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PubMed1995

Lighting conditions alter Candida albicans-induced sleep responses in rabbits.

To evaluate the influence of light on sleep patterns after microbial challenge, we studied rabbits housed in 12:12-h light-dark (LD), constant light (LL), or constant darkness (DD) before and after intravenous Candida albicans inoculation. Compared with the LD group, uninoculated LL rabbits sporadically increased slow-wave sleep and delta-wave amplitudes during the circadian period previously associated with the dark phase. In contrast, uninfected DD rabbits showed reduced sleep during the circadian period previously associated with the light phase. Inoculation of LD rabbits with Candida approximately 2 h after light onset increased slow-wave sleep and delta-wave amplitudes during hours 4-8 postinoculation and reduced these parameters during hours 20-46. In contrast, Candida-inoculated LL rabbits demonstrated increased slow-wave sleep for up to 28 h after inoculation, with little subsequent reduction; delta-wave amplitudes were similar to those of LD rabbits. Candida-inoculated DD rabbits demonstrated attenuated increases in slow-wave sleep and delta-wave amplitudes, but the suppression phase was not altered. We conclude that lighting conditions modulate microbially induced sleep alterations.

Animals↗

PubMedDate not supplied

[Urinary tract infection by Candida species].

OBJECTIVES: To determine the frequency and characteristics of urinary tract infection (UTI) by Candida in diabetic patients (with and without symptoms) and to compare them with non-diabetic patients (with and without symptoms). DESIGN: Longitudinal, descriptive, and observational study. SETTING: Study conducted at the "Dr Ignacio Chavez" Clinic of family medicine, ISSSTE: Mexico. PARTICIPANTS: There were 2 kinds of patients; 1 with diabetes mellitus diagnosis (DM) with and without clinical picture of probable urinary tract infection (UTI), and 1 without DM and with and without clinical picture of probable UTI. MAIN MEASUREMENTS: A urine culture and a confidential questionnaire were administered to find the presence of urinary symptoms and likely risk factors associated with the infection. To associate these risks, the chi2 statistical method was used, with significance at 95% and Fisher's Exact Test for small frequencies, using the EpiInfo V.6.0 program. RESULTS: Two hundred thirty seven patients between 28 and 82 years old were included. The prevalence of urinary infection by Candida was 5.1%, but only 33% of these had C albicans. There was no association between candidiasis and factors like age, sex, or presence of DM, but it was related to previous treatments, previous UTI and the evolution time of DM. CONCLUSIONS: The conscious search by both doctor and laboratory for Candida micro-organisms as factors causing UTI is important. This is especially so in those patients with factors of risk that may condition Candida's presence.

Adult↗

PubMedDate not supplied

Candida endophthalmitis associated with total parenteral nutrition.

Candida albicans is the most common fungal infection which can occur in patients receiving total parenteral nutrition therapy. While rare, Candida endophthalmitis also can occur and must be considered as a potential risk of this treatment. Early detection and management of this disorder can alter the visual outcome for these patients. Systemic administration of amphotericin B and fluocytosine is the most common form of treatment for Candida endophthalmitis. In cases not responsive to systemic administration of antifungal agents, surgical management through pars plana vitrectomy can potentially eradicate the infection and preserve vision. We present a case of bilateral Candida endophthalmitis treated with amphotericin B and fluocytosine, and also with pars plana vitrectomy with the intracameral injection of amphotericin B into the anterior vitreous cavity. Systemic and intracameral use of antifungal drug therapy combined with vitrectomy restored useful vision to the patient.

Adult↗

PubMed1991

Late recurrent Candida endocarditis.

Late recurrent Candida endocarditis (LRCE) developed on a prosthetic mitral valve 22 months after treatment for primary native mitral valve endocarditis. The LRCE was difficult to diagnose; results of two dimensional echocardiography and repeated blood cultures were negative. Only transesophageal echocardiography revealed a vegetation and only lysis centrifugation blood cultures demonstrated candidemia. Postmortem examination revealed a large Candida vegetation on the prosthetic valve and Candida in the mitral valve ring. This case and a review of the literature indicate that Candida endocarditis treated with amphotericin B and prosthetic valve replacement may recur months after treatment, and that LRCE, which is difficult to diagnose and treat, may be best prevented by lifelong antifungal suppressive therapy.

