|
| ||
|
|
||
C. Glabrata (c + glabrata)
Selected AbstractsRole of the Slt2 mitogen-activated protein kinase pathway in cell wall integrity and virulence in Candida glabrataFEMS YEAST RESEARCH, Issue 3 2010Taiga Miyazaki Abstract The Slt2 mitogen-activated protein kinase pathway plays a major role in maintaining fungal cell wall integrity. In this study, we investigated the effects of SLT2 deletion and overexpression on drug susceptibility and virulence in the opportunistic fungal pathogen Candida glabrata. While the ,slt2 strain showed decreased tolerance to elevated temperature and cell wall-damaging agents, the SLT2 -overexpressing strain exhibited increased tolerance to these stresses. A mutant lacking Rlm1, a transcription factor downstream of Slt2, displayed a cell wall-associated phenotype intermediate to that of the ,slt2 strain. When RLM1 was overexpressed, micafungin tolerance was increased in the wild-type strain and partial restoration of the drug tolerance was observed in the ,slt2 background. It was also demonstrated that echinocandin-class antifungals were more effective against C. glabrata under acidic conditions or when used concurrently with the chitin synthesis inhibitor nikkomycin Z. Finally, in a mouse model of disseminated candidiasis, the deletion and overexpression of C. glabrata SLT2 resulted in mild decreases and increases, respectively, in the CFUs from murine organs compared with the wild-type strain. These fundamental data will help in further understanding the mechanisms of cell wall stress response in C. glabrata and developing more effective treatments using echinocandin antifungals in clinical settings. [source] Healthcare-associated candidemia,A distinct entity?,JOURNAL OF HOSPITAL MEDICINE, Issue 5 2010Joyti Gulia MD Abstract BACKGROUND: The concept of health care-associated infection (HCAI) was developed to address the fact that select patients now present to the hospital with infections due to traditionally nosocomial pathogens. Although epidemiologic studies document the clear existence of health care-associated pneumonia, little is known about fungal pathogens and their role in HCAIs. OBJECTIVE: To describe the epidemiology of health care-associated bloodstream infections (BSIs) due to candida species and to compare patients with HCA candidemia to nosocomial candidemia. DESIGN: Retrospective case series. SETTING: Academic, tertiary care hospital. MEASUREMENTS: We measured the proportion of cases of candidal BSI classified as health care-associated along with the microbiology of these infections. We compared health care-associated and nosocomial cases of candidemia with respect to demographics, severity of illness, and fluconazole susceptibility. RESULTS: We noted 233 cases of candidal BSI over a 3-year period. Nearly one-quarter represented an HCAI that presented to the hospital, as opposed to a nosocomial process. Although patients with HCA candidemia were similar to subjects with nosocomial infection in terms of underlying comorbidities and severity of illness, those with HCA yeast BSI were more likely to be immunosuppressed and to have their infection caused by a fluconazole-resistant organism. C. glabrata was seen more often in patients presenting to the hospital with an HCA case of candidemia. CONCLUSIONS: Clinicians must recognize the potential for candida species to cause HCA infections and to be present at time of hospital presentation. Physicians need to consider this and the distribution of species of yeast causing BSI in their institution when considering initial therapy for patients with a suspected BSI. Journal of Hospital Medicine 2010;5:298,301. © 2010 Society of Hospital Medicine. [source] Human laminin-332 degradation by Candida proteinasesJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 6 2008P. Pärnänen Background:, Human laminin-332 (Lm-332) degradation by 12 Candida strains and effects of synthetic proteinase inhibitors [Ilomastat (ILM), EDTA, chemically modified tetracycline-3(CMT-3), CMT-308, synthetic peptide CTT-2, and Pefabloc] were studied. Materials and methods:, Laminin-332 was incubated with sonicated cell fractions and 10 times concentrated cell-free fractions of reference and clinical strains of C. albicans, C. dubliniensis, C. guilliermondii, C. glabrata, C. krusei, and C. tropicalis. Proteolysis, pH effects, and inhibitors were analyzed by fluorography and zymography. Results:, Cell fractions of all species except C. guilliermondii and cell-free fractions