Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CANDIDA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 577 records · Page 32Linked to original sources
PubMed1996

Antifungal antibiotic benanomicin A increases susceptibility of Candida albicans to phagocytosis by murine macrophages.

Benanomicin A is an antifungal antibiotic produced by Actinomadura spadix. In the present study, we investigated the effect of benanomicin A on the phagocytosis of Candida albicans by murine peritoneal macrophages and on the cell-surface hydrophobicity (CSH) of C. albicans. Although pretreatment of macrophages with benanomicin A had no effect on the phagocytosis, addition of benanomicin A to the culture of macrophages and Candida cells increased the susceptibility of Candida cells to the phagocytosis by the macrophages. Pretreatment of Candida cells with benanomicin A also increased the susceptibility of Candida cells to the phagocytosis. When Candida cells were mixed with benanomicin A, the antibiotic bound irreversibly to Candida cells. These data suggest the possibility that the increased susceptibility of Candida cells to the phagocytosis is mediated by the binding of benanomicin A to Candida cells. Examination of physicochemical property of Candida cell surface showed that the CSH of Candida cells significantly decreased by the treatment with benanomicin A. Thus, binding of benanomicin A to Candida cells may induce biochemical/physicochemical alternation of the surfaces, so that they become more susceptible to phagocytosis by murine macrophages. These properties of benanomicin A, along with its antifungal activity, seem to be beneficial in the treatment of fungal infections.

Animals↗
PubMed1999

Factors influencing adherence of Candida spp. to host tissues and plastic surfaces.

Attachment of Candida spp. to host tissues and plastic surfaces is the first and a crucial step that initiates colonization by yeast cells and subsequent development of disseminated fungal infection. These infections are associated with high degree of morbidity, mortality and extra cost. Modern trends have focused not only on how best to treat but also on how to prevent Candida infections. To achieve this goal, the factors that influence the adherence of Candida spp. to biological and non biological surfaces have been studied. C. albicans adheres at a degree higher than that of the other Candida spp. and C. tropicalis adheres to a lesser extent. This may reflect the higher pathogenicity of C. albicans compared to the other Candida spp. Germinated C. albicans cells adhere to host tissue more readily than do yeast-phase. Sugars play an important role in the adherence of Candida spp. Overall, galactose was found to promote the adherence of Candida spp. to host tissues and plastic surfaces more than any other mono or disaccharide. Amino sugars on the other hand inhibit the adherence of the yeast cells. Divalent ions such as Ca2+ and Mg2+ promote the adherence of Candida spp. more than monovalent ions. Candida spp. express on their surface receptors, which interact with a wide variety of host proteins including fibrinogen, fibronectin, lamanin, and type I and IV collagen thus binding Candida spp. To glycoproteinaceous conditioning film at the blood-polymer interface. Coaggregation of Candida spp. with other bacteria promotes colonization of yeast cells to oral biofilm, host tissues, and to surfaces of the indwelling vascular catheters. These factors form the basis for the interference with the adherence of Candida spp.

Bacterial Adhesion↗
PubMed1994

[Utilization of enzymatic activity in strains of Candida isolated from the vagina for typing and evaluation of pathogenicity].

The study involved 255 strains of Candida isolated from vaginal secretions (194 with symptomatic mycosis and 61 from asymptomatic cases). Most frequently isolated species were Candida albicans, Candida krusei and Candida tropicalis. Determination of lipolytic properties at 30 degrees C and 37 degrees C and proteolytic abilities against albumin and casein permitted for differentiation of strains belonging to Candida albicans and remaining strains of other Candida species. This resulted also in determination of biotypes. Strains of Candida albicans belonged mainly to biotype I, while strains of Candida krusei and Candida tropicalis to biotype IX. Worth attention are results regarding symptomic candidiasis of vagina and enzymatic properties of Candida albicans. Among 145 strains of Candida albicans isolated from cases of symptomatic vaginal mycosis 67 (46.2%) exhibited both lipolytic (at 30 degrees C and 37 degrees C) and proteolytic activities against albumin and casein. At the same time, in asymptomatic mycosis only 14 (33.3%) strains of Candida albicans exhibited same properties.