Adult↗

PubMed2006

Candida infections in the intensive care unit: epidemiology, risk factors and therapeutic strategies.

This article reviews the epidemiology, predisposing risk factors and outcome of systemic Candida spp. infections in the intensive care unit setting. Incidence of systemic Candida infections in patients requiring intensive care has increased substantially in recent years; while diagnosis of serious Candida infection may be difficult, the clinical conditions which predispose patients to these infections are now better understood and effective antifungal therapies are becoming increasingly available. Severe fungal infections are generally associated with poor outcomes in these patients. Patients at highest risk for Candida infection may be potential candidates for early, presumptive therapy. In this article we review antifungal treatment, including the use of polyenes, azoles and echinocandines, and the role of prophylaxis.

Antifungal Agents↗

PubMed2004

Candida kefyr, an uncommon but emerging fungal pathogen: report of two cases.

Although Candida species are present as normal microflora of the human host, alterations in host defenses can lead to development of disease. Candida infections, ranging from urinary tract infections to bloodstream infections, are common in patients in the intensive care unit. Infections with non-albicans Candida sp are becoming more frequent, and resistance among these isolates is concerning. Candida kefyr is an uncommonly documented fungal pathogen. We report two cases of infection resulting from C. kefyr in our institution. The two patients had underlying disease states and drug therapies that increased the likelihood of developing an immunocompromised state. The C. kefyr isolates obtained from both patients were susceptible to amphotericin B, fluconazole, and itraconazole. Both patients had resolution of infection, one after receiving treatment with amphotericin B and the other with voriconazole.

Adult↗

PubMed1978

Systemic candidiasis produced by oral Candida administration in mice.

Systemic Candida infection from the gastrointestinal tract was examined in mice. Candida albicans was undetectable in the blood, lungs, spleen, liver or kidneys of mice 24 hr after oral Candida administration even under condition of severe damage to the host defence system, but became detectable in the liver and kidneys of mice when they received combined treatment of antibiotics, x-ray irradiation and dexamethasone 3 and 5 days after oral Candida administration.

Administration, Oral↗

PubMed1999

A phylogenetic study on galactose-containing Candida species based on 18S ribosomal DNA sequences.

Phylogenetic relationships of 33 Candida species containing galactose in the cells were investigated by using 18S ribosomal DNA sequence analysis. Galactose-containing Candida species and galactose-containing species from nine ascomycetous genera were a heterogeneous assemblage. They were divided into three clusters (II, III, and IV) which were phylogenetically distant from cluster I, comprising 9 galactose-lacking Candida species, C. glabrata, C. holmii, C. krusei, C. tropicalis (the type species of Candida), C. albicans, C. viswanathii, C. maltosa, C. parapsilosis, C. guilliermondii, and C. lusitaniae, and 17 related ascomycetous yeasts. These three clusters were also phylogenetically distant from Schizosaccharomyces pombe, which contains galactomannan in its cell wall. Cluster II comprised C. magnoliae, C. vaccinii, C. apis, C. gropengiesseri, C. etchellsii, C. floricola, C. lactiscondensi, Wickerhamiella domercqiae, C. versatilis, C. azyma, C. vanderwaltii, C. pararugosa, C. sorbophila, C. spandovensis, C. galacta, C. ingens, C. incommunis, Yarrowia lipolytica, Galactomyces geotrichum, and Dipodascus albidus. Cluster III comprised C. tepae, C. antillancae and its synonym C. bondarzewiae, C. ancudensis, C. petrohuensis, C. santjacobensis, C. ciferrii (anamorph of Stephanoascus ciferrii), Arxula terrestris, C. castrensis, C. valdiviana, C. paludigena, C. blankii, C. salmanticensis, C. auringiensis, C. bertae, and its synonym C. bertae var. chiloensis, C. edax (anamorph of Stephanoascus smithiae), Arxula adeninivorans, and C. steatolytica (synonym of Zygoascus hellenicus). Cluster IV comprised C. cantarellii, C. vinaria, Dipodascopsis uninucleata, and Lipomyces lipofer. Two galactose-lacking and Q-8-forming species, C. stellata and Pichia pastoris, and 5 galactose-lacking and Q-9-forming species, C. apicola, C. bombi, C. bombicola, C. geochares, and C. insectalens, were included in Cluster II. Two galactose-lacking and Q-9-forming species, C. drimydis and C. chiropterorum, were included in Cluster III.

