Candidiasis y Candida albicans / Candidiasis and Candida albicans

La candidiasis es una enfermedad micótica debida a levaduras pertenecientes al género Candida. Dentro del gran conjunto de microorganismos que colonizan al ser humano, Candida albicans es el agente etiológico más comúnmente detectado ya que habita como comensal en las superficies mucosas y la piel. C. albicans participa en procesos de fermentación de azúcares y asimilación de nutrientes, pero, en algunas ocasiones se relaciona con procesos patológicos. En los últimos años los avances tecnológicos y médicos; así como el aumento en la incidencia de infecciones por el virus de la inmunodeficiencia humana, el auge creciente de la terapia inmunomoduladora y el uso de antibióticos de amplio espectro durante largos períodos de tiempo se han convertido en los factores de riesgo más importantes para la creciente incidencia de infecciones por microorganismos del género Candida. Debido a esto, resulta imperativo el conocimiento de esta enfermedad y sus formas clínicas más importantes, así como el abordaje diagnóstico y el tratamiento actual; información que recolectamos en este documento para brindar una visión general sobre esta patología(AU)

Candidiasis is a fungal disease caused by yeasts belonging to the genus Candida. Within the large group of microorganisms that colonize humans, candida albicans is the most commonly detected etiological agent since it inhabits mucosal surfaces and skin as a commensal. C. albicans participates in sugar fermentation processes and assimilation of nutrients but, on some occasions, it is related to pathological processes. In recent years, technological and medical advances; As well as the increase in the incidence of human immunodeficiency virus infections, the growing boom in immunomodulatory therapy and the use of broad-spectrum antibiotics for long periods of time have become the most important risk factors for the increasing incidence of infections by microorganisms of the genus Candida. Due to this, knowledge of this disease and its most important clinical forms, as well as the current diagnostic approach and treatment, is imperative; information that we collect in this document to provide an overview of this condition(AU)

Candida famata Infection Presenting as an Erosive Patch on the Sole of an Immunocompetent Patient / 대한피부과학회지

Candida famata previously called Torulopsis famata or Debaryomyces hansenii, is usually found in natural substrates. It was earlier considered nonpathogenic in humans; however, a number of clinical cases of human infection have been reported showing isolation of this yeast. Dermatologic literature contains only a few reports regarding cutaneous infection caused by Candida famata. An 18-year old woman presented with a 4-month history of a 4.0×3.0 cm sized erythematous erosive patch on her left sole. A skin biopsy revealed numerous spores and hyphae in the epidermis. Histopathological specimens showed positive findings using the Periodic acid-Schiff and Gomori methenamine silver stains but negative findings using acid-fast bacilli stain. Cultures from skin scrapings yielded numerous colonies. Identification of the fungus was processed up to species level using VITEK 2 (bioMérieux, Inc. Hazelwood, MO, USA), and Candida famata was isolated. She was administered itraconazole at a dose of 200 mg once daily, and following 5 weeks of therapy, the erosive lesion was noted to have completely healed with postinflammatory hyperpigmentation.

Micosis superficiales: estudio retrospectivo de corte transversal en la ciudad de Córdoba, Argentina / Superficial mycoses: retrospective cross-sectional study in the city of Córdoba, Argentina

