Background Increased hospitalisation rates in the Coronavirus disease 19 (COVID‐19) era lead to a new wave of hospital‐acquired infections such as emerging multidrug‐resistant Candida auris. We aimed to evaluate and estimate the global prevalence of coronavirus‐associated C. auris infection (CACa). Methods We searched related databases between December 2019 and April 2022 for studies that reported data about CACa. Meta‐analysis was performed using MedCalc software version 20.104 according to the DerSimonian and Laird method applying the random‐effects model. We evaluated heterogeneity using the χ2‐based Q statistic (significant for p‐value < .1) and the I2 statistic (>75% indicative of ‘notable’ heterogeneity). Moreover, if possible, an odds ratio (OR) analysis was performed for eligible data. Results Our meta‐analysis includes ten eligible studies, including 1942 patients hospitalised with COVID‐19; 129 were C. auris cases. The overall pooled prevalence of CACa was estimated at 5.7%. The mortality rate of CACa was estimated at 67.849%. Hypertension was the most prevalent comorbidity (59.374%), followed by diabetes mellitus (52.898%) and cardiovascular diseases (31.392%). Men with a prevalence rate of 80.012% were 3.27 (OR) times more prone to getting infected by C. auris. Conclusion We concluded that the prevalence of C. auris infections decreased during the COVID‐19 pandemic and the prevalence gradient changed from Asia to America. Unfortunately, there are many descriptive studies with duplicate content in the field of epidemiology of C. auris infections which are increasing every day. We suggest further non‐descriptive studies to accurately establish the cause‐and‐effect relationships between C. auris and COVID‐19 infections.
Background The accurate occurrence rate of C. auris infections is still not clear, mainly due to the defects in detection and identification tools routinely used. In this study, we used conventional PCR and real‐time PCR assays for sensitive and specific detection/identification of C. auris from either yeast isolates or clinical specimens collected from various patients in different parts of Iran. Our survey is the first large‐scale study rating the incidence of C. auris infections in Iran. Methods A total of 439 yeast isolates and 590 clinical specimens were screened by specific C. auris‐PCR, targeting the ITS region. The validity of positive samples was assessed by sequencing. Results Four out of 590 clinical specimens (0.68%) were positive by conventional PCR, while in real‐time PCR performed on 100 clinical samples, including those four samples positive in conventional samples, 6 samples were positive. A complete agreement of the identification of positive cases with sequencing results was documented. Among 439 culture isolates, none was positive for C. auris. After following up and resampling of the patients with positive PCR, only one specimen showed positive culture for C. auris, which was confirmed by sequencing. Conclusion C. auris is not a common cause of systemic or superficial fungal infections in Iran, and a few detected positive cases can be considered as a commensal, coloniser or infecting yeast which may potentially emerge in some clinical and therapeutical conditions. Mycological and phenotypical assays are not sensitive approaches for isolation/identification of C. auris, unless a specific and sensitive molecular‐based method is applied.
: The multidrug-resistant fungal pathogen Candida auris has been associated with healthcare. We need to address COVID-19 pandemic as well as the ongoing global fungal epidemic caused by C. auris, a multi-drug-resistant fungus spreading rapidly throughout the world. This study was conducted on patients admitted to an ICU in Isfahan, Iran, from November 2020 to February 2021 to determine the spectrum of C. auris colonization in immunocompromised patients hospitalized in an intensive care unit (ICU). Therefore, clinical swabs were collected from 32 immunocompromised patients for C. auris detection upon ICU admission after 7 to 14 days. A rich culture medium was used to evaluate C. auris growth at a higher temperature (40°C) and salinity (10% wt/vol) in Sabouraud dextrose agar, which can be used in combination with a C. auris-specific polymerase chain reaction method. C. auris was not isolated in the clinical samples of patients. The most common colonizer was Candida albicans, followed by C. glabrata, C. parapsilosis, and C. tropicalis. Candida glabrata was the only species with noticeable growth in the Salt SDA, with D-Mannitol as a carbon source. Currently, C. auris is not a common cause of systemic or superficial fungal infections in Iran. The screening of patients admitted to the ICU for C. auris could aid in the identification of colonized patients and could simplify the application of infection control measures.
Cockroaches are known as mechanical vectors of some pathogens that can infect humans. The present study aims to rapidly identify Periplaneta americana fungal pathogens from sewer systems of public hospitals in Esfahan using the polymerase chain reaction (PCR) technique. A total of 55 P. americana cockroaches were randomly collected by direct trapping from sewer systems of seven hospitals and screened for fungal infectious agents using standard morphological methods and the PCR sequencing. From the American cockroach, we isolated 62 yeasts and 31 molds from the surface, hemocoel, and digestive tract of P. americana. Based on DNA sequence comparisons and other taxonomic characteristics, they were identified as more than four species of yeast and four species of mold. Yeast species including Pichia kudriavzevii, Candida glabrata, Pichia kluyveri, and Candida viswanathii, and molds such as Aspergillus niger, Penicillium italicum, Mucor plumbeus, and Rhizopus oryzae were isolated repeatedly from the surface, hemocoel, and digestive tract of P. americana. Our results show that the use of a combination of morphological, molecular techniques, and phylogenetic analysis can lead to the identification of pathogenic fungal agents in American cockroaches and also knowledge of fungal pathogens-arthropod host relationships.
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