scholarly journals Correlation between antifungal consumption and distribution of Candida spp. in different departments of a Lebanese hospital

2018 ◽  
Vol 12 (02.1) ◽  
pp. 33S
Author(s):  
Lyn Awad ◽  
Hani Tamim ◽  
Ahmad Ibrahim ◽  
Dania Abdallah ◽  
Mohammad Salameh ◽  
...  
Keyword(s):  
Candida Species ◽  
Candida Glabrata ◽  
Fungal Infections ◽  
Statistical Significance ◽  
Candida Spp ◽  
Antifungal Stewardship ◽  
Days Of Therapy ◽  
Major Shift ◽  
The Difference ◽  
Antifungal Consumption

Introduction: Recently there has been a significant increase in the incidence of fungal infections attributed to Candida species worldwide, with a major shift toward non-albicans Candida (NAC). Herein, we described the distribution of Candida species among different departments in a Lebanese hospital and calculated the antifungal consumption in this facility. We, then, correlated the consumption of antifungals and the prevalence of Candida species. Methodology: This was a retrospective study of Candida isolates recovered from the hospital microbiology laboratory database between 2010 and 2015. Data on antifungal consumption between 2008 and 2015 were extracted from the hospital pharmacy database. Spearman's coefficient was employed to find a correlation between Candida species distribution and antifungal consumption. Results: The highest antifungal consumption was seen in the haematology/oncology department (days of therapy/1000 patient days = 348.12 ± 85.41), and the lowest in the obstetrics department (1.36 ± 0.47). The difference in antifungal consumption among various departments was statistically significant (p < 0.0001). Azoles were the most common first-line antifungals. A non-homologous distribution of albicans vs. non-albicans was noted among different departments (p = 0.02). The most commonly isolated NAC was Candida glabrata, representing 14% of total isolates and 59% of NAC. The total antifungal consumption correlated positively with the emergence of NAC. The use of azoles correlated positively with Candida glabrata, while amphotericin B formulations correlated negatively with it. None of these correlations reached statistical significance. Conclusion: Different Candida species were unequally distributed among different hospital departments, and this correlated with consumption of antifungals in respective departments, highlighting the need for antifungal stewardship.

scholarly journals 2114. Correlation Between Antifungal Consumption and the Distribution of Candida Species in a Hospital in Colombia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S715-S716
Author(s):  
Harold T Arboleda ◽  
German A Moreno ◽  
Karen M Ordonez Diaz
Keyword(s):  
Candida Species ◽  
Statistical Significance ◽  
General Ward ◽  
Medical Surgery ◽  
Contributing Factors ◽  
Candida Spp ◽  
Defined Daily Doses ◽  
Cross Transmission ◽  
Antifungal Consumption ◽  
Oncology Unit

Abstract Background In recent years, a shift toward non albicans Candida infections has been described. An increase in the prescription of antifungals has been attributed as the cause of this change, but this issue has not been evaluated in Colombia. Methods The distribution of Candida spp. over an 11-year period 2007–2018 were extracted of the software WHONET 5.6. Antifungal drug consumption was measured as the number of defined daily doses (DDD)/100 patient-days over a 6-year period 2012–2018. Spearman’s coefficient was performed to find a correlation between antifungal consumption and distribution of Candida species. Results A total of 811 non-duplicate isolates of Candida spp. were included. An increase in the frequency of isolates was observed in the period 2013–2016 (Figure 1). The highest number of isolates were collected from the intensive care unit (ICU) (35.6%) followed of medical ward (22%). Non albicans Candida predominated (58%) in the period evaluated. The shift toward non albicans Candida was presented in 2015 (Figure 2). A non-homologous distribution of albicans vs. non-albicans was noted between ICU and general ward (P = 0.026). 152 (18.7%) isolates were recovered from blood. C. parapsilosis was the most commonly species identified in the blood cultures of ICU in contrast to C. albicans in general ward (Figures 3 and 4). Intravenous fluconazole was the main antifungal prescribed in ICU (mean 0.094 DDD/100 PD). Oral fluconazole was the principal antifungal prescribed in a medical-surgery ward (mean 0.021 DDD/100 PD) and oncology unit (mean 0.429DDD/100 PD). None of the correlations between antifungal consumption and recovery of non albicans species reached a statistical significance. Conclusion The shift toward non albicans Candida is possible even in the presence of a low consumption of antifungals. This finding suggests the possibility of other contributing factors such as cross transmission and microbiome alteration. Disclosures All authors: No reported disclosures.

