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https://www.readbyqxmd.com/read/28809155/microbe-profile-candida-albicans-a-shape-changing-opportunistic-pathogenic-fungus-of-humans
#1
Neil A R Gow, Bhawna Yadav
(a) Morphotypes of Candida albicans (blue sector, vegetative forms; pink sector, forms related to mating or changes in ploidy). Cell types shown include: budding yeast cells; elongated conjoined yeasts forming pseudohyphae; parallel-sided hyphae; chlamydospores formed from suspensor cells; enlarged goliath cells formed under zinc deprivation (unpublished study, image from Duncan Wilson); intestinal gut form cells (image from Suzanne Noble); mating competence defined by white-grey-opaque cell transitions (images from Guanghua Huang); elongated chemotactic shmoo-mating projections leading to tetraploid zygote formation (images from David Soll and Karla Daniels); trimera formed by unequal chromosome segregation under antifungal exposure (image from Judith Berman)...
August 15, 2017: Microbiology
https://www.readbyqxmd.com/read/28797491/candidemia-in-the-intensive-care-unit
#2
REVIEW
Oleg Epelbaum, Rachel Chasan
Candidemia presents several challenges to the intensive care unit (ICU) community. Recognition and treatment of this infection is frequently delayed, with dramatic clinical deterioration and death often preceding the detection of Candida in blood cultures. Identification of individual patients at the highest risk for developing candidemia remains an imperfect science; the role of antifungal therapy before culture diagnosis is yet to be fully defined in the ICU. The absence of well-established molecular techniques for early detection of candidemia hinders efforts to reduce the heavy clinical and economic impact of this infection...
September 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28797484/overview-of-treatment-approaches-for-fungal-infections
#3
REVIEW
Eva M Carmona, Andrew H Limper
Invasive fungal diseases cause high morbidity and mortality in an immunocompromised host. Antifungals are the drugs of choice and can be divided into 4 main groups: polyenes, azoles, echinocandins, and pyrimidine analogues. Each class has its specific mechanism of action, spectrum of activity, and pharmacokinetic and side effects. It is important to understand the precise use of the established and new antifungal agents to successfully manage these complex infections in an already tenuous and frail host. This article discusses the main characteristics, clinical uses, and secondary effects of the main antifungals used in clinical practice...
September 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28782390/treatment-of-pneumocystis-jirovecii-pneumonia-in-hiv-infected-patients-a-review
#4
Yu-Shan Huang, Jen-Jia Yang, Nan-Yao Lee, Guan-Jhou Chen, Wen-Chien Ko, Hsin-Yun Sun, Chien-Ching Hung
Pneumocystis pneumonia is a potentially life-threatening pulmonary infection that occurs in immunocompromised individuals and HIV-infected patients with a low CD4 cell count. Trimethoprim-sulfamethoxazole has been used as the first-line agent for treatment, but mutations within dihydropteroate synthase gene render potential resistance to sulfamide. Despite advances of combination antiretroviral therapy (cART), Pneumocystis pneumonia continues to occur in HIV-infected patients with late presentation for cART or virological and immunological failure after receiving cART...
August 5, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28774702/candida-and-invasive-mould-diseases-in-non-neutropenic-critically-ill-patients-and-patients-with-haematological-cancer
#5
REVIEW
A L Colombo, J N de Almeida Júnior, Monica A Slavin, Sharon C-A Chen, Tania C Sorrell
Critically ill patients and patients with haematological cancer are HIV-negative populations at high risk of invasive fungal infections. In intensive-care units, candidaemia and intra-abdominal candidiasis predominate, but aspergillosis has emerged as a lethal, under-recognised cause of pneumonia. In patients with haematological malignancies or who have undergone stem-cell transplantations, pulmonary disease due to aspergillus and other mould diseases predominate. In this Series paper, we provide an update on risk assessment, new diagnostic strategies, and therapeutic approaches...