Journal Article↗

PubMed2003

Candida esophagitis: risk factors in non-HIV population in Pakistan.

AIM: Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching hospital. METHODS: Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications' (ICD-9-CM), with candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were studied. RESULTS: Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34% of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and diabetes mellitus (OR 4.39, CI 1.34-14.42). The frequent clinical symptoms were retrosternal discomfort, dysphagia and epigastric abdominal pain with endoscopic appearance of scattered mucosal plaques. Another endoscopic lesion was associated with candida esophagitis in 15% patients. CONCLUSION: Carcinomas, diabetes mellitus, corticosteroid and antibiotic therapy are major risk factors for candida esophagitis in Pakistan. It is an easily managed complication that responds to treatment with nystatin.

Adult↗

PubMed2000

[Susceptibility to fluconazole and itraconazole in isolates of Candida spp. from HIV-positive and HIV-negative patients]

We studied the possible differences in the pattern of susceptibility to fluconazole and itraconazole in 393 isolates of Candida spp. from the oral cavity of HIV-positive patients and 102 isolates from HIV-negative patients with candidemia or candiduria. We used the broth microdilution method according to the NCCLS guidelines. We observed a decrease in the susceptibility to fluconazole in the group of HIV-positive patients in comparison to those who were HIV negative, especially in Candida albicans (MIC(90) 32 mg/l vs. 1 mg/l and Candida glabrata (MIC(90) 64 mg/l vs. 16 mg/l). Furthermore, we did not find any resistant strains in the HIV-negative group. For itraconazole, the MIC(90) was two dilutions greater in the HIV-positive patients, except for C. albicans, which had a much higher MIC(90) (4 mg/l vs. 0.12 mg/.). Therefore, the decrease in the susceptibility of Candida spp. in the HIV-positive patients must be taken into account when establishing a specific antifungal therapy.

Journal Article↗

PubMedDate not supplied

[Comparative evaluation of clinical, cytological and cell culture methods of candida vulvovaginitis diagnosis].

98 patients with Candida vulvovaginitis (CVV) were examined clinically, cytologically and culturally. Three clinical forms of CVV were distinguished: acute and subacute (26 and 23 patients, respectively)--before treatment, and remission (49 patients)--after treatment. The clinical diagnosis of CVV before the treatment was confirmed cytologically and/or in cultures (87.7%), in remission cytologically (4%), by cultures (20 patients). Candida in the phase of budding and pseudomycelium were prevalent in acute CVV (84.4%). In a subacute form Candida occurred in 30.3%, while in the remaining cases blastospores were observed. Significant correlation between the intensity of Candida colonies growth and phase of development on the mucous membrane was not found. Compared to the cultural method, the cytological technique is more cost effective, faster and simpler.

Candidiasis, Vulvovaginal↗

PubMedDate not supplied

[Nosocomial urinary tract infections by Candida species].

