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At least 973 records · Page 54Linked to original sources
PubMed2000

Value of Candida polymerase chain reaction and vaginal cytokine analysis for the differential diagnosis of women with recurrent vulvovaginitis.

OBJECTIVES: Recurrent vulvovaginitis remains difficult to diagnose accurately and to treat. The present investigation evaluated the utility of testing vaginal specimens from women with symptomatic recurrent vulvovaginitis for Candida species by polymerase chain reaction (PCR) and for cytokine responses. METHODS: Sixty-one consecutive symptomatic women with pruritus, erythema, and/or a thick white discharge and a history of recurrent vulvovaginitis and 31 asymptomatic women with no such history were studied. Vaginal swabs were tested for Candida species by PCR, for the antiinflammatory cytokine interleukin (IL)-10, and for the proinflammatory cytokine IL-12. RESULTS: C. albicans was detected in 19 (31.1%) of the patients as well as in three (9.7%) controls (P = 0.03). Both IL-10 (31.1% vs. 0%) and IL-12 (42.6% vs. 6.5%) were also more prevalent in the recurrent vulvovaginitis patients (P < 0.001). However, there was no relation between the presence or absence of Candida and either cytokine. Detection of IL-12 in 14 women indicated the stimulation of a vaginal cell-mediated immune response possibly from an infectious agent. The presence of only IL-10 in six patients indicated a suppression of vaginal cell-mediated immunity and was consistent with a possible allergic etiology. The absence of both IL-10 and IL-12 in other patients, similar to that found in healthy controls, suggested a noninfectious, nonallergic etiology of their symptoms. CONCLUSION: Many women with recurrent vulvovaginitis are not infected with Candida. Testing for Candida should be required in this population. Treatment with only anti-Candida medication will clearly be inadequate for the majority of women with this condition.

Candida albicans↗
PubMed1978

Specific inhibition of in vitro Candida-induced lymphocyte proliferation by polysaccharidic antigens present in the serum of patients with chronic mucocutaneous candidiasis.

A specific inhibitory activity of in vitro proliferative responses of normal human lymphocytes to Candida metabolic antigen was found in the serum of 6 out of 23 children with chronic mucocutaneous candidiasis. In each of the six patients, the presence of an inhibitory activity was associated with Candida-specific cellular defects, characterized by a negative-skin test and a lack of in vitro lymphocyte proliferation. The presence of a circulating inhibitor was detected during relapses of the disease and disappeared under antifungal therapy. This inhibitory effect was not associated with any toxicity on tested lymphocytes. The factor was shown to be nondialysable, thermostable, nonprecipitable with ammonium sulfate and absorbable on anti-Candida antibodies or concanavalin A-coupled agarose columns. Altogether, these results suggest that the inhibitory factor is not an immunoglobulin, but rather a polysaccharidic antigen of Candida albicans. An inhibition of Candida-induced proliferative response of normal human lymphocytes was also obtained by addition of polysacharide antigens or purified mannans from C. albicans to cultures. Candida polysaccharidic antigens appeared, therefore, to be involved in specific depression of cellular functions observed in chronic candidiasis.

Adolescent↗
PubMed2003

Effects of doxycycline, metronidazole and their combination on Candida species colonization of the human oropharynx, intestinal lumen and vagina.

The present study reports about the effect of doxycycline and/or metronidazole on colonization by Candida organisms of the human gastrointestinal (GI), oropharyngeal tract and vagina. Treatment with doxycycline or metronidazole for 10 days increased, but not significantly, the GI, oropharyngeal or vaginal colonization by Candida species. The combination of doxycycline and metronidazole, used for the same period, caused a significant increase of 2.5 log10 CFU/g of stools (mean) colonization by Candida. Likewise, 2 out of 9 patients treated with the combination had substantially increased colonization of their vagina by Candida species. This effect, however, could not be expressed statistically due to the semiquantitative nature of the vaginal cultures. In contrast, the combination did not increase oropharyngeal colonization. In conclusion, doxycycline and metronidazole as monotherapies, did not increase significantly Candida colonization in the cavities examined. The combination of doxycycline and metronidazole had a substantial effect, increasing the GI and vaginal colonization by Candida organisms.