of C. albicans, and C. dubliniensis showed 20,70 kDa gelatinases at pH 5.0 and 6.0. At pH 7.6, C. glabrata, C. krusei, and C. tropicalis cell fractions and C. tropicalis cell-free fractions showed 55,70 kDa gelatinases. CMT-3, CMT-308, and CTT-2 inhibited Candida gelatinases slightly better than Pefabloc, ILM, and EDTA. No Candida fractions degraded Lm-332 at pH 7.6, but at pH 5.0, 100 kDa bands were generated by cell fractions of C. dubliniensis and C. tropicalis; C. albicans and C. glabrata clinical strains; and C. guilliermondii reference strain. C. krusei reference strain yielded three 100,130 kDa bands. C. albicans, C. dubliniensis, and C. tropicalis reference and clinical strain's cell-free fractions generated 100 kDa band. Conclusions:, Laminin-332 degradation is pH-dependent and differences exist between studied Candida strains. Lm-332 degradation can exert functional disturbances on basement membrane integrity, possibly aiding Candida cell invasion into tissues. Certain synthetic matrix metalloproteinase inhibitors (CMTs, CTT) can inhibit Candida proteinases and may be therapeutically useful in future. [source] Clinical evaluation of resilient denture liners.JOURNAL OF PROSTHODONTICS, Issue 3 2003Part 2: candida count, speciation Purpose The purpose of this study was to count and to speciate Candida isolated from 2 resilient denture liners, Molloplast-B and MPDS-SL. Materials and Methods A group of 20 patients each had 1 maxillary denture and 2 mandibular dentures fabricated. One mandibular denture was lined with Molloplast-B, and 1 was lined with MPDS-SL. Each denture was used for 3 months. At the end of the 3-month period, the mandibular denture was surrendered, and a 5 × 5-mm circular resilient liner sample was obtained from the tissue surface of the lingual flange. Samples were processed, and Candida was isolated and counted. Speciation of Candida was performed using CHROMagar Candida and API 20C AUX strips. Results Molloplast-B had, on average, 5 times as many CFU/sample as MPDSL-SL, but this difference was not significant (p= 0.26). A sign test gave a similar nonsignificant trend (p= 0.057). CHROMagar identified several Candida species, and confirmation was made using API 20C AUX strips. One patient was lost to follow-up. Of 19 Molloplast-B samples, 7 had no growth, 4 grew C. albicans, 3 grew C. parapsilosis, 2 grew C. glabrata, 1 grew C. tropicalis, 2 grew a Trichosporon spp., and 2 grew a nonidentifiable colony. The analogous counts for 19 MPDS-SL samples were 10, 4, 1, 3, 0, 1, and 1 (p= 0.45 for culture positively, exact McNemar test). ConclusionsCandida growth on Molloplast-B was not significantly different from growth on MPDS-SL. Several yeast species were cultured from each material. The rates of culture-positive testing did not differ between the 2 resilient denture liners. [source] Assimilation of NAD+ precursors in Candida glabrataMOLECULAR MICROBIOLOGY, Issue 1 2007Biao Ma Summary The yeast pathogen Candida glabrata is a nicotinamide adenine dinucleotide (NAD+) auxotroph and its growth depends on the environmental supply of vitamin precursors of NAD+. C. glabrata salvage pathways defined in this article allow NAD+ to be synthesized from three compounds , nicotinic acid (NA), nicotinamide (NAM) and nicotinamide riboside (NR). NA is salvaged through a functional Preiss,Handler pathway. NAM is first converted to NA by nicotinamidase and then salvaged by the Preiss,Handler pathway. Salvage of NR in C. glabrata occurs via two routes. The first, in which NR is phosphorylated by the NR kinase Nrk1, is independent of the Preiss,Handler pathway. The second is a novel pathway in which NR is degraded by the nucleosidases Pnp1 and Urh1, with a minor role for Meu1, and ultimately converted to NAD+ via the nicotinamidase Pnc1 and the Preiss,Handler pathway. Using C. glabrata mutants whose growth depends exclusively on the external NA or NR supply, we also show that C. glabrata utilizes NR and to a lesser extent NA as NAD+ sources during disseminated infection. [source] A review of molecular techniques to type Candida glabrata isolatesMYCOSES, Issue 6 2010S. Abbes Summary Candida glabrata has emerged as a common cause of fungal infection causing mucosal and systemic infections. This yeast is of concern because of its reduced antifungal susceptibility to azole antifungals such as fluconazole. A clear understanding of the epidemiology of Candida infection and colonisation required a reliable typing system for the evaluation