Candida↗
PubMed1999

Adhesion of oral Candida species to human buccal epithelial cells following brief exposure to nystatin.

Opportunistic oral infections caused by Candida albicans and non-albicans Candida species are particularly common in compromised patients. Nystatin, which belongs to the polyene group of antimycotics, is frequently used as a topical agent in the treatment of oro-pharyngeal candidosis. It is recognized that due to the delivery mode of nystatin (i.e. topical, intermittent), as well as the cleansing effect of saliva within the oral environment, the yeasts undergo a relatively brief exposure to this drug during treatment. Nevertheless, there is a sparsity of data on the effect of such brief exposure to nystatin on the pathogenic attributes of Candida such as their adherence to host surfaces. The adhesion of microbes to host mucosal surfaces is a major determinant of successful colonization and infection. Thus the main aim of our investigation was to compare the in vitro adhesion of 30 oral isolates of Candida belonging to six different species (comprising Candida albicans, Candida tropicalis, Candida glabrata, Candida guilliermondii, Candida krusei and Candida parapsilosis) to human buccal epithelial cells, following their brief exposure (1 h) to minimum inhibitory concentration of nystatin, and subsequent removal of the drug. The adhesion of these isolates to buccal epithelial cells was assessed by a previously described adhesion assay. Compared with the controls, there was a significant reduction in buccal epithelial cell adhesion of all six Candida species after drug exposure (54%-68%). However the adhesion of C. albicans isolates was the least affected by nystatin exposure, which was significantly different from that of the non-albicans species. These findings imply that sub-therapeutic levels of nystatin, which are likely to persist in the oral cavity during dosing intervals, may also be beneficial, as they inhibit candidal colonization. The significant difference in nystatin-induced suppression of adhesion between C. albicans and the non-albicans species investigated is a further testimonial for the pre-eminent virulence of the former species.

Antifungal Agents↗
PubMed2006

[Correlation of oral Candida spp. and denture-wearing in healthy elderly].

OBJECTIVE: To investigate the frequency and intensity of Candida spp. incidence from the oral cavities of the healthy elderly in Chengdu, and to study the role of the dentures in the distribution of oral Candida spp. METHODS: A total of 212 individuals(age > 60 years) were divided into four groups: A1 (48 man with dentures), B1 (61 man without dentures), A2 (53 women with dentures) and B2 (50 women without dentures). Samples of their oral flora were obtained by rinsing with 10 mL PBS solution. The samples were centrifuged and resuspended in PBS (500 microL), and plated onto Sabouraud's dextrose agar. CHROMagar Candida, sugar assimilation patterns (API 20C AUX tests) were used to determine Candida spp. The total number of yeast colonies on the plates was considered as the relative intensity of oral Candida. RESULTS: Candida spp. was isolated from 116 healthy elderly individuals (54.72%), such as C. albicans, C. parapsilosis, C. krusei, C. guilliermondii, C. tropicalis, etc. The frequency of Candida spp. in A1, B1, A2 and B2 was 66.67%, 36.07%, 64.15%, and 56.00%, respectively. The frequency of C. albicans in A1, B1, A2 and B2 was 56.25%, 21.31%, 56.60% and 38.00%, respectively. The frequency of Candida spp. and the intensity of Candida spp. were greater for individuals in the denture-wearing group than that in the control. CONCLUSION: The frequency and intensity of Candida spp. incidence from the healthy elderly are closely correlated with denture-wearing, and the differences of the frequency and intensity of Candida spp. incidence in the elderly are due to the differences of frequency and intensity of C. albicans incidence.

Aged↗
PubMed1996

Variable antifungal susceptibility of wild-type Candida albicans phenotypes from neutropenic hosts.