July 31, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28774698/the-global-problem-of-antifungal-resistance-prevalence-mechanisms-and-management
#6
REVIEW
David S Perlin, Riina Rautemaa-Richardson, Ana Alastruey-Izquierdo
All serious fungal infections need appropriate antifungal therapy for successful patient outcome. Only a few classes of antifungal drugs are available, so the emergence of resistance to single drug classes and now multidrug resistance greatly hampers patient management. Azole resistance among Candida and Aspergillus species is one of the greatest challenges to clinical success, followed by echinocandin and multidrug resistance among some Candida species, especially Candida glabrata. The spread of agriculturally derived azole-resistant Aspergillus fumigatus and emerging threats such as multidrug resistant Candida auris are also alarming...
July 31, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28758337/changes-in-the-distribution-of-colonising-and-infecting-candida-spp-isolates-antifungal-drug-consumption-and-susceptibility-in-a-french-intensive-care-unit-a-10-year-study
#7
Milène Sasso, Claire Roger, Magali Sasso, Hélène Poujol, Saber Barbar, Jean-Yves Lefrant, Laurence Lachaud
Monitoring fungal ecology and resistance to antifungal agents within intensive care units (ICU) is essential for the management of invasive fungal infections. Therefore, a retrospective descriptive study was carried in the ICU of Nimes University Hospital, France, from 2007 to 2016. As the majority of invasive fungal infections in ICU are caused by Candida species, the study objectives were to describe Candida species distribution, to assess candidaemia incidence and to monitor the antifungal drug susceptibility of Candida isolates and the consumption of antifungal agents...
July 31, 2017: Mycoses
https://www.readbyqxmd.com/read/28756598/risk-factors-and-predictors-of-mortality-of-candidaemia-among-critically-ill-patients-role-of-antifungal-prophylaxis-in-its-development-and-in-selection-of-non-albicans-species
#8
Matthaios Papadimitriou-Olivgeris, Anastasia Spiliopoulou, Fotini Fligou, Iris Spiliopoulou, Lora Tanaseskou, Georgios Karpetas, Markos Marangos, Evangelos D Anastassiou, Myrto Christofidou
PURPOSE: The aim of the present study is to identify risk factors for development and predictors of mortality of candidaemia among critically ill patients. METHODS: A 1:7 case-control study was conducted during a 4-year period (2012-2015) in a Greek Intensive Care Unit (ICU). Candidaemia was confirmed by positive blood cultures. All yeasts were identified using API 20C AUX System or Vitek 2 Advanced Expert System. Epidemiologic data were collected from the ICU computerized database and patients' chart reviews...
July 29, 2017: Infection
https://www.readbyqxmd.com/read/28744860/echinocandins-in-antifungal-pharmacotherapy
#9
REVIEW
Akash Patil, Soumyajit Majumdar
OBJECTIVES: Echinocandins are the newest addition of the last decade to the antifungal armamentarium, which, owing to their unique mechanism of action, selectively target the fungal cells without affecting mammalian cells. Since the time of their introduction, they have come to occupy an important niche in the antifungal pharmacotherapy, due to their efficacy, safety, tolerability and favourable pharmacokinetic profiles. This review deals with the varying facets of echinocandins such as their chemistry, in-vitro and in-vivo evaluations, clinical utility and indications, pharmacokinetic and pharmacodynamic profiles, and pharmacoeconomic considerations...
July 26, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28739797/unraveling-drug-penetration-of-echinocandin-antifungals-at-the-site-of-infection-in-an-intra-abdominal-abscess-model
#10
Yanan Zhao, Brendan Prideaux, Yoji Nagasaki, Min Hee Lee, Pei-Yu Chen, Landry Blanc, Hsinpin Ho, Cornelius J Clancy, Minh Hong Nguyen, Véronique Dartois, David S Perlin
Intra-abdominal candidiasis (IAC) is a prominent invasive fungal infection associated with high mortality. Prompt antifungal therapy and source control are crucial for successful treatment. Echinocandin antifungal drugs are first-line agents. Yet, their clinical effectiveness is highly variable with known potential for breakthrough resistance, and little is known about drug exposure at the site of infection. Using matrix-assisted desorption/ionization mass spectrometry imaging technology, we investigated the spatial and quantitative distribution in tissue lesions for two echinocandin drugs, micafungin and CD101, in a clinically relevant IAC mouse model...