of strain relatedness. In this study, we discuss the different molecular approaches for typing C. glabrata isolates. Recent advances in the use of molecular biology-based techniques have enabled investigators to develop typing systems with greater sensitivities. Several molecular genotypic approaches have been developed for fast and accurate identification of C. glabrata in vitro. These techniques have been widely used to study diverse aspects such as nosocomial transmission. Molecular typing of C. glabrata could also provide information on strain variation, such as microvariation and microevolution. [source] Zeocin resistance as a dominant selective marker for transformation and targeted gene deletions in Candida glabrataMYCOSES, Issue 6 2006Alex J. Alderton Summary Many of the genetic tools used to generate gene knockouts in Candida glabrata exploit auxotrophic markers but this is not suitable for use with clinical strains. Antibiotic resistance markers, however, allow one to target genes to be deleted without any prior genetic manipulation of clinical isolates. Such antibiotic selection markers have been widely reported for the manipulation of Saccharomyces cerevisiae. However, very few antibiotic resistance markers have been shown to be useful in C. glabrata. Here, we report the use of Zeocin resistance (ZeoR), encoded by the ble gene from Streptoalloteichus hindustanus, as a new positive selection marker for the genetic manipulation of C. glabrata including clinical strains that we show are significantly more sensitive to Zeocin than to G418. The potential of the ZeoR marker for targeted gene disruption in C. glabrata was confirmed by constructing deletions of the ADE2 in both a laboratory and a clinical strain of C. glabrata, using both short (90 bp) and long (400 bp) homology cassettes. [source] Yeast associated with human infections in south-eastern NigeriaMYCOSES, Issue 6 2006L. N. Abia-Bassey Summary A total of 1921 specimens from nine clinical sources were examined by direct microscopy and culture to recover yeast associated with human infection. Identification of yeast was based on their carbon assimilation patterns, using API 20C AUX and ID 32 C (bioMérieux, France) commercial kits. A total of 178 specimens (9.3%) were positive for yeast. Most of the yeast isolates were recovered from urine samples and genital swabs. Prevalence was significantly higher in women (14.7%) than in men (1.4%) (P < 0.05). The age group 21,30 years recorded the highest prevalence of yeast infection (65.2%) followed by age group 11,20 years (16.9%) and >40 years (9.0%). When genital samples were considered, prevalence was significantly higher in the age group 21,30 years than that in older ones (P < 0.05). Isolates recovered included seven species of Candida and Trichosporon inkin. C. albicans accounted for the highest number of isolates (128) followed by C. tropicalis (23) and C. parapsilosis (9). Two isolates each of C. famata and C. norvegensis were recorded and are reported for the first time in Nigeria. The two isolates of T. inkin were recovered from perianal lesions and are also reported for the first time from Nigeria. C. albicans, C. glabrata, C. parapsilosis and C. krusei were found to be the most common yeast species that act as agents of human disease in south-eastern Nigeria. [source] In vitro adhesion of Candida species to denture base materialsMYCOSES, Issue 2 2006X. Y. He Summary Adhesion of Candida species to prosthetic acrylic resins is an essential first step in the pathogenesis of denture stomatitis. Data on the relative adhesion of pathogenic non- albicans Candida species to different denture base materials are sparse. The purpose of the present study was to investigate in vitro adhesion of C. albicans, C. glabrata, C. krusei and C. dubliniensis to four different denture base materials. Specimens of both heat-cured resins (VertexTM Rapid Simplified and ProBaseTM Hot) and cold-cured resins (Paladur® A and Paladur® B) were prepared using a novel method and the adhesion of four strains each of the foregoing Candida species evaluated microscopically using a soft imaging system. There was a significant difference in yeast adherence between Vertex and the other resins. Only C. glabrata attached to Vertex, while all the remainder of the tested species adhered to all other resins tested except ProBase, which resisted C. krusei adhesion. There was a significant difference in candidal adhesion between cold-cured and heat-cured resins