Epidemiology and Virulence Determinants including Biofilm Profile of<i>Candida</i>Infections in an ICU in a Tertiary Hospital in India

Kaur, Ravinder; Goyal, Ritu; Dhakad, Megh Singh; Kumar, Rakesh

doi:10.1155/2014/303491

Cited by 21 publications

(23 citation statements)

References 32 publications

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“…Jarvis (15) and Pfaller (16) had reported 50 to 70% Candida albicans isolation, Roilides et al (17) 65%, Ariff S (18) 55% of isolation in their respective studies. Indian studies which reported almost similar findings were S Narain (53.3%)(19), Kaur R (50%) (20). However, Kotwal A et al (21) noted a much higher prevalence of C.albicans (78.1%).…”

Section: Discussionmentioning

confidence: 64%

Virulence Determinants of Candida Infections in High Risk Neonates and Infants in a Tertiary Hospital of North India

2017

IJSR

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Introduction: Candida spp. are considered as opportunistic pathogens because they posses many virulence factors which contributes in the pathogenesis of Candida infections. The virulence of Candida spp. is attributed to certain factors like biofilm formation, and the production of hydrolytic enzymes. Objective: To study the virulence factors of Candida infections among high risk neonates and infants. Materials and methods: Samples were collected aseptically from 128 high risk neonates and infants.They were cultured and identified by standard microbiological techniques and their virulence factors such as biofilm formation was demonstrated by tube method, egg yolk agar for proteinase activity, bovine serum albumin agar for phospholipase activity and sabouraud dextrose agar with sheep blood for haemolytic activity. Results: All the virulence markers were significantly associated with the development of candidiasis among neonates and infants. However among all these factors biofilm and hemolysin production were found to be highly significant. Biofilm formation in this study was more often found in the non albicans Candida spp. (95%) as compared to Candida albicans. C. tropicalis produces stronger biofilms (40% were 3+ & 10% were 4+) than C. albicans (10.3% produced 3+ and 4+ biofilms). Phospholipase activity was noted in 34.7% of Candida spp., Maximum phospholipase production was seen in NAC spp. (65%) as compared to C. albicans (13.6%). Proteinase activity was seen 38.8% of Candida isolates. Conclusion: As non-albicans Candida infections are on the rise, microbiology laboratories should go for complete identification of all yeast isolates and their virulence.

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Section: Discussionmentioning

confidence: 64%

Virulence Determinants of Candida Infections in High Risk Neonates and Infants in a Tertiary Hospital of North India

2017

IJSR

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“…Patients in ICU are at a higher risk of acquiring nosocomial infections compared with patients in general wards due to the severity of the underlying illnesses and iatrogenic factors related to the high frequency of invasive procedures needed for the monitoring and treatment which include insertion of intravascular catheters, endotracheal intubation, and positive pressure ventilation, urinary catheterization and surgical operations. 10,11 In India, C. tropicalis is the most common cause of health care associated candidemia. 12 The increased isolation of C. tropicalis from various clinical types of candidiasis is of concern because of its ability to develop rapid resistance to fluconazole.…”

Section: Discussionmentioning

confidence: 99%

Candida tropicalis: insight into the characteristics and outcome of adult patients admitted in medical and surgical intensive care units

Sandhu¹,

Aggarwal²,

Kumar³

et al. 2019

Int J Res Med Sci

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Background: Non albicans species are emerging increasingly as significant ICU pathogens. The increasing incidence of C. tropicalis infections is a significant problem because of its ability to develop rapid resistance to fluconazole.Methods: The study was designed to isolate, evaluate the risk factors and outcome of C. tropicalis infection from intensive care units. Identification was done by the biochemical methods. A total of 89 patients culture positive for C. tropicalis were selected for retrospective analysis over a period of one year. We collected various data about risk factors and outcome from the medical records.Results: A total of 89 patients culture positive for Candida tropicalis were analysed. Majority of these culture isolates were obtained from their blood (59.55%) followed by urine samples (31.46%). The indwelling devices (93.2%) remained a highest risk followed by prolonged administration of antibiotic therapy (92.1%) and admission in ICU for more than a week (88.8%). Overall mortality rate was 31.5%. Mortality was higher in patients with longer total length of stay in hospital (89.3%; p 1.000), indwelling devices (85.7%; p 0.5663) and in whom the antimicrobial therapy was administered for prolonged duration (82.1%; p 0.7581), although these factors remained statistically insignificant. 92.1% of isolates were sensitive to amphotericin B and showed 52.8%; 9.0% sensitivity to itraconazole and fluconazole respectively.Conclusions: C. tropicalis is now classified as the third or fourth NAC species being commonly isolated from clinical samples and associated with persistent systemic infections leading to a longer stay in the hospital. Several virulence factors seem to be responsible for high dissemination and mortality.

