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Invasive candidiasis

Ricardo Ferrer, Rafael Zaragoza, Alejandro H Rodríguez, Emilio Maseda, Pedro Llinares, Santiago Grau, Francisco Álvarez-Lerma, Guillermo Quindós, Miguel Salavert, Rafael Huarte
BACKGROUND: Although the management of invasive fungal infection (IFI) has improved, a number of controversies persist regarding the approach to invasive fungal infection in non-neutropenic medical ward patients. AIMS: To identify the essential clinical knowledge to elaborate a set of recommendations with a high level of consensus necessary for the management of IFI in non-neutropenic medical ward patients. METHODS: A prospective, Spanish questionnaire, which measures consensus through the Delphi technique, was anonymously answered and e-mailed by 30 multidisciplinary national experts, all specialists (intensivists, anesthesiologists, microbiologists, pharmacologists and specialists in infectious diseases) in IFI and belonging to six scientific national societies...
October 18, 2016: Revista Iberoamericana de Micología
Fabio de Araujo Motta, Libera Maria Dalla-Costa, Marisol Dominguez Muro, Andrea Lenzi, Gledson Luiz Picharski, Marion Burger
BACKGROUND: Candida species are the primary cause of invasive fungal infection in hospitalized children. There are few data on risk factors for postoperative candidemia in pediatric patients with congenital heart defects. This study aimed to identify risk factors for candidemia in patients with congenital heart defects who underwent cardiac surgery. METHODS: This was a case-control study conducted in patients admitted to a pediatric cardiology intensive care unit from January 2006 to December 2013...
November 2016: Pediatric Infectious Disease Journal
He Wang, Ying-Chun Xu, Po-Ren Hsueh
In the Asia-Pacific region, Candida albicans is the predominant Candida species causing invasive candidiasis/candidemia in Australia, Japan, Korea, Hong Kong, Malaysia, Singapore and Thailand whereas C. tropicalis is the most frequently encountered Candida species in Pakistan and India. Invasive isolates of C. albicans, C. parapsilosis complex and C. tropicalis remain highly susceptible to fluconazole (>90% susceptible). Fluconazole resistance (6.8-15%), isolates with the non-wild-type phenotype for itraconazole susceptibility (3...
October 18, 2016: Future Microbiology
L F A Guimarães, M Halpern, A S de Lemos, E F de Gouvêa, R T Gonçalves, M A A da Rosa Santos, M Nucci, G Santoro-Lopes
INTRODUCTION: Invasive fungal disease (IFD) is an important complication after solid organ transplantation (SOT). A marked geographic variation in the epidemiology of IFD after kidney transplantation (KT) has been suggested by the results of previous studies. Nevertheless, data from Latin American centers are scarce. OBJECTIVE: This study sought to describe the epidemiology of IFD at a Brazilian KT center. METHODS: This study was a retrospective single-center cohort study that included patients who underwent KT between 1998 and 2009 and were followed up until July 2015...
September 2016: Transplantation Proceedings
Wei Liu, Zui Zou, Xin Huang, Hui Shen, Li Juan He, Si Min Chen, Li Ping Li, Lan Yan, Shi Qun Zhang, Jun Dong Zhang, Zheng Xu, Guo Tong Xu, Mao Mao An, Yuan Ying Jiang
Glycosylphosphatidyl inositol anchored proteins (GPI-APs) on fungal cell wall are essential for invasive infections. While the function of inositol deacylation of GPI-APs in mammalian cells has been previously characterized the impact of inositol deacylation in fungi and implications to host infection remains largely unexplored. Herein we describe our identification of BST1, an inositol deacylase of GPI-Aps in Candida albicans, was critical for GPI-APs cell wall attachment and host infection. BST1-deficient C...
October 6, 2016: Scientific Reports
Cinzia Auriti, Marco Falcone, Maria Paola Ronchetti, Bianca Maria Goffredo, Sara Cairoli, Rosamaria Crisafulli, Fiammetta Piersigilli, Tiziana Corsetti, Andrea Dotta, Manjunath P Pai
High doses of micafungin are advocated in neonates with systemic candidiasis but limited pharmacokinetic (PK) and safety data are available to support their use. Eighteen preterm neonates and infants with systemic candidiasis, 3 with meningitis, were treated for at least 14 days with 8 to 15 mg/kg/day of intravenous micafungin. Plasma concentrations (4 measurements) were determined after the third dose and cerebrospinal-fluid (CSF) concentrations were also obtained in three patients. Population PK analyses were used to identify the optimal model and further validated using external data (n=5)...
October 3, 2016: Antimicrobial Agents and Chemotherapy
Elizabeth J Polvi, Anna F Averette, Soo Chan Lee, Taeyup Kim, Yong-Sun Bahn, Amanda O Veri, Nicole Robbins, Joseph Heitman, Leah E Cowen
Fungal pathogens have evolved diverse strategies to sense host-relevant cues and coordinate cellular responses, which enable virulence and drug resistance. Defining circuitry controlling these traits opens new opportunities for chemical diversity in therapeutics, as the cognate inhibitors are rarely explored by conventional screening approaches. This has great potential to address the pressing need for new therapeutic strategies for invasive fungal infections, which have a staggering impact on human health...
