exudates and Candidemia

Candida parapsilosis is an important pathogen of healthcare-associated bloodstream infections (BSI) causing high mortality and morbidity in immunocompromised patients in addition to other Candida species including C. albicans, C. tropicalis, C. glabrata, and C. krusei. Knowledge on recent local species distribution and trend is essential. An increase in the proportion of C. parapsilosis candidemia has been recently observed as a result of many risk factors. The distribution of candidemia has been changing in the last three decades. To determine the proportion of different Candida species causing candidemia in a tertiary-care hospital during January 2001 - December 2018, a retrospective study performed in a 853-bedded tertiary-care hospital in north-eastern Malaysia. All cases of candidemia from January-2001 to December-2018 were included, and the review was performed based on patients' medical records and laboratory database. The frequency of different Candida species was determined. This study showed that out of 1175 patients with candidemia, C. parapsilosis was the most common species contributing to 29.2% (343/1175) of candidemia, followed by C. albicans 20.1% (236/1175), C. tropicalis 18.7% (220/1175), C. glabrata 6.0% (71/1175), C. guilliermondii 3.7% (43/1175), C. rugosa 1.9% (22/1175), C. famata 1.7% (20/1175), C. krusei 1.4% (16/1175), C. dubliniensis 0.8% (9/1175), C. lusitaniae 0.7% (8/1175), C. lipolytica 0.3% (4/1175), C. pelliculosa 0.3% (4/1175), C. haemulonii, C. kefyr, C. utilis and C. inconspicua (1/1175 each). In addition, 14.9% (175/1175) belonged to Candida spp. which were not identified to species level. In conclusion, a different scenario for the proportion of Candida species with C. parapsilosis predominates over C. albicans as a nosocomial pathogen leading to candidemia has been shown in this study.

Topics: Candida; Candida parapsilosis; Candidemia; Cross-Sectional Studies; Humans; Malaysia; Retrospective Studies; Tertiary Care Centers

Non-albicansCandida species have emerged as fungal pathogens that cause invasive infections, with many of these species displaying resistance to commonly used antifungal agents. This study was confined to studying the characteristics of clinical isolates of the C. rugosa complex and C. pararugosa species.. Seven isolates of the C. rugosa complex and one isolate of C. pararugosa were obtained from two tertiary referral hospitals in Malaysia. Their antifungal susceptibilities, biofilm, proteinase, phospholipase, esterase and haemolysin activities were characterized. Biofilms were quantified using crystal violet (CV) and tetrazolium (XTT) reduction assays at 1.5, 6, 18, 24, 48 and 72 h.Results/Key findings. The E-test antifungal tests showed that both species have elevated MICs compared to C. albicans and C. tropicalis. The highest biomass was observed in one of the C. rugosa isolates (0.237), followed by C. pararugosa (0.206) at 18 h of incubation. However, the highest bioactivity was observed in the C. rugosa ATCC 10571 strain at 24 h (0.075), followed by C. pararugosa at 48 h (0.048) and the same C. rugosa strain at 24 h (0.046), with P<0.05. All isolates exhibited high proteinase activity (+++) whereas six isolates showed very strong esterase activity (++++). All the isolates were alpha haemolytic producers. None of the isolates exhibited phospholipase activity.. Elevated MICs were shown for the C. rugosa complex and C. pararugosa for commonly used antifungal drugs. Further studies to identify virulence genes involved in the pathogenesis and genes that confer reduced drug susceptibility in these species are proposed.

Topics: Antifungal Agents; Biofilms; Candida; Candidemia; Candidiasis; Hospitals, Teaching; Humans; Malaysia; Microbial Sensitivity Tests; Peptide Hydrolases; Phospholipases; Skin; Tertiary Care Centers

To compare the specific intracellular proteinase A activity in clinical isolates of Candida species isolated from Iranian and Malaysian patients, the blood and kidneys of mice infected by Candida cells isolated from these human patients.. The intracellular proteinase A was extracted using glass beads and ultracentrifugation from yeasts cells and purified by ion-exchange chromatography (DEAE-cellulose), followed by affinity chromatography (ConA-agarose). Purity of proteinase A was controlled by SDS-PAGE and its identification was realized by western blot. Enzyme activity was performed using azocasein as substrate.. Intracellular proteinase A enzyme activity was higher in Candida albicans (C. albicans) than in non-albicans Candida isolates from Malaysian and Iranian patients, mice blood and mice kidneys (P<0.05). In clinical Candida spp. from human patients, proteinase A activity was significantly higher in Malaysian samples than in their Iranian counterparts (P<0.05). However, Candida spp. isolates obtained from blood and kidneys of mice infected by human clinical strains of Candida spp. showed no significant differences in proteinase A activity between Malaysian and Iranian samples (P>0.05). On the other hand, in both clinical and control yeast isolates obtained from Malaysian and Iranian patients, significant differences were found between systemic and non-systemic samples (P<0.05) but this difference was not observed in mice blood and kidneys.. In the present study, a strong proteinase A activity was observed for C. albicans and higher expression of this enzyme in clinical isolates from Malaysian and Iranian patients with systemic candidiasis indicated higher virulent nature of this yeast species when compared with non-albicans Candida strains.

Topics: Animals; Aspartic Acid Endopeptidases; Blotting, Western; Candida; Candidemia; Candidiasis; Caseins; Chromatography, Affinity; Chromatography, Ion Exchange; Electrophoresis, Polyacrylamide Gel; Female; Fungal Proteins; Humans; Iran; Kidney; Malaysia; Mice; Mice, Inbred BALB C; Random Allocation; Species Specificity; Specific Pathogen-Free Organisms; Ultracentrifugation

This study was conducted to determine the proteinase, phospholipase, and biofilm forming abilities of Candida isolates in blood cultures of specimens from patients at the University Malaya Medical Center, Kuala Lumpur, Malaysia. Proteinase and phospholipase activities were detected in 93.7% and 73.3%, respectively, of 15 Candida albicans isolates. Amongst the 26 non-C. albicans Candida isolates, proteinase and phospholipase activities were detected in 88.5% and 7.7% of the isolates, respectively. There was no significant difference in the expression levels of proteinase amongst the Candida isolates studied (P = 0.272), but the phospholipase activity of C. albicans was significantly higher than that of the non-C. albicans Candida isolates (P = 0.003). There was no significant difference in the biofilm forming abilities of C. albicans and non-C. albicans Candida isolates on the polystyrene microtiter wells (P = 0.379). In addition, the findings of this study demonstrate increased resistance of Candida isolates in biofilms to amphotericin and fluconazole, as compared to their planktonic counterparts.

Topics: Academic Medical Centers; Antifungal Agents; Biofilms; Candida albicans; Candidemia; Humans; Malaysia; Microbial Sensitivity Tests; Peptide Hydrolases; Phospholipases