Las micosis superficiales son enfermedades que afectan de forma frecuente al ser humano. En la ciudad de Córdoba, Argentina, existe muy poca información acerca de las mismas.Por tal motivo se realizó un estudio retrospectivo, de corte transversal, con muestras de 2.855 pacientes, tomadas entre 2008 y 2009 en distintos tipos de centros asistenciales, con el fin de obtener datos epidemiológicos actualizados. Se incluyeron pacientesmayores de 15 años, de ambos sexos, residentes en la mencionada ciudad. El análisis estadístico se realizó con pruebas de bondad de ajuste chi cuadrado, con un nivel de significación del 5%. En los resultados se obtuvo un mayor porcentaje del sexo femenino enla concurrencia a laboratorios de micología, y la edad media fue de 44, 35 años. La topografía más frecuente en centros privados fueron las onicomicosis, mientras que en hospitales públicos se estudiaron con mayor frecuencia las afecciones de piel. Los estudiosmicológicos revelaron el 65,18% de exámenes directos con presencia de elementos fúngicos y en el 34,82% resultaron negativos. En hospitales públicos se detectó en el examendirecto el 15,72% de Malassezia spp., mientras que en centros privados el 7,89%. En los exámenes micológicos de cultivo se aislaron en mayor proporción dermatofitos del géneroTrichophyton,seguidos de levaduras no lipofílicas del género Candida. Por su parte, sedestacó que los pacientes que en mayor proporción asistieron a los centros asistenciales fueron de barrios cuyas necesidades básicas insatisfechas poseían un rango del 2,21% al 6,63%...

Micosis superficiales en pacientes del estado Anzoátegui, Venezuela, periodo 2002-2012 / Superficial mycoses in patients from Anzoátegui state, Venezuela, period 2002-2012

Las enfermedades fúngicas superficiales que afectan la piel y sus faneras son motivo de consultas en los servicios básicos de triaje y en dermatología. Se encuentran distribuidas en Venezuela con una incidencia de 92,9%. El objetivo del presente estudio fue conocer los géneros y especies que causan dermatomicosis en pacientes residentes del estado Anzoátegui, Venezuela, en el período 2002-2012. Se estudiaron 4257 pacientes con edades entre 7 meses y 79 años. La prevalencia general fue de 30,9%. Las más frecuentes fueron las dermatofitosis (44,7%). M. canis produjo 148 casos de tiña de la cabeza. Tres agentes dermatofiticos representaron el 95% de todos los casos, con predominio significativo de T. mentagrophytes representado por un 50%. La candidosis se presentó en 28,4%. C. albicans, y el complejo C. parapsilosis, fueron responsables del 80% de los casos. Otras especies identificadas fueron C. tropicalis (n = 41; 11,0%), C. glabrata (n = 10; 2,7%), C. guilliermondii (n = 6; 1,6%), C. krusei (n = 4; 1,1%). Pitiriasis versicolor se presentó en (22,4%), y en menor frecuencia la onicomicosis por mohos no dermatofitos, dominando Fusarium oxysporum (n = 34; 65,4%), Aspergillus terreus (n = 16; 30,8%) y Scytalidium dimidiatum (2; 3,8%). Raros casos de onicomicosis por Trichosporon (0,5%) y un caso de tinea negra. Estos resultados revelan una alta frecuencia de las micosis superficiales con predominio de las dermatofitosis indicando la existencia de un problema de salud pública.

Superficial fungal diseases that affect the skin and its appendages are frequently seen in basic triage and in dermatology services. These diseases are distributed in Venezuela with an incidence of 92.9%. The aim of this study was to determine the genera and species that cause dermatomycoses in residents of Anzoátegui state, Venezuela, during the period 2002-2012. A total of 4257 patients with a presumptive diagnosis of superficial mycoses were studied, with ages from 7 months to 79 years. The overall prevalence was 30.9%. The most frequent were dermatophytosis (44.7%). M. canis produced 148 cases of tinea capitis. Three dermatophytic agents represented 95% of all cases, with a significant predominance of T. mentagrophytes with 50%. Candidosis occurred in 28.4%. C. albicans, and the C. parapsilosis complex, were responsible for 80% of the cases. The other species identified were C. tropicalis (n = 41, 11.0%), C. glabrata (n = 10, 2.7%), C. guilliermondii (n = 6, 1.6%), C. krusei (n = 4, 1.1%). Pityriasis versicolor occurred in 22.4% of the cases studied, and less frequently were present onychomycosis produced by a non dermatophytic mold: Fusarium oxysporum (n = 34, 65.4%), Aspergillus terreus (n=16, 30.8%) and Scytalidium dimidiatum (n=2; 3.8%). Rare cases of Trichosporon onychomycosis (0.5%) and one case of black tinea were also found. Health education in the population is recommended to promote measures to prevent transmission of these fungi and prevent the spread of this silent public health problem.