scholarly journals Impact of the SARS-CoV-2 Pandemic in Candidaemia, Invasive Aspergillosis and Antifungal Consumption in a Tertiary Hospital

2021 ◽  
Vol 7 (6) ◽  
pp. 440
Author(s):  
Juan Vicente Mulet Bayona ◽  
Nuria Tormo Palop ◽  
Carme Salvador García ◽  
Begoña Fuster Escrivá ◽  
Mercedes Chanzá Aviñó ◽  
...  
Keyword(s):  
Candida Species ◽  
Great Increase ◽  
Fungal Infections ◽  
Invasive Pulmonary Aspergillosis ◽  
Tertiary Hospital ◽  
Third Wave ◽  
Candida Auris ◽  
The Third ◽  
Antifungal Consumption ◽  
Hospital General

In addition to the increase in fungal infections that has been observed in the last few decades, it has been reported that severe clinical COVID-19 can increase the risk of invasive fungal infections. The main objective of this study was to evaluate if there had been an increase in candidaemia and invasive pulmonary aspergillosis (IPA) cases since the onset of the SARS-CoV-2 pandemic. Data were retrospectively collected from April 2019 to March 2021, from patients admitted to Consorcio Hospital General Universitario de Valencia (Spain). A total of 152 candidaemia cases (56 of which were due to Candida auris) and 108 possible IPA cases were detected. A great increase in candidaemia cases was produced during the first and the third epidemic waves of the SARS-CoV-2 pandemic (June 2020, and January 2021, respectively), while an increase in IPA cases was produced during the third wave. The 28-day mortality rates in patients affected by candidaemia and IPA increased in 2020 and 2021. C. auris has displaced the other Candida species, becoming the most isolated Candida species in blood cultures since the onset of the SARS-CoV-2 pandemic. Antifungal consumption increased in 2020 when compared to 2019, especially echinocandins, voriconazole and isavuconazole.

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 2106. Evaluation of Isavuconazole for the Prophylaxis and Treatment of Invasive Fungal Infections at a Large Academic Medical Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S712-S713
Author(s):  
Christine Vu ◽  
Meenakshi Rana ◽  
Patricia Saunders-Hao
Keyword(s):  
Fungal Infections ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Invasive Fungal Infections ◽  
Prescribing Practices ◽  
Candida Spp ◽  
Antifungal Stewardship ◽  
Hospital Formulary

Abstract Background Isavuconazole is an azole antifungal with in vitro activity against various fungi, including Candida spp, Aspergillus, and Mucormycetes. Currently, isavuconazole is FDA approved for the treatment of invasive aspergillosis and mucormycosis; however, there remains limited data to support prophylaxis use. Compared with other first-line azoles, isavuconazole’s broad spectrum of activity, favorable safety profile, and oral bioavailability makes it an attractive antifungal option. In July 2017, isavuconazole was added to our hospital formulary as a restricted antimicrobial. Since then, we have seen increased use for both prophylaxis and treatment of invasive fungal infections. Methods A single-center, retrospective chart review was conducted on adult patients who received at least 1 dose of isavuconazole at The Mount Sinai Hospital between July 1, 2017 and December 31, 2018. The electronic medical record was utilized to collect information on therapeutic indication, dosing, formulation, duration, reasons for switching to isavuconazole, prior antifungals, and proven or probable breakthrough invasive fungal infections (bIFIs) based on EORTG/MTG definitions. Results 54 patients received 61 courses of isavuconazole. Reasons for switching to isavuconazole are described in Table 1. Eleven patients received inappropriate intravenous formulations and 14% of orders were prescribed isavuconazole without a loading dose (Table 2). We identified 4 proven/probable bIFIs, representing 7.4% of patients and 6.6% of courses (Table 3). All patients died within 60 days of bIFI onset. Conclusion Since its addition to hospital formulary, we have observed varying isavuconazole prescribing practices, highlighting the need for improved antifungal stewardship. Rates of bIFIs on isavuconazole were lower than previously reported studies. Additional studies are needed to provide guidance on isavuconazole use and determine its role as prophylaxis therapy. Disclosures All authors: No reported disclosures.

