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Aetiology and Laboratory Diagnosis
Published in Raimo E Suhonen, Rodney P R Dawber, David H Ellis, Fungal Infections of the Skin, Hair and Nails, 2020
Raimo E Suhonen, Rodney P R Dawber, David H Ellis
Candida krusei is regularly associated with some forms of infant diarrhoea and occasionally with systemic disease. It has also been reported to colonise the gastrointestinal, respiratory and urinary tracts of patients with granulocytopenia. Environmental isolations have been made from beer, milk products, skin, faeces of animals and birds and pickle brine.
Antifungal Drugs and Susceptibility Testing of Fungi
Published in Rossana de Aguiar Cordeiro, Pocket Guide to Mycological Diagnosis, 2019
Débora de Souza Colares Maia Castelo-Branco, Glaucia Morgana de Melo Guedes, Marcos Fábio Gadelha Rocha
The same systems used for the phenotypical identification of fungal species, such as the Vitek 2 System (BioMérieux, France), can also be used to evaluate the antifungal susceptibility of the isolates. These devices are only able to identify and analyze yeast isolates belonging to the species they contain in their database. Thus, they can reliably perform antifungal susceptibility assay with Candida albicans, Candida tropicalis, Candida parapsilosis, Candida glabrata, and Candida krusei, and few others. The methodology applied by these devices is a broth microdilution using only three to five drug concentrations for each tested drug, which allows the evaluation of fungal growth inhibition and estimation of MIC values. These analyses are performed in manufactured cards or panels, which contain the drugs to be tested, that is, amphotericin B, flucytosine, fluconazole, voriconazole, caspofungin, and micafungin. The results are then released as MIC values, followed by the susceptibility category (S, I, or R) and epidemiological category (WT or NWT). These automated methods are very practical for the most prevalent yeast pathogens, but their major drawback is the lack of flexibility to perform the assays, as the tested species must be in the system database and the products and reagents used are developed, industrialized, and supplied by the companies.
Rational Use of Antifungals for Invasive Fungal Infections in the Institutional Setting
Published in Robert C. Owens, Paul G. Ambrose, Charles H. Nightingale, Antibiotic Optimization, 2004
Richard H. Drew, Melissa D. Johnson, Elizabeth Dodds Ashley, John R. Perfect
In vitro susceptibility testing of Candida spp has had limited application in routine clinical practice, which likely relates to issues regarding the need for timely accessibility to these test results. The lack of automated testing methods makes these processes extremely labor intensive, time consuming, and costly. Therefore, many institutions limit susceptibility testing of Candida spp. to specific circumstances in which there is a high suspicion of resistance and often rely on reference laboratories for these services. Specific indications for which- susceptibility testing may be routinely performed include non- albicans Candida bloodstream isolates with unpredictable susceptibility to azoles (such as Candida glabrata), isolates from patients with increased risk of resistance (such as those receiving prior antifungal therapy), and yeast isolates obtained from patients with relapsed infection. Because Candida krusei is inherently resistant to fluconazole, susceptibility testing for organisms to this agent is not recommended and resistance can be presumed. Newly proposed guidelines for disk diffusion testing methods for yeasts may facilitate testing procedures to allow more rapid availability of these test results (14). An automated panel for susceptibility testing of yeasts was recently approved by the Food and Drug Administration, but has not yet been widely implemented in clinical laboratories. In time, these advances may permit routine testing of all isolates and allow more widespread application of susceptibility test results to patient care.
Diphenyl diselenide suppresses key virulence factors of Candida krusei, a neglected fungal pathogen
Published in Biofouling, 2022
Bruna Graziele Marques da Silva, Ana Paula Pinto, Juliene Cristina da Silva Passos, João Batista Teixeira da Rocha, Carlos Alberto-Silva, Maricilia Silva Costa
Candida krusei infections are also relevant in the clinical setting with a high mortality rate (40–58%) (Bhattacharya et al. 2020). Fluconazole and other azole antifungals are commonly used to treat infections (Whaley et al. 2016); however, C. krusei is intrinsically resistant to this drug (Ricardo et al. 2014) and responds poorly to standard antifungal therapies (Gómez-Gaviria and Mora-Montes 2020). For these reasons, the development of effective antifungal therapies against infections related to the pathogen C. krusei is highly required. In the present study, showed, for the first time, that (PhSe)2 exhibits potent antifungal activity more than (p-Cl-PhSe)2 against C. krusei, inhibiting the adherence process to cervical epithelial cells and biofilm formation, relevant virulence factors for the early stage of the Candida-host interaction and infection process. An innovative method for controlling Candida infections is to use compounds that influence adhesion qualities and biofilm formation. This may reduce the emergence of resistant strains by reducing the pathogenic qualities of NAC species. The findings of this study suggest that (PhSe)2 could be a potential antifungal medication for Candida infections, and they back up the theory that suppression of growth, adhesion, and biofilm formation are factors in organochalcogen drugs' therapeutic success.
Therapeutic prospective of plant-induced silver nanoparticles: application as antimicrobial and anticancer agent
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2018
Krushna C. Hembram, Rahul Kumar, Laxman Kandha, Pankaj K. Parhi, Chanakya N. Kundu, Birendra K. Bindhani
Similarly, multidrug resistance is constantly increasing with the increasing uses of antibiotics for the treatment of several pathogenic diseases. The use of broad-spectrum antibiotics has created resistance too many of the microbial human pathogens which appears as a major threat for mankind. More than 25% resistance reported in invasive staphylococcal isolates which are known to be methicillin resistance Staphylococcus aureus in some countries, which shows these pathogen required an efficient drug for their control. Candida albicans strains including Candida glabrata and Candida krusei are resistant to commonly used antimycotic drug fluconazole. Emergence of resistance viral strains are creating massive problem in antiretroviral therapy, particularly in case of HIV. Similar resistance problem were observed in case of plant infecting pathogens. Thus, there is an urgency demanding new alternatives for treatment and controlling these infectious pathogens [2].
Poor in vivo efficacy of caspofungin, micafungin and amphotericin B against wild-type Candida krusei clinical isolates does not correlate with in vitro susceptibility results
Published in Journal of Chemotherapy, 2018
Tamás Kardos, Renátó Kovács, Gábor Kardos, Istvan Varga, Aliz Bozó, Zoltán Tóth, Fruzsina Nagy, László Majoros
The primarily fluconazole resistant Candida krusei is one of the most important non-albicans Candida species causing life-threatening infections among severely ill patients. Hematological malignancies, neutropenia, solid tumors and recent gastrointestinal surgery are well-known risk factors for invasive infections caused by C. krusei. It is a major pathogen in breakthrough fungemia in patients with fluconazole chemoprophylaxis.1,2 For many decades, amphotericin B (AMB) was the only systematically used anti-fungal agent for the treatment of invasive C. krusei infections; however, in vitro and in vivo data suggest that efficacy of AMB is strongly questionable against C. krusei.3–6 As echinocandins (anidulafungin, caspofungin and micafungin) show relatively low minimum inhibitory concentration (MIC) values and concentration-dependent fungicidal activity against C. krusei in vitro, currently echinocandins are among the preferred anti-fungals against C. krusei, besides AMB and voriconazole.7,8 However, mortality rate due to invasive infections by C. krusei among intensive care unit patients is still unacceptably high (50–70%) even with the widely used echinocandin therapy.9–11