Experimental murine model of intra-abdominal infections caused by some non-albicans Candida species

Background: Even though intra-abdominal candidiasis (IAC) has been increasingly recognized, with associated high morbidity and mortality rates, its pathogenesis remains poorly understood. This model aims to study the pathogenicity and invivo susceptibility of non-albicans Candida species associated with IAC in human in order to predict the frequency of infections, outcome of clinical disease and response to antifungal therapy. Methodology: Both immunosuppressed and immunocompetent female CD-1 mice were challenged intraperitoneally with 5 x 108 CFU/ml inoculum of five non-albicans Candida strains; Candida glabrata, Candida parapsilosis, Candida lipolytica, Candida tropicalis and Candida guilliermondii. Mice were closely observed for symptoms. Treated groups received voriconazole (40 mg/kg/day) or micafungin (10 mg/kg/day) 24 hours after infection depending on invitro susceptibility results. Survival rate, mean survival time and fungal tissue burdens were recorded for all groups. Results: All infected groups developed hepatosplenomegaly, peritonitis and multiple abscesses on intra-abdominal organs and mesenteries. C. glabrata and C. lipolytica represented the most and the least virulent strains respectively in terms of survival rate, mean survival time and fungal burden in both immunosuppressed and immunocompetent models. Following treatment, all immunocompetent animals survived the entire duration of experiments (0% mortality rate), while mortality rate was relatively high (20-60%) in immunosuppressed mice. Treatment failed to eradicate the infection in immunosuppressed mice despite significant decrease of the fungal burden and increase mean survival time. Conclusion: This study reports an increasing pathogenicity of non-albicans Candida species, with persistent infection among immunosuppressed animals

Candida species: the silent enemy

Candida species are known to causeserious infections in immunocompromised patients but uncommon cases have been reported in immunocompetent individuals regardless of the harmless co-existence of the fungi with the host. Recently, the incidence rate of candidiasis has increased dramatically alongside the emergence of antifungal resistance. Although conventional methods to ensure prompt diagnosis of candidiasisfor effective therapy have been established, thescientific world is witnessing progress in the development of more accurate, timelyand cost-effective methods that is coinciding with the molecular revolutionand advanced DNA analysis. Moreover, the challenges of resistance of Candida to available antifungal agents are being met with the deployment of molecular techniques to investigate the mechanisms of resistance. This review is an attempt to provide up-to-date information on the persistent problems of Candidawith highlights on the clinical importance, molecular diagnosis,and resistance to candidate antifungal drugs;azoles and echinocandins

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

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

Sensibilite aux antifongiques des Candida spp isoles dans les candidoses digestives chez les sujets seropositifs au VIH a Yaounde-Cameroun

Les mycoses digestives sont habituellement retrouvees chez les sujets immunodeprimes en particulier les patients atteints de SIDA; Le but de cette etude etait de contribuer a une meilleure prise en charge des candidoses digestives chez les sujets positifs au VIH. L'objectif principal etait d'etudier le profil de sensibilite aux antifongiques des Candida spp isoles chez ces patients.MeTHODES Il s'agit d'une etude transversale et descriptive realisee de septembre 2011 a janvier 2012. Apres avoir obtenu le consentement des patients; un ecouvillonnage du muguet buccal et les selles ont ete ensemences sur milieu selectif Candichrom II. Le test de filamentation a permis de discriminer C. albicans de C. dublinensis. L'antifongigramme a ete realise par methode de diffusion sur gelose casitone. Les antifongiques testes etaient : amphotericine B; fluconazole; ketoconazole; miconazole; nystatine; itraconazole. Le logiciel EPI info 7 a ete utilise pour l'analyse des donnees et Excel pour les graphiques. ReSULTATS Nous avons identifie 4 especes : Candida albicans; Candida glabrata; Candida dublinensis et Candida tropicalis avec une predominance de Candida albicans (45;65) et Candida glabrata (44;92). La quasi-totalite des souches 99 etaient sensibles au miconazole; 87 au ketoconazole; 62 a l'itraconazole; 38 au fluconazole; 5a l'amphotericine B. L'espece ayant presente le plus de resistance aux antifongiques etait Candida glabrata. CONCLUSION :Les derives azoles sont plus actifs que les polyenes. L'activite du fluconazole est limitee. Nous recommandons aux prescripteurs de preconiser l'utilisation du ketoconazole qui est plus actif et peut etre une alternative au fluconazole