scholarly journals The Trends in the Distribution of Candida species Causing Candidemia at a Community Hospital in 2005 and 2014

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S87-S87
Author(s):  
Celestine Ishiekwene ◽  
Maxine Seales Kasangana ◽  
Monica Ghitan ◽  
Margaret Kuhn-Basti ◽  
Edward Chapnick ◽  
...  
Keyword(s):  
New York ◽  
Antifungal Therapy ◽  
Candida Species ◽  
Fungal Infections ◽  
Medical Center ◽  
Retrospective Chart Review ◽  
Common Species ◽  
Published Data ◽  
Candida Spp ◽  
Common Cause

Abstract Background Candida remains the most common cause of invasive fungal infections, with an attributable morality of 15–35%. Although five Candida species (C. albicans, C. tropicalis, C. parapsilosis, C. glabrata, and C. krusei) account for 92% of cases of candidemia, Candida albicans remains the most common cause of candidemia. However, recent studies report that the frequency of non albicans species are increasing globally and the distribution of Candida spp. varies significantly among different geographic regions and hospitals units. Objective We determine the distribution of Candida species causing candidemia at an adult level 1 Trauma Center in Brooklyn, New York and compared the trends of Candida species between 2005 and 2014. The results were compared with trends of US data collected in 2004 and 2012. Knowledge of the frequency of causative species would facilitate appropriate selection of empiric antifungal therapy. Methods We performed a retrospective chart review of patients with candidemia who were admitted in 2005 and 2014. We determined the frequency of Candida species and compared 2005 data with those in 2014. Results In total, 226 and 109 patients with candidemia were admitted to our hospital in 2005 and 2014, respectively. Although, C. albicans was the most common species (43% of candidemia in 2005), its frequency decreased to 33% in 2014. The frequencies of C. glabrata and C. parapsilosis increased in 2014 compared with those in 2005 (24% vs. 16% and 33% vs. 26%, respectively). Figure 1 compared the proportion of Candida species in Maimonides Medical Center to National data. Conclusion Our finding of an increase in non-albicans spp. causing candidemia is consistent with published reports. We saw more cases of C. parapsilosis compared with published data. Our results may be used to inform empiric antifungal therapy. Disclosures All authors: No reported disclosures.

scholarly journals Presumptive Identification of Candida spp. from Clinical Isolates and Anticandidal Effect of Essential Oils

YMER Digital ◽  
2021 ◽  
Vol 20 (11) ◽  
pp. 254-261
Author(s):  
S S Khandare ◽  
◽  
A P Moon ◽  
M G Ingale ◽  
◽  
...  
Keyword(s):  
Essential Oils ◽  
Candida Species ◽  
Candida Glabrata ◽  
Candida Parapsilosis ◽  
Biochemical Characterization ◽  
Morphological Characterization ◽  
Candida Krusei ◽  
Clinical Samples ◽  
Candida Spp ◽  
Life Threatening

Candida is normal flora of human skin, mouth, vagina, colon and causes mycosis worldwide. Candida causes oral thrush, vaginitis and other potentially life-threatening diseases. This study assesses anticandidal potential of essential oils against Candida species isolated from clinical samples obtained from Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra. On the basis of morphological characterization on Sabouraud dextrose agar, CHROMagar, Germ tube test and biochemical characterization, Candida species identified as Candida albicans, Candida krusei, Candida glabrata, Candida parapsilosis. Clove, thyme, cinnamon and eucalyptus essential oils with concentrations of 6.2, 12.5, 25, 50 and 100 μg/ml were used to study their anticandidal activity. C. albicans demonstrated zone of inhibition (ZOI) 29, 20, 32, 29 mm, Candida krusei 25, 25, 30, 21 mm, Candida glabrata 24, 22, 31, 32mm,Candida parapsilosis 33,31,33, 29mm towards clove, thyme, cinnamon and eucalyptus oil (each at 100 μg/ml) respectively which are highest ZOI as compared with antifungal agent Amphotericin-B, which showed 16, 13, 12, 8 mm against C. albicans, C. krusei, C.glabrata and C. parapsilosis respectively. All Candida spp. produced biofilms and enzyme lipase. This study will facilitate the development of novel broad-spectrum key molecules against a range of Candida species.