Candidiasis cutánea generalizada en recién nacido a término / Generalized cutaneous candidiasis in newborn at term

Introducción. La candidiasis cutánea es una enfermedad que afecta tanto a población infantil como adulta. Las forma de presentación puede ser localizada o sistémica y el agente etiológico múltiple, siendo las especies infecciosas de Candida albicans más prevalentes en niños. Objetivo. Presentar un caso de candidiasis cutánea congénita cuya causa aparente fue la transmisión vertical durante el parto. Material y metodología. Se describe el caso de un recién nacido a término expuesto a una candidiasis vaginal subclínica, que desarrolló una candidiasis cutánea congénita por C. albicans asociada a sepsis y dificultad respiratoria en las primeras 24 horas de vida. Se practicaron hemocultivos, biopsia cutánea de las lesiones pápulopústulo-vesiculosas, análisis de sangre y punción lumbar. Resultados. En la bioquímica y el hemograma se encontró una proteína C reactiva de 5,7 mg/dl, leucocitosis con desviación a la izquierda y anemia leve. A las 24 horas, en el control se encontró una proteína C reactiva (7,82 mg/dl) que fue en aumento progresivo durante tres días, por lo que se practicó punción lumbar. El hemocultivo fue positivo para Staphylococcus aureus. La biopsia cutánea dio como resultado histológico la candidiasis cutánea. Conclusiones. El diagnóstico precoz es fundamental para prevenir complicaciones derivadas del cuadro producido por C. albicans en neonatos.

Introduction. Cutaneous candidiasis is a disease that affects children as well as adults. The presentation may be localized or systemic, and with multiple etiological agents. The most prevalent infecting species in children differs from that of the adult. Objective. A case is presented where a congenital cutaneous candidiasis was transmitted to the child during birth. Materials and methods. A full term newborn was exposed to a subclinical vaginal candidiasis infection, and 24 hr after birth, developed congenital cutaneous candidiasis. The etiological agent was Candida albicans, and was associated with sepsis and respiratory distress. Blood cultures, cutaneous biopsy of vesicular lesions, blood tests and lumbar puncture were performed. Results. Biochemistry and blood count showed a CRP of 5.7 mg/dl, leukocytosis with left shift and mild anemia. After 24 hr, the blood analyses showed an increase in a CRP (7.8 mg/dl) and increased progressively for three days; consequently, a lumbar puncture was performed. Blood culture was positive for Staphylococcus aureus. Cutaneous biopsy confirmed the cutaneous candidiasis. Conclusions. The early diagnosis is essential to prevent complications derived by the Candida albicans in newborns.

Eficácia de antifúngicos tópicos em diferentes dermatomicoses: uma revisão sistemática com metanálise / Efficacy of topical antifungal drugs in different dermatomycoses: a systematic review with meta-analysis

OBJETIVO: Avaliar e comparar a eficácia dos antifúngicos tópicos empregados no tratamento de cada dermatomicose. MÉTODOS: Foi desenvolvida uma revisão sistemática de ensaios clínicos randomizados, publicados em português, espanhol ou inglês até julho de 2010, que comparassem o uso de antifúngicos azólicos e alilamínicos entre si ou com placebo, no tratamento de candidíase cutânea, e das tineas versicolor, pedis, cruris e corporis. Os desfechos de eficácia avaliados foram cura micológica ao final do tratamento e cura sustentada. RESULTADOS: Dos 4.424 estudos inicialmente identificados, 49 alcançaram os critérios de seleção, sendo incluídos nas metanálises. Os dados agrupados de eficácia demonstraram superioridade dos antifúngicos frente a placebo, independente da dermatomicose avaliada, com valores de odds ratio (OR) variando de 2,05 (IC 95% 1,18-3,54) a 67,53 (IC 95% 11,43-398,86). Alilaminas foram superiores aos azólicos apenas para o desfecho cura sustentada (OR 0,52 [IC 95% 0,31-0,89]). CONCLUSÃO: Há evidência consistente da superioridade dos antifúngicos com relação ao uso de placebo, não sendo mais justificável a realização de estudos controlados por placebo. Alilaminas mantêm a cura micológica por períodos mais extensos que fármacos azólicos. Dada a significativa diferença de custo entre as classes, recomenda-se a realização de análises farmacoeconômicas.

