Epidemiological characteristics of Candida species colonizing oral and rectal sites of Jordanian infants

Abstract

BackgroundThere is evidence that Candida colonization contributes to increasing invasion of candidiasis in hospitalized neonates. Few studies investigated the epidemiology and risk factors of Candida colonization among hospitalized and non-hospitalized infants. This prospective study investigated the major epidemiological characteristics of Candida species colonizing oral and rectal sites of Jordanian infants.MethodsInfants aged one year or less who were examined at the pediatrics outpatient clinic or hospitalized at the Jordan University Hospital, Amman, Jordan, were included in this study. Culture swabs were collected from oral and rectal sites and inoculated on Sabouraud dextrose agar. All Candida isolates were confirmed by the Remel RapID yeast plus system, and further investigated for specific virulence factors and antifungal susceptibility MIC using E-test. Genotyping of C. albicans isolates was determined using random amplified polymorphic DNA (RAPD) analysis method.ResultsA total of 61/492 (12.4%) infants were colonized with Candida species by either their oral/rectal sites or both. Rectal colonization was significantly more detected than oral colonization (64.6% verses 35.4%), particularly among hospitalized infants aged more than one month. The pattern and rates of colonization were as follows: C. albicans was the commonest species isolated from both sites and accounted for 67.1% of all isolates, followed by C.kefyr (11.4%), each C. tropicalis and C. glabrata (8.9%) and C. parapsilosis (3.8%).A various rates of Candida isolates proved to secrete putative virulence factors in vitro; asparatyl proteinase, phospholipase and hemolysin. C. albicans were associated significantly (P < 0.05) with these enzymes than other Candida species. All Candida isolates were susceptible to amphotericin B and caspofungin, whereas 97% of Candida species isolates were susceptible to fluconazole using E-test.The genetic similarity of 53 C. albicans isolates as demonstrated by dendrogram revealed the presence of 29 genotypes, and of these one genotype accounted for 22% of the isolates.ConclusionThis study presents important epidemiological features of Candida colonization of Jordanian infants.

Resistant virulent Candida species colonizing preterm neonates and in vitro promising prospect of chlorhexidine gluconate

“…Grown as planktonic cells, none of the isolates exhibited resistance towards both antifungals. Our results are comparable with the results of Issa et al (2011).…”

“…To begin with, 50/52 (96%) Candida isolates produced phospholipase, which was significantly higher in Candida albicans. Similar findings have been reported by other investigators (Oksuz et al, 2007;Issa et al, 2011). Moreover, high phospholipase production, which might reflect a more virulent nature (Mohan das and Ballal, 2008), was demonstrated in 22/31 (71%) Candida albicans.…”

“…On the other hand, our study revealed significantly more non-albicans Candida producing proteinase than Candida albicans producing proteinase (33.3% versus 6.5%, P = 0.022). This agrees with the work of Mohan das and Ballal (2008) on blood culture isolates, but is contradictory to the work of others studying either colonizing or clinical isolates (Oksuz et al, 2007;Gokce et al, 2007;Issa et al, 2011); where the percentage of C. albicans producing proteinase was significantly higher than non-albicans Candida. Biofilm formation represents a protected mode of growth that allows cells to survive and disperse to colonize new niches (Hall-Stoodley et al, 2004).…”

Positions and Numbers of FKS Mutations in Candida albicans Selectively Influence In Vitro and In Vivo Susceptibilities to Echinocandin Treatment

“…To determine whether strain RR CL evolved from S CL or replaced S CL under selection pressure of CAS, RAPD genotyping of the clinical isolates was performed. The efficacy of RAPD as a typing method for clinical C. albicans isolates was previously demonstrated (17,18). RAPD revealed a clonal relationship between the isolates (Fig.…”

The Relative Frequency and Susceptibility Patterns of Candida Species Isolated from Blood and Urine of Children with Malignancy

“…Cornistein et al revealed that the history of receiving antibiotics increased the probability of Candida colonization (13). In contrast, Issa et al reported no relationship between antibiotics use and extent of infections with Candida species (14). The difference in findings may be due to the length of the treatment period and the types of antibiotics taken.…”