scholarly journals Identification of Candida Species Circulating in Dakar using Multiplex Nested PCR

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Aida Badiane
Keyword(s):  
Nested Pcr ◽  
Candida Species ◽  
Fungal Infections ◽  
Test Tube ◽  
Species Level ◽  
Storage Medium ◽  
Group I ◽  
Vaginal Swabs ◽  
Identification Of Fungi ◽  
The Difference

Background: In most developing countries, laboratory identification of Fungi belonging to the genus Candida is often problematic. The germ test tube known as Blastese test, which is the most used has the limitation that it only differentiates the C. albicans complex from other Candida complexes. Not only it is important to know the involvement of other species in the occurrence of fungal infections, but also the difference in sensitivity to the azoles used in the treatment of these fungal infections makes it necessary to identify the Fungi at the species level. The objective of this study was to identify by multiplex nested PCR the Candida species isolated in the laboratory of Parasitology and Mycology of Aristide Le Dantec Hospital, Senegal. Methodology: Candida isolates were obtained from patients who were admitted to the laboratory of Parasitology and Mycology with suspected fungal infections. After identification by conventional methods, isolates were preserved in a storage medium and kept at -20°C. Species identification was performed by nested PCR. Results: A total of 42 yeast isolates were collected after culture on Sabouraud medium, among which 10 (24%) from vaginal swabs and 32 (76%) from patients suffering from superficial mycoses (skin and nails). C. albicans represented 68% and nonCandida albicans (NAC) species 32%. The distribution of the NAC species was as follows: C. parapsilosis (group I and II) 17% (8), C. tropicalis 8.5% (4), C. kefyr 4.25% (2) and C. lusitaniae 2.15% (1). Mixed infection with two species represented 17.39% of the isolates. Conclusion: This study shows that other Candida species are common in Dakar, although their identification is not routinely performed in most laboratories. Thus, it is necessary to improve the technical facilities in these diagnostic laboratories.

New and Promising Chemotherapeutics for Emerging Infections Involving Drug-resistant Non-albicans Candida Species

2019 ◽  
Vol 19 (28) ◽  
pp. 2527-2553 ◽  
Author(s):  
Laura Nunes Silva ◽  
Thaís Pereira de Mello ◽  
Lívia de Souza Ramos ◽  
Marta Helena Branquinha ◽  
André Luis Souza dos Santos
Keyword(s):  
Candida Species ◽  
Fungal Infections ◽  
Public Health Problem ◽  
Global Scale ◽  
Rapid Identification ◽  
Fungal Species ◽  
Emerging Infections ◽  
Candida Spp ◽  
Infected People ◽  
Populations At Risk

Fungal infections are a veritable public health problem worldwide. The increasing number of patient populations at risk (e.g. transplanted individuals, cancer patients, and HIV-infected people), as well as the use of antifungal agents for prophylaxis in medicine, have favored the emergence of previously rare or newly identified fungal species. Indeed, novel antifungal resistance patterns have been observed, including environmental sources and the emergence of simultaneous resistance to different antifungal classes, especially in Candida spp., which are known for the multidrug-resistance (MDR) profile. In order to circumvent this alarming scenario, the international researchers’ community is engaged in discovering new, potent, and promising compounds to be used in a near future to treat resistant fungal infections in hospital settings on a global scale. In this context, many compounds with antifungal action from both natural and synthetic sources are currently under clinical development, including those that target either ergosterol or &#946;(1,3)-D-glucan, presenting clear evidence of pharmacologic/pharmacokinetic advantages over currently available drugs against these two well-known fungal target structures. Among these are the tetrazoles VT-1129, VT-1161, and VT-1598, the echinocandin CD101, and the glucan synthase inhibitor SCY-078. In this review, we compiled the most recent antifungal compounds that are currently in clinical trials of development and described the potential outcomes against emerging and rare Candida species, with a focus on C. auris, C. dubliniensis, C. glabrata, C. guilliermondii, C. haemulonii, and C. rugosa. In addition to possibly overcoming the limitations of currently available antifungals, new investigational chemical agents that can enhance the classic antifungal activity, thereby reversing previously resistant phenotypes, were also highlighted. While novel and increasingly MDR non-albicans Candida species continue to emerge worldwide, novel strategies for rapid identification and treatment are needed to combat these life-threatening opportunistic fungal infections.