Anti-Bacterial Agents↗
PubMed2006

Screening of Tanzanian medicinal plants for anti-Candida activity.

BACKGROUND: Candida albicans has become resistant to the already limited, toxic and expensive anti-Candida agents available in the market. These factors necessitate the search for new anti-fungal agents. METHODS: Sixty-three plant extracts, from 56 Tanzanian plant species obtained through the literature and interviews with traditional healers, were evaluated for anti-Candida activity. Aqueous methanolic extracts were screened for anti-Candida activity by bioautography agar overlay method, using a standard strain of Candida albicans (ATCC 90028). RESULTS: Twenty- seven (48%) out of the 56 plants were found to be active. Extracts of the root barks of Albizia anthelmintica and Balanites aegyptiaca, and roots of Plectranthus barbatus showed strong activity. CONCLUSION: The extracts that showed strong anti-Candida activity are worth of further investigation in order to isolate and identify the active compounds.

Albizzia↗
PubMed1993

Characterization of a human chorionic gonadotropin-like protein from Candida albicans.

Studies from our laboratory have demonstrated that human CG (hCG), human LH, (hLH), and an hCG-like protein extracted from Xanthomonas maltophilia were able to induce Candida albicans transition from the blastospore to the germ tube stage. In the present study, we describe the characterization of an hCG-like material extracted from Candida albicans blastospores (CaCGLP), which is potent in inducing transition and presumably represents the endogenous transition-inducing substance. This material was extracted from Candida albicans blastospores with glacial acetic acid and purified by affinity chromatography using a polyclonal rabbit anti-hCG antibody. The product obtained is a 68-kilodalton single band protein, as analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot analysis. Under reduced conditions a protein smear is seen. Amino acid analysis showed a predominance of glycine (22%), followed by serine (12%), and glutamate (12%). This protein reacted in the following hCG immunoassays: 1) a polyclonal rabbit anti-hCG equilibrium assay, 2) a carboxyl-tail hCG equilibrium assay, 3) two hCG equilibrium assays using monoclonal antibodies (CG no. 4 and CG no. 9), 4) a free alpha-subunit equilibrium assay using a monoclonal antibody, and 5) an ultrasensitive immunoradiometric assay for hCG which does not cross-react with hLH, nor the free beta-subunit of hCG. The CaCGLP showed no reaction in a specific hLH immunoradiometric assay. When CaCGLP was tested in the transition assay, in the presence of 4% rat serum, it was found that this protein was 100 times more potent than hCG in producing Candida albicans transition. We conclude that Candida albicans produces a protein that has certain tertiary structure similarities to hCG and that this material is able to induce germ tube formation. We postulate that CaCGLP has an autocrine/paracrine effect in Candida albicans as a transition factor to control its own pathogenicity.

Amino Acids↗
PubMed2003

Detection of candida by polymerase chain reaction vs microscopy and culture in women diagnosed as recurrent vulvovaginal cases.