for three Candida species (C. albicans, P = 0.039; C. glabrata, P = 0.002 and C. krusei, P = 0.000). The type of denture base material and whether they are heat-cured or cold-cured play an important role in modifying candidal adhesion. [source] Comparative evaluation of Candi Select test and conventional methods for identification of Candida albicans in routine clinical isolatesMYCOSES, Issue 3-4 2002S. Foongladda Candida albicans; Identifizierung; Candi Select- Test; Bewertung. Summary. The Candi Select test (Sanofi Diagnostics, Pasteur, Marnes-La-Coquette, France) is a new yeast-selective medium for the identification of Candida albicans in the clinical laboratory. The performance of this test was compared with the conventional methods of chlamydospore formation, germ tube formation and carbohydrate fermentation. Four hundred and twenty clinical yeast isolates from 412 fresh clinical specimens, including 283 C. albicans, 59 C. tropicalis, 39 Trichosporon spp., 19 C. glabrata, 11 Cryptococcus neoformans and 9 other yeasts, were evaluated. Colonies of C. albicans produced a blue-green colour on the Candi Select media which could be distinguished from the other yeasts with the naked eye within 24,48 h. The sensitivity and specificity of the Candi Select test for the identification of C. albicans were 99.65% and 97.08%, respectively. The blue-green colonies of C. albicans were easy to identify and recognize in mixed cultures and did not need detailed microscopic examination. Zusammenfassung., Der Candi Select-Test (Sanofi Diagnostics Pasteur, Marnes-La-Coquette, Frankreich) ist ein neuer selektiver Nährboden für die Identifizierung von Candida albicans im klinischen Labor. Die neue Methode wurde mit den konventionellen Methoden der Chlamydosporenbildung, der Keimschlauchbildung und der Kohlenhydrat-Gärung verglichen. Vierhundertzwanzig Hefeisolate, nämlich 283 C. albicans, 59 Candida tropicalis, 39 Trichosporon spp., 19 Candida glabrata, 11 Cryptococcus neoformans und 9 andere Hefen, isoliert aus 412 frischen klinischen Untersuchungsproben, wurden mit allen Methoden untersucht. Mit blossem Auge erkennbar, unterschieden sich innerhalb von 24,48 Stunden die blau-grünen Farbkolonien von C. albicans von allen anderen Hefen auf dem Candi Select Nährboden. Sensitivität und Spezifizität des Candi Select Tests für die Identifizierung von C. albicans betrugen 99.65% und 97.08%. Die blau-grünen Farbkolonien von C. albicans waren in den Mischkulturen leicht zu identifizieren, eine mikroskopische Untersuchung erübrigt sich daher. [source] Trends in species causing fungaemia in a tertiary care medical centre over 12 yearsMYCOSES, Issue 11-12 2001Preeti N. Malani Candida albicans; Candida glabrata; Fungämie; Candidämie; Fluconazol. Summary., Trends in the species of yeast causing fungaemia over a 12-year period at a large tertiary care medical centre were reviewed. A total of 966 unique episodes of fungaemia occurred in 898 patients. There was an overall trend toward fewer fungaemic episodes due to Candida albicans and more due to Candida glabrata and Candida parapsilosis. However, C. albicans remained the predominant species causing fungaemia, and the proportion due to other species varied from year to year. Candida glabrata was disproportionately isolated from older adults, whereas C. parapsilosis was common among neonates and infants. The trends of increasing isolation of C. glabrata and decreasing isolation of C. albicans were associated with increasing usage of fluconazole, but changes in the proportion of fungaemias due to other species appeared to have no association with fluconazole usage. Zusammenfassung., U¨ber eine 12-Jahresperiode hin wurden in einer Großklinik die Hefeisolate von Funga¨mie-Patienten statistisch erfasst. Bei 898 Patienten wurden 966 Funga¨mie-Episoden beobachtet. Insgesamt zeigte sich ein Trend zu weniger Funga¨mie-Episoden durch Candida albicans und zu mehr durch Candida glabrata und Candida parapsilosis. Trotzdem blieb C. albicans die dominante Art als Funga¨mie-Erreger; der Anteil anderer Hefearten variierte von Jahr zu Jahr. Candida glabrata wurde relativ ha¨ufiger von a¨lteren Patienten isoliert, C. parapsilosis ha¨ufiger von Neugeborenen und Kindern. Die Trends zunehmender Isolierung von C. glabrata und sinkender Isolierungsha¨ufigkeit von C. albicans waren mit dem steigenden Einsatz von Fluconazol assoziiert. A¨nderungen in den Anteilen der Funga¨mie-Fa¨lle durch andere Arten zeigten jedoch keine Beziehung zum