  
João Nóbrega de Almeida Júnior ◽  
Daniel Wagner de Castro Lima Santos ◽  
Fabiane Carlesse ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Species Complex ◽  
Antifungal Susceptibility ◽  
Its Region ◽  
Multidrug Resistant ◽  
Sensu Stricto ◽  
Culture Collection ◽  
Reference Laboratory ◽  
Yeast Cultures ◽  
Candida Haemulonii

There is worldwide concern with the increasing rates of infections due to multiresistant Candida isolates reported in tertiary medical centers. We checked for historical trends in terms of prevalence rates and antifungal susceptibility of the Candida haemulonii species complex in our yeast stock culture collected during the last 11 years. The isolates were identified by sequencing the rDNA internal transcribed spacer (ITS) region, and antifungal susceptibility tests for amphotericin B, voriconazole, fluconazole, anidulafungin, and 5-fluorocytosine were performed by the Clinical and Laboratory Standards Institute (CLSI) microbroth method. A total of 49 isolates were identified as Candida haemulonii sensu stricto (n = 21), followed by C. haemulonii var. vulnera (n = 15) and C. duobushaemulonii (n = 13), including 38 isolates cultured from patients with deep-seated Candida infections. The prevalence of the C. haemulonii species complex increased from 0.9% (18 isolates among 1931) in the first period (December 2008 to June 2013) to 1.7% (31 isolates among 1868) in the second period (July 2014 to December 2019) of analysis (p = 0.047). All isolates tested exhibited high minimum inhibition concentrations for amphotericin B and fluconazole, but they remained susceptible to 5-fluorocytosine and anidulafungin. We were able to demonstrate the increased isolation of the multiresistant Candida haemulonii species complex in our culture collection, where most isolates were cultured from patients with deep-seated infections.

scholarly journals Total Protein Profile and Drug Resistance in Candida albicans Isolated from Clinical Samples

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Kamal Uddin Zaidi ◽  
Abin Mani ◽  
Vijay Thawani ◽  
Arti Mehra
Keyword(s):  
Drug Resistance ◽  
Candida Albicans ◽  
Amphotericin B ◽  
Total Protein ◽  
Opportunistic Infections ◽  
Protein Profile ◽  
Antifungal Susceptibility ◽  
Morphological Difference ◽  
Clinical Isolates ◽  
Clinical Samples

This study was done to assess the antifungal susceptibility of clinical isolates of Candida albicans and to evaluate its total protein profile based on morphological difference on drug resistance. Hundred and twenty clinical isolates of C. albicans from various clinical specimens were tested for susceptibility against four antifungal agents, namely, fluconazole, itraconazole, amphotericin B, and ketoconazole. A significant increase of drug resistance in clinical isolates of C. albicans was observed. The study showed 50% fluconazole and itraconazole resistance at 32 μg mL−1 with a MIC50 and MIC90 values at 34 and 47 and 36 and 49 μg mL−1, respectively. All isolates were sensitive to amphotericin B and ketoconazole. The SDS-PAGE protein profile showed a prevalent band of ~52.5 kDa, indicating overexpression of gene in 72% strains with fluconazole resistance. Since the opportunistic infections of Candida spp. are increasing along with drug resistance, the total protein profile will help in understanding the evolutionary changes in drug resistance and also to characterize them.

scholarly journals Microscopic Evaluation, Molecular Identification, Antifungal Susceptibility, and Clinical Outcomes inFusarium,Aspergillusand, Dematiaceous Keratitis

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Devarshi U. Gajjar ◽  
Anuradha K. Pal ◽  
Bharat K. Ghodadra ◽  
Abhay R. Vasavada
Keyword(s):  
Clinical Outcomes ◽  
Amphotericin B ◽  
Molecular Identification ◽  
Antifungal Agents ◽  
Antifungal Susceptibility ◽  
Its Region ◽  
Fungal Species ◽  
Fungal Keratitis ◽  
Accurate Identification ◽  
Microscopic Evaluation

