جستجوی مقالات مرتبط با کلیدواژه « candida » در نشریات گروه « پزشکی »

Candida albicans in the oral cavity causes denture-induced stomatitis, but current treatments have side effects and contribute to drug resistance. Selenium nanoparticles (SeNPs) show promise as an antimicrobial agent, but their effectiveness against C. albicans is unknown and warrants further research.

 Acrylic resins containing different concentrations of SeNPs (0.2, 2, and 10 g/mL) were formulated and evaluated against C. albicans isolates. The minimum inhibitory concentration (MIC) of SeNPs was determined, and a fungal biofilm was developed on acrylic samples. The quantity of biofilm was assessed using scanning electron microscopy (SEM) and optical density (OD) at 570 nm after staining with crystal violet. Statistical analysis was performed using STATA software, with Kruskal-Wallis and Mann-Whitney tests to establish significance (P<0.05).

 The MIC of SeNPs was 25%. The OD in the group with 10% SeNPs was 0.477 and 0.547 in the group with 0.2%. Kruskal-Wallis test results showed that at least two groups among those studied had significant differences (P=0.0273). In pairwise comparisons, the differences between all the groups were statistically significant (P=0.049). SEM analysis confirmed the destruction of C. albicans cell walls, leading to reduced colonization, with the 10% group showing the highest efficacy.

The study demonstrated that SeNPs are effective against C. albicans colonization when combined with acrylic resin. Specifically, SeNPs exhibited enhanced antifungal properties at a concentration of 10%. These findings confirm that SeNPs are a promising alternative to traditional antifungal agents for treating oral candidiasis and denture-induced stomatitis.

Invasive candidiasis are the most prevalent fungal infections in solid organ transplant (SOT) recipients. In this regards, emerging pathogens and antifungal resistance are concerning issues in transplantation medicine.

Regarding universal prophylaxis in SOT recipients, particularly with fluconazole, and the emergence of azole-resistant species, the present study was conducted to species identification and antifungal susceptibility profiles of yeasts isolated from SOT recipients.

All adults undergone solid organ transplantations between 21 March -22 September 2022 in Abu-Ali Sina transplant center, Shiraz, Iran, were included with 6 months follow-up. Species identification of isolated yeasts from different clinical specimens was performed by ITS1-5.8S-ITS2 gene sequencing. Antifungal susceptibility testing was determined according to the microbroth dilution method documented by CLSI.

During the study period, 28 of 383 (9.8%) adult SOT recipients developed at least one positive culture of yeasts isolated from different clinical specimens. Candiduria was the most prevalent type of involvement by Candida species. The incidence rate of invasive candidiasis was 2.6%. Of 54 isolated yeasts, C. albicans was the most frequent species (22/54, 40.7%), followed by C. glabrata (11/54, 20.3%), and C. parapsilosis (9/54, 16.7%). Resistance or decreased susceptibility to fluconazole was found in 55% of isolates, and also 13% of isolates were known crossresistant to different azole antifungal drugs.

Our results showed a high incidence of azole- resistant Candida strains causing candidiasis in SOT recipients. Indeed, the findings support the need to perform antifungal susceptibility testing of yeast isolates in immunocompromised patients to guide proper treatment.

Understanding the epidemiology of Candida species among cancer patients is crucial for preventing invasive infections. This study aimed to identify Candida species and assess risk factors among cancer patients receiving chemotherapy in Birjand, eastern Iran.

The samples were obtained from the oral cavity of 140 patients and the initial identification of Candida species was carried out through fungal cultures. Subsequently, Candida isolates were molecularly identified using the PCR-RFLP method with the restriction enzyme Msp1. Furthermore, the demographic characteristics, risk factors, and clinical history of the patients were extracted and scrutinized using a multiple logistic regression model.

Among the 140 patients examined, 55 individuals (39.3%) tested positive for oral candidiasis (OC). Notably, Hemorrhagic cancer emerged as the most common type of cancer associated with OC (46.7%). The predominant species isolated was the Candida albicans complex (64.8%), followed by the Candida glabrata complex (26.8%). A noteworthy finding was the significant association between the occurrence of OC and the number of chemotherapy sessions (P<0.05). Conversely, no significant correlations were detected between OC and variables such as sex, age, type of cancer, occupation, residence, underlying disease, and drug use (P>0.05).

