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https://www.readbyqxmd.com/read/29325218/equal-candida-score-an-ecmm-score-derived-from-current-guidelines-to-measure-quality-of-clinical-candidemia-management
#1
Sibylle C Mellinghoff, Martin Hoenigl, Philipp Koehler, Anil Kumar, Katrien Lagrou, Cornelia Lass-Flörl, Jacques F Meis, Vidya Menon, Riina Rautemaa-Richardson, Oliver A Cornely
Candida species frequently cause blood stream infections and are reported to be the third to tenth most commonly isolated pathogens. Guidelines and standardized treatment algorithms provided by professional organisations aim to facilitate decision-making regarding diagnosis, management, and treatment of candidemia. In routine clinical practise, however, it may be challenging to comply with these guidelines. The reasons include lack of familiarity or feasibility to adherence, but also their length and complexity...
January 11, 2018: Mycoses
https://www.readbyqxmd.com/read/29325167/a-multicentre-study-of-antifungal-susceptibility-patterns-among-350-candida-auris-isolates-2009-17-in-india-role-of-the-erg11-and-fks1-genes-in-azole-and-echinocandin-resistance
#2
Anuradha Chowdhary, Anupam Prakash, Cheshta Sharma, Milena Kordalewska, Anil Kumar, Smita Sarma, Bansidhar Tarai, Ashutosh Singh, Gargi Upadhyaya, Shalini Upadhyay, Priyanka Yadav, Pradeep K Singh, Vikas Khillan, Neelam Sachdeva, David S Perlin, Jacques F Meis
Background: Candida auris has emerged globally as an MDR nosocomial pathogen in ICU patients. Objectives: We studied the antifungal susceptibility of C. auris isolates (n = 350) from 10 hospitals in India collected over a period of 8 years. To investigate azole resistance, ERG11 gene sequencing and expression profiling was conducted. In addition, echinocandin resistance linked to mutations in the C. auris FKS1 gene was analysed. Methods: CLSI antifungal susceptibility testing of six azoles, amphotericin B, three echinocandins, terbinafine, 5-flucytosine and nystatin was conducted...
January 9, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29311085/the-rim-pathway-mediates-antifungal-tolerance-in-candida-albicans-through-newly-identified-rim101-transcriptional-targets-including-hsp90-and-ipt1
#3
Cécile Garnaud, Encar García-Oliver, Yan Wang, Danièle Maubon, Sébastien Bailly, Quentin Despinasse, Morgane Champleboux, Jérôme Govin, Muriel Cornet
Invasive candidiasis (IC) is a major cause of morbidity and mortality despite antifungal treatment. Azoles and echinocandins are used as first-line therapies in IC. However, their efficacy is limited by yeast tolerance and the emergence of acquired resistance. Tolerance is a reversible stage due to the yeast's capacity to counter the antifungal drug exposure, leading to persistent growth. In C. albicans, multiple stress signaling pathways have been shown to contribute to this adaptation. Among those, the Rim pH-responsive pathway, through its transcription factor Rim101p, was shown to mediate azole and echinocandin tolerance...
January 8, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29311082/deletion-of-ada2-increases-antifungal-drug-susceptibility-and-virulence-in-candida-glabrata
#4
Shang-Jie Yu, Ya-Lin Chang, Ying-Lien Chen
Candida glabrata, the second most frequent cause of candidiasis after Candida albicans, is an emerging human fungal pathogen that is intrinsically drug tolerant. Currently, studies of C. glabrata genes involved in drug tolerance are limited. Ada2, a component serving as a transcription adaptor of the Spt-Ada-Gcn5 acetyltransferase (SAGA) complex, is required for antifungal drug tolerance and virulence in C. albicans However, its roles in C. glabrata remain elusive. In this study, we found that ada2 mutants demonstrated severe growth defects at 40°C but only mild defects at 37°C or 25°C...