The aim of the present study was to investigate the relationship between phenotypes of Candida albicans strains isolated from clinical specimens and susceptibility of the strains to two antifungal agents, itraconazole and fluconazole. Oropharyngeal, gastrointestinal tract, and urogenital tract specimens were collected from 131 neutropenic patients with Candida infection who had received no previous prophylactic treatment. The most frequent species isolated was Candida albicans, followed by Candida glabrata, Candida tropicalis, Candida krusei, and Candida parapsilosis. Each of the 44 Candida albicans strains recovered was found to express one of four phenotypes: smooth, irregular, fuzzy or stipple. Mean minimum inhibitory concentrations (MICs) of itraconazole and fluconazole as determined by the microdilution method and the E-test were consistently higher for Candida albicans strains expressing the stipple phenotype. The mean MICs for the four phenotypes of the Candida albicans strains ranged between 0.35 microgram/ml and 2.41 micrograms/ml for itraconazole and 2.78 micrograms/ml for fluconazole. Antifungal susceptibility of the stipple phenotype requires careful appraisal, especially in patients clinically unresponsive to azole chemotherapy or in cases of life-threatening, deep-seated Candida infections.

Analysis of Variance↗
PubMed2003

Global distribution and outcomes for Candida species causing invasive candidiasis: results from an international randomized double-blind study of caspofungin versus amphotericin B for the treatment of invasive candidiasis.

In a randomized study, caspofungin was compared with amphotericin B for the treatment of invasive candidiasis in a total of 239 adults from 56 sites in 20 countries. This study provided a unique opportunity to assess the frequency and outcome of invasive candidiasis caused by different Candida species worldwide, and the results are presented here. Efficacy was primarily assessed at the end of intravenous therapy using a modified intent-to-treat (MITT) analysis. This analysis was performed on 224 of the 239 patients enrolled in the study. Attempts were made to collect baseline Candida isolates from all patients for species identification at a central laboratory. Yeasts were identified to the species level using two commercial systems and microscopic examination. Viable baseline isolates were recovered from 210 of the 224 (94%) patients included in the MITT analysis. Candida albicans was the most frequently isolated species in all regions and was responsible for 45% of cases overall. Nevertheless, the majority of cases of infection were caused by non- albicans Candida species. In the USA and Canada, Candida glabrata was the second most commonly isolated pathogen (18%). In contrast, Candida parapsilosis and Candida tropicalis accounted for 55% of cases in Latin America. Outcomes were comparable for patients treated with caspofungin (74% overall; 64% and 80% for infections due to Candida albicans and non- albicans species) and amphotericin B (62% overall; 58% and 68% for infections due to Candida albicans and non- albicans species), and were generally similar across continents. The distribution of Candida species isolated from patients enrolled in a clinical trial may not be representative of pathogens causing invasive candidiasis in the general population. Nevertheless, our findings may affect the regional choice of empirical antifungal therapy for seriously ill patients with suspected or documented invasive candidiasis since different Candida species have varying susceptibility to conventional antifungal drugs.

Adult↗
PubMed1999

Evaluation of six commercial tests and the germ-tube test for presumptive identification of Candida albicans.

Six commercial tests (Albicans ID, bioMérieux, France; CandiSelect, Sanofi Diagnostics Pasteur, France; CHROMagar Candida, Becton Dickinson, USA; Fluoroplate Candida, Merck, Germany; Fongiscreen 4H, Sanofi Diagnostics Pasteur; and Murex Candida albicans, Murex Diagnostics, USA) and the germ-tube test for presumptive identification of Candida albicans were evaluated using clinical isolates of Candida albicans (n = 350) and of non-albicans yeasts (n = 135). Sensitivities and specificities of all tests regarding the identification of Candida albicans were greater than 97%. The two tests that also allow presumptive identification of some non-albicans yeasts (CHROMagar Candida and Fongiscreen 4H) did not identify all isolates of Candida glabrata and Candida tropicalis. In addition, CHROMagar Candida identified as Candida glabrata some isolates belonging to different species of non-albicans yeasts.

Candida albicans↗
PubMed1999

Increased adherence of fluconazole-resistant isolates of Candida species to explanted esophageal mucosa.