OBJECTIVE: To evaluate and compare the efficacy of topical antifungal drugs applied to the treatment of each dermatomycosis. METHODS: A systematic review of randomized clinical trials, published in Portuguese, Spanish and English until July 2010, which compared the use of azole and allylamine antifungal drugs among themselves and with placebo in the treatment of cutaneous candidiasis and T. versicolor, T. pedis, T. cruris and T. corporis was performed. The efficacy outcomes evaluated were mycological cure at the end of treatment and sustained cure. RESULTS: Of the 4,424 studies initially identified, 49 met the selection criteria and were included in the meta-analyses. The grouped efficacy data evidenced the superiority of antifungal drugs compared to placebo, regardless of the dermatomycosis under evaluation, with odds ratio values ranging from 2.05 (95% CI 1.18-3.54) to 67.53 (95% CI 11.43-398.86). Allylamines were better than azoles only for the outcome sustained cure (OR 0.52 [95% CI 0.31-0.89]). CONCLUSION: There is consistent evidence of the superiority of antifungal drugs over the use of placebo, and placebo-controlled studies are no longer justifiable. Allylamines maintain the mycological cure for longer periods compared to azole drugs. Given the significant cost difference among the classes, pharmacoeconomic analyses should be performed.

Onicomicosis: epidemiología, agentes causales y evaluación de los métodos diagnósticos de laboratorio / Onychomycoses: epidemiology, causative agents and assessment of diagnostic laboratory methods

Desde marzo de 2007 hasta marzo de 2011 se estudiaron prospectivamente 414 pacientes con onicodistrofias en un laboratorio privado de Esquel. La prevalencia de onicomicosis de pie fue del 78 %; la de mano, del 58 %. Los principales agentes etiológicos fueron Trichophyton rubrum, Candida spp. y Trichophyton mentagrophytes. El desarrollo de dermatofitos prevaleció en las onicopatías de pie y el de Candida spp. en las de uñas de mano (ambos, p < 0,05). En las onicomicosis candidiásicas predominaron especies diferentes a Candida albicans. Las onicomicosis fueron más frecuentes en los hombres que en las mujeres. A su vez, en los hombres hubo más aislamientos de T. rubrum en pies (p < 0,05) y mayor proporción de exámenes directos (ED) y cultivos positivos (ambos, p < 0,05). La correlación entre los resultados del ED y del cultivo fue del 68 %. El rédito de ambos métodos se asoció a un mayor tamaño de la lesión ungueal. El ED fue más efectivo en onicodistrofias que superaban los 5 años de evolución. La positividad del cultivo fue independiente de la cronicidad de la onicodistrofia.

Since March 2007 to March 2011, 414 patients with onychopathies were prospectively analyzed. Prevalence of the toenail and fingernail mycoses was 78 % and 58 %, respectively. The major etiological agents were Trichophyton rubrum, Candida spp. and Trichophyton mentagrophytes. Dermatophytes were more frequently cultured from toenails, whereas Candida spp. from fingernails (both, p < 0.05). In candidal onychomycosis, species different from C. albicans were prevalent. A higher prevalence of toenail and fingernail mycoses, a predominance of T. rubrum in toenails (p < 0.05), and greater positivity in the direct examination (DE) and in culture (both, p < 0.05) were more frequently observed in men than in women. The correlation between DE and culture was 68 %. DE and culture yields were associated with a greater size lesion. DE was more effective in onycodystrophies with duration of more than 5 years. Culture positivity was independent of nail affection chronicity.

