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PubMed1991

Defective Candida opsonin and procidin function in patients with recurrent pyogenic infection: a common immunodeficiency.

Polymorphonuclear cell function tests were performed in 340 patients with recurrent unexplained infections. Serum-dependent defects in phagocytosis and intracellular killing of Candida albicans (Candida opsonin and procidin defects) were specifically associated with susceptibility to recurrent pyogenic infections, Candida opsonin defects occurring in 12.7% and Candida procidin defects in 20.8% of patients compared with 3.7% of healthy controls. Saccharomyces cerevisiae opsonin deficiencies were also found frequently in patients with recurrent infections, being present in 18.2% compared with 7.4% controls, although not specifically in those with pyogenic infection.

Adolescent↗
PubMed1987

Characterization of a soluble carnitine acetyltransferase from Candida tropicalis.

Carnitine acetyltransferase was purified from the cytoplasmic fraction of Candida tropicalis grown on alkanes in continuous culture. By ion-exchange chromatography the enzyme was resolved in two fractions with the same specific activity of 80 U/mg. The molecular mass of both enzyme forms, determined by non-denaturing gradient gel electrophoresis, was 540 kDa. After SDS electrophoresis only one band of 64 kDa was detected indicating that both enzymes are oligomers each containing eight subunits. Isoelectric focusing in agarose under non-denaturing conditions demonstrated the presence of at least four different charged species in the pH range between 5.6 and 6.7. After isoelectric focusing in 9 M urea/1% Nonidet P-40 gels, both enzyme forms were resolved into four bands. Peptide mapping, performed by cyanogen bromide cleavage of polypeptides separated by denaturing isoelectric focusing followed by second-dimension SDS electrophoresis, revealed a very high degree of homology between these polypeptides. The presence of the octameric form of carnitine acetyltransferase already in the starting material was demonstrated by non-denaturing gradient gel electrophoresis and immunoblotting. Antibodies against carnitine acetyltransferase from C. tropicalis ATCC 32113 formed precipitation lines with extracts from several Candida species but not with extracts of Candida utilis, Candida ethanothermophilum and an another strain of C. tropicalis.

Acetyltransferases↗
PubMed1989

Comparative activity in vitro of cilofungin (LY 121019) with other agents used for treatment of deep-seated Candida infections.

Cilofungin (LY 121019) is a semi-synthetic lipopeptide antifungal agent that inhibits beta-1,3-D-glucan synthase activity in the cell wall of yeasts. Clinical strains of Candida species were tested for susceptibility to cilofungin and seven other antifungal agents. Candida albicans and Candida tropicalis were susceptible to cilofungin with mean MICs of 0.3 and 0.08 microgram/ml respectively. For most other species the mean MICs were greater than 1-2 micrograms/ml of cilofungin. Studies on the paradoxical growth effect observed with cilofungin in Sabouraud broth showed that, at high concentrations of cilofungin, sufficient damage occurred to make damaged cells highly susceptible to killing by fresh cilofungin. The damaged cells also had increased susceptibility to other antifungal agents to which they were normally resistant. These observations indicate that cilofungin may be a useful agent for the treatment of many invasive Candida infections, either alone or in combination with certain other antifungal agents.

Antifungal Agents↗
PubMedDate not supplied

Growth of Candida albicans in normal and altered faecal flora in the model of continuous flow culture.

We used the model of faecal microflora under continuous flow culture (CFC) conditions to study the growth of Candida albicans in mixed cultures. The development of Candida is usually limited by the high germ counts of aerobic and anaerobic bacteria. Candida growth in faecal flora could be obtained neither by the continuous inflow of C. albicans CFC monocultures nor by intermittent input of highly concentrated suspensions of C. albicans into the system. If the system was run under aerobic conditions development of C. albicans could be observed. After some days, however, the faecal flora again suppressed further development of the yeasts. Only marked destruction of the aerobic and anaerobic microflora by antibiotics resulted in growth or overgrowth of Candida albicans.

Aerobiosis↗
PubMedDate not supplied

Characterization of specific anti-Candida IgM, IgA and IgE: diagnostic value in deep-seated infections.

The proposed serological diagnosis of systemic Candida infections is based on a microplate immunocapture technique detecting IgM, IgA and IgE anti-Candida antibodies. Activity is revealed with a suspension of human erythrocytes sensitized with somatic antigen of Candida albicans, and is quantified on an automated plate reader. The sera were obtained from patients with deep-seated (n = 56) and superficial (n = 193) candidosis. We compared this immunological method with a combination of indirect immunofluorescence and co-immunoelectrodiffusion. The immunocapture method was more sensitive (80.4% vs. 48.2% with indirect immunofluorescence and 58.9% with co-immunoelectrodiffusion), and often provided the diagnosis at an earlier stage, with clear therapeutic advantages. The IgA isotype was a particularly valuable marker of deep-seated Candida infections.