The adherence of fluconazole-resistant and fluconazole-susceptible isolates of Candida albicans to explanted rabbit esophageal mucosa was examined in vivo. Among six Candida albicans isolates collected from HIV-infected patients, three fluconazole-resistant (MIC > 64 microg/ml) isolates attached more avidly than three fluconazole-susceptible strains (MIC < or = 0.5 microg/ml) to esophageal mucosa (P < or = 0.05). When three strains each of six different Candida spp. were compared, the more inherently fluconazole-resistant isolates adhered more avidly in the following order: Candida glabrata>Candida krusei>Candida albicans fluconazole-sensitive>Candida tropicalis>Candida parapsilosis. Nonetheless, fluconazole-resistant Candida albicans demonstrated the greatest degree of adherence in comparison to all fluconazole-susceptible Candida albicans (P<0.001) and to all Candida spp. tested (P<0.001). Thus, the refractoriness of esophageal candidiasis in patients infected with fluconazole-resistant isolates may be related to both in vitro drug resistance and increased mucosal adherence.

Animals↗
PubMed2001

Molecular monitoring of Candida albicans infections in liver transplant recipients.

This report describes the use of the 27A probe for the molecular monitoring of Candida albicans infections in liver transplant recipients. Nosocomial candidiasis is the major fungal infection in liver transplant recipients, with Candida albicans being the species most frequently isolated. The molecular epidemiology of Candida albicans infections has been widely investigated, but scant attention has been focused on monitoring the identity of infecting strains in individual patients over the entire course of their hospitalization. In the study presented here, a total of 179 Candida albicans isolates were collected from 10 liver transplant recipients during multiple surveillance cultures performed before and after liver transplantation and from three healthcare workers at the Transplant Unit of Ospedale di Cisanello, Pisa (Italy). Computer-aided analysis of the 27A-probed DNA fingerprints, used to compare the genetic relatedness of all the Candida albicans isolates, showed that most of the patients colonized with Candida albicans before transplantation harbored a unique Candida albicans genotype. This genotype persisted over the entire course of hospitalization and caused multiorgan failure in two patients, both of whom died from endogenously borne Candida albicans infections. Nosocomial acquisition of Candida albicans strains could be monitored in a timely manner in the other patients; for some of them, subsequent strain replacement was registered at different body sites during the post-transplant period. Neither cross-infection between patients nor transmission from healthcare workers to patients occurred in this hospital setting. These results indicate that the molecular monitoring of Candida albicans strains isolated from liver transplant recipients during their hospitalization may provide timely information about the identity of individual Candida albicans strains causing infections.

Adult↗
PubMed2003

Epidemiology of Candida colonization in an intensive care unit of a teaching hospital in Kuwait.

The incidence of Candida infections in intensive care units (ICU) is increasing. Although most cases of candidemia are caused by commensal strains colonizing the patients' own body sites, recent studies have suggested that the source of Candida infection can also be exogenous. This study was carried out to prospectively investigate the frequency of Candida colonization among patients and health care personnel of an ICU of a teaching hospital in Kuwait. A total of 57 patients and 45 nurses were investigated. Candida isolates were identified to the species level by the Vitek identification system. The typing of selected isolates was performed by randomly amplified polymorphic DNA (RAPD) using three different arbitrary primers (CARAPD1, AP3, CT5). Of the 526 samples collected from 57 patients, 180 (34%) yielded Candida species. These included 112 (62%) C. albicans, 37 (21%) C. glabrata, 15 (8%) C. parapsilosis, 11 (6%) C. tropicalis, 3 (2%) C. krusei and 2 (1%) C. lusitaniae isolates. Thirty-seven patients (65%) were colonized by Candida at some point of stay in the ICU. Seven (12%) patients yielded more than one Candida species from the sites/specimens tested. The frequency of Candida isolation was highest from oropharynx, followed by rectum, groin, urine and trachea. Twenty-five (6%) of the 448 swabs from the nurses yielded Candida and included C. albicans (n = 16), C. parapsilosis (n = 4) and C. famata (n = 5). While all the three primers yielded varying patterns in RAPD analyses for each Candida species, the results obtained by AP3 were most discriminatory. The data showed that the colonizing Candida isolates recovered from various body sites of the patients, as well as the nursing staff, were different. However, when RAPD profiles of three blood culture isolates from candidemic patients were analyzed, the DNA fingerprint produced by one C. parapsilosis blood culture isolate was similar to C. parapsilosis recovered from the hands of two nurses, suggesting exogenous acquisition of infection.