Fluonazol-Einsatz. [source] Karyotyping of Candida albicans and Candida glabrata from patients with Candida sepsisMYCOSES, Issue 5-6 2000Klempp-Selb The aim of this study was to determine the relatedness of Candida strains from patients suffering from Candida septicaemia by typing of Candida isolates from blood cultures and different body sites by pulsed field gel electrophoresis (PFGE using a contour-clamped homogenous electric field, CHEF). We studied 17 isolates of Candida albicans and 10 isolates of Candida glabrata from six patients. Four patients suffered from a C. albicans septicaemia, one patient from a C. glabrata septicaemia, and one patient had a mixed septicaemia with C. albicans and C. glabrata. Eight isolates from blood cultures were compared with 19 isolates of other sites (stool six, urine four, genital swab four, tip of central venous catheter three, tracheal secretion one, sputum one). PFGE typing resulted in 10 different patterns, four with C. albicans and six with C. glabrata. Five of the six patients had strains of identical PFGE patterns in the blood and at other sites. Seven isolates of a 58-year-old female with a C. glabrata septicaemia fell into five different PFGE patterns. However, they showed minor differences only, which may be due to chromosomal rearrangements within a single strain. Thus it appears, that the colonizing Candida strains were identical to the circulating strains in the bloodstream in at least five of six patients. [source] Impact of the transcriptional regulator, Ace2, on the Candida glabrata secretomePROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 2 2010David A. Stead Abstract Candida glabrata is a major fungal pathogen of humans, and the virulence of C. glabrata is increased by inactivation of the transcription factor, Ace2. Our previous examination of the effects of Ace2 inactivation upon the intracellular proteome suggested that the hypervirulence of C. glabrata ace2 mutants might be caused by differences in the secretome. Therefore in this study we have characterised the C. glabrata secretome and examined the effects of Ace2 inactivation upon this extracellular proteome. We have identified 31 distinct proteins in the secretome of wild-type C. glabrata cells by MS/MS of proteins that were precipitated from the growth medium and enriched by affinity chromatography on concanavalin A. Most of these proteins are predicted to be cell wall proteins, cell wall modifying enzymes and aspartyl proteinases. The endochitinase Cts1 and the endoglucanase Egt2 were not detected in the C. glabrata secretome following Ace2 inactivation. This can account for the cell separation defect of C. glabrata ace2 cells. Ace2 inactivation also resulted in the detection of new proteins in the C. glabrata secretome. The release of such proteins might contribute to the hypervirulence of ace2 cells. [source] Proteomic analysis of the pH response in the fungal pathogen Candida glabrataPROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 3 2008Pia Schmidt Abstract Micro-organisms must adapt to environmental change to survive, and this is particularly true for fungal pathogens such as Candida glabrata. C. glabrata is found both in the environment and in diverse niches in its human host. The ambient pH of these niches varies considerably, and therefore we have examined the response of C. glabrata to changes in ambient pH using a proteomic approach. Proteins expressed in C. glabrata cells growing at pH,4.0, 7.4 or 8.0 were compared by 2-DE, and 174 spots displaying reproducible and statistically significant changes in expression level were identified by peptide mass fingerprinting, thereby extending our 2-DE map of the C. glabrata proteome to a total of 272 identified spots. Proteins involved in glucose metabolism, the TCA cycle, respiration and protein synthesis were expressed at lower levels during growth at pH,7.4 and/or 8.0, whereas proteins involved in stress responses and protein catabolism were expressed at higher levels under these alkaline conditions. Our data suggest that C. glabrata perceives low pH as less stressful than higher pH. This contrasts with another opportunistic fungal pathogen of humans, Candida albicans [source] A novel monoclonal antibody recognizing ,(1,3) glucans in intact cells of Candida and Cryptococcus,APMIS, Issue 10 2008N. KONDORI The cell walls of all medically important fungi contain a unique polyglucose compound, ,(1,3) glucan. In the present study, murine monoclonal antibodies