January 8, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29311063/mutant-prevention-concentration-and-mutant-selection-window-of-micafungin-and-anidulafungin-in-clinical-candida-glabrata-isolates
#5
María Ángeles Bordallo-Cardona, Laura Judith Marcos-Zambrano, Carlos Sánchez-Carrillo, Elia Gómez G de la Pedrosa, Rafael Cantón, Emilio Bouza, Pilar Escribano, Jesús Guinea
Background: We report the mutant prevention concentration (MPC) and mutant selection window (MSW) for micafungin and anidulafungin administered to treat Candida glabrata We also determine the mutation frequency.Methods: We studied 20 echinocandin-susceptible, fluconazole-intermediate, and FKS wild-type C. glabrata isolates. Adjusted inocula were stroked directly onto Sabouraud agar plates containing different concentrations of micafungin or anidulafungin and visually inspected daily for up to 5 days of incubation...
January 8, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29304214/biofilms-and-beyond-expanding-echinocandin-utility
#6
Emily L Larkin, Sharvari Dharmaiah, Mahmoud A Ghannoum
Echinocandins have been in use for over 15 years, starting with the first approval in 2001. Current trends, such as increasing resistance to fluconazole and shifts toward non-albicans spp. of Candida, suggest a growing role for echinocandins, as reflected by recent (2016) updates to guidelines that recommend echinocandins as first-line treatment for candidaemia. The efficacy, tolerability, and safety of echinocandins and their target site of action (1,3-β-d-glucan synthesis) have prompted research into potential new uses, such as for treatment of biofilm infections, MDR Candida auris and dermatophytes...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29304213/echinocandin-prophylaxis-in-patients-undergoing-haematopoietic-cell-transplantation-and-other-treatments-for-haematological-malignancies
#7
David J Epstein, Susan K Seo, Janice M Brown, Genovefa A Papanicolaou
Antifungal prophylaxis is the standard of care for patients undergoing intensive chemotherapy for haematological malignancy or haematopoietic cell transplantation (HCT). Prophylaxis with azoles reduces invasive fungal infections and may reduce mortality. However, breakthrough infections still occur, and the use of azoles is sometimes complicated by pharmacokinetic variability, drug interactions, adverse events and other issues. Echinocandins are highly active against Candida species, including some organisms resistant to azoles, and have some clinical activity against Aspergillus species as well...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29304212/use-of-echinocandin-prophylaxis-in-solid-organ-transplantation
#8
Maddalena Giannella, Shahid Husain, Faouzi Saliba, Pierluigi Viale
Invasive fungal infections (IFIs) are a major threat to patients undergoing solid organ transplantation (SOT). Owing to improvements in surgical techniques, immunosuppression therapy and antifungal prophylaxis, the incidence of IFIs has been decreasing in recent years. However, IFI-associated morbidity and mortality remain significant. Invasive candidiasis (IC) and aspergillosis (IA) are the main IFIs after SOT. Risk factors for IC and IA continue to evolve, and thus strategies for their prevention should be constantly updated and targeted to both individual patient risk factors and local epidemiology...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29304211/we-can-do-better-a-fresh-look-at-echinocandin-dosing
#9
Justin C Bader, Sujata M Bhavnani, David R Andes, Paul G Ambrose
First-line antifungal therapies are limited to azoles, polyenes and echinocandins, the former two of which are associated with high occurrences of severe treatment-emergent adverse events or frequent drug interactions. Among antifungals, echinocandins present a unique value proposition given their lower rates of toxic events as compared with azoles and polyenes. However, with the emergence of echinocandin-resistant Candida species and the fact that a pharmacometric approach to the development of anti-infective agents was not a mainstream practice at the time these agents were developed, we question whether echinocandins are being dosed optimally...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29304208/what-has-changed-in-the-treatment-of-invasive-candidiasis-a-look-at-the-past-10-years-and-ahead
#10
Matteo Bassetti, Elda Righi, Philippe Montravers, Oliver A Cornely
The treatment of invasive candidiasis has changed greatly in the past decade and must continue to evolve if we are to improve outcomes in this serious infection. A review of recent history may provide insights for the future. The morbidity and mortality of invasive candidiasis remain difficult to measure despite an obvious clinical burden. Current treatment guidelines now recommend echinocandins as first-line empirical treatment, with fluconazole as an acceptable alternative for selected patients, reflecting the efficacy demonstrated by echinocandins and increasing resistance observed with fluconazole...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29304207/changes-in-the-epidemiological-landscape-of-invasive-candidiasis
#11
Frederic Lamoth, Shawn R Lockhart, Elizabeth L Berkow, Thierry Calandra
The epidemiology of invasive candidiasis has evolved in recent years, warranting a review of the changes and the implications for current and future diagnosis and treatment. The overall burden of invasive candidiasis remains high, particularly in the expanding populations of patients at risk of opportunistic infection, such as the elderly or immunosuppressed. Progressive shifts from Candida albicans to non-albicans Candida spp. have been observed globally. The recent emergence of novel, multiresistant species, such as Candida auris, amplifies the call for vigilance in detection and advances in treatment...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29304206/an-introduction-to-the-future-of-echinocandin-therapy
#12
Matteo Bassetti
No abstract text is available yet for this article.