Purpose.Fusarium,Aspergillus, and Dematiaceous are the most common fungal species causing keratitis in tropical countries. Herein we report a prospective study on fungal keratitis caused by these three fungal species.Methodology. A prospective investigation was undertaken to evaluate eyes with presumed fungal keratitis. All the fungal isolates (n=73) obtained from keratitis infections were identified using morphological and microscopic characters. Molecular identification using sequencing of the ITS region and antifungal susceptibility tests using microdilution method were done. The final clinical outcome was evaluated in terms of the time taken for resolution of keratitis and the final visual outcome. The results were analyzed after segregating the cases into three groups, namely,Fusarium,Aspergillus, and Dematiaceous keratitis.Results. Diagnosis of fungal keratitis was established in 73 (35.9%) cases out of 208 cases. The spectra of fungi isolated wereFusariumspp. (26.6%),Aspergillusspp. (21.6%), and Dematiaceous fungi (11.6%). The sequence of the ITS region could identify theFusariumandAspergillusspecies at the species complex level, and the Dematiaceous isolates were accurately identified. Using antifungal agents such as fluconazole, natamycin, amphotericin B, and itraconazole, the minimum inhibitory concentrations (MICs) forFusariumspp. were >32 μg/mL, 4–8 μg/mL, 0.5–1 μg/mL, and >32 μg/mL, respectively. Antifungal susceptibility data showed thatCurvulariaspp. was highly resistant to all the antifungal agents. Overall, natamycin and amphotericin B were found to be the most effective antifungal agents. The comparative clinical outcomes in all cases showed that the healing response in terms of visual acuity of the Dematiaceous group was significantly good when compared with theFusariumandAspergillusgroups (P<0.05). The time required for healing in theFusariumgroup was statistically significantly less when compared with theAspergillusand Dematiaceous groups.Conclusion. This study demonstrates important differences in microscopic features of scraping material and antifungal susceptibility between the three groups. Early and accurate identification coupled with the MIC data, and thereby appropriate treatment is crucial for complete recovery.

scholarly journals Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period

2019 ◽  
Vol 5 (1) ◽  
pp. 19 ◽  
Author(s):  
Maria Noni ◽  
Angeliki Stathi ◽  
Ilia Vaki ◽  
Aristea Velegraki ◽  
Levantia Zachariadou ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Invasive Candidiasis ◽  
Candida Parapsilosis ◽  
Antifungal Susceptibility ◽  
Invasive Infection ◽  
First Line ◽  
Identification Of Species ◽  
Pediatric Populations ◽  
Therapeutic Protocols ◽  
Isolated Species

Candida species are a common cause of invasive infection in neonates and children. The aim of our study was to evaluate the epidemiology and microbiology of invasive candidiasis (IC) in the largest tertiary Greek pediatric hospital during a 10-year period. A retrospective cohort study was performed from January 2008 to December 2017. Identification of species and antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) methodology. During the study period, 178 cases of IC were recorded. The tissue distribution included blood (87.1%), cerebrospinal (7.9%), peritoneal (3.9%) and pleural fluids (1.1%). Candida albicans and Candida parapsilosis (sensu lato) were the most frequently isolated species (47.8% and 28.7% respectively). From period 2008–2012 to period 2013–2017, a significant decrease in IC rates was detected (0.21 cases/1000 hospitalization days VS 0.11 cases/1000 hospitalization days, P = 0.040), while median minimum inhibitory concentrations (MICs) of amphotericin B were significantly increased for both C. albicans and C. parapsilosis (sl) (P = 0.037 and P = 0.004 respectively). The decrease in IC rates may reflect the increased awareness as well as the effective infection control initiatives and antifungal interventions. However, the significant increase in the MICs for amphotericin B and echinocandins such as caspofungin, raises concerns about their common use as first-line treatment. Epidemiologic monitoring is, therefore, critically important in order to evaluate and optimize therapeutic protocols for IC in pediatric populations.

scholarly journals Antifungal Susceptibility of 596 Aspergillus fumigatus Strains Isolated from Outdoor Air, Hospital Air, and Clinical Samples: Analysis by Site of Isolation

2005 ◽  
Vol 49 (8) ◽  
pp. 3495-3497 ◽  
Author(s):  
J. Guinea ◽  
T. Peláez ◽  
L. Alcalá ◽  
M. J. Ruiz-Serrano ◽  
E. Bouza
Keyword(s):  
Aspergillus Fumigatus ◽  
Amphotericin B ◽  
Antifungal Susceptibility ◽  
Antifungal Drugs ◽  
Clinical Samples ◽  
Outdoor Air

ABSTRACT We analyzed the activities of six antifungal drugs (amphotericin B, itraconazole, voriconazole, posaconazole, caspofungin, and micafungin) against 596 Aspergillus fumigatus strains isolated from outdoor air, hospital air, and clinical samples. We did not find differences among the susceptibilities by site of isolation.

scholarly journals Epidemiology and Antifungal Susceptibilities of Mucoralean Fungi in Clinical Samples from the United States

