Invasive fungal infections and COVID-19: a review

Invasive fungal diseases (IFDs) are major causes of morbidity and mortality among hospitalized patients all over the world with a global prevalence of 15%. Since the first case of COVID-19 was reported on February 27, 2020, in Nigeria, it had been discovered across all geopolitical zones in Nigeria. As the medical community confronts the ongoing COVID-19 pandemic, determining whether patients infected with SARS-CoV-2 develop fungal complications, especially invasive aspergillosis, is crucial. This review aimed to highlight the fungal co-infections that might be associated with SARS-CoV-2 infection, and modalities for their diagnosis, prevention, and management, with the view to reducing the high mortality associated with these infections

Federation of infectious diseases societies of southern Africa guideline: Recommendations for the detection, management and prevention of healthcare-associated candida auris colonisation and disease in South Africa

Candida auris has been detected at almost 100 South African hospitals, causing large outbreaksinsome facilities, and this pathogen now accounts for approximately 1 in 10 cases of candidaemia. The objective of this guideline is to provide updated, evidence-informed recommendations outlining a best-practice approach to prevent, diagnose and manage C.auris disease in public- and private-sector healthcare settings in South Africa. The 18 practical recommendations cover five focus areas: laboratory identification and antifungal susceptibility testing, surveillance and outbreak response, infection prevention and control, clinical management and antifungal stewardship

Phytochemical analysis, antioxidant and anti-Candida albicans activities of Annona cherimola Mill. fruit pulp

Aims: The main objectives of the present study were to characterize the phytochemical profile of Annona cherimola Mill, to assess its antioxidant characteristics and its antifungal activity against Candida albicans. Methods and Material: Aqueous decoction, aqueous infusion, aqueous maceration, and methanolic maceration were screened for the presence of phytochemicals and to quantify content of phenolics, tannins, and flavonoids. Furthermore, antioxidant activity was assessed using DPPH and FRAP assays, as well the assessment of antifungal activity for the different extracts. Results: Results showed that phenols, tannins, flavonoids, and saponins were present in the four extracts. The aqueous maceration extract presented the highest total phenolic content (3.687 mg GAE/g of extract). Decoction extract showed the lowest phenolic content 2.504 mg GAE/g. Besides, infusion showed the most important total flavonoids content (2.567mg CE/g). The most relevant total antioxidant activity was found for decoction (lowest IC50 12.61 mg/ml AAE). The aqueous maceration exhibited the less antioxidant activity (IC50= 21.98 mg/ml AAE). The best scavenging activity was observed for decoction (IC50=7.27 mg/mL). All the extracts showed a reducing capacity. Infusion exhibited the best reducing power (EC50 = 11.29 mg/mL), compared to decoction (EC50 = 39.32 mg/mL). Regarding antifungal activity, at 100 and 200 µg/mL, decoction and methanolic maceration resulted in 6 and 9 mm inhibition zone, respectively. In addition, at higher doses (800 and 2000 µg/mL), inhibition zone increased in a dose dependent manner for all the extracts. Conclusions: Annona cherimola Mill. could be an important source of bioactive molecules with antioxidant and antifungal activities

Antifungals susceptibility pattern of Candida spp. isolated from female genital tract at the Yaoundé Bethesda Hospital in Cameroon

Introduction: vaginal candidiasis is considered as an important public health problem worldwide and its incidence has increased nowadays. In recent years, inappropriate and disproportionate use of antifungal drugs, automedication as well as non compliance have caused drug resistance.Methods: this study aimed at determining the in vitro antifungal susceptibility patterns of Candida species isolated from female genital tract at Yaoundé Bethesda Hospital in Cameroon. Two hundred and fourthy five women (age range: 15 years to 49 years) attending the hospital were recruited between January and June 2014 in this cross sectional study. Vaginal smears were collected using sterile swabs from each participant and cultured on sabouraud dextrose agar supplemented with chloramphenico l 0.5%; identification of Candida spp. was performed following standard methods. The disk diffusion method was used for antifungal susceptibility testing.Results: out of the 245 vaginal smears collected, 94 (38.4%) strains of yeast were isolates among which 43 (45.7%) were Candida albicans and 51 (54.3%) were non albicans. The highest susceptibility of the isolates was seen for nystatin 62 (83.78%), ketoconazole 61 (82.43%) and fluconazole 60 (81.08%).Conclusion: despite the noticeable resistance of Candida spp. isolates to miconazole and itraconazole, the results indicate that nystatin, ketoconazole and fluconazole are the drugs of choice for the therapy of vaginal candidiasis in this region

In Vitro Antifungal Susceptibility Patterns of Candida Albicans from HIV and AIDS Patients Attending the Nylon Health District Hospital in Douala; Cameroon