Adolescent↗
PubMed2005

Malassezia and Candida colonisation on glans penis of circumcised men.

The Malassezia yeast are members of the normal human cutaneous flora in adults. They also are reported as part of the microflora of the male genital region in mostly uncircumcised males. It has been reported that Malassezia sympodialis and Malassezia globosa are the most frequent yeast belonging to the resident microflora of the penis as in other human skin areas. The aim was to evaluate the prevalence of Malassezia and Candida yeast colonisation on the glans penis of circumcised males. Impression preparations were made on modified Dixon agar. The isolates were identified by morphological and physiological characteristics. A total of 245 circumcised males were included in the study. Of the 245 patients examined, 55 (22.4%) were found to have a mycologically proven yeast fungi on their glans penis. In 17 (30.9%) Malassezia, in 36 (65.5%) Candida, in one (1.8%) Malassezia and Candida, and in one (1.8%) Saccharomyces strains were detected. Malassezia furfur (66.7%) was the most common species among the lipophilic yeast, followed by Malassezia globosa (11.1%), Malassezia obtusa (11.1%) and Malassezia slooffiae (11.1%). Candida albicans was the most common non-lipophilic yeast (46.0%), that was isolated among the other yeast, followed by unidentified Candida strains (18.9%), Candida tropicalis (8.1%), Candida glabrata (8.1%), Candida parapsilosis (8.1%), Candida zeylanoides (5.4%), Candida guilliermondii (2.7%) and Saccharomyces cerevisiae (2.7%). The results of this study showed that Malassezia species were also colonised like Candida on the glans penis of circumcised males.

Adult↗
PubMed1993

Candida-specific cell-mediated immunity is demonstrable in mice with experimental vaginal candidiasis.

Women with recurrent vulvovaginal candidiasis often demonstrate a down-regulation of cell-mediated immunity (CMI) to Candida albicans detected by a lack of cutaneous delayed-type hypersensitivity (DTH) to Candida antigens. However, the role of systemic CMI as a host defense mechanism against recurrent vulvovaginal candidiasis is not well understood, in part because of the lack of a well-defined murine model of vaginal candidiasis. The present study was undertaken to determine: (i) whether soluble Candida culture filtrate antigens (CaCF) could be used to induce and detect Candida-specific CMI in mice and (ii) whether these antigens would be useful in detecting systemic CMI in mice given an experimental Candida vaginal infection. To this end, mice were immunized subcutaneously with CaCF in complete Freund's adjuvant, and within 7 days they developed Candida-specific DTH reactivity detected by footpad swelling (increase in footpad thickness, 0.36 mm) 24 h after footpad challenge with CaCF. Adoptive transfer studies showed that the DTH responsiveness was elicited by CD4+ DTH T cells. In mice given a vaginal inoculum of C. albicans blastoconidia (5 x 10(5)), footpad challenge with CaCF resulted in positive DTH responses (0.24 mm) as early as 1 week, responses similar to immunization in 2 to 3 weeks (0.33 mm), and sustained low levels of DTH reactivity (0.15 mm) through 10 weeks of vaginal infection. Vaginal lavage cultures revealed that peak vaginal Candida burden occurred 1 week post-vaginal inoculation (10(5) CFU) and declined 16-fold by week 10. These results provide evidence that Candida-specific systemic CMI is generated and can be detected longitudinally in mice with Candida vaginitis by a multiantigen preparation of Candida organisms which both initiates and detects Candida-specific CMI.

Animals↗
PubMed1995

Differential susceptibility of yeast and hyphal forms of Candida albicans to proteolytic activity of macrophages.

