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PubMed1992

Detection of Candida cell forms in Pap smears during pregnancy.

In a prospective study of 124 urban black pregnant women, 43% had Candida isolated from endocervical cultures and 20% had Candida cell forms on cytological Pap-stained cervical specimens. The presence of Candida cell forms on Pap smears had a better correlation with Candida colonisation when normal lactobacillary flora was present, when Trichomonas vaginalis parasites were absent and when the infecting Candida species was C. albicans. Positive cultures were strongly related to a number of clinical signs and symptoms, but Pap smears were not. Neither Candida culture nor Candida cells in Pap smear revealed an association with premature delivery, birth weight, severe neonatal morbidity or mortality. We confirm that the routine cervical Pap smear is not a sensitive method for diagnosing symptomatic fungal infection. More specifically, some of the Pap smear characteristics, such as disturbed lactobacillary flora or co-infection with T. vaginalis, interfere with accurate diagnosis.

Candida↗
PubMed1991

Role of candida in pathogenesis of antibiotic-associated diarrhoea in elderly inpatients.

The part that candida plays in antibiotic-associated diarrhoea was investigated in 24 elderly inpatients (mean age 74 years) who tested negative for Clostridium difficile toxin and other intestinal pathogens. 7 had intestinal overgrowth of Candida species (greater than or equal to 10(5) cfu/ml). None of the 24 matched, antibiotic-treated controls without diarrhoea had candida overgrowth. All 5 patients with diarrhoea and candida overgrowth treated with oral nystatin responded with resolution of diarrhoea and lowering of faecal counts to less than 10(4) cfu/ml within 7 days of start of antifungal therapy despite continuation of antibacterial therapy. In the other 2 patients with candida overgrowth, the diarrhoea subsided spontaneously and faecal candida counts returned to normal (less than 10(4) cfu/ml) after antibacterial agents were withdrawn. In patients without candida overgrowth, diarrhoea persisted until antibiotics were withdrawn, at a mean of 16 days after study entry.

Aged↗
PubMed2004

Distribution and antifungal susceptibility of Candida species causing candidemia from 1996 to 1999.

Susceptibilities to amphotericin B and fluconazole of 383 Candida species isolated from blood were determined. Candida albicans was the most common species (55.6%), followed by Candida parapsilosis (17.5%), Candida tropicalis (16.5%), Candida glabrata (5.2%), Candida guilliermondii (2.3%), and others (2.9%). All but three isolates, Candida ciferrii, C. tropicalis, and C. glabrata, one each, were susceptible to amphotericin B. A total of 367 (95.8%) and 15 (4.2%) isolates were susceptible and susceptible-dose dependent to fluconazole, respectively. Only one isolate, a C. glabrata, was resistant to fluconazole. Few patients (13%) having prior fluconazole treatments may explain the low rate of resistance to fluconazole in this study.

Amphotericin B↗
PubMed2005

Differentiation between Candida species isolated from diabetic foot by fatty acid methyl ester analysis using gas chromatography.

Gas chromatography (GC) was used to differentiate 100 isolates of Candida species (Candida parapsilosis, Candida albicans, Candida tropicalis, Candida famata and Candida glabrata) from 22 of 509 diabetic patients in whom the same species had been isolated from ulcer and interdigital spaces of the same and/or the other foot. All clinical isolates were identified by quantitative differences in the composition of six cell fatty acids (CFA). The values of the coefficients of variability (CV) of CFA show that the isolates from foot ulcers and interdigital spaces of the same diabetic patient probably belong to different chemotypes of the same Candida species.

Aged↗
PubMed2000

Vaginal colonization by Candida in asymptomatic women with and without a history of recurrent vulvovaginal candidiasis.