Adolescent↗
PubMed1997

Quantitative cultures of Candida from mouthwash fluid in HIV-infected patients: a longitudinal study.

The density of Candida colonization in mouthwash fluid of 59 HIV-seropositive patients and 21 controls was determined. No significant difference in colony-forming units was found. No correlation was found between the colonizing density of Candida albicans and the CD4 count among the patients. Twenty-seven of the HIV-seropositive patients were followed for almost 3 years. No difference was found between the number of Candida albicans colony-forming units at the first and second time of sampling. Vaccination with HIV IIIB GP 160 vaccine did not have any influence on the prevalence of Candida albicans.

Adolescent↗
PubMed1997

[Candida identification: experiences with the Vitek automated system].

We report about our experiences obtained with the Vitek system (bioMerieux, Nürtingen) for identification of 1160 clinical Candida isolates. The Vitek system correctly identified 1005 (86.6%) Candida isolates (probability > or = 85%): 776 (66.9%) strains were identified after 24 h of incubation, 229 (19.7%) required 48 h of incubation. In 4.4% (n = 51) we found results with a lower probability (< 85%). After 24 h of incubation 38 (14.6%) of the 260 C. tropicalis isolates tested were misidentified as C. parapsilosis; we obtained the correct results after 48 h of incubation. 104 (9%) isolates were wrongly identified after 48 h of incubation. The majority of these strains (n = 82) were biochemically minimally reactive Candida species. Overall, the Yeast Biochemical Card system provides a reliable method for the rapid, automated identification of medically important Candida species.

Automation↗
PubMed2004

Update on antifungal treatment of invasive Candida and Aspergillus infections.

Invasive Candida and Aspergillus infections are among the most common serious complications occurring in chronically immunosuppressed patients, in particular those with hematological malignancies and transplant recipients. A rational, early systemic antifungal treatment can be based upon imaging diagnostic techniques as well as upon conventional mycological and non-culture-based procedures. The availability of well tolerable and highly efficacious systemic antifungals has improved the spectrum of therapeutic options and the success rates of antifungal treatment. However, with respect to high treatment costs associated with these new agents, it is mandatory to specify indications and limitations for the use of these substances. Voriconazole may well become the new standard primary treatment of invasive aspergillosis. The role of the new echinocandins such as caspofungin, which has recently been approved for salvage treatment of resistant and refractory Aspergillus infections, in primary or combination treatment of invasive aspergillosis must be further studied. Caspofungin is at least as effective as, yet significantly better tolerated than amphotericin B for primary treatment of invasive candidosis in non-neutropenic patients, and has been approved for this indication. The selection of systemic antifungals in patients with invasive Candida infection critically depends upon the identification of Candida species involved, because some non-albicans Candida spp. are resistant to azole antifungals.

Antifungal Agents↗
PubMed2004

Influence of voriconazole and fluconazole on reconstituted multilayered oesophageal epithelium infected by Candida albicans.

Reconstituted multilayered oesophageal epithelium appears to be a good basis to test the efficacy of voriconazole (VOR) and fluconazole (FLU) in the tissue. The resulting model of a Candida oesophagitis was approaching the in vivo situation. We infected the tissue with 2 x 10(6) cfu of the Candida albicans strain SC5314. In the trials with FLU we also used clinical strains. Four hours after infection a good growth of C. albicans appeared mainly with hyphae on the surface of the tissue and a tendency to invasion. The destruction of the tissue began after 36 h. VOR (2 and 16 microg ml-1, respectively) prevented the penetration of hyphae into the tissue, when it was given 4-8 h after infection. It was less effective in reduction of Candida growth on the tissue surface. When VOR was given 16-24 h postinfection, the Candida infiltration stopped more slowly. Thirty-six hours after infection VOR application could not stop the destruction of the tissue despite reducing the fungi. The results with FLU (32 microg ml-1) were in principle the same, but not so distinct. FLU seems to be more effective against clinical strains of C. albicans than against the type strain.

Antifungal Agents↗
PubMed2004

[Mycoserologic tests in surgical intensive care patients and patients with Candida oesophagitis].

We retrospectively analysed the results of Candida serological testing of 126 surgical intensive care patients. There were high numbers of patients which were mycoserologically positive (haemagglutination test HAT 86.4%, immunoglobulin subclasses 85.3%). Positive microbiological cultures of Candida spp. were found in 43.7% of the patients. Patients with positive cultural findings had an increased HAT titre in 83.9% and increased immunoglobulins in 74.2%. These patients were suspected to have a Candida infection. The correlation to higher titres was much closer in patients with an invasive Candida infection like candidaemia and oesophagitis.