Candidiasis mucocutánea: espectro clínico / Clinical spectrum of mucocutaneous candidiasis

La candidiasis mucocutánea es una infección superficial común en nuestro medio, con múltiples factores de riesgo para su desarrollo. En las últimas décadas se ha incrementado su presentación, ya que tiene gran asociación con el VIH-sida, aunque también se presenta en personas inmunocompetentes. El agente etiológico más común es Candida albicans. La candidiasis superficial puede comprometer piel, mucosas y uñas, y existe la forma mucocutánea crónica que se asocia a enfermedades autoinmunitarias. Se hace una revisión de las principales formas de candidiasis mucocutánea y su implicación clínica en la población general.

In vitro Antifungal Susceptibility Testing of Clinically-isolated Trichophyton Species to Luliconazole / 대한의진균학회지

BACKGROUND: Luliconazole (LLCZ) is an imidazole antifungal agent widely used in Japan for treatment of tinea, cutaneous candidiasis, and pityriaisis versicolor, etc. Theoretically, its potent antifungal activity should make it a viable option for various conditions of dermatophytoses, but there has been no studies to support the notion thus far. OBJECTIVE: This prompted the authors to investigate the distribution of minimum inhibitory concentration (MIC) of luliconazole by carrying out in vitro antifungal susceptibility test on Trichophyton (T.) species clinically isolated from Korean subjects with tinea pedis. METHODS: In vitro antifungal susceptibility test, with broth macrodilution method of luliconazole and terbinafine hydrochloride (TBF) as reference drug on two clinically isolated Trichophton species (22 strains of T. rubrum, 5 of T. mentagrophytes), was carried out. RESULTS: The range of MIC for LLCZ on the total of 27 strains was 0.0110~0.0140 microg/mL (geometric mean: 0.0027 microg/mL), and the range for TBF was 0.0120~0.0250 microg/mL (geometric mean: 0.0042 microg/mL). Additionally, the geometric mean for MIC of LLCZ on T. mentagrophytes was 0.0125 microg/mL, and on T. rubrum, it was 0.0019 microg/mL. No strain showed resistance in vitro. CONCLUSIONS: The authors hence demonstrated that antifungal activity of LLCZ in vitro against Trichophyton species clinically isolated from Korean subjects is quite superior. These findings emphasize the usefulness of LLCZ, a promising new imidazole, for the topical management of dermatophytoses.

Mural Folliculitis and Alopecia with Cutaneous Candidiasis in a Beagle Dog / 한국실험동물학회지

A one-year-old male Beagle dog showed dermatitis, alopecia and scales. Examination of the affected dog revealed generalized alopecia, patchy erythema, and superficial erosions with histological evidence of mural folliculitis. External tests for parasites in scraped skin samples were negative. However, fungal culture tests and polymerase chain reaction revealed the existence of Candida in the lesion. These results suggest that cutaneous candidiasis may induce mural folliculitis and alopecia in dogs.

Micoses superficiais em idosos residentesem entidade beneficente na Região Norte do estado do Rio Grande do Sul / Superficial Mycosis in elderly people living in beneficent entity in the north of Rio Grande do Sul

As micoses superficiais são definidas como infecções que afetam as camadas superficiais da pele, assim como pêlos e unhas. O objetivo do presente estudo foi verificar a prevalência de micoses superficiais em idosos residentes ementidade beneficente localizada na região Norte do Estado do Rio Grande do Sul, Brasil, em estudo retrospectivo, referente ao período de março de 2002 a novembro de 2007. Foram analisadas amostras de 124 idosos com suspeita clínica de micoses superficiais, as quais 28,2% (35/124) foram positivas. Dermatofitose foi a micose mais freqüente, presente em 73,6% das amostras positivas e candidíase, em 26,4%. Em relação ao sexo dos pacientes, 57,1% (20/35) pertenciam ao sexo feminino. As espécies de dermatófitos isoladas através da cultura foram Trichophyton rubrum e Trichophyton mentagrophytes. Quanto ao gênero Candida, a espécie prevalente foi a Candida albicans . Estudos abordando a etiologia e epidemiologia das micoses superficiais são importantes, pois auxiliam o controle e prevenção destas infecções.