OBJECTIVE: The asymptomatic carriage of Candida in the vagina of women with a history of recurrent vulvovaginal candidiasis was compared with that of women with no such history. METHODS: Vaginal swabs from 50 women with a history of recurrent vulvovaginal candidiasis and 45 women with one or fewer episodes of candidal vaginitis within the past 12 months were evaluated for Candida by wet mount/Gram stain, culture, and polymerase chain reaction (PCR). All women were asymptomatic for at least 30 days. RESULTS: Candida was identified in 28 women by PCR, in 14 women by culture, and in 13 women by wet mount/Gram stain. Candida was identified by PCR in a similar proportion of patients with previous recurrent vulvovaginal candidiasis (30%) and in controls (28.8%). However, Candida was identified by culture in more women with previous recurrent vulvovaginal candidiasis (22%) than in controls (6.6%, P = .04); it also was identified by wet mount/Gram stain in more women with recurrent vulvovaginal candidiasis (22%) than in controls (4.4%, P = .01). For the recurrent vulvovaginal candidiasis patients, culture and wet mount/Gram stain had a sensitivity of 66.6% compared with PCR. For the controls, the sensitivity of the two former assays relative to PCR was only 15.3%. CONCLUSION: Women with a history of recurrent vulvovaginal candidiasis have more easily detectable Candida in their vagina, even when asymptomatic, than do other women. A relative inefficiency in regulating the proliferation of Candida in the vagina may increase susceptibility to periodic symptomatic recurrences.

Adult↗
PubMed2001

Bioaccumulation of copper(II) and nickel(II) by the non-adapted and adapted growing Candida sp.

The effect of copper(II) and nickel(II) ions on the growth and bioaccumulation properties of non-adapted and adapted growing cells of a non-pathogenic Candida sp. has been tested under laboratory conditions as a function of initial pH and initial metal ion concentration. Optimum pH value for maximum metal ion accumulation was determined as 4.0 for both the metal ions. Although the copper(II) adapted Candida sp. was capable of removing of copper(II) with the maximum specific uptake capacity of 36.9 mg g-1 at 783.6 mg dm-3 initial copper(II) concentration, non-adapted Candida was only capable of bioaccumulating copper(II) with 23.1 mg g-1 maximum uptake capacity from aqueous solution at 578.7 mg dm-3 initial copper(II) concentration. The non-adapted and nickel(II) adapted Candida cells also showed the highest nickel(II) uptake capacities (46.8 and 30.8 mg g-1, respectively) at 321.5 and 300.6 mg dm-3 initial nickel(II) concentrations, respectively. For both the non-adapted and nickel(II) adapted Candida sp., the growth of cells was totally inhibited by 500 mg dm-3 of nickel(II) ions. The results also indicated that copper(II) adapted Candida sp. has been found to be more efficient to accumulate larger amounts of copper(II) than that of nickel(II) bioaccumulated by nickel(II) adapted Candida at higher initial metal ion concentrations without loosing its biological activity.

Adaptation, Physiological↗
PubMed2003

CHROMagar Candida medium as a practical tool for the differentiation and presumptive identification of yeast species isolated from salads.

CHROMagar Candida medium was used to study the diversity of yeast biota of salad samples, and to presumptively identify the isolates. This medium was originally developed for the selective isolation and presumptive identification of some clinically important yeast species such as Candida albicans, Candida tropicalis, Candida krusei, and Candida glabrata on the basis of differences in colour and surface of colonies. Ninety three yeast strains representing 33 species from the culture collection and 39 fresh isolates from different mayonnaise-based mixed salads showed a wide range of hue of colony colours ranging from white to yellow, orange, red, pink, purple, blue, green, etc., as well as different morphological appearances on the CHROMagar Candida medium. Therefore, CHROMagar Candida medium facilitates the detection of mixtures of yeast species from different samples on a single isolation plate and this medium can be a practical method for the differentiation and rapid presumptive identification of many yeast species occurring frequently in different kind of foods.

Agar↗
PubMed1997

In vitro antifungal activity of BMS-181184 against systemic isolates of Candida, Cryptococcus, and Blastomyces species.

BMS-181184 is a water-soluble derivative of the pradimicin group of antifungal compounds. We determined the in vitro activities of BMS-181184 and comparator agents amphotericin B, 5-fluorocytosine, fluconazole, and ketoconazole against 184 systemic fungal isolates collected at the Health Sciences Centre in Winnipeg, Canada, between 1987 and 1995. BMS-181184 demonstrated MICs of between 1 and 8 micrograms/mL for all Candida albicans, Candida glabrata, Candida tropicalis, Candida krusei, Candida lusitaniae, and Cryptococcus neoformans isolates tested. BMS-181184 was less active against Candida parapsilosis (MIC90 = 16 micrograms/mL) and Blastomyces dermatitidis (MIC90 = 32 micrograms/mL). Isolates of Candida species with fluconazole MICs of > or = 16 micrograms/mL and those with fluconazole MICs of < or = 8 micrograms/mL demonstrated similar BMS-181184 sensitivities.