Antibodies, Fungal↗
PubMed2004

[Candida-specific antibodies in intensive care and non-intensive care patients].

The titres of indirect anti-Candida haemagglutination test (C-HAT) and specific immunoglobulins C-IgM, C-IgG and C-IgA in 328 intensive care (IT) patients and 166 non-intensive care (NIT) patients were compared by statistical test methods. Positive correlations were found between values of C-HAT and all three Candida-specific immunoglobulins. At an interval of < or =7 days in the first patient group only, the changes in the course of titres were statistically highly significant. For C-IgM the short-term increase of titres can be interpreted in the sense of happened mycotic infection in connection with the clinical picture. In IT patients we found an average increase of C-IgM at 259.3, C-IgG at 174.7, C-IgA at 59.8 U ml(-1) and of three titre steps in C-HAT. In our experience of diagnostics of Candida infections in intensive care area with non-neutropenic patients the short-term determination of the anti-Candida immunoglobulin subclasses C-IgM and C-IgG and of C-HAT as screening test should not be neglected.

Antibodies, Fungal↗
PubMed2004

[The significance of interleukins and of Candida-IgE in chronic recurrent vulvovaginal candidosis].

We examined 104 patients with chronic recurrent vulvovaginal candidosis; 41 healthy women were selected for the control group. Vaginal samples were taken, and yeasts were grown and tested for Candida strains: 29.8% of samples contained Candida spp.; two of the control women were infected. We also identified interleukin IL-4, 5 and 13, but there was only significant increase in IL-4. In addition, prostaglandin E2, whole IgE and Candida-specific-IgE was identified. Also here prostaglandin E2 and the Candida IgE were significantly higher in comparison with the control group, while whole IgE showed no significant increase. This resulted in an allergic component in the chronic recurrent vulvovaginal candidosis, which suggested that therapy should be reconsidered.

Antibodies, Fungal↗
PubMed2005

Hydrolytic enzymes as virulence factors of Candida albicans.

Candida albicans is a facultative pathogenic micro-organism that has developed several virulence traits enabling invasion of host tissues and avoidance of host defence mechanisms. Virulence factors that contribute to this process are the hydrolytic enzymes. Most of them are extracellularly secreted by the fungus. The most discussed hydrolytic enzymes produced by C. albicans are secreted aspartic proteinases (Saps). The role of these Saps for C. albicans infections was carefully evaluated in numerous studies, whereas only little is known about the physiological role of the secreted phospholipases (PL) and almost nothing about the involvement of lipases (Lip) in virulence. They may play an important role in the pathogenicity of candidosis and their hydrolytic activity probably has a number of possible functions in addition to the simple role of digesting molecules for nutrition. Saps as the best-studied member of this group of hydrolytic enzymes contribute to host tissue invasion by digesting or destroying cell membranes and by degrading host surface molecules. There is also some evidence that hydrolytic enzymes are able to attack cells and molecules of the host immune system to avoid or resist antimicrobial activity. High hydrolytic activity with broad substrate specificity has been found in several Candida species, most notably in C. albicans. This activity is attributed to multigene families with at least 10 members for Saps and Lips and several members for PL B. Distinct members of these gene families are differentially regulated in various Candida infections. In future, prevention and control of Candida infections might be achieved by pharmacological or immunological tools specifically modulated to inhibit virulence factors, e.g. the family of Saps.

Candida albicans↗
PubMed2006

In vitro adhesion of Candida species to denture base materials.

Adhesion of Candida species to prosthetic acrylic resins is an essential first step in the pathogenesis of denture stomatitis. Data on the relative adhesion of pathogenic non-albicans Candida species to different denture base materials are sparse. The purpose of the present study was to investigate in vitro adhesion of C. albicans, C. glabrata, C. krusei and C. dubliniensis to four different denture base materials. Specimens of both heat-cured resins (Vertex(TM) Rapid Simplified and ProBase Hot) and cold-cured resins (Paladur A and Paladur B) were prepared using a novel method and the adhesion of four strains each of the foregoing Candida species evaluated microscopically using a soft imaging system. There was a significant difference in yeast adherence between Vertex and the other resins. Only C. glabrata attached to Vertex, while all the remainder of the tested species adhered to all other resins tested except ProBase, which resisted C. krusei adhesion. There was a significant difference in candidal adhesion between cold-cured and heat-cured resins for three Candida species (C. albicans, P = 0.039; C. glabrata, P = 0.002 and C. krusei, P = 0.000). The type of denture base material and whether they are heat-cured or cold-cured play an important role in modifying candidal adhesion.

Acrylic Resins↗
PubMed2006

Detection of Candida species by PCR in self-collected vaginal swabs of women after taking antibiotics.

