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Invasive Candidiasis
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Candida spp. are part of the commensal flora and normally do not cause disease. In the presence of certain risk factors, Candida spp. can cause local disease (i.e. thrush) or invasive disease which is often caused by any combination of increased colonization, damage to mucosa or skin, presence of an intravascular device and immunocompromise. Fungal diagnostic tests have relatively low sensitivity and specificity, and particularly blood cultures, have a long turnaround time, resulting in delays in starting effective antifungal treatment or unnecessary use of antifungals with risk of drug toxicities and emergence of resistance. It is therefore worthwhile to consider the following.
Diagnostic Approach to Rash and Fever in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Lee S. Engel, Charles V. Sanders, Fred A. Lopez
The sudden onset of dermal nodules may indicate disseminated candidiasis. Infections caused by Candida spp. have increased over the last several years [279,280]. Risk factors for disseminated candidiasis include malignancy, neutropenia, antimicrobial therapy, severe burn injuries, IV catheters, postoperative drain placement, hemodialysis, total parenteral antibiotics, and systemic steroid administration [281–283]. The lesions start as macules and progress to erythematous papules or nodules that are discrete, firm, and non-tender and may show a characteristic pale center. The lesions are most typically found on the trunk and extremities [283–286]. Skin biopsy and histological examination will often reveal aggregates of hyphae and spores within the dermis [286].
Candida spp.
Published in Rossana de Aguiar Cordeiro, Pocket Guide to Mycological Diagnosis, 2019
Silviane Praciano Bandeira, Glaucia Morgana de Melo Guedes, Débora de Souza Colares Maia Castelo-Branco
Sample collection for laboratory diagnosis of Candida spp. depends on the infection site. In cutaneous mucosal lesions, most clinical specimens are collected using sterile swabs that must be immediately processed; otherwise, they must be packed in a sterile transport medium or saline, since Candida species are susceptible to desiccation. In dry lesions, as in onychomycosis, nail scrapings obtained from the region of progression, where there is a confluence of healthy with diseased tissue, may be used. In systemic candidiases, clinical specimens such as blood, bronchoalveolar aspirate, bronchial lavage material, urine, and biopsy of several organs can be used for diagnosis. The guidelines regarding the collection and transportation of different clinical samples were described in Chapter 1.
Bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis in reproductive-age women in Yunnan, China: a descriptive study
Published in Journal of Obstetrics and Gynaecology, 2022
Ting Zhao, Xiao Xiao, Li Xiao, Xiao-Mei Wu, Tao Yuan
Similar to our study, which showed a low prevalence of VVC (18.65%) among reproductive-age women, a previous study conducted on a European population reported that approximately 44% of patients had an episode of VVC within a year (Corsello et al. 2003). Approximately 75% of women are affected by VVC at some point in their lifetime, with pregnancy being a predisposing factor. In our study, several risk factors for this condition, including an age of 30–39 years (OR = 2.12, 95% CI: 1.03–4.38; p = .038), were most strongly associated with VVC in Yunnan Province. We explored the relationship between two identified risk factors for these infections: douching and pregnancy. Pregnancy plays a major role in colonisation and infection. Leli et al. (2013) demonstrated frequent Candida spp. colonisation in the vagina of pregnant women than in the vagina of non-pregnant women. This is due to the high concentration of oestrogen during pregnancy, which provides a favourable environment for the growth of Candida spp. Our results also found that women with a history of miscarriage are more likely to develop VVC, which is associated with numerous adverse outcomes, including predisposition to vaginal infections such as BV and VVC (Xu et al. 2019). However, we did not find any significant association between douching and the occurrence of any of these three infections in our study population, despite the reported links.
A nationwide study on characteristics and outcome of cancer patients with sepsis requiring intensive care
Published in Acta Oncologica, 2022
Edda Vesteinsdottir, Martin Ingi Sigurdsson, Magnus Gottfredsson, Asbjorn Blondal, Sigurbergur Karason
Only cultures taken within the first 48 h of ICU care, or in emergency departments and wards shortly before ICU admission were analysed in the study. Infections were considered hospital-acquired if they manifested more than 48 h after hospital admission. The initial empirical antimicrobial therapy was defined as insufficient if the cultured pathogens, which were considered clinically relevant, were resistant to the agents used by standard in vitro susceptibility tests. Cultures of commensal skin bacteria (e.g. coagulase-negative staphylococci) in blood were not considered pathogens unless cultured from repeated sets. Isolated findings of Candida spp. in respiratory or urine cultures were regarded as colonising organisms. Multi-resistant pathogens were defined as pathogens resistant to three or more classes of antibiotics. Microbiology findings were reviewed by a specialist in infectious diseases (MG).
Lactobacillus casei reduces the extracellular matrix components of fluconazole-susceptible Candida albicans biofilms
Published in Biofouling, 2021
Beatriz H. D. Panariello, Marlise Inez Klein, Luana Mendonça Dias, Amanda Bellini, Vitoria Bonan Costa, Paula Aboud Barbugli, Ana Claudia Pavarina
Understanding the interaction between Lactobacillus spp. and C. albicans biofilms is important to develop anti-Candida approaches. The constant maintenance of the intestinal and oral microbiota can prevent the development and prevalence of diseases caused by Candida spp. (Hatakka et al. 2007; Dos Santos et al. 2009; Mendonça et al. 2012). It has been shown that several species of the genus Lactobacillus have anti-Candida activity, possibly by direct inhibition, competition for adhesion sites, or production of secondary metabolites with antimicrobial activity (Ribeiro et al. 2020). However, the effect of these probiotics on the extracellular matrix of C. albicans biofilms has not yet been fully elucidated. Thus, this study investigated whether the interaction with Lactobacillus interferes with the extracellular matrix of biofilm of fluconazole-susceptible and -resistant C. albicans dual-species biofilms.