Anthracyclines↗
PubMed1999

Trends in species distribution and susceptibility to fluconazole among blood stream isolates of Candida species in the United States.

National surveillance of blood stream infections (BSI) attributable to Candida spp. has been limited to date. Recent studies have suggested in increase in the proportion of BSI attributable to non-Candida albicans species and have also raised concerns regarding the emergence of antifungal resistance among Candida spp. The increased utilization of broad-spectrum antifungal agents and the recognition of Candida spp. as prominent pathogens with the potential for developing antifungal resistance, emphasize the need for ongoing surveillance of antifungal susceptibility patterns. In this investigation trends in species distribution and susceptibility to fluconazole among BSI isolates of Candida spp. referred to our laboratory by United States hospitals were evaluated over the 7-year period from 1992 to 1998. A total of 1579 BSI isolates from more than 50 medical centers were processed. Overall, C. albicans accounted for 52% of isolates followed by C. glabrata (18%), C. parapsilosis (15%), C. tropicalis (11%), and C. krusei (2%). The proportion of BSI isolates that were C. albicans ranged from 45% in 1992 to 60% in 1998. Among the non-C. albicans isolates, C. glabrata succeeded C. parapsilosis as the most common species beginning in 1995. Overall, the susceptibility of all Candida species (C. albicans plus all other species) to fluconazole remained stable (MIC90, 16 micrograms/mL). The fluconazole MIC90 for C. albicans was 0.5-2.0 micrograms/ml for all years studied except 1995 (8.0 micrograms/mL) and was 1.0 microgram/mL overall. The present study suggests a continued prominent role of C. albicans as a cause of BSI, and a constant level of susceptibility of Candida BSI isolates to fluconazole over 7 years. These data should serve as a baseline for future surveillance efforts for anti-fungal agents tested against yeast BSI isolates.

Antifungal Agents↗
PubMed2003

HIV-1 and its transmembrane protein gp41 bind to different Candida species modulating adhesion.

Oral candidiasis in HIV-1-infected individuals is widely believed to be triggered by the acquired T-lymphocyte immunodeficiency. Recently, binding of the HIV-1 envelope protein gp160 and its subunit gp41, and also of the whole virus itself, to Candida albicans has been shown. The present study shows that, in addition to C. albicans, HIV-1 gp41 also binds to yeast and hyphal forms of Candida dubliniensis, a species which is closely related to C. albicans, and to Candida tropicalis but not to Candida krusei, Candida glabrata or Saccharomyces cerevisiae. The previous finding that gp41 binding to C. albicans augments fungal virulence in vitro is supported by the observation that the yeast showed an enhanced adhesion to HIV-infected H9 cells in comparison to uninfected cells. In line with these results soluble gp41 itself reduced binding of C. albicans to both endothelial and epithelial cell lines, confirming a dominant role of the gp41 binding moiety on the surface of Candida for adhesion. Surface-associated secreted aspartic proteinases (Saps) play an important role in candidial adhesion, but are not likely to be involved in the interaction as gp41 binding to the C. albicans parental wild-type strain was comparable to that of three different isogenic Sap deletion mutants. Furthermore, gp41 binding to the yeast killer toxin-susceptible C. albicans strain 10S was not inhibitable by an anti-YKT receptor antibody. In conclusion, HIV-1 interacts with different clinically important Candida spp., and may thereby affect the outcome of the respective fungal infection.

Aspartic Acid Endopeptidases↗
PubMed2003

The effect of a denture adhesive on the colonization of Candida species in vivo.