The objectives were to compare the outcome of polymerase chain reaction (PCR), culture and microscopy of introital and vaginal samples for detection of candida in women with a history of recurrent vulvovaginal candidosis (RVVC). One hundred and three women with a history of RVVC, i.e. with at least four episodes of the condition in the previous year and who consulted with complaints consistent with a new episode, were studied. Introital and vaginal swabs were cultured on Sabouraud and CHROMagar. Isolated strains were identified on the chromogenic agar and by API 32C kits and by Vitek automatized identification system (BioMérieux, France). PCR for detection of Candida spp. was performed on vaginal lavage fluid. There was a complete agreement in the recovery rate when using the two agar media. However, complete concordance was not obtained between culture and PCR. In 32 (43.8%) of 73 women both PCR and culture were positive, and in 17 (23.3%) both were negative. In 15 (20.5%), only cultures proved positive, while in another 13 (17.8%) patients only the PCR was positive. Four of the PCR-negative became PCR-positive on retesting after dilution of the sample to try to reduce any potential putative PCR inhibitors. In the 47 PCR-positive women, 26 (55.3%) of the introital smears and 31 (65.9%) posterior vaginal smears showed candida morphotypes. In the 25 PCR-negative women, the corresponding figures were 9 (36.0%) and 17 (68.0%), respectively. The PCR test identified Candida albicans in 21 (87.5%) instances, but failed to do so in three (12.5%) cases in which the metabolic/assimilation tests were positive for this species. The corresponding figures for non-albicans Candida spp. were four (57%) and three (43%), respectively. The study of women with RVVC did not show any uniform agreement between the different diagnostic methods used to identify candida in genital samples or for speciation of yeast isolates. Thus reliance only on microscopy, culture or PCR may lead to inaccurate results.

Adolescent↗
PubMedDate not supplied

Asymptomatic oral carriage of Candida species in HIV-infected patients in the highly active antiretroviral therapy era.

Oropharyngeal candidiasis is the most common opportunistic fungal infection in individuals infected with human immunodeficiency virus. CD4+ lymphocytes count and the quantification of viral RNA in blood plasma have been found to be the main markers of HIV disease progression. The present study was conducted to evaluate Candida sp. diversity in the oral cavity of HIV-infected patients and to determine whether there was association of CD4+ cell count and viral load with asymptomatic oral Candida carriage. Out of 99 HIV-positive patients studied, 62 (62.6%) had positive culture for Candida (oral carriage) and 37 patients (37.4%) had Candida negative culture (no oral carriage). The etiologic agents most common were C. albicans and C. tropicalis. The range of CD4+ was 6-2305 cells/mm3 in colonized patients and 3-839 cells/mm3 for non-colonized patients, while the viral load was 60-90016 copies/mL for colonized patients and 75-110488 copies/mL for non colonized patients. The viral load was undetectable in 15 colonized patients and in 12 non colonized patients. Our results showed that there was no significant difference of the variables CD4+ cell count and viral load between oral candida carriage and no oral candida carriage patients.

Adolescent↗
PubMed2006

[Utilization of tomato juice agar (V8 agar) in the presumptive identification of Candida dubliniensis].

We evaluated the capacity of tomato juice agar (V8 agar) to differentiate Candida dubliniensis from Candida albicans based on chlamydospore production. Candida albicans (n= 93) and Candida dubliniensis (n= 26) were studied; 100% of Candida dubliniensis showed chlamydospores and in 92.5% of Candida albicans isolates these elements were absent. These results suggest this medium as an alternative tool for presumptive differentiation between these species.

Agar↗
PubMed1991

Characterization of a factor(s) from partially purified human gonadotrophin preparations which inhibit(s) the binding of radiolabelled human LH and human chorionic gonadotrophin to Candida albicans.

We have shown previously that partially purified human chorionic gonadotrophin (hCG) preparations inhibited the specific binding of 125I-labelled hLH or hCG to Candida albicans membranes at much lower concentrations than did highly purified hLH or hCG preparations. We now describe the characterization and partial purification of a heat-labile glycoprotein from commercially available gonadotrophin preparations. The factor strongly inhibited LH binding to Candida membranes, but not to sheep or pig luteal LH receptors. This material had a molecular weight of 16,000-21,000 daltons, bound strongly to CM-Sepharose at physiological pH, and could be resolved completely from hCG and from epidermal growth factor-like factors present in commercial gonadotrophin preparations. Its activity was not attenuated by a range of inhibitors specific for the four major classes of proteolytic enzymes, nor did it inhibit hormone binding by causing degradation of 125I-labelled hLH or hCG tracers. Factors which inhibited hLH binding to Candida membranes were also present in partially purified human urinary and equine serum gonadotrophin preparations and in placental extracts, but were not detected in highly purified CG of hLH preparations. The properties of this factor were similar to those described for beta-core protein, a cleavage product of the beta subunit of hCG which is a contaminant of commercial gonadotrophin preparations. Highly purified beta-core protein inhibited 125I-labelled hLH binding to Candida membranes, but not to sheep luteal binding sites. Preparations of hCG depleted of inhibitor activity could stimulate adenylate cyclase activity in Candida membranes almost five fold. In contrast, partially purified inhibitor preparations strongly inhibited basal adenylate cyclase activity (to 18% of control levels). These observations suggest that endogenous LH-like factors, perhaps similar to beta-core proteins of hCG, may play a role in the regulation of morphogenesis in Candida species.