Superficial mycosis are defined as infections which affect superficial layers of skin, hair and nails. The aim ofthis paper was to verify prevalence of superficial mycosis in elderly people living in beneficent entity in the North of Rio Grande do Sul, Brazil, in a retrospective study, from March 2002 to November 2007. Samples of 124 elderly people with clinic suspect of superficial mycosis diagnosis were analyzed, being 28.2% (35/124) positive. Dermatophytosis was the mostcommon mycosis, present in 73.6% of the positive samples and candidiase in 26.4%. 57.1% (20/35) of the patients were females. Species of dermatophytes, isolated by culture were Trichophyton rubrum and Trichophyton mentagrophytes. In Candidiasis, Candida albicans was the prevalent specie. Studies of etiology and epidemiology of superficial mycosis are important because they help to control and prevent infections.

Avalia ao da susceptibilidade a antifungicos de diferentes espécies de leveduras candida isoladas de mucosa bucal e pele / Evaluation of antifungal susceptibility of different species of candida yeast isolated from buccal mucosa and skin

A variabilidade das diferentes especies de Candida sp, juntamente com as distintas respostas as formas de tratamento, desenvolveram a necessidade da utiliza tao de diferentes metodos diagn6sticos e esquemas terapeuticos. Entre as leveduras deste grupo, a Candida albicans e urn dos pat6genos mais comuns envolvidos nas candidiases mucocutaneas e da orofaringe, porem as especies nao albicans tern aumentado em numero e em importancia devido ao acrescimo do perfil de resistencia aos antifUngicos. A resistencia da Candida albicans e das especies nao albicans ao fluconazole outros derivados az61icos e descrito na literatura com freqOencia, o que torna importante a realiza tao de testes de susceptibilidade. Neste contexte esta pesquisa tern como objetivo determinar o perfil de susceptibilidade das leveduras Candida em diferentes sftios anatomicos. As leveduras isoladas da mucosa bucal e de pele foram semeadas em CHROMagar Candida, incubadas por 48 horas, a 35°C sendo posteriormente identificadas e avaliado in vitro o perfil de susceptibilidade utilizando o metodo da macrodilui tao. Entre as 25 amostras analisadas, verificou-se urn perfil de resistencia maior ao fluconazol em compara tao ao cetoconazol, sendo que 44% dos isolados de boca e 50% de pele mostraram-se resistentes ao fluconazol.

The variability of the different species of Candida sp, together with the distinct responses to treatment, elicited the need of using different diagnostic methods and therapeutic programs. Among the yeast of this group, Candida albicans is one of the most common pathogens involved in muco-cutaneous and oropharingeal candidiases, but the non-albicans species have increased in number and importance due to antifungal resistance. The resistance of Candida albicans and the non-albicans species to fluconazole and other azolic derivatives is frequently reported, which makes susceptibility tests important. Within this scope, this research has the purpose of determining the susceptibility profile of Candida yeast from different anatomical sites. The yeast cells isolated from buccal mucosa and skin were seeded in CHROMagar Candida, incubated for 48 hours at 35°C; later, they were identified and the susceptibility profile was assessed in vitro using themacrodilution method. Of the 25 samples analyzed, a higher profile of resistance to fluconazole compared to ketoconazole was noticed, where 44% ofthe buccal and 50% ofthe skin isolates were resistant to fluconazole.

Micoses superficiais na infância / Superficial mycoses in childhood

Os autores descrevem as principais micoses superficiais na infância. Seus fatores predisponentes, agentes etiológicos, mecanismos de transmissão e o tratamento são discutidos.