July 24, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28731650/efficacy-and-safety-of-caspofungin-in-children-systematic-review-and-meta-analysis
#11
María T Rosanova, David Bes, Pedro Serrano Aguilar, Leticia Cuellar Pompa, Norma Sberna, Roberto Lede
INTRODUCTION: Invasive fungal infections are a significant cause of morbidity and mortality in children. Caspofungin is an echinocandin used as an alternative treatment in the prevention and/or treatment of certain invasive fungal infections in children, although compared to the standard treatment there is little evidence on its efficacy and safety. OBJETIVES: To evaluate the efficacy and safety of caspofungin compared with other antifungal drugs for the prevention and/or treatment of invasive fungal infections in children...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28705674/molecular-bases-of-antifungal-resistance-in-filamentous-fungi
#12
Cheshta Sharma, Anuradha Chowdhary
Invasive mould infections due to Aspergillus species, Fusarium spp., Scedosporium spp. and other filamentous fungi remain a significant cause of morbidity and mortality in immunocompromised patients. Antifungal therapy is required for successful patient management; however, limited antifungal drugs and emergence of drug resistance pose a challenge to the clinicians for the effective management of the disease. The evolution of multidrug resistant strains due to selective pressure and the intrinsically resistant pathogenic species are a major concern...
July 10, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28702763/pharmacokinetics-of-antifungal-drugs-practical-implications-for-optimized-treatment-of-patients
#13
REVIEW
Romuald Bellmann, Piotr Smuszkiewicz
INTRODUCTION: Because of the high mortality of invasive fungal infections (IFIs), appropriate exposure to antifungals appears to be crucial for therapeutic efficacy and safety. MATERIALS AND METHODS: This review summarises published pharmacokinetic data on systemically administered antifungals focusing on co-morbidities, target-site penetration, and combination antifungal therapy. CONCLUSIONS AND DISCUSSION: Amphotericin B is eliminated unchanged via urine and faeces...
July 12, 2017: Infection
https://www.readbyqxmd.com/read/28699797/candidemia-and-invasive-candidiasis-among-hospitalized-neonates-and-pediatric-patients
#14
Rachel Harrington, Sylvia L Kindermann, Qingjiang Hou, Robert J Taylor, Nkechi Azie, David L Horn
OBJECTIVE: To investigate the epidemiology, treatment, length of stay (LOS) and costs for neonatal and pediatric inpatients with invasive candidiasis (IC). METHODS: The Cerner Health Facts Database was used to assess inpatients (2005-2014) identified by positive blood or cerebrospinal fluid (CSF) Candida cultures. Log-transformed LOS and cost were examined in candidemia-only patients (n= 191) using multivariable linear regression. RESULTS: 202 patients had a positive culture (blood: n = 192; CSF: n = 10; both: n = 2)...
July 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28696236/combination-therapy-with-isavuconazole-and-micafungin-for-treatment-of-experimental-invasive-pulmonary-aspergillosis
#15
Vidmantas Petraitis, Ruta Petraitiene, Matthew W McCarthy, Laura L Kovanda, Myo H Zaw, Kaiser Hussain, Naima Shaikh, Bo Bo W Maung, Navjot K Sekhon, William W Hope, Thomas J Walsh
Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity and mortality in immunocompromised patients. We hypothesized that simultaneous inhibition of biosynthesis of ergosterol in the fungal cell membrane and (1→3)-β-D-glucan in the cell wall, respectively, by the antifungal triazole isavuconazole and the echinocandin micafungin, may result in improved outcome in experimental IPA in persistently neutropenic rabbits. Treatment groups included isavuconazole (ISA) at 20 (ISA20), 40 (ISA40), and 60 (ISA60) mg/kg/day, micafungin at 2 mg/kg/day (MFG2), or combinations of (ISA20+MFG2), (ISA40+MFG2), (ISA60+MFG2), and untreated rabbits (UC)...