Women undergoing antibiotic treatment can develop vulvovaginal candidiasis. This study evaluated polymerase chain reaction (PCR) for the detection of Candida species in comparison with the conventional laboratory culture methods in samples from women with and without symptoms of postantibiotic candidiasis. The self-collected vaginal swabs from 90 women, with no recent symptoms of vulvovaginal candidiasis (VVC), who were prescribed antibiotics for non-genital infection were evaluated 8 days after completion of antibiotics and/or at the time of developing symptoms of VVC. Broad-spectrum fungal PCR was performed on extracted DNA from each sample. Overall PCR detected four additional Canidida albicans, three Candida parapsilosis and one Candida tropicalis when compared with culture. All but one case additionally detected by PCR were found in patients with no VVC symptoms. PCR, although more sensitive than conventional culture methods, in this small number of cases, has not been able to detect Candida species in significantly more patients with symptoms suggestive of candidiasis. The results of this study may indicate that other agents including other yeast species may be responsible for symptoms of postantibiotic vulvovaginitis.

Anti-Bacterial Agents↗
PubMed2005

Rapid identification of Candida spp. in peritonitis patients by Raman spectroscopy.

This prospective study evaluated Raman spectroscopy for the identification of clinically relevant Candida spp. in peritonitis patients. A Raman database was developed by measuring spectra from 93 reference strains belonging to ten different Candida spp. Clinical samples were obtained from the surgical department and intensive care unit of a tertiary university hospital. In total, 88 peritoneal specimens from 45 patients with primary, secondary or tertiary peritonitis were included. Specimens were cultured initially on a selective Sabouraud medium that contained gentamicin to suppress bacterial growth. For conventional identification, a chromogenic medium was used for presumptive identification, followed by use of the Vitek 2 system for definitive identification (requiring a total time of 48-96 h). Raman measurements were taken on overnight cultures from Sabouraud-gentamicin medium. Thirty-one samples were positive for Candida by culture. Using multivariate statistical analyses, a prediction accuracy of 90% was obtained for Raman spectroscopy, which appears to offer an accurate and rapid (12-24 h) alternative for the identification of Candida spp. in peritonitis patients. The reduced turn-around time is of great clinical importance for the treatment of critically ill patients with invasive candidiasis in intensive care units.

Candida↗
PubMed2006

Inflammatory response and clinical course of adult patients with nosocomial bloodstream infections caused by Candida spp.

Candida spp. are an important cause of nosocomial bloodstream infection (nBSI) and are associated with significant morbidity and mortality. An historical cohort study was performed to evaluate the clinical course of 60 randomly selected adult patients with nBSIs caused by Candida spp. Patients with BSI caused by Candida albicans (n = 38) and non-albicans spp. (n = 22) were compared with 80 patients with Staphylococcus aureus BSI by serial systemic inflammatory response syndrome (SIRS) and APACHE II scores. The patients had a mean age of 52 years, the length of hospital stay before BSI averaged 21 days, and 57% of patients required care in an intensive care unit before BSI. The mean APACHE II score was 17 on the day of BSI, and 63% of BSIs were caused by C. albicans. Antifungal therapy within the first 24 h of onset of BSI was appropriate in 52% of patients. Septic shock occurred in 27% of patients, and severe sepsis in an additional 8%. Overall mortality was 42%, and the 7-day mortality rate was 27%. The inflammatory response and clinical course were similar for patients with BSI caused by C. albicans and non-albicans spp. In univariate analysis, progression to septic shock was correlated with high overall mortality, as was an APACHE II score >25 at the onset of BSI. In multivariate analysis, the APACHE II score at the onset of BSI and a systemic inflammatory response independently predicted overall mortality, but the 7-day mortality rate was only predicted independently by the APACHE II score. Clinical course and mortality in patients with Candida BSI were predicted by systemic inflammatory response and APACHE II score, but not by the infecting species.

APACHE↗
PubMed2005

Candida antigen in the treatment of basal cell carcinoma.

BACKGROUND: Basal cell carcinoma (BCC) is the most common skin cancer. Recently, there has been renewed interest in various immunotherapies in the treatment of BCC. The current study is a randomized, open-label, placebo-controlled trial of intralesional Candida antigen in the treatment of nodular BCC. OBJECTIVE: The objective of this study was to evaluate the safety and efficacy of intralesional Candida antigen in the treatment of BCC. RESULTS: In the control group, no patients had complete clearing of their tumor. In the Candida group, 10 of 17 (56%) patients had complete clearing of their tumor. The Fisher exact test was used to compare the two treatment groups. This showed the difference in clearance rates to be of borderline significance, with a p value of .105. CONCLUSION: Although immunotherapy with repeated injections of Candida antigen appears to be effective in clearing superficial and nodular BCCs, it is unlikely to alter our current treatment of BCC.

Antigens, Fungal↗