BACKGROUND: Isolation of a yeast in urine does not necessarily indicate infection, but Candida urinary tract infection is an increasing nosocomial problem. In this study the clinical significance of candiduria was investigated in a Brazilian university hospital. METHODS: Between January and December 1998 species of Candida were isolated in the urine of 166 patients admitted to a tertiary-care general hospital at Ribeirão Preto, SP, Brazil. The data of 100 of these patients were retrospectivelly reviewed concerning microbiological, epidemiological, and clinical aspects of candiduria. RESULTS: C. tropicalis was found in 53% of the patients and C. albicans in 36%. Urine cultures yielded more than 20.000 yeast colonies/ml in 76% of cases. Neurological, cardiac and other chronic diseases, cancer, and trauma were frequent underlying illnesses. Diabetes mellitus was present in 25% of patients. The major predisposing factors associated with candiduria were previous antibiotic therapy (93%) indwelling urinary catheter (83%), surgery in the last 60 days (48%), renal failure (32%), concomitant bacterial infections (28%), use of corticosteroids (20%), and use of other immunosuppressive drugs (10%). Therapy for candiduria, fluconazole or amphotericin B with one exception, was given only to 43/100 patients. The overall mortality in the 60 days after the candiduria episode was 40%. CONCLUSIONS: The non-albicans species of Candida were the major agents of candiduria and are emergent pathogens of the urinary tract in critically ill patients. The underlying illnesses, risk factors and high mortality commonly associated with Candida urinary tract infection were also observed in a Brazilian university hospital.

Adolescent↗

PubMed2001

Bilateral endogenous Candida endophthalmitis after induced abortion.

AIM: Analysis of the development and treatment of bilateral Candida endophthalmitis after induced abortion in a healthy 31-year-old patient. METHOD: A diagnosis of bilateral Candida endophthalmitis was established on the basis of positive vaginal culture, serological finding, and culture for Candida hyphae from the vitreous aspirate. The treatment of the disease consisted of prolonged systemic therapy with amphotericin B and fluconazole and pars plana vitrectomy with intravitreal amphotericin B injection. RESULTS: After the combined systemic therapy with antibiotics, fungistatics, and corticosteroids proved to be insufficient, pars plana vitrectomy with intravitreal instillation of amphotericin B was performed, which led to the improvement of visual function. After surgery, visual function was maintained with prolonged systemic therapy with fluconazole and methylprednisolone. CONCLUSION: Complicated induced abortion may cause bilateral Candida endophthalmitis in a young healthy woman. Elimination of the cause of fungemia and adequate systemic treatment did not cure bilateral endophthalmitis. Pars plana vitrectomy with intravitreal instillation of 5-microg amphotericin B proved as a method of choice in treating this severe ophthalmic disease.

Abortion, Induced↗

PubMed1997

Candida krusei infections and fluconazole therapy.

Candida species are by far the most common agents of mucosal fungal infection in man. While Candida albicans is the most notorious pathogen in this group, non-albicans species such as Candida krusei are gradually emerging as pathogens of concern, especially in compromised hosts. It is thought that the wide use of the newer triazole drug, fluconazole, in HIV-infected individuals is contributing to this phenomenon. Studies in both humans and animals have now demonstrated prophylactic and therapeutic failure of fluconazole against C. krusei due to increasing resistance of the organism to this azole. Thus, the indiscriminate use of fluconazole, a drug with relatively minimal toxicity and excellent pharmacokinetics, may lead to the development of widespread resistance to this azole among Candida species.

Journal Article↗

PubMed2002

[Vulvovaginitis caused by Candida spp. and Trichomonas vaginalis in sexually active women].

Vulvovaginitis accounts for 20 to 30% of gynecological diseases and it is observed in women from 20 to 30 years of age. It has a higher frequency in women using oral contraceptives and during the third trimester of pregnancy. The aim of this research was to assess the prevalence of Candida spp and Trichomonas vaginalis in patients with the diagnosis of vulvovaginitis from the Gynecology Service in Hospital Universitario "Ruiz y Páez" in Ciudad Bolívar and Hospital "Raúl Leoni" in San Félix (Bolívar State, Venezuela). Two hundred women with symptoms of vulvovaginitis were examined, and samples were taken from the uterocervical cul-de-sac. Each patient was asked to fill a questionnaire. The following studies were made in each sample: a) fresh wet mount examination, b) orange acridine and Giemsa stains for Trichomonas and c) culture for the identification of yeasts. The latter were identified by means of the germinal tube assay, resistance to actidione and the presence of clamidospores in rice-cream agar and sugar utilization test, using the commercial kit ID32C (BioMérieux). Only in 57 women of 200 patients with vulvovaginitis the causative agent was demonstrated; Candida spp was present in 84.2% (n = 48) and Trichomonas vaginalis in 14% (n = 8). A single case of Zygosaccharomyces spp (1.8%) was detected. The age group mainly affected was that of 25-35 years old, the 38.6% of the studied population. Candida species detected were: C. albicans in 87% of cases (n = 42), C. glabrata, in 10.42% (n = 5), and C. guillermondii, in 2.08 (n = 1). Vaginal flux, vulvar pruritus and leucorrhoea were observed in significant number of patients with vulvovaginal candidiasis. The use of antibiotics was considered predisposing factor for Trichomonas vaginalis infection. The relationship between age and the etiological agent was not statistically significant. Due to the low specificity of clinical manifestations of infections caused by Candida spp and Trichomonas vaginalis, we conclude that performing the etiologic diagnosis of vulvovaginitis is necessary in order to take the appropriate therapeutic and preventive measures, specially in those patients with a recurrent disease.