scholarly journals Identification of Cryptic Species of Four Candida Complexes in a Culture Collection

2019 ◽  
Vol 5 (4) ◽  
pp. 117
Author(s):  
Gustavo Fontecha ◽  
Kathy Montes ◽  
Bryan Ortiz ◽  
Celeste Galindo ◽  
Sharleen Braham
Keyword(s):  
Cryptic Species ◽  
Candida Species ◽  
Fungal Infections ◽  
Sensu Stricto ◽  
Culture Collection ◽  
Antifungal Drugs ◽  
Correct Identification ◽  
Candida Spp ◽  
Simple Method ◽  
First Report

Candida spp. are one of the most common causes of fungal infections worldwide. The taxonomy of Candida is controversial and has undergone recent changes due to novel genetically related species. Therefore, some complexes of cryptic species have been proposed. In clinical settings, the correct identification of Candida species is relevant since some species are associated with high resistance to antifungal drugs and increased virulence. This study aimed to identify the species of four Candida complexes (C. albicans, C. glabrata, C. parapsilosis, and C. haemulonii) by molecular methods. This is the first report of six cryptic Candida species in Honduras: C. dubliniensis, C. africana, C. duobushaemulonii, C. orthopsilosis, and C. metapsilosis, and it is also the first report of the allele hwp1-2 of C. albicans sensu stricto. It was not possible to demonstrate the existence of C. auris among the isolates of the C. haemulonii complex. We also propose a simple method based on PCR-RFLP for the discrimination of the multi-resistant pathogen C. auris within the C. haemulonii complex.

scholarly journals Antifungal resistance profile and enzymatic activity of Candida species recovered from human and animal samples

Bio-Research ◽  
2019 ◽  
Vol 17 (1) ◽  
pp. 1044A-1055A
Author(s):  
IE Mba ◽  
EI Nweze
Keyword(s):  
Enzymatic Activity ◽  
Candida Species ◽  
Vaginal Swab ◽  
Fungal Species ◽  
Resistance Rate ◽  
Antifungal Resistance ◽  
Candida Spp ◽  
Significant Difference ◽  
The Difference

Candida is currently the most implicated pathogenic fungal species recognized as the major cause of a variety of human infections all over the world. This study investigated species distribution, enzymatic activities, and antifungal resistance profiles of human and animal Candida species. Clinical Candida species (n=220) were isolated from urine, high vaginal swab (HVS) and blood while Candida species (n=128) were isolated from rectal swab, ear swab, blood, feces, and milk in animals: goat, sheep, cattle, pig and chicken. The identification of the species was performed using standard methods. Enzymatic activity was screened using plate methods. Susceptibility testing was carried out using disk diffusion and broth microdilution methods. A statistically significant difference (P=0.031) was observed in the distribution of Candida spp. recovered from humans and animals. The Pz values of human Candida species for proteinase, hemolysin, lipase and phospholipase were 0.65±0.97, 0.61±0.81, 0.59±0.47 and 0.76±0.74 respectively while that of Candida species recovered from animal were 0.67±0.13, 0.61±0.95, 0.62±0.67 and 0.69±0.70 respectively. No statistically significant difference (P>0.05) in the in vitro enzymatic activity was observed between the two groups. High azole-resistance rate was observed. Resistance was higher among human Candida isolates compared to animal isolates although the difference was not considered statistically significant (p = 0.519). Our findings suggest that the enzymatic activity (virulence potential) and resistance patterns are similar in the two groups investigated. This study underscores the importance of animals especially pets and their products as potential sources/reservoirs of pathogenic and multi-azole resistant Candida species in Nigeria.

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