HIV and AIDS are major public health problems in Cameroon where the HIV prevalence is 5.5. Candidiasis is the leading opportunistic mycosis in HIV and AIDS patients. The objective of this study was to determine the in vitro antifungal susceptibility pattern of Candida albicans in HIV and AIDS patients to eight antifungal agents in the Nylon Health District of Douala in Cameroon. Three hundred and four HIV and AIDS patients were recruited between March and August 2007 to participate in a cross-sectional study. All subjects who fulfilled the inclusion criteria were enrolled. Informed consent was obtained from all subjects before samples were collected. Three samples comprising oral swabs; vagina/urethra swabs and a mid-stream urine were collected from each subject. Specimens were cultured on sabouraud dextrose agar and C. albicans isolates were identified using the germ tube technique. The disk diffusion method was used for antifungal susceptibility testing using eight antifungal agents. The prevalence of candidiasis in the study population was 67.8 (95 CI: 62.5-73.1) and that of C. albicans was 42.8 (95 CI: 37.2-48.4). Oral swabs had the highest prevalence of C. albicans followed by vaginal/urethral samples (52.6 vs. 29.7) subjects had C. albicans infection at more than one collection site. There was a statistically significant difference in the infectivity of C. albicans with age; sex and site of infection (P0.05). C. albicans isolates were most sensitive to ketoconazole (80) followed by econazole (64.6) while fluconazole and 5-flurocytosin recorded the poorest sensitivities (22.9 vs 24.6; respectively). There was a statistically significant difference in the sensitivity pattern of antifungal agents with respect to the site of isolation of the organism (P0.05). Ketoconazole is the drug of choice for the treatment of C. albicans infection in HIV and AIDS patients in the Nylon Health District of Douala; Cameroon

Antimicrobial activity of Coleus aromaticus (benth) against microbes of reproductive tract infections among women

Coleus aromaticus (Benth) is a commonly available medicinal herb in India. The antimicrobial activity of this herb is tested as a cure for reproductive tract infections (RTI) among women. Fresh leaf has been used as a disc in different diameters to test the antimicrobial activity; against RTI causing microbes. Candida krusei showed the highest zone of inhibition of growth; followed by Candida albicans; Proteus mirablis; Escherichia coli; Staphylococcus aureus ; Enterococcus faecalis ; Klebsiella pneumoniae and the least inhibition was observed for Neisseria gonohorreae. Coleus aromaticus exhibits an effective antifungal and marked antibacterial activity. Using the leaf as a disc seems to be a novel and easy method that can be used initially to access the antimicrobial activity of a herb; before proceeding for further studies. This herb seems to be an ideal choice to treat RTI infections among women

In-Vitro Susceptibility Pattern of Candida isolated from Women with Vaginal Candidiasis to four Anti-fungal Agents in Dar es Salaam; Tanzania

Objective: To determine anti-fungal susceptibility pattern of Candida species (n = 272) isolated from women with vaginal candidiasis (VC) in Dar es Salaam; Tanzania against varying concentrations (0.05 to 12.8 g/ml) of miconazole; clotrimazole; ketoconazole and nystatin using agar dilution and broth macro-dilution methods. Test isolates and reference strains: Clinical isolates and reference strains; Candida albicans (ATCC 32354); Candida krusei (ATCC6258); Candida parapsilosis (ATCC22019) and Candida glabrata (ATCC2001).Methods: Determination of minimum inhibitory concentration ranges; and MIC50 and MIC90 (required to inhibit 50and 90of the isolates); respectively. MIC for nystatin was least concentration that prevented visible growth while for the azoles MIC was the concentration that caused 80growth inhibition compared with drug free control. Results: The MIC for Candida albicans; Candida famata; Candida krusei; Candida lusitaniae; Candida parapsilosis and Candida norvegensis were between 0.05 to 0.2 g/ml against all four anti-fungal drugs tested. Some Candida tropicalis and Candida glabrata isolates had moderately high (MIC =6.4) and high MICs (12.8 g/ml); especially with the azole anti-fungal drugs. The overall agreement between the results of the two methods were 88; and for individual antifungals the agreement was 90.8; 91.3; 80and 88for clotrimazole; ketoconazole; miconazole and nystatin; respectively. C. glabrata and C. parapsilosis gave low agreement (68- 75) for the azole antifungals. Conclusions: i) most of the clinical isolates had low MIC values to all the four anti-fungal drugs tested; indicating susceptibility; ii) some strains of C. tropicalis and C. glabrata had high MIC values; and; iii) there was a good overall agreement ( 88) between agar dilution and broth macro-dilution methods. There is a need for a follow-up in-vivo study to determine clinical response following treatment with the investigated anti-fungals

Communication: A comparison of in vitro antifungal activity of the methanol extract of various parts of Lagerstroemia parviflora

The Minimum Inhibitory Concentration (MIC) of the methanol extract of various parts of Lagerstroemia parviflora Roxb were determined against different fungi belonging to Candida; Aspergillus and Penicillium species. Further; zones of inhibition produced by the crude extracts against the fungal strains were measured and compared with those produced by a standard antifungal agent; griseofulvin. The leaf extract was proved to have the maximum activity followed by the flower and the bark extracts against the tested strains. All extracts were found to be fungistatic in their action