2021 ◽  
Author(s):  
Hamid Badali ◽  
Connie Cañete-Gibas ◽  
Dora McCarthy ◽  
Hoja Patterson ◽  
Carmita Sanders ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Antifungal Susceptibility ◽  
The United States ◽  
Time Frame ◽  
Clinical Samples ◽  
Treatment Regimens ◽  
Susceptibility Profiles ◽  
Susceptibility Patterns ◽  
The U.S

The global incidence of mucormycosis has increased in recent years owing to higher numbers of individuals at risk for these infections. The diagnosis and treatment of this aggressive fungal infection are of clinical concern due to differences in species distribution in different geographic areas and susceptibility profiles between different species that are capable of causing highly aggressive infections. The purpose of this study was to evaluate the epidemiology and susceptibility profiles of Mucorales isolates in the U.S. over a 52-month period. Species identification was performed by combined phenotypic characteristics and DNA sequence analysis, and antifungal susceptibility testing was performed by CLSI M38 broth microdilution for amphotericin B, isavuconazole, itraconazole, and posaconazole. During this time-frame, 854 isolates were included, representing 11 different genera and over 26 species, of which Rhizopus (58.6%) was the predominant genus followed by Mucor (19.6%). The majority of isolates were cultured from the upper and lower respiratory tracts (55%). Amphotericin B demonstrated the most potent in vitro activity, with GM MICs of ≤0.25 μg/mL against all genera with the exception of Cunninghamella species (GM MIC 1.30 μg/mL). In head-to-head comparisons the most active azole was posaconazole followed by isavuconazole. Differences in azole and amphotericin B susceptibility patterns were observed between the genera with the greatest variability observed with isavuconazole. Awareness of the epidemiology of Mucorales isolates and differences in antifungal susceptibility patterns in the U.S. may aide clinicians in choosing antifungal treatment regimens. Further studies are warranted to correlate these findings with clinical outcomes.

scholarly journals In vitro Antifungal Susceptibility Profiles of Cryptococcus neoformans var. grubii and Cryptococcus gattii Clinical Isolates in Guangxi, Southern China

2021 ◽  
Vol 12 ◽  
Author(s):  
Najwa Al-Odaini ◽  
Xiu-ying Li ◽  
Bing-kun Li ◽  
Xing-chun Chen ◽  
Chun-yang Huang ◽  
...  
Keyword(s):  
Cryptococcus Neoformans ◽  
Amphotericin B ◽  
Southern China ◽  
Antifungal Susceptibility ◽  
Sensu Stricto ◽  
Cryptococcus Gattii ◽  
Antifungal Drugs ◽  
In Vitro Antifungal Susceptibility ◽  
Susceptibility Profiles

This study analyzed the in vitro drug sensitivity of Cryptococcus spp. from Guangxi, Southern China. One hundred three strains of Cryptococcus were recovered from 86 patients; 14 were HIV positive and 72 were HIV negative. Ninety-two strains were identified as Cryptococcus neoformans var. grubii, while 11 strains were identified as Cryptococcus gattii (5 C. gattii sensu stricto and 6 Cryptococcus deuterogattii). The recovered strains were tested against commonly used antifungal drugs (fluconazole, amphotericin B, 5-fluorocytosine, itraconazole, and voriconazole) and to novel antifungal drugs (posaconazole and isavuconazole) using CLSI M27-A4 method. The results showed that all isolates were susceptible to most antifungal drugs, of which the minimum inhibitory concentration (MIC) ranges were as follows: 0.05–4 μg/ml for fluconazole, 0.25–1 μg/ml for amphotericin B; 0.0625–2 μg/ml for 5-fluorocytosine, 0.0625–0.25 μg/ml for itraconazole, 0.0078–0.25 μg/ml for voriconazole, 0.0313–0.5 μg/ml for posaconazole, 0.0020–0.125 μg/ml for isavuconazole for C. neoformans var. grubii isolates, and 1–16 μg/ml for fluconazole, 0.125–1 μg/ml for 5-fluorocytosine, 0.25–1 μg/ml for amphotericin B, 0.0625–0.25 μg/ml for itraconazole, 0.0156–0.125 μg/ml for voriconazole, 0.0156–0.25 μg/ml for posaconazole, and 0.0078–0.125 μg/ml for isavuconazole for C. gattii isolates. Furthermore, some C. neoformans var. grubii isolates were found to be susceptible-dose dependent to 5-fluorocytosine and itraconazole. In addition, a reduction in the potency of fluconazole against C. gattii is possible. We observed no statistical differences in susceptibility of C. neoformans var. grubii and C. gattii in the tested strains. Continuous observation of antifungal susceptibility of Cryptococcus isolates is recommended to monitor the emergence of resistant strains.

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