A Case of Congenital Cutaneous Candidiasis in a Premature Baby / 대한피부과학회지

Although candidal infections are common in the neonatal period, less than 100 cases of Congenital Cutaneous Candidiais (CCC) have been reported in the English literature. CCC appears to be acquired in the uterus by the ascension of organisms from an infected vagina into the uterine cavity. In this report, we describe a premature baby with CCC. At 6 months, his mother had a vaginal candidial infection which was treated. Her pregnancy terminated in preterm labor at 32 weeks. Desquamated patches that involved the trunk and extremities were noted at birth. The possibility of CCC was considered and numerous psedohyphae and spores were seen in the lesions by KOH microscopic examination. The skin lesions cleared completely after 2 weeks of topical clotrimazole cream.

Genotype comparisons of strains of Candida albicans from patients with cutaneous candidiasis and vaginal candidiasis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is uncertain whether genotypes of Candida albicans (C. albicans) are associated with colonizing body locations or variant conditions of infection. The aim of this study was to investigate whether there are significant associations between strain genotypes and body sites of infection and to determine the potential pathogenesis of cutaneous candidiasis at multiple locations.</p><p><b>METHODS</b>A total of 151 strains of C. albicans were isolated from 74 infant patients with cutaneous candidiasis and 61 female patients with vaginal candidiasis. Patients were grouped according to the body sites and underlying conditions of infection. Genotypes were identified by polymerase chain reaction (PCR) of the 25S rDNA and PCR-restriction fragment length polymorphism (RFLP) of ALT repeats digested with EcoRI and Clal.</p><p><b>RESULTS</b>Ten genotypes were detected. There were significant differences in genotype frequencies between the two groups. However, we found no clear association between genotypes and the sites of cutaneous infection or the underlying conditions of vaginal candidiasis (VVC). In addition, strains of C. albicans from multiple cutaneous locations of the same patient had identical genotypes.</p><p><b>CONCLUSIONS</b>Populations of C. albicans from patients with cutaneous and vaginal candidiasis were genetically different. However, the lack of genetic difference between strains from different body sites with cutaneous infections or from different underlying conditions for VVC suggests no evidence of genotype selection for different skin surfaces or patients with different underlying conditions for VVC.</p>

[Comparision of MICs of some Iranian herbal essences against azole resistance and azole susceptible of candida albicans]

Candida albicans is the most important species, cause candida infections. The common forms of candidiasis are cutaneous and mucosal candidiasis, include oral [thrush], Vaginal candidiasis and onychomycosis. Different studies showed the drug resistance between candida albicans isolates, so it seems necessary to find replacement treatment for prevention of this resistance, side effects and avoidance of recurrent infection. Aim of this study is to determine of MICs of three essences against candida albicans isolates. Also, we compared the effects of essences between azole resistance and azole susceptible isolates. In this study, 30 candida albicans isolates [16 azole resistance and 14 azole susceptible isolates] obtained from oral, vaginal and nails of patients with candidiasis were evaluated. In order to determine of susceptibility of Zataria multiflora, Geranium herbarum and Artemisia sieberi essences against candida albicans, Macrodilution broth Serial dilution of essences was prepared in sabouraud glucose broth tubes. Essences were solved in DMSO [0.12] as solvent. The same solvent at an appropriate concentration was used as a control [with and without organisms]. After inoculation, incubation and subculture, MICs, compared to control tubes were determined. The obtained results of MICs for Zataria multiflora, Geranium herbarum and Artemisia sieberi were between 0.11-0.25 micro l/ml [mean: 0.18 micro l/ml], 0.4-1.25 micro l/ml [mean: 0.83 micro l/mI] and 0.62-1.25 micro l/ml [mean: 1.4 micro l/ml], respectively. Also, there are not significant differences in MICs of these essences against azole resistance and azole susceptible isolates. We conclude that anti-candida activity of three herbal essences under study, against azole resistance and azole susceptible isolates were similar. With attention to resistance of different candida albicans to synthetic and chemical antifungals, these herbal essences are safe replacement treatments for cutaneous and mucosal candidia infections