Adenylyl Cyclases↗
PubMed1993

Early Candida isolations in febrile patients after abdominal surgery.

The significance of finding Candida sp. in febrile patients after abdominal surgery was studied in a prospective study on 107 patients. The patients were divided into 3 groups, based on the isolation and time of sampling of Candida sp. and on any other microbiological documentation of the infection. Eight patients were found Candida-positive either by blood cultures or by cultures of urine, abdominal pus, tracheal aspirate or wound exudate within the first postoperative week and had significantly greater mortality than patients with other infections or later Candida sp.-isolation (50% vs 10%, p < 0.05). Isolation of Candida was associated with prolonged antibiotic therapy, extended central vein catheterization, parenteral nutrition and operations on the small bowel, ascending colon or pancreas, but not with the underlying illness. The results support the view that isolation of Candida sp. within the first week after surgery does not represent harmless colonization but is rather associated with serious morbidity.

Abdomen↗
PubMed1997

[Distribution of Candida species and mutans streptococci related to oral conditions in elderly persons].

The purpose of this investigation was to find the relationship between the occurrence of Candida species and mutans streptococci at 7 sites (saliva, tongue, mucosa, teeth, clasp, external, and mucosal denture surfaces) in the mouth of 97 elderly persons (males: 43, age: 76.4 +/- 6.7 years; females: 54, age: 75.0 +/- 6.6 years). Among the subjects, there were complete denture wearers (n = 20), partial denture wearers (n = 45), and non-denture wearers (n = 32). Candida species were more significantly (p < 0.001) predominant in complete and partial denture wearers (80% each) than in non-denture (18.8%) wearers. The presence of Candida was highest on the mucosal denture surfaces followed by clasp, tongue, and remaining teeth in that order. Positive correlation were significantly found between the CFU numbers of Candida species and mutans streptococci present on the external surfaces (p < 0.001), natural teeth (p < 0.001), clasp (p < 0.01), and saliva (p < 0.05). A negative correlation (r = -0.503; p < 0.001) was found between the number of teeth and the CFU numbers of Candida species. Moreover, the CFU numbers of both groups of microorganisms also increased in 80-year-old and over persons. Candida species were most predominantly found in persons with poor oral and denture cleanliness.

Age Factors↗
PubMed1999

[Epidemiology of yeast colonization and oropharyngeal infection other than Candida albicans in patients with HIV infection].

BACKGROUND: An increasing frequency of opportunistic fungal infections in immunosuppressed patients in recent years. Concurrent with this finding, it has been noted an increasing use of fluconazole. In addition, non-Candida albicans species (NCAS), most of which are fluconazole-resistant have been increasing isolated. The aim of this study was to investigate the epidemiology of colonization and infection due to NCAS in HIV-infected patients. PATIENTS AND METHODS: A cross sectional study was conducted with HIV-infected patients in different stages, who were attended at two hospitals in Alicante, Spain. We assessed the prevalence and microbiology of oropharyngeal colonization and infection due to Candida spp., and its fluconazole susceptibility patterns. To determine the clinical risk factors for the development of fluconazole resistance, we carried out a case-control study with prevalent cases. RESULTS: We studied 168 strains from 153 patients. NCAS were isolated in 32 (21%) of them, 25 (77%) were colonized, and 5 (26%) had infection due to NCAS. The most common isolate was Candida glabrata (n = 15). MICs were significantly higher for NCAS than for Candida albicans species, with a MIC50 of 16 and 0.25 microgram/ml, respectively, and a MIC90 of 128 micrograms/ml and 8 micrograms/ml (p = 0.0001). The median CD4 cell count in patients with NCAS was 0.06 x 10(9)/l, and 0.19 x 10(9)/l patients with Candida albicans (p = 0.009). Overall, 56% of the patients with NCAS and 41% of the patients with Candida albicans had been treated with fluconazole (p = 0.1). CONCLUSIONS: NCAS are isolated in a high proportion of HIV infected patients. Most of the NCAS have a decreased susceptibility to fluconazole. The only risk factor associated with the acquisition of NCAS in HIV-infected patients is an advanced immunosuppression.