The prevalence of Candida spp. and its correlation with the number of chemotherapy sessions underscored the importance of preventive measures. These findings provided valuable insights for designing targeted interventions to mitigate the burden of oral candidiasis in this vulnerable population.

 Studies on head and neck cancer (HNC) patients undergoing radiotherapy have revealed increased numbers of Candida spp., leading to oral candidiasis and oral mucositis. The effects of laser therapy on Candida spp. have been studied with varied results. This study aimed to investigate the effect of low-level laser therapy (LLLT) on C. albicans colonies isolated from HNC patients undergoing radiotherapy.

 This study included a treated group, wherein 11 C. albicans isolates were obtained from the saliva of HNC patients undergoing radiotherapy at a dose exceeding 30 Gy. The control groups consisted of an untreated negative control and a positive control treated with nystatin. The treatment groups were subjected to LLLT in continuous mode for 50 seconds at a wavelength of 976 nm, 0.1 W at a dose of 5 J/cm2 for Laser 1 (L1) group and 0.2 W at a dose of 10 J/cm2 for Laser 2 (L2) group. The tests were conducted using C. albicans inoculum equivalent to a 0.5-McFarland suspension on 96-well plates. All test group inoculums were then cultured on Sabouraud dextrose agar (SDA), and the colony count was assessed at 104 CFU/mL.

 LLLT at 5 and 10 J/ cm2 reduced C. albicans colonies by 7.01% and 10.94%, respectively, but the reductions were not statistically significant (P>0.05). Nystatin eliminated all the colonies.

 LLLT shows potential for reducing C. albicans colonies in HNC patients undergoing radiotherapy. However, further studies with varied parameters and methods are necessary.

The biofilm formation has been widely recognized as one of the main mechanisms of antimicrobial resistance development in microorganisms. However, few studies are focusing on this phenomenon in Candida spp. in clinical settings, especially on immuno-compromised patients.

In this study, both the rate of biofilm formation in those patients and its drug susceptibility in initial and mature biofilm were assessed using crystal violet assay and dilution method.

The results demonstrated that the biofilm formation rate was similar between albicans and non-albicans Candida. However, the biofilm formation capacity was more pronounced in non-albicans Candida, especially, C. glabrata. As expected, there was a significant relationship between biofilm formation and drug resistance. In addition, our study reconfirmed that the age of high concentration of antifungal agents only affected Candida before its biofilm formation regardless of its biofilm formation capacity. In the contrary, once the biofilm was formed even elevated drug concentrations did not show sufficient efficacy, highlighting a need for high dosage at the early stage of treatment for those patients.

The results of this study highlighted the importance of using appropriate antifungal agents for Candida treatment before the formation of biofilm.

The capability to cause invasive infection, multi-drug resistance, and health care-associated outbreaks of Candida auris have made it a pathogen of great concern. Estimating how many patients in our intensive care unit had C. auris colonization and what characteristics put patients at risk for having Candida spp. colonization were the primary goals of the study.

Swabs from axilla and groin were collected from 229 patients getting admitted to the ICU. Samples were inoculated into CHROMagarTM Candida Plus medium. Colonies presumptively identified as C. auris by the presence of light blue with blue halo and were confirmed by VITEK-2.

Our study showed that only one patient was colonized with C. auris. A total of 47 (20.5%) patients were colonized with Candida spp., of which Candida parapislosis was the predominant organism. History of antibiotic use and cerebrovascular accident were independent risk factors in Candida colonization.

Active screening for Candida auris in all patients is not required in our hospital as the prevalence was very low and not cost-effective. Therefore we plan to modify our screening strategy and use risk factors based surveillance strategy as it may serve as an ideal strategy.

Candida species are known as one of the most prevalent agents causing opportunistic gastrointestinal infections in immunodeficient patients.

In this study, species distribution of Candida was determined in pediatric heart transplant recipients with and without gastrointestinal symptoms.

