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BackgroundBloodstream infections due to Candida species cause significant morbidity and mortality, and the epidemiology of Candida infection is changing. Surveillance for candidemia is necessary to detect trends in species distribution and antifungal resistance.MethodsThe medical and electronic records of all patients who had candidemia at the authors’ hospital from 2009 to 2011 were reviewed for demographic data and clinical information, including the infecting Candida species, resistance to antifungals and survival, and the presence of risk factors associated with candidemia.ResultsA total of 133 distinct episodes of candidemia were identified over the study period. The annual incidence of candidemia ranged between 0.71 and 0.85 cases/1000 hospital discharges. The most frequent Candida species were C. tropicalis (28.6%), followed by C. albicans (23.3%) and C. parapsilosis (19.5%). The rates of susceptibility to antifungal agents were as followed: voriconazole (97.8%), itraconazole (69.5%), fluconazole (46.1%), ketoconazole (38.9%). Out of 131 evaluable patients, 34 (26.0%) died within 30 days from the onset of candidemia. C. tropicalis candidemia was associated with the highest mortality rate (44.7%). Regarding the crude mortality in the different units, patients in Hemato-Oncology ward had the highest mortality rate (66.7%), followed by patients in cardiovascular wards and ICU (57.1% and 25.6%, respectively). Predictors of 30-day mortality were identified by uni- and multivariate analyses. Complicated abdominal surgery, presence of central venous catheter (CVC), neutropenia, candidemia due to C. tropicalis and poor treatment with fluconazole were significantly associated with the 30-day mortality. Presence of CVC (odds ratio[OR] = 4.177; 95% confidence interval [CI] = 1.698 to 10.278; P = 0.002) was the only independent predictor for mortality in the multivariate analysis.ConclusionThis report provides baseline data for future epidemiological and susceptibility studies and for the mortality rates associated with candidemia in our hospital. The knowledge of the local epidemiological trends in Candida species isolated in blood cultures is important to guide therapeutic choices.

The photocatalysis of water-splitting coupling with pollutant degradation was achieved on Mn-doped g-C 3 N 4 nanoribbon (Mn-CNNR) with double purposes of environmental protection and renewable energy production. The photocatalytic efficiency of water splitting using Mn-CNNR-3 in pure water was 2.71 times higher than that using bulk g-C 3 N 4 (CNB) under visible-light illumination. The yields of H 2 and O 2 for Mn-CNNR-3 reached 593.35 μmol/g cat and 59.47 μmol/g cat in methylene blue (MB) solution, and the degradation efficiency of MB simultaneously attained 96.1%. The Mn-CNNR-3 catalyst exhibited good photocatalytic activity after 5 cycles. The D 2 O-tracer experiment proved that H 2 gas was produced by water splitting rather than MB degradation in the photocatalytic system. On the basis of theoretical simulation and measurements, the separation of photogenerated carriers was assuredly promoted by the nanoribbon construction and Mn doping. Meanwhile, by Mn doping, the process from H 2 O 2 to hydroxide radicals on the g-C 3 N 4 surface became beneficial in thermodynamics and experiment, further facilitating the complex photocatalysis. Furthermore, the photocatalytic mechanism was proposed to explain the detailed process of water splitting coupling with MB degradation. The present work sheds light on the design of multifunctional photocatalysts to simultaneously tackle the problems of energy crisis and environmental pollution.

BackgroundThe yeast Candida is one of the most frequent pathogens isolated from bloodstream infections and is associated with significant morbidity and mortality. Problems with clinical and microbiological diagnosis of invasive candidiasis (IC) have prompted the development of non-culture-based laboratory methods. Previous reports suggest that serological detection of antibodies might be useful for diagnosing systemic candidiasis.MethodsDiagnosis of IC using antibodies against recombinant Candida albicans enolase (Eno) and fructose-bisphosphate aldolase (Fba1) was evaluated. Using recombinant Eno and Fba1 as coating antigens, enzyme-linked immunosorbent assays (ELISAs) were used to analyze sera from patients with candidemia (n = 101), Candida colonization (n = 50), bacteremia (n = 84), invasive aspergillosis (n = 40); and from healthy controls (n = 200).ResultsThe results demonstrated that ELISA detection of anti-Eno and anti-Fba1 IgG distinguished IC from other pathogenic infections in patients and healthy individuals. The sensitivity, specificity, and positive and negative predictive values were 72.3%, 94.7%, 78.5% and 93% for anti-Eno, and 87.1%, 92.8%, 76.5% and 96.4% for anti-Fba1 antibodies, respectively. Combining these two tests improved sensitivity up to 90.1% and negative predictive value up to 97.1%, with specificity and positive predictive values of 90.6% and 72.2%. The tests were specific to the Candida genus and antibody titers were higher for candidemia patients than for controls. Positive antibody tests were obtained before blood culture results for 42.2% of patients for anti-Eno and 51.1% for anti-Fba1.ConclusionThese data suggest that tests that detect IgG antibodies against Candida enolase and fructose-bisphosphate aldolase, especially when used in combination, could be a powerful tool for diagnosing IC.