PURPOSE: The purpose of this study was to evaluate the effect of a single denture adhesive on oral quantities of Candida species in vivo by determination of absolute and proportional counts of Candida species on dentures and in saliva of individuals who used this denture adhesive for a period of 14 days. MATERIALS AND METHODS: Samples were collected from saliva and maxillary dentures of 12 patients who wore existing dentures without adhesives for 2 weeks, then wore dentures with adhesive (Poly Grip Free; Glaxo Smith Kline, U.K.) for 2 weeks. Periodically, maxillary dentures were sampled by adding saline to the intaglio surface, dispersing by sonication and removing aliquots for culturing. These aliquots and saliva were diluted and plated in duplicate on bismuth sulfite, glycerine, and glucose yeast agar (Biggy) for recovery of Candida and on trypticase soy agar for total viable counts (TVC) of the microbiota. After 72 hours of incubation at 37 degrees C in air with 10% CO(2), colony-forming units were enumerated. In each individual, absolute counts of Candida and TVC, and proportional counts of Candida relative to TVC were compared and statistically evaluated during the periods of no adhesive use (control) and adhesive use (test). RESULTS: There were no statistically significant differences between the test and control periods for recovery of total Candida or TVC in saliva or on dentures, or the percent of Candida relative to TVC in saliva or on dentures. CONCLUSION: Within the limitations of this study, the data suggested that the denture adhesive tested did not significantly alter the denture microbiota during the 14-day trial period.

Adhesives↗
PubMed2003

The relationship between oral Candida carriage and the secretor status of blood group antigens in saliva.

OBJECTIVE: The aim of the study was to investigate the relationship between oral Candida carriage and the secretor status of blood group antigens. STUDY DESIGN: Unstimulated whole saliva and oral rinse samples were obtained from 180 healthy subjects. These samples were plated on Sabouraud's dextrose agar media to determine oral Candida carriage. Sodium dodecylsulfate polyacrylamide gel electrophoresis and immunoblotting were performed on whole saliva samples to determine the secretor status of blood group antigens. RESULTS: The oral Candida carriage rate was found to be 45.0%. The sensitivity of the concentrated rinse culture proved to be superior. Oral Candida carriage was not significantly related to the blood group or secretor status of ABH or Lewis antigens. No significant relationship was found between oral Candida carriage and salivary flow rate. However, smoking affected oral Candida carriage. CONCLUSION: Oral Candida carriage in healthy individuals is not significantly related to blood group or secretor status.

ABO Blood-Group System↗
PubMed2001

Antifungal activity of histatin-5 against non-albicans Candida species.

Fungicidal effects of histatin-5 against 26 oral isolates belonging to 5 non-albicans Candida species were examined. Fifty microM of histatin-5 killed more than 95% of Candida tropicalis and Candida guilliermondii isolates and more than 90% of Candida parapsilosis and Candida krusei. However, Candida glabrata was less sensitive to the peptide (mean 62.9%). Our results, taken together, demonstrated that histatin-5 possessed the fungicidal activity against Candida species other than C. glabrata.

Analysis of Variance↗
PubMed2000

Differentiation of Candida strains by lectin-mediated agglutination kinetics.

The lectin-mediated agglutination kinetics of Candida albicans, Candida tropicalis, Candida glabrata, Candida krusei, Candida kefyr, and Candida parapsilosis strains isolated from immunocompromised patients was investigated. The rate of the lectin-induced cell agglutination depends on the physiological state of the yeast cell population. Therefore, the Candida strains have to be cultivated and investigated under identical conditions. Lentil lectin (prepared from Lens culinaris), castor lectin, and concanavalin A were used. Different yeast species showed different agglutination behaviour. Furthermore, the lectin-mediated rate of agglutination is a strain-specific property which makes it possible to distinguish between different yeast strains of the same species. It is concluded that the lectin-mediated agglutination kinetics allows reproducible differentiation of yeast strains of the same species.

Agglutination↗
PubMed1999

HIV-Protease inhibitors reduce cell adherence of Candida albicans strains by inhibition of yeast secreted aspartic proteases.

Since the introduction of new anti-retroviral agents such as human immunodeficiency virus (HIV) protease inhibitors, oropharyngeal candidiasis is less often observed in acquired immune deficiency syndrome patients. Secretory aspartic proteases of Candida albicans, which have similarities to the HIV aspartic proteases, are pathogenicity factors that have been intensively investigated in recent years. The inhibitory effect of four different HIV aspartic protease inhibitors (ritonavir, saquinavir, indinavir, and nelfinavir), on the activity of different Candida albicans secretory aspartic proteases was demonstrated. These anti-retroviral agents were able to inhibit Candida albicans secretory aspartic proteases 1, 2, and 3 which are involved in Candida adherence. As a consequence of these results we used selected HIV protease inhibitors in an adherence assay of Candida cells to epithelial cells. Ritonavir and saquinavir inhibited adherence of Candida albicans under the chosen experimental conditions similarly to the in vitro results, whereas indinavir had no effect. This inhibition was shown to be concentration dependent. The specificity of these effects with respect to the secretory aspartic proteases was demonstrated by competitive binding experiments using purified recombinant secretory aspartic proteases. On the basis of these studies we conclude that lower rates of oropharyngeal candidiasis in individuals receiving potent anti-retroviral therapy could reflect not only an improvement in the immune system but also direct inhibition of Candida secretory aspartic proteases by HIV protease inhibitors.