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29303621/cost-effectiveness-of-de-escalation-from-micafungin-versus-escalation-from-fluconazole-for-invasive-candidiasis-in-china
#13
Dechang Chen, Xianyao Wan, Eliza Kruger, Can Chen, Xiaomeng Yue, Liang Wang, Jiuhong Wu
AIMS: Guidelines on treating invasive candidiasis recommend initial treatment with a broad-spectrum echinocandin (e.g., micafungin); then switching to fluconazole if isolates prove sensitive (de-escalation strategy). This study aimed to evaluate the cost-effectiveness of de-escalation from micafungin versus escalation from fluconazole from a Chinese public payers perspective. MATERIALS AND METHODS: Cost-effectiveness was estimated using a decision analytic model, in which patients begin treatment with fluconazole 400 mg/day (escalation) or micafungin 100 mg/day (de-escalation)...
January 5, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29251506/scanning-quadrupole-data-independent-acquisition-part-b-application-to-the-analysis-of-the-calcineurin-interacting-proteins-during-treatment-of-aspergillus-fumigatus-with-azole-and-echinocandin-antifungal-drugs
#14
Praveen R Juvvadi, M Arthur Moseley, Christopher J Hughes, Erik J Soderblom, Sarah Lennon, Simon R Perkins, J Will Thompson, Scott J Geromanos, Jason Wildgoose, Keith Richardson, James I Langridge, Johannes P C Vissers, William J Steinbach
Calcineurin is a critical cell-signaling protein that orchestrates growth, stress response, virulence, and antifungal drug resistance in several fungal pathogens. Blocking calcineurin signaling increases the efficacy of several currently available antifungals and suppresses drug resistance. We demonstrate the application of a novel scanning quadrupole DIA method for the analysis of changes in the proteins coimmunoprecipitated with calcineurin during therapeutic antifungal drug treatments of the deadly human fungal pathogen Aspergillus fumigatus...
December 29, 2017: Journal of Proteome Research
https://www.readbyqxmd.com/read/29241891/cost-effectiveness-of-candida-polymerase-chain-reaction-detection-and-empirical-antifungal-treatment-among-patients-with-suspected-fungal-peritonitis-in-the-intensive-care-unit
#15
Arnaud Pagès, Xavier Iriart, Laurent Molinier, Bernard Georges, Antoine Berry, Patrice Massip, Blandine Juillard-Condat
BACKGROUND: Mortality from intra-abdominal candidiasis in intensive care units (ICUs) is high. It takes many days for peritoneal-fluid fungal culture to become positive, and the recommended empirical antifungal therapy involves excessive costs. Polymerase chain reaction (PCR) should produce results more rapidly than fungal culture. OBJECTIVES: To perform a cost-effectiveness analysis of the combination of several diagnostic and therapeutic strategies to manage Candida peritonitis in non-neutropenic adult patients in ICUs...
