Clinical features, antifungal susceptibility, and outcome of Candida guilliermondii fungemia: An experience in a tertiary hospital in mid-Taiwan

Tseng, Ting-Yu; Chen, Tsung-Chia; Ho, Cheng-Mao; Lin, Pin Wen; Tsai, Chia-Ta; Wang, Jen-Hsien; Chi, Chih-Yu; Ho, Mao‐Wang

doi:10.1016/j.jmii.2016.08.015

Cited by 20 publications

(14 citation statements)

References 35 publications

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“…The mean age of patients in our study was older than the mean ages in previous studies, possibly because we mainly focused on critically ill patients; critically ill patients are often older than other patients [2, 19, 20]. Similar to other studies, C. albicans was the most common species causing candidemia, followed by C. parapsilosis, C. glabrata, and C. tropicalis [21–25].…”

Section: Discussionsupporting

confidence: 53%

Epidemiology, species distribution, antifungal susceptibility and mortality risk factors of candidemia among critically ill patients: a retrospective study from 2011 to 2017 in a teaching hospital in China

Xiao

Wang

Zhu

et al. 2019

Antimicrob Resist Infect Control

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Background Candidemia is still a common life-threatening disease and causes significant morbidity and mortality, especially in critically ill patients. We conducted this study to analyze the epidemiology, clinical characteristics, species distribution, antifungal susceptibility and mortality risk factors of candidemia in an intensive care unit. Methods We retrospectively analyzed patients with candidemia in the intensive care unit of our hospital from 2011 to 2017. The clinical characteristics, including clinical and laboratory data, antibiotic therapies, underlying conditions, and invasive procedures and outcomes, were analyzed. We also performed a logistic regression analysis to identify the independent risk factors for mortality. Results In this six-year retrospective study, we identified 82 patients with candidemia. The median age of the patients was 76 years (range, 26 years to 91 years), and 50 of the patients (61%) were male. Candida albicans was the most common fungal species (38/82, 46.3%), followed by Candida parapsilosis (16/82, 19.5%), Candida glabrata (13/82, 15.9%), and Candida tropicalis (12/82, 14.6%). Most isolates were susceptible to the antifungal agents. The all-cause mortality rate was 51.2%. In binary logistic regression analysis, the worst Glasgow coma score (GCS), PaO 2 /FiO 2 ratio (P/F ratio), and mean arterial pressure (MAP) within three days after admission were independent risk factors for mortality. Conclusions Candida albicans was the most frequently isolated fungal species. Most isolates were susceptible to the antifungal agents. The worst GCS score, P/F ratio, and MAP within three days after admission were independent risk factors for mortality due to candidemia in critically ill patients.

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Section: Discussionsupporting

confidence: 53%

Epidemiology, species distribution, antifungal susceptibility and mortality risk factors of candidemia among critically ill patients: a retrospective study from 2011 to 2017 in a teaching hospital in China

Xiao

Wang

Zhu

et al. 2019

Antimicrob Resist Infect Control

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“…M. guilliermondii is rarely recognized as an invasive pathogen, it is part of the normal microbiota of the skin and mucosa. Infections caused by this species are particularly common in immunocompromised people (Clancy and Calderone, 2012;Tseng et al, 2017). C. parapsilosis was one of the most common white yeasts in our samples.…”

Section: Discussionmentioning

confidence: 72%

Environmental characteristics and taxonomy of microscopic fungi isolated from washing machines

et al. 2019

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Washing machines (WMs) are convenient places for fungal colonization. This study is focused on fungal diversity of WMs, and investigates relationships between habits of WM users and colonising species. Housekeeping conditions and habits were assessed in Hungary with a questionnaire. Several fungal species were identified by microscopy and sequence analysis of diagnostic loci. Based on the results, 32 % of the sampled WMs were highly polluted with various species of fungi. Forty six percent of them were colonised also by opportunistically human pathogenic species. In total, 32 yeast and 39 filamentous fungal strains were isolated. Growth tests were conducted with five selected taxa (Cutaneotrichosporon dermatis, Cystobasidium slooffiae, Meyerozyma guilliermondii, Candida parapsilosis and the Fusarium oxysporum species complex (FOSC)) to ascertain their tolerance ranges. None of the examined isolates were able to grow >50 C, 4.10 < pH < 10.88. FOSC could grow at high salinity. More species were detected in WMs operated in rooms without heating systems (p ¼ 0.0025). The number of species was higher in WMs located in the kitchen than the ones kept in bathroom or in other rooms (p ¼ 0.0205). WMs may serve as a reservoir of pathogenic fungi, the presence of which may depend on the usage of these devices.