were produced against linear and ,(1,6) branched ,(1,3) glucans, and their specificities were characterized for reactivity to other , glucans, fungal cell wall fragments, and fungal cells. Their reactivity was also compared with that of rabbit polyclonal antibodies raised against the same immunogens. Two mouse monoclonal antibodies (AG and BG) recognized immunoreactive epitopes in ,(1,3)(1,6) glucan by ELISA. In an inhibition assay of the anti-,(1,3)(1,6) activity of the monoclonals, the homologous antigen effectively inhibited the activity as expected, while ,(1,3) also inhibited the assay but to a much lesser extent. No inhibition was obtained by ,(1,3)(1,4) or ,(1,6), while a cell wall extract of Candida albicans (PPM) effectively inhibited both monoclonals. Cell wall fragments of C. albicans (CaCW) and Cryptococcus neoformans (CnCW) inhibited the anti-,(1,3)(1,6) activity of AG, while BG was much less or not inhibited at all. Immunofluorescence confirmed the unique antibody specificity of AG by its recognition of a ,(1,3)(1,6)-associated epitope on the cell surfaces of C. albicans,C. krusei, C. glabrata, and nonencapsulated C. neoformans. The epitope for the AG antibody is suggested to be present in the branching point of ,(1,3)(1,6), or in the randomly coiled ,(1,3) polyglucan due to the presence of branches. Thus, monoclonal antibodies to ,(1,3)(1,6) glucans may have potential as tools in the laboratory diagnosis of invasive yeast infections. [source] Candida glabrata, an emerging fungal pathogen, exhibits superior relative cell surface hydrophobicity and adhesion to denture acrylic surfaces compared with Candida albicansAPMIS, Issue 9 2002G. Luo Oral candidosis is a common opportunistic infection in debilitated individuals and Candida glabrata is the second most frequently isolated species from this condition, after Candida albicans. Candidal adherence to various biological or non-biological surfaces is considered a prerequisite for colonization, and pathogenesis of candidal infections, and their relative cell surface hydrophobicity (CSH) is likely to be a possible contributory force involved in this process. Whereas a large body of data on the latter features of C. albicans is available, there is surprisingly little information on C. glabrata. As a comprehensive database on the relative adhesion and CSH of Candida spp. is instructive and useful, we investigated in vitro the latter attributes of 34 oral isolates of C. glabrata and 15 isolates of C. albicans. There were remarkable intraspecies differences in both the CSH and the adhesive ability of C. glabrata strains (p<0.001). Compared with C. albicans, C. glabrata demonstrated a four-fold greater CSH value (30.63±11.20% vs 7.23±3.56%, p<0.0001) and a two-fold greater tendency to adhere to denture acrylic surfaces (75.18±39.96 vs 30.36±9.21, p<0.0001). A significant positive correlation between CSH and adhesion was also noted for both C. glabrata (r=0.674, p<0.0001) and C. albicans (r=0.636, p<0.05). When the effect of different incubation conditions on the relative CSH and adherence of C. glabrata was examined, CSH and the adherence to acrylic surfaces of four of six C. glabrata isolates were significantly affected by a reduction of the culture temperature (from 37 °C to 25 °C). A positive relationship also emerged when the temperature-induced variations in the adherence values were correlated with their relative CSH. These data provide hitherto unavailable archival information on important pathogenic attributes of the two most common oral Candida species that may help explain their predominance in this milieu. [source] Candidemia in patients with hematologic malignancies in the era of new antifungal agents (2001-2007)CANCER, Issue 20 2009Stable incidence but changing epidemiology of a still frequently lethal infection Abstract BACKGROUND: The incidence, epidemiology, Candida species distribution, resistance patterns, and outcome of candidemia in high-risk hematologic malignancy and/or stem cell transplantation patients have not been extensively described since the introduction of new antifungal agents. METHODS: In this retrospective study, the authors reviewed the medical records and microbiologic data of hematologic malignancy patients with candidemia at The University of Texas M. D. Anderson Cancer Center from March 2001 to February 2007. RESULTS: The authors analyzed 173 episodes of candidemia (170 patients), 125 (72%) of which were breakthrough cases after prior