Adolescent↗

PubMed2000

Using Kl LAC4 as a Reporter Gene in Candida albicans.

The lacZ gene which codes for beta-galactosidase from E.coli does not work in Candida albicans. In this work a reporter system with Kl LAC4 gene was contructed, coding for beta-galactosidase from Kluyveromyces lactis. Kl LAC4 gene was fused to the promoter of ADH1 of Candida albicans with the terminator sequence of ADH1 at the tail. The constructed plasmid, named pYPB1-LAC4, was used to transform Candida albicans. beta-galactosidase activity was measured by plate assay, when cultured on solid medium, and by photometric assay, when cultured in liquid medium. The results suggest that LAC4 of Kluyveromyces lactis can serve as a reporter gene in Candida albicans.

Journal Article↗

PubMed2000

CEK2, a Novel MAPK from Candida albicans Complement the Mating Defect of fus3/kss1 Mutant.

A novel MAPK(mitogen-activated protein kinase) gene, CEK2(Candida albicans extracellular signal-regulated kinase 2), was isolated by screening the Candida albicans library based on oligonucleotide probe hybridization and degenerated PCR. The CEK2 gene is 1 119 bp in length, and coding for a 373 aa protein. The CEK2 shares 56% homology with CEK1 from Candida albicans, 55 % homology with FUS3 from S. cerevisiae. From the deduced amino acid sequence, the Cek2 protein contains a conserved ATP binding site and a Ser/Thr kinase activity signal and a conserved TEY sequence was located at L(12) region. In vitro kinase activity assay showed Cek2 could phosphorylate MBP(myelin bovine protein) but not histone H1. CEK2 gene could complement the fus3/kss1 mutant and underwent mating signal induction by a tester strain, but CEK1 gene could not complement with the fus3/kss1 mutant. CEK2 is therefore a FUS3 homolog in Candida albicans.

Journal Article↗

PubMed2002

Endogenous Candida endophthalmitis after two consecutive procedures of suction dilatation and curettage.

Endogenous Candida endophthalmitis (ECE) is a rare disease. We present a patient with Candida endophthalmitis after two consecutive procedures of suction dilatation and curettage for elective abortion. A 24-year-old single woman who received a suction dilatation and curettage one week ago developed pain and blurred vision in the right eye. Endogenous Candida endophthalmitis was diagnosed and treated with oral fluconazole and pars plana vitrectomy with adjunction of intravitreal amphotericin B injection. The vitreous culture revealed Candida albicans. The vitreous inflammation subsided greatly after the initial treatment but flared up after the second dilatation and curettage for incomplete abortion 5 days after the vitrectomy. The oral fluconazole was replaced by intravenous amphotericin B, and a second vitrectomy with injection of intravitreal amphotericin B was performed. Postoperatively, the intraocular inflammation resolved gradually. Six months after the second vitrectomy, the best-corrected visual acuity in the right eye was 20/25. The excellent visual acuity of this patient was attributed to the early diagnosis and aggressive treatment. For patients with mild disease, less toxic oral fluconazole as the systemic antifungal agent instead of more toxic intravenous amphotericin B has been recommended. For those with advanced disease, intravitreal amphotericin B in conjunction with vitrectomy has been advocated by many eye surgeons.

Adult↗