December 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29229638/sequencing-of-fks-hot-spot1-from-saprochaete-capitata-searching-for-a-relationship-with-reduced-echinocandin-susceptibility
#16
Inés Arrieta-Aguirre, Pilar Menéndez-Manjón, María Soledad Cuétara, Iñigo Fernández de Larrinoa, Juan Carlos García-Ruiz, María Dolores Moragues
Saprochaete capitata, formerly known as Geotrichum capitatum, is an emerging fungal pathogen with low susceptibility to echinocandins. Here, we report the nucleotide sequence of the S. capitata Hot Spot 1 region of the FKS gene (FKS HS1) which codifies for the catalytic subunit of β-1,3-D-glucan synthase, the target of echinocandins. For that purpose, we firstly designed degenerated oligonucleotide primers derived from conserved flanking regions of the FKS1 HS1 segment of 12 different fungal species. Interestingly, the analysis of the translated FKS HS1 sequences of 12 isolates of S...
December 11, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29228268/low-and-constant-micafungin-concentrations-may-be-sufficient-to-lead-to-resistance-mutations-in-fks2-gene-of-candida-glabrata
#17
María Ángeles Bordallo-Cardona, Pilar Escribano, Laura Judith Marcos-Zambrano, Judith Díaz-García, Elia Gómez de la Pedrosa, Rafael Cantón, Emilio Bouza, Jesús Guinea
We studied the ability of five echinocandin-susceptible C. glabrata isolates to acquire in vitro resistance to anidulafungin and micafungin. All isolates became phenotypically resistant after 2-4 days of exposure to low and constant micafungin concentrations (P < .05). Mutations in the HS1 region of the FKS2 gene were found in all isolates. The acquisition of resistance was not related to the previous use of antifungal treatment in the patients or the presence of mutations at MSH2 gene. We found differences (P < ...
December 8, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29223551/recent-advances-in-delivery-of-antifungal-agents-for-therapeutic-management-of-candidiasis
#18
REVIEW
Bhakti Sawant, Tabassum Khan
Candidiasis is a fungal infection caused by yeasts that belong to the genus Candida. There are over twenty species of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans. Candida yeasts normally reside in the intestinal tract and can be found on mucous membranes and skin without causing infection; however, overgrowth of these organisms can cause symptoms to develop. Presence of other diseases that compromises the patient's immunity makes it more difficult to treat...
December 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29222034/management-of-invasive-candidiasis-and-candidemia-in-critically-ill-adults-expert-opinion-of-the-european-society-of-anaesthesia-esa-intensive-care-scientific-subcommittee
#19
REVIEW
Ruth-Aoibheann OLeary, Sharon Einav, Marc Leone, Krisztina Madách, Claude Martin, Ignacio Martin-Loeches
OBJECTIVE: The global burden of invasive fungal disease is increasing. Candida albicans remains the leading cause of fungal blood stream infections although non-albicans Candidal infections are emerging. Areas of controversy regarding diagnosis and management are hampering our ability to respond effectively to this evolving threat. The purpose of this narrative review is to address current controversies and provide recommendations to supplement guidelines. DIAGNOSIS OF INVASIVE CANDIDIASIS: Diagnosis of invasive candidiasis requires a combination of diagnostic tests and patient risk factors...
December 5, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29212705/update-from-a-twelve-year-nationwide-fungaemia-surveillance-increasing-intrinsic-and-acquired-resistance-causes-concern
#20
K M T Astvad, H K Johansen, B L Røder, F S Rosenvinge, J D Knudsen, L Lemming, H C Schønheyder, R K Hare, L Kristensen, L Nielsen, J B Gertsen, E Dzajic, M Pedersen, C Østergård, B Olesen, T S Søndergaard, M C Arendrup
New data from the Danish National Fungaemia Surveillance 2012-15 is reported and epidemiological trends are investigated in a 12-year perspective (2004-15). During 2012-15, 1900 out of 1939 (98%) fungal bloodstream isolates were included. The average incidence was 8.4/100,000 inhabitants and this appears to be stabilizing after the increase to 10.1/100,000 in 2011. The incidence was higher in males than females (10.0 vs 6.8) and in patients above 50 years, mainly driven by an increasing incidence among 80-89 years old males (65...
December 6, 2017: Journal of Clinical Microbiology
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