antifungal agents, mainly fluconazole (28 [22%]), caspofungin (25 [20%]), and voriconazole (18 [14%]). The incidence of candidemia (per 100,000 inpatient days) remained relatively stable, from 13.9 in 2001 to 19.2 in 2006. However, compared with the findings of previous studies at the authors' institution, the frequency of Candida glabrata and C. krusei infection decreased (to 5% and 17%, respectively) and C. parapsilosis (24%) and C. tropicalis (21%) increased. C. parapsilosis fungemia was associated with prior caspofungin use (P < .001). The overall 30-day crude mortality rate was 38%, and the attributable mortality rate was 19%, similar to previous findings at the authors' institution. The Candida species associated with the highest mortality rate was C. glabrata. CONCLUSIONS: Despite the widespread use of antifungal prophylaxis and the introduction of new antifungal agents, the incidence and associated mortality rates of candidemia remained stable in high-risk hematologic malignancy patients. However, its epidemiological characteristics have shifted, with C. parapsilosis and C. tropicalis becoming more common. Cancer 2009. © 2009 American Cancer Society. [source] Potential risk factors for infection with Candida spp. in critically ill patientsCLINICAL MICROBIOLOGY AND INFECTION, Issue 6 2004D. Peres-Bota Abstract The incidence, risk factors and prognostic factors for candidal infection were determined in a prospective study of 280 infected patients. Thirty-one (11%) patients were infected with Candida spp., sub-divided into 18 (58%) with C. albicans, and 13 (42%) with non- albicans spp. (six C. glabrata, three C. parapsilosis, and one each of C. krusei, C. tropicalis, C. guilliermondii and C. lusitaniae). Infection with Candida spp. was always associated with concurrent bacterial infection. By univariate logistic regression analysis, the degree of morbidity and the duration of mechanical ventilation were independent predictive factors for death, but infection with Candida spp., was not. Factors associated with Candida spp. infection were the degree of morbidity, intensive care unit length of stay, alterations of immune response, and the number of medical devices involved. By multivariate logistic regression analysis, the only independent risk factor for candidal infection was intensive care unit length of stay. [source] Multicenter evaluation of the reproducibility of the proposed antifungal susceptibility testing method for fermentative yeasts of the Antifungal Susceptibility Testing Subcommittee of the European Committee on Antimicrobial Susceptibility Testing (AFST-EUCAST)CLINICAL MICROBIOLOGY AND INFECTION, Issue 6 2003M. Cuenca-Estrella Objective To evaluate the intra- and inter-laboratory reproducibility of a new standard for susceptibility testing of fermentative yeasts. This standard is based on the M27-A procedure of the National Committee for Clinical Laboratory Standards (NCCLS), but incorporates several modifications, including spectrophotometric growth-dependent endpoint reading. Methods Nine laboratories participated in the study. Common material lots were used to test six Candida species (one each of C. albicans, C. tropicalis, C. parapsilosis, C. glabrata, C. krusei, and C. lusitaniae), and two quality control strains (C. krusei ATCC6258 and C. parapsilosis ATCC22019). Triplicate testing on three separate days was performed in microtiter format with RPMI,2% glucose, pH 7.0. Flucytosine, fluconazole and itraconazole were tested. In total, 3888 MIC values were included in the analyses. Reproducibility was calculated by means of agreement (percentage of MICs within one two-fold dilution of the mode) and intraclass correlation coefficient (ICC, maximum value of 1). Results The average intra-laboratory agreements were 99% and 96% after 24 h and 48 h of incubation, respectively, with ICCs of 0.98 and 0.97 (P < 0.05). Two strains exhibiting a trailing effect showed intra-laboratory agreement of 92% and ICCs of <,0.91 at 48 h. The inter-laboratory agreement was 94% and 88% after 24 h and 48 h, respectively, with ICCs of 0.93 and 0.91 (P < 0.05). Lower values of agreement and ICCs were obtained for strains exhibiting trailing after 48 h of incubation. Itraconazole yielded the lowest values of reproducibility. Conclusion The new procedure of EUCAST for antifungal susceptibility testing is a reproducible method within and between laboratories and offers several advantages over the NCCLS approved method. [source] | |||||||||||||