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“…e test range was as follows: FCZ, 0.125 to 64 mg/L; VCZ, 8 mg/L; and ICZ, 8 mg/L (European Society of Clinical Microbiology and Infectious Diseases, 2020). MIC values were interpreted according to EUCAST 2020 and CLSI M27 (Clinical and Laboratory Standards Institute, 2017; European Society of Clinical Microbiology and Infectious Diseases, 2020; Tseng et al, 2018). EUCAST 2020 did not provide any breakpoints for M. guilliermondii; therefore, based on Tseng et al (2018), we determined the epidemiological cutoff values for non-wild isolates (resistant) as >8, >0.5, and >1 mg/L for FCZ, VCZ, and ICZ, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…Some authors have indicated that M. guilliermondii as a re-emerging pathogen, especially in patients with cancer. e documented cases of infection indicate a mortality rate of up to 66% (Ahangarkani et al, 2019;Castillo-Bejarano et al, 2020;Tseng et al, 2018). In M. guilliermondii, cross-resistance between MTX and FCZ has never been observed before.…”

Section: Candida Guilliermondii)mentioning

confidence: 99%

Detection of Cross-Resistance Between Methotrexate and Azoles in Candida albicans and Meyerozyma guilliermondii: An In Vitro Study

2021

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In recent years, there has been a rapid increase in the incidence of Candida infections. The different species of the genus Candida vary in their virulence abilities and susceptibility to antifungal agents, depending on several external factors. The result of such modifications may be cross-resistance, which is understood as an acquired resistance to a certain antimicrobial agent after exposure to another drug. The aim of this study was to determine the possibility of cross-resistance between fluconazole, voriconazole, itraconazole, and methotrexate in Candida albicans and Meyerozyma guilliermondii (syn. Candida guilliermondii ). Fifteen strains of M. guilliermondii and eight strains of C. albicans , including the standard strains, were tested. For all strains, the minimum inhibitory concentrations (MICs) for fluconazole, voriconazole, and itraconazole were determined before and after stimulation with methotrexate. The median MICs in M. guilliermondii before and after stimulation were 9.333 and 64 mg/L ( p = 0.005) for fluconazole; 0.917 and 1.667 mg/L ( p = 0.001) for itraconazole, respectively. No significant change in MIC was observed for voriconazole. For C. albicans strains, the median MICs before and after stimulation were 0.917 and 64 mg/L ( p = 0.012) for fluconazole; 0.344 and 1.135 mg/L ( p = 0.018) for voriconazole, respectively. There was no significant change in MIC values for itraconazole. Thus, this study demonstrates the presence of cross-resistance between voriconazole, itraconazole, fluconazole, and methotrexate for the selected strains. Methotrexate exposure induces different responses when certain drugs are used for various species. Therefore, if a patient was previously exposed to methotrexate, there may be a higher risk of treatment failure with fluconazole than with other azoles such as voriconazole for fungemia caused by M. guilliermondii or itraconazole for C. albicans infection.

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Clinical features, antifungal susceptibility, and outcome of Candida guilliermondii fungemia: An experience in a tertiary hospital in mid-Taiwan

Cited by 20 publications

References 35 publications

Epidemiology, species distribution, antifungal susceptibility and mortality risk factors of candidemia among critically ill patients: a retrospective study from 2011 to 2017 in a teaching hospital in China

Epidemiology, species distribution, antifungal susceptibility and mortality risk factors of candidemia among critically ill patients: a retrospective study from 2011 to 2017 in a teaching hospital in China

Environmental characteristics and taxonomy of microscopic fungi isolated from washing machines

Detection of Cross-Resistance Between Methotrexate and Azoles in Candida albicans and Meyerozyma guilliermondii: An In Vitro Study

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