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“…[21] Hence, an in vitro antifungal susceptibility test of Candida species was performed to determine their resistance patterns, and highlight an emerging trend if any, for future reference. Besides as therapy, in HIV seropositive individuals, FL is also recommended in lifelong prophylaxis to prevent complicated severe opportunistic infections in AIDS.…”

Section: Discussionmentioning

confidence: 99%

“…[2] Though most Indian studies on in vitro antifungal resistance patterns of Candida isolates, revealed either nil or very low percentage of FL resistance in C. albicans isolated from various clinical specimens,[2] a higher percentage of C. albicans , isolated from Intensive Care Unit patients, were found to be resistant to FL. [21]…”

Section: Discussionmentioning

confidence: 99%

Diversity and antifungal resistance patterns of prevalent opportunistic pathogenic yeasts colonizing the oral cavities of asymptomatic human immunodeficiency virus-infected individuals, and their relation to CD4 ⁺ counts

Kumar

Muralidhar

Banerjee

et al. 2015

Indian J Sex Transm Dis

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Background:Yeasts are important opportunistic pathogens, in individuals infected with human immunodeficiency virus (HIV). Yeast species inhabiting the oral mucosa of HIV-infected persons can act as source of oral lesions, especially as the individual progresses towards immunocompromised state. Present study was conducted to evaluate the diversity of yeasts in oral cavities of asymptomatic HIV-infected persons and their association with CD4+ cell counts.Materials and Methods:100 HIV seropositive subjects and 100 healthy controls were screened for oral yeast carriage using standard procedures.Results:Of the 100 HIV-seropositive persons screened, 48 were colonized by different yeasts, either alone or in association with another species. Candida albicans was the most common species (56.90%) while non C. albicans Candida (NCAC) accounted for 39.65%. Among NCAC, Candida tropicalis and Candida krusei were most common. One isolate each of rare opportunistic pathogenic yeasts, Geotrichum candidum and Saccharomyces cereviseae, was recovered. The control group had an oral candidal carriage rate of 23%; C. albicans was the predominant species, followed by Candida glabrata, C. tropicalis and Candida parapsilosis. Antifungal susceptibility testing revealed no resistance in C. albicans, to the commonly used antifungal agents, whereas resistance or dose dependent susceptibility to fluconazole was observed in some of the NCAC species.Conclusion:Oral carriage of opportunistic pathogenic yeasts was greater in HIV-seropositive persons heading towards immunocompromised state, as evidenced by their CD4+ cell count. The predominant yeast isolated in this study (C. albicans), was found to be susceptible to commonly used antifungals.

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Epidemiology and Virulence Determinants including Biofilm Profile ofCandidaInfections in an ICU in a Tertiary Hospital in India

Cited by 21 publications

References 32 publications

Virulence Determinants of Candida Infections in High Risk Neonates and Infants in a Tertiary Hospital of North India

Virulence Determinants of Candida Infections in High Risk Neonates and Infants in a Tertiary Hospital of North India

Candida tropicalis: insight into the characteristics and outcome of adult patients admitted in medical and surgical intensive care units

Diversity and antifungal resistance patterns of prevalent opportunistic pathogenic yeasts colonizing the oral cavities of asymptomatic human immunodeficiency virus-infected individuals, and their relation to CD4 ⁺ counts

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Epidemiology and Virulence Determinants including Biofilm Profile ofCandidaInfections in an ICU in a Tertiary Hospital in India

Cited by 21 publications

References 32 publications

Virulence Determinants of Candida Infections in High Risk Neonates and Infants in a Tertiary Hospital of North India

Virulence Determinants of Candida Infections in High Risk Neonates and Infants in a Tertiary Hospital of North India

Candida tropicalis: insight into the characteristics and outcome of adult patients admitted in medical and surgical intensive care units

Diversity and antifungal resistance patterns of prevalent opportunistic pathogenic yeasts colonizing the oral cavities of asymptomatic human immunodeficiency virus-infected individuals, and their relation to CD4 + counts

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Diversity and antifungal resistance patterns of prevalent opportunistic pathogenic yeasts colonizing the oral cavities of asymptomatic human immunodeficiency virus-infected individuals, and their relation to CD4 ⁺ counts