The dimorphic transition of Candida albicans from the yeast (Y-Candida) to the hyphal (H-Candida) form is a complex event whose relevance in fungal pathogenicity is still poorly understood. Using a cloned macrophage (M phi) cell line (ANA-1), we have previously shown that a M phi can discriminate between the two fungal forms, eliciting different secretory responses. In the present study, we investigated the susceptibility of Y-Candida and H-Candida to M phi proteolytic activity. In particular, sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot (immunoblot) techniques were employed to analyze the patterns of lyticase proteinaceous extracts from cell walls of Y-Candida and H-Candida which had been unexposed or exposed to ANA-1 M phis for 3 h. Silver staining allowed detection of a complex protein pattern in both forms of C. albicans, qualitatively and quantitatively differing from each other, mainly at molecular masses below 106 kDa. Western blot staining with anti-C. albicans mannan antibodies and convalescent-phase sera of mice previously infected systemically or intracerebrally with C. albicans showed that, after contact with M phis, Y-Candida but not H-Candida proteinaceous cell wall components are profoundly modified, with substantial reduction and/or disappearance of many bands. Our experimental approach provides initial insights into the differential susceptibility of Y-Candida and H-Candida to the proteolytic activity of M phis.

Animals↗
PubMed1995

Use of CHROMagar Candida medium for isolation of yeasts from dental samples.

A new differential medium, CHROMagar Candida, for the isolation of clinically important yeasts was investigated to determine its usefulness in facilitating the study of oral yeasts. The recovery of yeasts on the medium was not significantly different from the recovery on Sabouraud dextrose agar. The identities of 450 green colonies on CHROMagar Candida, presumptively identified as Candida albicans on the basis of the manufacturer's instructions, were confirmed by testing for beta-N-acetylgalactosaminidase. Candida tropicalis also formed distinctive colonies, and other yeasts including Candida (Torulopsis) glabrata, Candida Parapsilosis, Candida Magnoliae, Candida lusitaniae, Candida Famata, Candida kefir, and Saccharomyces cerevisiae were readily distinguished from C. albicans and C. tropicalis isolates. CHROMagar Candida is a very useful medium, and its use will facilitate the study of yeasts associated with dental diseases.

Candida↗
PubMed2001

Evaluation of Etest method for determining caspofungin (MK-0991) susceptibilities of 726 clinical isolates of Candida species.

The performance of the Etest for testing the susceptibilities to caspofungin (MK-0991) of 726 isolates of Candida spp. was assessed against the National Committee for Clinical Laboratory Standards (NCCLS) microdilution broth method. The NCCLS method employed RPMI 1640 broth medium, and MICs were read after incubation for 48 h at 35 degrees C. MICs were determined by Etest for all 726 isolates with RPMI agar containing 2% glucose (RPG) and were read after incubation for 48 h at 35 degrees C. The Candida isolates included Candida albicans (n = 486), Candida glabrata (n = 96), Candida tropicalis (n = 51), Candida parapsilosis (n = 47), Candida krusei (n = 11), Candida lusitaniae (n = 2), and Candida guilliermondii (n = 33). In addition, a subset of 314 isolates were also tested by Etest using Casitone agar (CAS) and antibiotic medium 3 agar (AM3). The Etest results obtained using RPG correlated well with reference MICs. Overall agreement was 94% with RPG, 82% with CAS, and 79% with AM3. When RPG was used, agreement ranged from 79% for C. parapsilosis to 100% for C. krusei, C. lusitaniae, and C. guilliermondii. When CAS was used, agreement ranged from 0% for C. lusitaniae to 100% for C. glabrata. With AM3, agreement ranged from 0% for C. lusitaniae to 100% for C. guilliermondii. All three media supported growth of each of the Candida species. Etest results were easy to read, with sharp zones of inhibition. In most instances (75%) where a discrepancy was observed between the Etest and the reference method, the Etest MIC was lower. The Etest method using RPG appears to be useful for determining caspofungin susceptibilities of Candida species.

Anti-Bacterial Agents↗
PubMed2005

CHROMagar Candida medium for direct susceptibility testing of yeast from blood cultures.