October 2016: PLoS Genetics
Y-K Pang, M Ip, J H S You
Early initiation of antifungal treatment for invasive candidiasis is associated with change in mortality. Beta-D-glucan (BDG) is a fungal cell wall component and a serum diagnostic biomarker of fungal infection. Clinical findings suggested an association between reduced invasive candidiasis incidence in intensive care units (ICUs) and BDG-guided preemptive antifungal therapy. We evaluated the potential cost-effectiveness of active BDG surveillance with preemptive antifungal therapy in patients admitted to adult ICUs from the perspective of Hong Kong healthcare providers...
September 29, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Zheng-Xin He, Lan-Chun Shi, Xiang-Yang Ran, Wei Li, Xian-Ling Wang, Fu-Kun Wang
Early and accurate diagnosis of invasive candidiasis (IC) is very important. In this study, a lateral flow immunoassay (LFIA) was developed to detect antibody against Candida albicans enolase (Eno). Colloidal gold particle labeled mouse anti human IgG (1.0 mg/L) was used as the detector reagent. Recombinant enolase (rEno, 1.0 mg/L) and goat anti IgG (1.0 mg/L) were immobilized in test and control lines, respectively, of a nitrocellulose membrane, acting as the capture reagents. The LFIA was used to detect anti Eno in 38 sera from clinically proven IC patients, as well as in 50 healthy control subjects...
2016: Frontiers in Microbiology
Yi Wang, Cindy S Ma, Yun Ling, Aziz Bousfiha, Yildiz Camcioglu, Serge Jacquot, Kathryn Payne, Elena Crestani, Romain Roncagalli, Aziz Belkadi, Gaspard Kerner, Lazaro Lorenzo, Caroline Deswarte, Maya Chrabieh, Etienne Patin, Quentin B Vincent, Ingrid Müller-Fleckenstein, Bernhard Fleckenstein, Fatima Ailal, Lluis Quintana-Murci, Sylvie Fraitag, Marie-Alexandra Alyanakian, Marianne Leruez-Ville, Capucine Picard, Anne Puel, Jacinta Bustamante, Stéphanie Boisson-Dupuis, Marie Malissen, Bernard Malissen, Laurent Abel, Alain Hovnanian, Luigi D Notarangelo, Emmanuelle Jouanguy, Stuart G Tangye, Vivien Béziat, Jean-Laurent Casanova
Combined immunodeficiency (CID) refers to inborn errors of human T cells that also affect B cells because of the T cell deficit or an additional B cell-intrinsic deficit. In this study, we report six patients from three unrelated families with biallelic loss-of-function mutations in RLTPR, the mouse orthologue of which is essential for CD28 signaling. The patients have cutaneous and pulmonary allergy, as well as a variety of bacterial and fungal infectious diseases, including invasive tuberculosis and mucocutaneous candidiasis...
September 19, 2016: Journal of Experimental Medicine
R Ferrer, R Zaragoza, P Llinares, E Maseda, A Rodríguez, G Quindós
OBJECTIVES: Infections caused by Candida species are common in critically ill patients and contribute to significant morbidity and mortality. The EPICO Project (Epico 1 and Epico 2.0 studies) recently used a Delphi approach to elaborate guidelines for the diagnosis and treatment of this condition in critically ill adult patients. We aimed to evaluate the impact of a multifaceted educational intervention based on the Epico 1 and Epico 2.0 recommendations. DESIGN: Specialists anonymously responded to two online surveys before and after a multifaceted educational intervention consisting of 60-min educational sessions, the distribution of slide kits and pocket guides with the recommendations, and an interactive virtual case presented at a teleconference and available for online consultation...
September 16, 2016: Medicina Intensiva
D R Andes, N Safdar, J W Baddley, B Alexander, L Brumble, A Freifeld, S Hadley, L Herwaldt, C Kauffman, G M Lyon, V Morrison, T Patterson, T Perl, R Walker, T Hess, T Chiller, P G Pappas
BACKGROUND: Invasive candidiasis (IC) is a common cause of mortality in solid organ transplant recipients (OTRs), but knowledge of epidemiology in this population is limited. METHOD: The present analysis describes data from 15 US centers that prospectively identified IC from nearly 17,000 OTRs. Analyses were undertaken to determine predictors of infection and mortality. RESULTS: A total of 639 cases of IC were identified. The most common species was Candida albicans (46...
September 19, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Judith M Martin, Mercedes Macias-Parra, Peter Mudry, Umberto Conte, Jean L Yan, Ping Liu, M Rita Capparella, Jalal A Aram
BACKGROUND: Data on safety and efficacy of voriconazole for invasive aspergillosis (IA) and invasive candidiasis/esophageal candidiasis (IC/EC) in pediatric patients are limited. METHODS: Patients aged 2-<18 years with IA and IC/EC were enrolled in two prospective open-label, non-comparative studies of voriconazole. Patients followed dosing regimens based on age, weight, and indication, with adjustments permitted. Treatment duration was 6-12 weeks for IA patients, ≥14 days after last positive Candida culture for IC patients, and ≥7 days after signs/symptoms resolution for EC patients...