Adult↗
PubMedDate not supplied

[Fungemia by Candida non albicans in patients with HIV infection].

OBJECTIVE: To analyse candidemia by Candida non albicans in adult HIV-infected patients from 1989 to August 1998. PATIENTS AND METHODS: We retrospectively reviewed all HIV patients who presented at least one positive peripheral blood culture for Candida spp. Clinical, epidemiologic, immunologic and evolutive characteristics, and risk factors for candidemia were analysed. RESULTS: During this period of time, 2,025 HIV-infected patients were diagnosed. Five of them developed candidemia by C. albicans and 6 by C. non albicans. These last ones were all men with mean age of 32.1 years old, and intravenous drug use was the risk factor for HIV in 5 of them; aids had previously been diagnosed in 4 patients and 3 had receipt imidazoles. None was neutropenic. Three cases were nosocomially acquired. Median CD4 cell count was 108.6 x 10(6)/l (3-366). Candida krusei was isolated in two intravenous drug users, Candida parapsilosis in two other patients and Candida glabrata and Candida tropicalis in one of the other two cases each. We treated 2 patients with amphotericin B and 2 with fluconazole. One patient died. CONCLUSIONS: Candidemia is not frequent in HIV-infected patients. Candidemia by C. non albicans in HIV-infected patients presents similar characteristics as in other immunodepressed patients and it is fundamentally associated with previous use of imidazoles, nosocomial acquisition and late-stage aids. It is noteworthy that C. krusei was isolated in two intravenous drug users.

AIDS-Related Opportunistic Infections↗
PubMed2000

Rapid identification of fluconazole resistance using Chromagar Candida.

Although extremely rare 10 years ago, antifungal drug resistance is becoming a major problem in certain populations, especially in those infected with HIV. This study was undertaken to study the resistance of Candida species isolated in our hospital to Fluconazole using Chrom agar Candida. The Candida strains which were routinely isolated from clinical specimens like blood, urine, sputum, pus, fluid and homograft isolates were included in the study. 142 Candida isolates were tested by using Chrom agar Candida incorporated with fluconazole. 16 strains were found to be resistant to Fluconazole and 126 strains sensitive to Fluconazole. Nine were C tropicalis, 3 C krusei, 2 C guillermondii, 1 Geotrichum candidum and one was an unidentified strain of Candida. The MIC of the 16 strains were done using RPMI 1640 medium by macro broth dilution method. MIC of 9 strains was 64 & > 64 micrograms/ml of 6 strains 32 micrograms/ml and 1 strain 16 micrograms/ml.

Antifungal Agents↗
PubMed2001

[Is endoscopic diagnosis of Candida albicans esophagitis reliable? Correlations with pathology and mycology].