In this study, 59 stool samples were collected from heart transplant recipients including patients with and without gastrointestinal symptoms aged between 1-17 years. The patients underwent heart transplant surgery at Rajaei Cardiovascular, Medical & Research Center, in Tehran. Sabouraud dextrose agar was used for the initial culture, and CHROMagar Candida media were used for initial differentiation. Definitive species identification of Candida isolates was performed using PCR-RFLP and sequencing following DNA extraction.

In the present study 13 (22 %) overgrowth isolates associated with patients with gastrointestinal symptoms were positive for Candida spp. using microscopy and culture. The Candida spp. including C. albicans 5 (38.5%), C. glabrata 4 (30.7%), C. guilliermondii 2 (15.4%), and mixed infection of C. albicans and C. glabrata 2 (15.4%) were identified.

C. albicans was the predominant species in pediatric heart transplant recipients with Candida intestinal colonization that was substantiated by the presence of pseudohyphae on microscopy, which could be consider as an evidence of invasion.

 Invasive fungal infection (IFI) is a life-threatening condition, particularly in individuals with compromised immune systems.

 Our study aims to evaluate IFI in hospitalized patients with hematological malignancies.

 In this retrospective cross-sectional study, we evaluated patients with hematological malignancies admitted to two university hospitals in Tehran, Iran, from 2020 to 2021 for IFI. We selected only those patients who had been hospitalized for at least four days for antimicrobial treatment. Data analysis was conducted using SPSS-26 software, employing Mann-Whitney U, chi-square, and Fisher exact tests.

 During the study period, 60 out of 213 patients with hematological malignancies were admitted for antimicrobial treatment. The average age of the patients was 57.1 years, with fever being the most common symptom, reported in 63.3% of cases. We identified 24 cases of
IFI, including three proven cases (Candida spp.) and 21 probable cases. Statistical analysis showed a lower mean neutrophil count in the IFI group compared to the non-IFI group (3862 versus 12881, P = 0.001) and a higher mortality rate (58.3% versus 27.8%, P = 0.031).

 Our study revealed that severe neutropenia is a significant risk factor for IFI, and the mortality rate associated with IFI remains high despite advances in the treatment of hematological malignancies.

Early diagnosis of candidemia is of vital importance in reducing mortality and morbidity. The main objective of the study was to determine the TTP (Time to Positivity) of different species of Candida causing bloodstream infection and to see whether TTP can help differentiate Candida glabrata which is frequently fluconazole resistant from Fluconazole sensitive Candida.

TTP (Time to positivity) and AAT (Appropriate Antifungal therapy) were noted for Blood cultures becoming positive for Candida. Presence of Risk factors for candidemia like prolonged ICU stay, neutropenia, Total Parenteral Nutrition (TPN), use of steroids , broad spectrum antibiotics, use of Central Venous Catheter, Foleys catheter were also analyzed.

The most frequent isolates were Candida parapsilosis, Candida tropicalis and Candida albicans. The median TTP for all Candida isolates in our study was 34 hours. The diagnostic sensitivity of TTP for detecting C. glabrata and C. tropicalis in patients with candidemia was 88% and 85% respectively. TTP showed that there was no difference in survival between TTP <24 hrs. and > 24hrs. Initiation of antifungal therapy <24 hours and > 24hrs after onset of candidemia had no association with survival.

Longer TTP maybe predictive of C. glabrata while shorter TTP may be predictive of C. tropicalis. In our study we found that fluconazole resistant Candida causing blood stream infection is quite unlikely if the TTP of the isolate is <48hrs.

Amphotericin B is a broad-spectrum antifungal agent commonly used to treat Candida haemulonii infection. C. haemulonii was isolated from patients reported to be intrinsically resistant to amphotericin B, encoded by the ERG2 and ERG11 genes. However, there have been limited studies concerning amphotericin B-resistant C. haemulonii in Indonesia. The objective of this study is to explore the phenotypic and genotypic characteristics (ERG2 and ERG11) of C. haemulonii isolated from the ICU of a referral hospital in Indonesia.

Identification and susceptibility tests were conducted using VITEK2. Thereafter, DNA was extracted and amplified using conventional PCR followed by DNA sequencing (Sanger method).

