COVID-19 and Candida duobushaemulonii superinfection: A case report

Awada, Bassem; Alam, Walid; Chalfoun, Maria; Araj, George F.; Bizri, Abdul Rahman

doi:10.1016/j.mycmed.2021.101168

Cited by 12 publications

(6 citation statements)

References 21 publications

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“…Thus, discrimination between these species warranted further testing (molecular, MALDI-TOF, WGS), which was kindly extended by colleagues from Lebanon, United States, and Canada (thanked under acknowledgment), whereby all of them revealed the identification as C . duobushaemulonii ( Awada et al, 2021 ). This reflected the difficulties in the proper identification of C .…”

Section: Discussionmentioning

confidence: 99%

“…The second was a case report on C . duobushaemulonii associated with coronavirus disease 2019 (COVID-19) disease ( Awada et al, 2021 ). Thus, in the absence of any characterization of C. auris isolates in Lebanon, this study was warranted to describe the genomic features, genetic relationships, and drug resistance profiles using WGS among C .…”

Section: Introductionmentioning

confidence: 99%

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Molecular Characterization of Candida auris Isolates at a Major Tertiary Care Center in Lebanon

et al. 2022

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BackgroundThe globally emerging Candida auris pathogens poses heavy burden to the healthcare system. Their molecular analyses assist in understanding their epidemiology, dissemination, treatment, and control. This study was warranted to describe the genomic features and drug resistance profiles using whole genome sequencing (WGS) among C. auris isolates from Lebanon.MethodsA total of 28 C. auris clinical isolates, from different hospital units, were phenotypically identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) and tested for antifungal resistance using Vitek-2 system and E test. The complete genomes were determined by WGS using long reads sequencing (PacBio) to reveal the clade distribution and antifungal resistance genes.ResultsCandida auris revealed uniform resistance to fluconazole and amphotericin B, with full susceptibility to echinocandins. Among key resistance genes studied, only two mutations were detected: Y132F in ERG11 gene and a novel mutation, D709E, found in CDR1 gene encoding for an ABC efflux pump. Phylogenetically, C. auris genomes belonged to South Asian clade I and showed limited genetic diversity, suggesting person to person transmission.ConclusionThis characterization of C. auris isolates from Lebanon revealed the exclusivity of clade I lineage together with uniform resistance to fluconazole and amphotericin B. The control of such highly resistant pathogen necessitates an appropriate and rapid recovery and identification to contain spread and outbreaks.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Molecular Characterization of Candida auris Isolates at a Major Tertiary Care Center in Lebanon

et al. 2022

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“…Nine case reports and seven case series were retrieved [108][109][110][111][112][113][114][115][116][117][118][119][120][121][122][123], together reporting 41 cases of candidemia (Table 4; detailed information about the individual studies is given in Table S4). The median time from ICU admission or intubation to the diagnosis of candidemia was 13.5 days (IQR 7.5-29.5), and more than 80% of the patients had an indwelling vascular catheter, received broad-spectrum antibiotics, and underwent mechanical ventilation before its onset.…”

Section: Case Reports and Case Seriesmentioning

confidence: 99%

Invasive Fungal Infections Complicating COVID-19: A Narrative Review

Casalini

Giacomelli

Ridolfo

et al. 2021

JoF

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Invasive fungal infections (IFIs) can complicate the clinical course of COVID-19 and are associated with a significant increase in mortality, especially in critically ill patients admitted to an intensive care unit (ICU). This narrative review concerns 4099 cases of IFIs in 58,784 COVID-19 patients involved in 168 studies. COVID-19-associated invasive pulmonary aspergillosis (CAPA) is a diagnostic challenge because its non-specific clinical/imaging features and the fact that the proposed clinically diagnostic algorithms do not really apply to COVID-19 patients. Forty-seven observational studies and 41 case reports have described a total of 478 CAPA cases that were mainly diagnosed on the basis of cultured respiratory specimens and/or biomarkers/molecular biology, usually without histopathological confirmation. Candidemia is a widely described secondary infection in critically ill patients undergoing prolonged hospitalisation, and the case reports and observational studies of 401 cases indicate high crude mortality rates of 56.1% and 74.8%, respectively. COVID-19 patients are often characterised by the presence of known risk factors for candidemia such as in-dwelling vascular catheters, mechanical ventilation, and broad-spectrum antibiotics. We also describe 3185 cases of mucormycosis (including 1549 cases of rhino-orbital mucormycosis (48.6%)), for which the main risk factor is a history of poorly controlled diabetes mellitus (>76%). Its diagnosis involves a histopathological examination of tissue biopsies, and its treatment requires anti-fungal therapy combined with aggressive surgical resection/debridement, but crude mortality rates are again high: 50.8% in case reports and 16% in observational studies. The presence of other secondary IFIs usually diagnosed in severely immunocompromised patients show that SARS-CoV-2 is capable of stunning the host immune system: 20 cases of Pneumocystis jirovecii pneumonia, 5 cases of cryptococcosis, 4 cases of histoplasmosis, 1 case of coccidioides infection, 1 case of pulmonary infection due to Fusarium spp., and 1 case of pulmonary infection due to Scedosporium.

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“…Data on candidemia in patients with COVID-19 is generally restricted to case reports [ 10 , 11 , 12 ] or small series of patients from different geographic areas [ 13 , 14 , 15 , 16 , 17 ]. In addition, heterogenous information comparing candidemia episodes in patients with and without COVID-19 is available [ 14 , 18 , 19 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence of Candidemia Is Higher in COVID-19 versus Non-COVID-19 Patients, but Not Driven by Intrahospital Transmission

Machado

Estévez

Sánchez‐Carrillo

et al. 2022

JoF

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There is scarce information on the actual incidence of candidemia in COVID-19 patients. In addition, comparative studies of candidemia episodes in COVID-19 and non-COVID-19 patients are heterogeneous. Here, we assessed the real incidence, epidemiology, and etiology of candidemia in COVID-19 patients, and compared them with those without COVID-19 (2020 vs. 2019 and 2020, respectively). We also genotyped all C. albicans, C. parapsilosis, and C. tropicalis isolates (n = 88), causing candidemia in both groups, providing for the first time a genotypic characterization of isolates gathered in patients with either COVID-19 or non-COVID-19. Incidence of candidemia was higher in patients with COVID-19 than non-COVID-19 (4.73 vs. 0.85 per 1000 admissions; 3.22 vs. 1.14 per 10,000 days of stay). No substantial intergroup differences were found, including mortality. Genotyping proved the presence of a low number of patients involved in clusters, allowing us to rule out rampant patient-to-patient Candida transmission. The four patients, involved in two clusters, had catheter-related candidemia diagnosed in the first COVID-19 wave, which demonstrates breaches in catheter management policies occurring in such an overwhelming situation. In conclusion, the incidence of candidemia in patients with COVID-19 is significantly higher than in those without COVID-19. However, genotyping shows that this increase is not due to uncontrolled intrahospital transmission.

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COVID-19 and Candida duobushaemulonii superinfection: A case report

Cited by 12 publications

References 21 publications

Molecular Characterization of Candida auris Isolates at a Major Tertiary Care Center in Lebanon

Molecular Characterization of Candida auris Isolates at a Major Tertiary Care Center in Lebanon

Invasive Fungal Infections Complicating COVID-19: A Narrative Review

Incidence of Candidemia Is Higher in COVID-19 versus Non-COVID-19 Patients, but Not Driven by Intrahospital Transmission

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