July 10, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28693479/pharmacoeconomic-analysis-of-antifungal-therapy-for-primary-treatment-of-invasive-candidiasis-caused-by-candida-albicans-and-non-albicans-candida-species
#16
Huang-Tz Ou, Tsung-Ying Lee, Yee-Chun Chen, Claudie Charbonneau
BACKGROUND: Cost-effectiveness studies of echinocandins for the treatment of invasive candidiasis, including candidemia, are rare in Asia. No study has determined whether echinocandins are cost-effective for both Candida albicans and non-albicans Candida species. There have been no economic evaluations that compare non-echinocandins with the three available echinocandins. This study was aimed to assess the cost-effectiveness of individual echinocandins, namely caspofungin, micafungin, and anidulafungin, versus non-echinocandins for C...
July 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28689871/cd101-a-long-acting-echinocandin-and-comparator-antifungal-agents-tested-against-a-global-collection-of-invasive-fungal-isolates-in-the-sentry-2015-antifungal-surveillance-program
#17
Michael A Pfaller, Shawn A Messer, Paul R Rhomberg, Mariana Castanheira
CD101 is a novel echinocandin with exceptional chemical stability and long-acting pharmacokinetics. The activity of CD101 and comparators was evaluated using CLSI broth microdilution methods against 713 invasive fungal isolates, including 589 Candida spp. (6 species), 14 C. neoformans, 97 A. fumigatus and 13 A. flavus species complex collected worldwide during 2015. All C. tropicalis, C. krusei and C. dubliniensis, 99.7% of C. albicans and 98.3% of C. glabrata were inhibited by ≤0.12 µg/mL of CD101, and these isolates were susceptible/wild type to other echinocandins using CLSI clinical breakpoint and epidemiological cutoff value (ECV) interpretive criteria...
July 6, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28686553/candidaemia-in-a-tertiary-care-academic-hospital-in-italy-the-impact-of-c-parapsilosis-complex-on-the-species-distribution-and-antifungal-susceptibility
#18
Maria Cristina Ghezzi, Grazia Brunetti, Valeria Visconti, Alessandra Giordano, Giammarco Raponi
PURPOSE: To analyse the species distribution and the susceptibility profiles to the major antifungal agents of Candida isolated from bloodstream infections (BSIs) in both intensive care units (ICUs) and non-ICU wards in a tertiary care hospital in Italy from 2010 until 2015. METHODOLOGY: Episodes of Candida BSI were recorded in a retrospective observational cohort study. Yeasts were isolated from both blood and intravascuIar devices (IVDs) and their susceptibility to antifungal drugs was tested using the microdilution method...
July 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28681815/identification-of-the-paradoxical-effect-of-caspofungin-and-micafungin-on-candida-albicans-growth-in-vitro-using-a-growth-curve-methodology
#19
Huang Zhouying, Li Chen, Wang Ruiqi, Liao Kang, Zeng Ji
BACKGROUND: The paradoxical effect of fungi, (which is a special phenomenon that certain Candida spp. might exhibit augmented growth in the presence of echinocandin at some concentration higher than the minimum inhibitory concentration) would be better illustrated through growth curves. MATERIALS AND METHODS: We investigated the paradoxical effect of caspofungin and micafungin on the growth and cell viability of 38 clinical isolates of Candida albicans using a microbial sensitivity test and growth curve methodology...
April 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28681316/donor-derived-candida-stellimalicola-in-a-clinical-specimen-preservation-fluid-contamination-during-pancreas-procurement
#20
Damien Dupont, Antoine Huguenin, Elodie Tisserand, Véronique Reiter, Emmanuel Morelon, Lionel Badet, Isabelle Villena, Martine Wallon, Dominique Toubas
We report here a case of possible donor-derived Candida stellimalicola infection after pancreas transplantation. Candida stellimalicola, an environmental non-filamentous yeast, was isolated from both the peritoneal fluid of the graft donor and the preservation fluid of the transplanted pancreas. Interestingly, this strain exhibited high minimum inhibitory concentrations to azoles. These results justified the use of echinocandins as therapy instead of fluconazole. This switch permitted a favorable outcome. To our knowledge, this is the first report of C...
July 5, 2017: Mycopathologia
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