The results of the phenotypic susceptibility test showed that all C. haemulonii were resistant to amphotericin B. ERG2 and ERG11 sequences showed the same amino acid sequence and corresponded to references that are resistant to amphotericin B.

The resistant properties of C. haemulonii against amphotericin B found in this study require further exploration, including comparing resistant and sensitive C. haemulonii to amphotericin B. In addition, it is necessary to analyze other genes besides ERG2 and ERG11.

Our study aimed to compare the twice-weekly and three-time weekly prophylactic fluconazole regimens among low birth weight premature neonates.
Premature neonates (40 cases) were divided into two groups and received two and three-times-weekly fluconazole regimens for three weeks. Surveillance of fungal colonization was performed before treatment and twice weekly.
Fungal colonization occurred in 11 infants in group A and 4 infants in group B (55% vs. 20%, p=0.022). In both groups, the rectum was the most common site of colonization. Candida glabrata, Candida orthopsilosis and, Candida albicans were the most commonly isolated species in both groups. There were no significant differences between the two groups regarding birth weight, gestational age, and other baseline risk factors for fungal colonization.
In this study, the three-times-weekly administration of prophylactic fluconazole appears to be more effective in preventing fungal colonization than the twice-weekly regimen among premature neonates.

 Recurrent vulvovaginal candidiasis (RVVC) is a widespread opportunistic gynecological condition resulting from infections by Candida albicans and non-C. albicans (NAC) species. Transforming growth factor-beta (TGF-β), a significant cytokine involved in cell-mediated immunity (CMI), plays a crucial role in vaginal infections.

 The current study was conducted to evaluate the differences in TGF-β gene expression between patients with RVVC and healthy individuals using real-time polymerase chain reaction (PCR).

 This case-control study involved 124 patients diagnosed with RVVC and 225 age-matched healthy individuals as controls. The mRNA expression of the TGF-β gene was measured using quantitative real-time PCR (QRT-PCR). Data analysis and the creation of graphs were carried out using SPSS and GraphPad PRISM software.

 The QRT-PCR findings showed higher TGF-β expression in RVVC patients compared to the control group, though the difference was not statistically significant (P = 0.2538).

 Our study revealed that the expression of the TGF-β1 isoform was elevated in patients with clinical manifestations in the vagina, although the increase was not statistically significant. Based on this outcome, further in vivo studies are necessary to elucidate the precise role of TGF-β isoforms in the vaginal tract of patients with RVVC.

Invasive fungal disease (IFD) is a common and serious consequence of leukemia in children and the incidence of these infections has increased due to chemotherapy. This study aimed to present the epidemiology of IFD in a cohort of children with leukemia from a tertiary reference institution in Oman.

A retrospective study of IFDs in pediatric patients below 13 years of age with newly diagnosed or relapsed leukemia was conducted at the Royal Hospital in Muscat, Oman. From 2010 to 2017, IFD episodes in children with leukemia were evaluated retrospectively, considering age, gender, type of leukemia, chemotherapy regimen, IFD detection phase, neutropenia, prevention, diagnostic method, and treatment.

Between 2010 and 2017, 198 children with leukemia were admitted and treated at Royal Hospital. Invasive fungal infection (IFI) was diagnosed in 32 patients out of 198 (16.1%), and IFI was defined as probable and proven in 53% (n=17) and 47% (n=15) of the cases, respectively. At 1.1:1, the male-to-female ratio was roughly equal. According to chest computed tomography scans, 65.6% of patients had radiological features of fungal infections. Positive fungal cultures were found in the bronchoalveolar lavage of three patients, 37.5% of whom had positive blood cultures, and 3% had positive urine cultures as a neonatal invasive candidiasis. In three patients, invasive aspergillosis caused pulmonary IFD, accounting for 9.3% of all infection sites. Candidaemia was found in 28% of IFD patients, and the most common organism was Candida tropicalis (15.6%), followed by Candida prapsilosis (6.25%). Furthermore, the major risk factor was febrile neutropenia.

In children with leukemia, invasive fungal infection is common and serious. Despite aggressive treatment, mortality among these high-risk patients remains high.