Aspartic Acid Endopeptidases↗
PubMed2006

MPO and cytokines in the serum of cancer patients in the context of Candida colonization and infection.

This study investigated the immunological factors, such as neutrophils number, the level of myeloperoxidase and IL-12, IL-10, TNF-alpha, IFN-gamma, that additionally might correlate with increased susceptibility to Candida infections in cancer patients. A total of 105 cancer patients were evaluated. Patients were examined twice for Candida colonization and presence of Candida antigen and DNA in bloodstream. Serum concentrations of MPO and selected cytokines were quantified by ELISA. The values for myeloperoxidase were decreased in Candida-colonized as well as deep-infected cancer patients groups, compared to healthy persons. In the group of patients suspected of deep candidiasis, we observed significantly elevated level of IFN-gamma compared to control. In the group of Candida-colonized patients, the concentrations of IL-12, TNF- alpha and IFN-gamma were significantly heightened when compared to control.MPO deficiency seems to be one of the important risk factor for deep candidiasis independently of the neutrophil count. The disturbances in cytokines levels in cancer patients group can be connected with underlying cancer disease, its treatment as well as Candida infection. The decreased level of TNF-alpha, in particular may be connected with Candida invasion.

Adult↗
PubMed1992

A role for complement receptor-like molecules in iron acquisition by Candida albicans.

Candida albicans, an opportunistic fungal pathogen of humans, is dependent upon iron for growth. Consequently, human serum inhibits C. albicans growth due to the presence of high affinity iron-binding proteins that sequester serum iron, making it unavailable for use by the organism. We report that in the inhibitory environment of human serum, the growth of C. albicans can be restored by the addition of exogenous hemoglobin or heme, but not by protoporphyrin IX, the heme precursor that does not contain iron. We further report that C. albicans can utilize cell surface proteins that are homologues of the mammalian complement receptors (CR) to rosette complement-coated red blood cells (RBC) and obtain RBC-derived iron for growth. The ability of Candida to acquire RBC-derived iron under these conditions is dependent upon Candida-RBC rosetting mediated by CR-like molecules. Unopsonized RBC do not support Candida growth in serum, and restoration of Candida growth in serum by complement-opsonized RBC is inhibited by monoclonal antibodies to the human CR type 3 (CR3). In addition, activation of the human alternative pathway of complement by Candida leads to "bystander" deposition of C3 fragments on the surface of autologous, unopsonized RBC, generating the ligands necessary for Candida-RBC rosetting. These results suggest that C. albicans has evolved a unique strategy for acquiring iron from the host, which exploits the host complement system, and which may contribute to the pathogenic potential of the organism.

Animals↗
PubMed2001

Role of Candida in antibiotic-associated diarrhea.

To quantitatively assess the role of Candida species in antibiotic-associated diarrhea (AAD), stool samples from a total of 395 patients and control subjects were cultured in differential isolation medium: 98 patients had AAD, 93 patients were taking antibiotics but did not have diarrhea (A(+)D(-)), 97 patients were not taking antibiotics but had diarrhea (A(-)D(+)), and 107 patients were control subjects (A(-)D(-)). In addition, secreted aspartyl proteinase (Sap) production was tested. In AAD patients, Candida positivity (77/98) and Candida overgrowth (62/98) were not different from that among A(+)D(-) patients (75/93 [P= .860] and 52/93 [P= .375], respectively). Candida overgrowth among A(-)D(+) patients (40/97, P= .003) was less frequent than among AAD patients, but Candida positivity was not different (80/97, P= .612). In control subjects, Candida positivity and overgrowth were less common than in all other groups. Production of Sap did not differ between patients with AAD and control subjects (P= .568 and P= .590, respectively). Data indicate that elevated Candida counts are a result of antibiotic treatment or diarrhea rather than a cause of AAD.

Age Distribution↗