Epidemiology of Candida albicans infections and role of non-Candida-albicans yeasts.
ABSTRACT Infections of the skin and the mucous membranes due to Candida species may occur either in immuncompromised or in non-immuncompromised patients. This is in contrast to systemic candidiasis (e.g. candidemia) which is only seen in severely immunocompromised patients. Bloodstream infections caused by Candida species are increasingly recognized in critical ill adult and pediatric individuals, with significant associated morbidity and mortality. Candida albicans is the single most common fungal species causing nosocomial infections. However, non-Candida albicans spp., including fluconazole-less-susceptible Candida glabrata, have become more common pathogens. In some patient populations such as hematological (neutropenic) patients Non-C. albicans species are detected much more frequently as compared to non-neutropenic patients in the intensive care. Non-C. albicans species are more likely to occur in patients, who receive or have received antifungal therapy with azoles (e.g. fluconazole). In this review the current epidemiological trends in mucosal and invasive candidiasis are discussed with regard to the role of non-Candida albicans species as the causative agent in immunocompromised patients.
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ABSTRACT: Because of the need for more effective and less harmful antifungal therapies, and interest in the synthesis of new carboximidamides, the goal of this study was to determine the antifungal and anti-enzyme activities of some new pyrazole carboximidamides and their cytotoxicity. For this purpose, tests were performed to evaluate: minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC); production of proteinases and phospholipase, and cytotoxicity of the extracts. Data were analyzed by ANOVA and Tukey Tests (α = 5%). The results were: MIC and MFC ≥ 62.5 μg/mL (C. albicans, C. parapsilosis, C. famata, C. glabrata, and Rhodotorula mucillaginosa) and MIC and MFC ≥ 15.6 μg/mL (C. lipolytica). The values of proteinase and phospholipase (Pz) of C. albicans before and after exposure to the compounds were: 0.6 (±0.024) and 0.2 (±0.022) and 0.9 (±0.074) and 0.3 (±0.04), respectively. These proteinase results were not significant (p = 0.69), but those of phospholipase were (p = 0.01), and 15.6 μg/mL was the most effective concentration. The cytotoxicity means were similar among the tests (p = 0.32). These compounds could be useful as templates for further development through modification or derivatization to design more potent antifungal agents. Data from this study provide evidence that these new pyrazole formulations could be an alternative source for the treatment of fungal infections caused by Candida. However, a specific study on the safety and efficacy of these in vivo and clinical trials is still needed, in order to evaluate the practical relevance of the in vitro results.Molecules 01/2014; 19(5):5806-5820. · 2.43 Impact Factor
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ABSTRACT: In this study, we explored the relationship between neutropenia (absolute neutrophil count (ANC) <1,500/mm(3)) and invasive fungal infection (IFI) in Chinese patients who had hematological malignancies treated with chemotherapy. We conducted a multicenter, prospective, non-interventional study of consecutive patients with hematological malignancies undergoing chemotherapy in China and determined clinical characteristics of patients who developed neutropenia and IFI. The results indicated that for the 2,177 neutropenic patients, 88 (4.0 %) were diagnosed with IFI. We found that a high risk of IFI (P < 0.05) is associated with male gender, non-remission of the primary disease, use of two or more broad-spectrum antibiotics, treatment with parenteral nutrition, presence of cardiovascular disease, history of IFI, and neutropenia. When the ANC was less than 1,000, 1,000∼500, 500∼100, and <100/mm(3), the incidence of IFI was 0.5, 5.2, 3.9, and 4.7 %, respectively (ANC > 1,000/mm(3) versus other groups, P < 0.001). When the ANC was less than 1,000, 500, or 100/mm(3) for 10 days or more, the incidence of IFI was 3.2 versus 6.1 % (P = 0.0052), 3.5 versus 7.1 % (P = 0.0021), and 3.1 versus 10.0 % (P < 0.001). When the ANC was less than 100/mm(3), taking antifungal prophylaxis reduced the incidence of IFI (P < 0.05). The IFI-attributable mortality rate was 11.7 %. In conclusion, Chinese patients with IFI, severe and prolonged neutropenia increases the incidence of IFI. The incidence of IFI associated with neutropenia was reduced when antifungal prophylaxis was given. IFI was associated with a significantly increased high mortality rate in hematological malignancy patients with neutropenia.Tumor Biology 03/2014; · 2.52 Impact Factor
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ABSTRACT: Aim: To evaluate the antifungal effect of gallic acid, catechin, luteolin and quercetin, phenolic compounds identified from flowers of North Eastern Portugal, against Candida planktonic and biofilm cells. Materials & methods: The MICs were determined in Candida planktonic cells and the effect of phenolic compounds on Candida biofilms was assessed through quantification of colony-forming units. Results: MIC values demonstrated that gallic acid presented the highest effect against all Candida species. Catechin showed a similar effect against Candida albicans American Type Culture Collection (ATCC) 90028 cells. In addition, gallic acid and quercetin had demonstrated only a minimal effect against Candida species biofilms. Conclusion: Gallic acid affected the growth of the different planktonic Candida species in all concentrations used; still, catechin showed a similar effect against C. albicans ATCC 90028 and Candida glabrata ATCC 2001 cells. In addition, only gallic acid and quercetin demonstrated a slight effect against all Candida species biofilms.Future Microbiology 02/2014; 9:139-46. · 4.02 Impact Factor