Regarding the wide-spectrum antimicrobial effects of curcumin and silver, this study aimed to evaluate the antifungal activity of green-synthesized curcumin-coated silver nanoparticles (Cur-Ag NPs) against a set of Candida and Aspergillus species.

Cur-Ag NPs were synthesized by mixing 200 µL of curcumin solution (40 mM) and 15 mL of deionized water. The mixture was stirred for 3-5 min, followed by the addition of 2.5 mL of silver nitrate solution (2.5 mM). The resulting solution was incubated for 3 days. Antifungal susceptibility of 30 fungal isolates of Aspergillus and Candida to fluconazole and itraconazole, as well as the activity of Cur-Ag NPs against the isolates, were determined, both alone and in combination, using broth microdilution according to the Clinical and Laboratory Standards Institute guidelines.

Cur-Ag NPs demonstrated promising antifungal activity, particularly against Candida species. The geometric mean value of the minimum inhibitory concentration of Cur-Ag NPs was significantly lower than that of fluconazole for all the studied fungi. Similarly, it was lower than those of itraconazole in C. albicans and A. fumigatus. The minimum fungicidal concentrations of Cur-Ag NPs were markedly better than those of fluconazole but still inferior to those of itraconazole.

Cur-Ag NPs demonstrated indisputable antifungal activity and great potential that can be harnessed to combat fungal infections, particularly those caused by azole-resistant strains of Aspergillus and Candida.

Candida species are one of the most common causes of otomycosis. Antifungal drugs commonly used in treatment often have a variety of side effects, including toxicity, cross-reactivity, and drug resistance. In recent years, along with the advances in nanotechnology and the motivation to find new antifungal drugs, there has been a growing interest in the use of nanoparticles such as nano-curcumin in the treatment of fungal infections. The aim of this study was to evaluate the antifungal sensitivity of nano-curcumin on Candida species isolated from otomycosis.

  In this experimental study, 100 isolated Candida samples from patients with otomycosis were included. Synthesis of nano-curcumin using chitosan (CS) nanoparticles was performed by ionic gelation method. Antifungal susceptibility testing was performed using broth microdilution method according to CLSI-M27-S4 guidelines on all Candida isolates to miconazole, clotrimazole and nanocurcumin. Data were analyzed in SPSS 27 software with independent t-test and chi-squared tests.

Curcumin nanoparticles showed antifungal activity against all Candida species. However, the mean MIC of miconazole and clotrimazole for different Candida species was significantly lower than curcumin nanoparticles, indicating the lower antifungal effect of nano-curcumin than these two antifungals. Also, the mean MIC of nano-curcumin was not significantly different among Candida species (P < 0.05), whereas it was significantly different for miconazole and clotrimazole (P < 0.05).

 The results of the present study showed that nano-curcumin had a lower antifungal effect than miconazole and clotrimazole, but due to nano-curcumin's safety, it can be used as a potential antifungal drug for the treatment of otomycosis after further investigation.

In vitro and in vivo researches have shown that silver nanoparticles have more antimicrobial properties with a lower concentration than antifungal agents against candida vaginitis. Therefore, this study evaluated the therapeutic effect of silver nanoparticles (Nivasha spray15ppm) compared to clotrimazole 1% vaginal cream on candida vaginitis.

In this clinical trial study, 110 women with confirmed candida vaginitis randomly were divided into test (n=58) and control (n=52) groups. Silver nanoparticles spray with an applicator (Nivasha 15 ppm), and clotrimazole 1% were administered to test and control groups, respectively. Then, within ten days, post-intervention checkup and patient self-reported for treatment results were recorded in checklists and the data were analyzed statistically.

The improvement rate in test group (98.0%) was 1.44 times higher than in control (67.9%). Moreover, disease symptoms after the intervention (including unusual secretions, itching and burning, redness) in test group were significantly less than in the control, but there was no significant difference in the ratio of edema in two groups )p=0.071(. Furthermore, the average recovery time (days) of all symptoms in test group was lower than control (p<0.05). Finally, the rate of patients' satisfaction with the treatment process in the test group (76.9%) was more than control (46.6%) (p=0.004).

Nivasha spray had more effectiveness compared to the clotrimazole 1%. Therefore, it can be used as an alternative drug in the treatment of Candida vaginitis.