Activites antifongiques de deux huiles essentielles sur les champignons des feves de cacao et de levures : Candida albicans et Cryptococcus neoformans

Les activites quotidiennes de l'homme l'exposent a la pollution environnementale par des microorganismes dont les champignons qui peuvent occasionner chez lui des mycoses ou detruire les produits vegetaux. Face e cela; les moyens de lutte employes se revelent plus ou moins efficaces mais sont; parfois dangereux. Chez le cacao la presence des toxines fongiques est a l'origine de la deterioration de sa qualite. Ainsi; sur des feves de provenances diverses; des especes Fongiques ont ete isolees par secousse et a partir d'un ecouvillon frotte aux Feves. Ensuite; il e ete teste deux huiles essentielles comestibles extraites de vegetaux ivoiriens. (Chenopodium ambrosioides et Melaleuca quinquenervia a 1 ml/L; 5 ml/L et 10 ml/L sur Aspergillus sp; Aspergillus niger; Aspergillus fumiganus; Mucor racemosus; Candida albicans et Cryptococcus neoformans. Aussi; une protection des feves de cacao par l'huile de Melaleuca quinquenervia a ete experimentee. Suite a ces differentes experiences; il a ete retenu d'une part; qu'a 1 ml/L et 5ml/l ces huiles essentielles ont des activites antifongiques. D'autre part. a 1ml/l Chenopodium ambrosioides agirait comme un Fongicide dans notre experience contrairement a l'huile de Melaleuca quinquenervia. Mais a 5 ml/1; l'huile de Melaleuca quinquenervia empeche le developpement de A. flavus; A. fumigatus; A. niger; Aspergillus sp; M. racemosus; Penicillium sp sur les feves de cacao pendant un mois. Ces experiences ont permis d'elucider l'impact de chacune des huiles sur les champignons. Vu la diversite de leurs activites; ces deux huiles essentielles pourraient etre utilisees comme produits antifongiques de lutte contre les champignons dans l'environnement et contre certaines mycoses

Sensibilite aux antifongiques des souches de Candida responsables de Candidose oropharyngee chez des sujets vivant avec le VIH

Cette etude menee en 1997 en milieu hospitalier senegalais se propose d'identifier les differentes especes de Candida isoles chez 60 sujets vivant avec le VIH et porteurs de Candidose oropharyngee. Par la meme occasion; elle tente de determiner leur sensibilite aux antifongiques ainsi que l'impact d'un traitement antifongique anterieurLes resultats de l'etude font ressortir que d'une part le serotype VIH1 favorise l'emergence des levures saprophytes de la muqueuse buccale par rapport au serotype VIH2; d'autre part; et que l'utilisation intempestive des antifongiques diminue la sensibilite de C. albicans aux polyenes. Une meilleure maitrise de ce phenomene contribuerait a ameliorer l'etat clinique des personnes vivant avec le VI

Antifungal metabolites from submerged culture of Ganoderma Lucidum (Polypore)

About 60 different basidiomycete cultures were screened for antimicrobial secondary metabolites.Among basidiomycetes screened for antimicrobial activity; the culture filtrate extract of the polypore; G. lucidum produced the most effective antifungal compounds. Growth in submerged culture of polypore and isolation methods of the two antifungal antibiotics are described. These compounds were released to the culture fluid and the maximum amount of antifungal compounds was obtained after 12 days of submerged growth at 120 resolution per minute (rpm). The culture filtrate were characterized biologically. These metabolites had a wide spectrum of antifungal activity and affected the growth of several saprophytic as well as pathogenic fungi. The minimal inhibitory concentration (MIC) of 201A against Candida albicans and Candida pseudotropicalis was less than 1 mcg/ml and 1-5 mcg/ml respectively. Inhibition diameterzone of 36 mm was produced when 10 mcg/disc of 201A was applied on agar medium seeded with Aspergillus flavus. Bacteria were affected only at high concentration

Efficacy of lamisil in the treatment of onychomycosis of the finger nail

Fungal infection of the nail is commonly encountered dermatological problem in Nigeria. It is observed to be more frequently encountered in female patients who for cosmetic reasons seek dermatological services readily than males. A strong association between tinea pedis and onychomycosis has also been established. The most commonly encountered dermatophyte in the infection of the nail is trichophyton rububrum; which is known to be very difficult to treat and to re-occur very often

An open non-comparative pilot study of the safety and efficacy of oral fluconazole in the treatment of dermatophyte infections in Nigeria

In an non-comparative study to assess the efficacy and safety of oral fluconazole in superficial fungal diseases of the skin; 82 adult Nigerian patients (58 males and 24 females) with clinical and mycological diagnosis of dermatomycoses were enrolled for the trial. Sixty-five patients completed the trial and each of them received a daily dose of 50mg fluconazole for a period of 4 weeks. An overall 90 per cent cure rate was observed in patients with other forms of dermatomycoses and 80 per cent for patients with pityriasis versicolor. The drug was well tolerated by all the patients and very few side effects were noticed