Distribution of Candida Species among HIV-Positive Patients with Oropharyngeal Candidiasis in Accra; Ghana

Introduction: Oropharyngeal candidiasis is a common occurrence in the course of human immunodeficiency virus (HIV) disease progression. Changes in the clinical severity of oropharyngeal candidiasis and type of Candida species profile may be a reflection of immunological changes in patients. The aim of this study was to undertake a baseline Candida species identification for future reference. Methodology: Oral swabs of 267 HIV-infected patients with oropharyngeal candidiasis were cultured and Candida species were identified by API 32 C. Results: A total of 201 (75.3) Candida species and 10 (3.7) non candida fungi were identified. Twenty different Candida species were isolated. Candida albicans was the most prevalent species (68.5) followed by C. tropicalis (7.4); C. krusei (6.4); C. parapsilosis (3.0) and C. sake (2.5). Other species ranged from 0.5 to 1.5.Positive culture was independent of whether patients were on anti-retroviral therapy or not. Conclusion: of all Candida isolates; 68.5 were identified as C. albicans. Since other uncommon species were also isolated; it may be necessary in this group of patients to identify Candida species causing severe infections

Educational needs and causes of false diagnosis of atypical squamous cells of unknown significance at a university hospital

The entity of atypical squamous cells of undetermined significance (ASCUS) in The Bethesda System 2001 for reporting cervical cytology is characterized by equivocal diagnosis, poor reproducibility and debatable management. This retrospective study was done to analyse the causes of false ASCUS if any and identify the educational needs as part of quality assurance programme. Cervical smears of all ASCUS cases reported over the one-year period were reviewed by the Cytopathologist. Relevant clinical data was retrieved. ASCUS was the most common type of abnormality representing 43.0 % cases among 294 abnormal smears reported during study period. 16.0% cases were found to be non ASCUS on review. The main four causes of over use of ASCUS diagnosis were poor quality smears and cellular atypia associated with Candida infection, atrophy and squamous metaplasia. Educational measures are being undertaken to avoid over diagnosis and improve the patient management (Afr J Reprod Health 2011; 15[1]: 111-114)

Candida species amongst pregnant women in Benin city, Nigeria: effect of predisposing factors

Genital samples from pregnant women were examined to determine the Candida species present and how some predisposing factors would affect the frequency of isolation of species. A total of 147 women (87 volunteer asymptomatic pregnant women and 60 asymptomatic nonpregnant women) were examined. High Vaginal Swabs (HVS) were collected in pairs while demographic data (age of individual; age of pregnancy; occupation and use of contraceptive pill) on each subject were obtained alongside. Samples were cultured on Sabouraud Dextrose Agar plates and incubated for 72 hours at 37oC. Results revealed five Candida species (C.albicans; C.glabrata; C.tropicalis; C.stellatoidea; C.parapsilosis) with 61.5; 17.9; 7.7; 5.1; 2.6frequency of isolation respectively; as against 73.7; 7.7; 1.4; 11.3; and 0.0for control. Women in the second trimester of pregnancy had the highest occurrence (68.8) while the age groups 24- 30 and 31-37 years had the highest occurrence in the control (46.2) and in the pregnant ones (51.7) respectively. Traders had 68.8; and full-time housewives; 26.7occurrence. More women who used contraceptives had Candida (58.3) as against non contraceptive users (35.3). The results support literature reports that there are high rates of colonization of the vagina of pregnant women by Candida. They also give credence to earlier reports that the factors determined here affect the frequency of isolation of Candida species from the vagina