AIM OF STUDY: To assess the reliability of endoscopic diagnosis of Candida albicans esophagitis. PATIENTS AND METHODS: A case - control prospective study was carried out from November 1997 to July 1998 at the Campus Teaching Hospital of Lome, in patients with esophagitis macroscopically suggestive of Candida albicans origin at upper digestive endoscopy. Fifteen subjects with normal endoscopy served as controls. Esophageal biopsies for mycologic and pathological examination were performed, as well as HIV serology. RESULTS: During the study period, 26 of the 850 endoscopies performed in our Unit revealed an esophagitis suggestive of Candida albicans origin. Mycology confirmed the presence of filamentous form of Candida albicans in 23 patients and pathology showed non-specific lesions of esophagitis, 20 with intramucous hyphae. HIV serology was positive in 19/23 patients (82.6%) and in 1/15 controls (6.6%). Sensitivity and specificity of upper GI endoscopy for the diagnosis of Candida albicans were 100 and 83.3% respectively; positive and negative predictive values were 88.5 and 100%, respectively. CONCLUSION: Upper digestive endoscopy is a reliable method for the diagnosis of Candida albicans esophagitis. However, mycological confirmation is warranted.

AIDS-Related Opportunistic Infections↗
PubMed2001

Rapid identification of fluconazole resistance using Chrom agar Candida.

All though extremely rare 10 years ago, antifungal drug resistance is becoming a major problem in certain populations, especially in those infected with HIV. This study was undertaken to study the resistance of Candida species isolated in our hospital to Fluconazole using Chrom agar Candida. The Candida strains which were routinely isolated from clinical specimens like blood, urine, sputum, pus, fluid and homograft isolates were included in the study. 142 Candida isolates were tested by using Chrom agar Candida incorporated with Fluconazole. 16 strains were found to be resistant to Fluconazole and 126 strains sensitive to Fluconazole. Nine were C. tropicalis, 3 C. krusei, 2 C. guillermondii, 1 Geotrichum candidum and one was an unidentified strain of Candida. The MIC of the 16 strains were done using RPMI 1640 medium by macro broth dilution method. MIC of 9 strains was 64 & > 64 ug/ml of 6 strains 32 ug/ml and 1 strain 16 ug/ml.

Agar↗
PubMed1975

The importance of candida as an infectious agent.

During the two and a half year period from January 1971 through Jyly 1973, 23 patients had cultures positive for candida from intra-abdominal isolates. Most of these patients had intestinal or biliary fistulas or abscesses and were seriously ill. Major contributing factors to the development of candidal infections included the extensive use of multiple antibiotics, multiple operations, advanced age, and debility. Thirty additional patients had cultures positive for candida from skin and subcutaneous isolates. Candida appeared to contribute to the poor healing of wounds in some of these patients, particularly those with peripheral vascular ischemic lesions and decubitus ulcers. Antibiotics and concurrent diseases, such as diabetes, cancer, renal failure, and cardiovascular disease, were common factors relating to the development and growth of candida in these patients. There is often considerable difficulty in determing whether or not candida is only a contaminant or is an infectious agent contributing to the illness of the patient. This must be determined in each individual instance. In spite of the fact that candida appeared to be a significant infectious agent in many of these patients, specific antifungal therapy was used sparsely. It is suggested that appropriate antifungal drugs be used in patients with significant disease and that there should be greater awareness of the factors leading to the development of these extremely serious candidal infections.

Adult↗
PubMed2002

[Architecture, influencing factors, and sensitivity to antifungal agents of Candida biofilm].

OBJECTIVE: To establish a model of Candida biofilm and to explore its characteristics, ultrastructure, influences by saliva and serum, and sensitivity to antifungal agents. METHODS: Evaluations of the in vitro growth kinetics, influences by saliva and serum, and sensitivity to antifungal agents of Candida biofilm were performed with the abated tetrazolium salt XTT method on a 96-well microtire petri dish. The ultrastructure of Candida biofilm was observed under Confocal Laser Scanning Microscope (CLSM). RESULTS: The bioactivity of Candida biofilm increased with culturing time and serum could obviously increase the action of biofilm. The Candida biofilm was significantly resistant to routine antifungal agents. CONCLUSION: The Candida cells adhered in biofilms are significantly different in morphology from those in suspension and are resistant to routine antifungal agents such as Amphotericine B, Fluconazole and Itraconazole.

Amphotericin B↗