An evaluation was performed on 95 blood cultures positive for Candida spp. to determine the correlation of direct susceptibility testing of fluconazole versus both standardized disk diffusion and MIC methods. For direct testing, an aliquot taken from BD BACTEC Plus and/or BD BACTEC Lytic/10 bottles (Becton Dickinson [BD], Sparks, MD) positive by gram stain for yeast was subcultured to CHROMagar Candida (BD), and a 25-microg fluconazole disk (BD) was placed on the plate. The area of growth inhibition surrounding the disk was measured at 24 and 48 h. In addition, a subculture of the isolate was tested by a microdilution MIC using YeastOne (TREK Diagnostics Systems Inc., OH) and disk diffusion (NCCLS M44-A) using a standardized inoculum plated onto CHROMagar Candida as well as Mueller-Hinton agar to which 2% glucose and 0.5 microg/ml methylene blue dye was added (MH-GMB). The categorical interpretation derived from the MIC was used as the reference to which the disk diffusion results were compared. There were a total of 41 Candida albicans, 23 Candida glabrata, 20 Candida parapsilosis, 9 Candida tropicalis, and 1 each of Candida krusei and Candida lusitaniae tested. At 24 h there was full agreement among the methods for all C. albicans, C. tropicalis, C. lusitaniae, and C. krusei isolates. For the C. parapsilosis isolates at 24 h there was one very major discrepancy using the direct CHROMagar and one major error with the standardized MH-GMB. The majority of the errors were seen at 24 h with the C. glabrata isolates. Of the 23 C. glabrata isolates at 24 h by direct CHROMagar, there were 10 minor and 1 very major error; by MH-GMB there were 12 minor and 2 very major errors; and by standardized CHROMagar Candida there were 13 minor and 2 major errors. There were no very major errors with C. glabrata when all plates were read at 48 h. At 24 h by the direct and standardized CHROMagar the majority of C. glabrata isolates were more resistant, whereas by MH-GMB they were more susceptible than the reference MIC interpretation. In summary, subculturing yeast directly from blood cultures onto CHROMagar to which a fluconazole disk has been added may provide a presumptive identification at 24 h and, with the exception of C. glabrata, was able to predict the susceptibility to fluconazole with the majority of Candida isolates examined in this evaluation.

Agar↗
PubMed2006

Candida colonization of the respiratory tract and subsequent pseudomonas ventilator-associated pneumonia.

BACKGROUND: Recovery of Candida from the respiratory tract of a critically ill patient receiving mechanical ventilation (MV) usually indicates colonization rather than infection of the respiratory tract. However, interactions between Candida and bacteria, particularly Pseudomonas, have been reported. Thus, Candida colonization of the respiratory tract may predispose to bacterial ventilator-associated pneumonia (VAP). METHODS: In a multicenter study of immunocompetent critically ill patients receiving MV for > 2 days, we compared the incidence of pneumonia in patients with and without (exposed/unexposed) respiratory-tract Candida colonization, matched on study center, admission year, and MV duration. RESULTS: Over the 4-year study period, of the 803 patients meeting study inclusion criteria in the six study centers, 214 patients (26.6%) had respiratory tract Candida colonization. Candida albicans was the most common species (68.7%), followed by Candida glabrata (20.1%) and Candida tropicalis (13.1%). Extrapulmonary Candida colonization was more common in exposed patients (39.7% vs 8.3%, p = 0.01). Exposed patients had longer ICU and hospital stays but similar mortality to unexposed patients. The matched exposed/unexposed nested cohort study identified bronchial Candida colonization as an independent risk factor for pneumonia (24.1% vs 17.6%; adjusted odds ratio [OR], 1.58; 95% confidence interval [CI], 0.94 to 2.68; p = 0.0860); the risk increase was greatest for Pseudomonas pneumonia (9% vs 4.8%; adjusted OR, 2.22; 95% CI, 1.00 to 4.92; p = 0.049). CONCLUSIONS: Candida colonization of the respiratory tract is common in patients receiving MV for > 2 days and is associated with prolonged ICU and hospital stays, and with an increased risk of Pseudomonas VAP.

Aged↗