September 15, 2016: Pediatric Infectious Disease Journal
Patrick J van der Geest, Nicole G M Hunfeld, Sophie E Ladage, A B Johan Groeneveld
BACKGROUND: In critically ill patients the incidence of invasive fungal infections caused by Candida spp. has increased remarkably. Echinocandins are recommended as initial treatment for invasive fungal infections. The safety and efficacy of micafungin compared to caspofungin is similar, but no comparison is made between anidulafungin and micafungin concerning safety and efficacy. We therefore performed a retrospective study to assess these aspects in critically ill patients with invasive candidiasis...
2016: BMC Infectious Diseases
Jessica E Morgan, Hadeel Hassan, Julia V Cockle, Christopher Lethaby, Beki James, Robert S Phillips
PURPOSE: The incidence of invasive fungal disease (IFD) is rising, but its treatment in paediatric haematology and oncology patients is not yet standardised. This review aimed to critically appraise and analyse the clinical practice guidelines (CPGs) that are available for paediatric IFD. METHODS: Electronic searches of MEDLINE, MEDLINE in-Process & Other non-Indexed Citations, the Guidelines International Network (GIN), and Google were performed and combined fungal disease (Fung* OR antifung*OR Candida* OR Aspergill*) with prophylaxis or treatment (prophyl* OR therap* OR treatment)...
September 11, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
A Montero, F Gilsanz, E Maseda
Invasive fungal disease is associated to a high mortality rate on critical ill patients. In the last decades an important epidemiological shift has been described. Early diagnosis and treatment are related with a better prognosis. The key factors lie in a set of predictive scores that allow to identify patients that will benefit of early treatment, as well as using diagnosis techniques that are culture independent. New diagnosis approximations are being developed with promising results: in situ hybridisation using PNA-FISH probes, MALDI-TOF MS and rapid nucleic acids detection assays...
September 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Alexandre Mery, Boualem Sendid, Nadine François, Marjorie Cornu, Julien Poissy, Yann Guerardel, Daniel Poulain
BACKGROUND: We recently developed a mass spectrometry (MS) procedure based on the detection of a serum disaccharide (MS-DS) in patients with invasive candidiasis (IC). Here, we compare the performance of MS-DS for the diagnosis of IC, invasive aspergillosis (IA) and mucormycosis (MM) with commercially available antigen detection tests. METHODS: This retrospective study included 48 patients (23 IC/74 sera, 15 IA/40 sera and 10 MM/15 sera) and 49 appropriate controls (102 sera)...
September 7, 2016: Journal of Clinical Microbiology
E Geoffrey Playford, Jeffrey Lipman, Michael Jones, Anna F Lau, Masrura Kabir, Sharon C-A Chen, Deborah J Marriott, Ian Seppelt, Thomas Gottlieb, Winston Cheung, Jonathan R Iredell, Emma S McBryde, Tania C Sorrell
BACKGROUND:  Delayed antifungal therapy for invasive candidiasis (IC) contributes to poor outcomes. Predictive risk models may allow targeted antifungal prophylaxis to those at greatest risk. METHODS:  A prospective cohort study of 6685 consecutive nonneutropenic patients admitted to 7 Australian intensive care units (ICUs) for ≥72 hours was performed. Clinical risk factors for IC occurring prior to and following ICU admission, colonization with Candida species on surveillance cultures from 3 sites assessed twice weekly, and the occurrence of IC ≥72 hours following ICU admission or ≤72 hours following ICU discharge were measured...
September 6, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Szu-Yun Fang, Kai-Che Wei, Wen-Chieh Chen, Shin-Jung Lee, Kuo-Chung Yang, Chieh-Shan Wu, Pei-Lun Sun
Superficial candida infections of the skin are common, but deep cutaneous candidiasis, including secondary dissemination to the skin from systemic candidiasis, candidaemia or primary invasion due to skin defects such as trauma, is rare. These patients are usually immunosuppressed, but immunocompetent hosts can be affected as well. Candida albicans is the most common pathogen. However, non-albicans Candida species can cause deep skin invasion in rare circumstances. We report a case of deep cutaneous candidiasis caused by Candida duobushaemulonii in a 68-year-old man...
September 7, 2016: Mycoses
Steven Gabardi, Spencer Martin, Mihir Sura, Anisa Mohammed, Yoav Golan
PURPOSE: In high-risk patients, candiduria may be associated with the development of urinary tract infections (UTI) and invasive candidiasis. The triazole antifungals achieve good urine concentrations, but their use is limited by the emergence of non-albicans Candida spp. with low-triazole susceptibility. The echinocandins remain fungicidal against many azole-resistant Candida spp., but low urine concentrations limit their use. We examined the rates of candiduria elimination in micafungin-treated patients...
November 2016: International Urology and Nephrology
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