First Case of Identification of Candida kefyr and Pichia kluyveri in Lebanese Water

Halawi, Mohammad; Nasser, Roudaina; Yassine, Wissam; Yusef, Hoda; Borjac, Jamilah; Zeaiter, Zaher

doi:10.1007/s11270-020-4460-y

Cited by 3 publications

(3 citation statements)

References 53 publications

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“…Out of the 100 NAC clinical isolates, 59 % were from females and 41% from male patients. The majority of the specimens (43%) were from the ICUs, followed by outpatients (24%), internal medicine (15%), nephrology (9%), surgery (5%) and urology (4%) departments as shown in figure (1). Urine was the predominant specimen from all departments displaying NAC spp.…”

Section: Resultsmentioning

confidence: 99%

“…Whereas 88 (88%) of the 100 NAC isolates identified by Vitek 2 showed negative GTT result, while 12 (12%) showed false positive results. Thus, GTT showed an overall sensitivity of 87.88%, specificity of 88%, PPV of 70.73%, NPV of 95.65% and accuracy of 87.97% as shown in table (1). For C. tropicalis all the 18 isolates were sensitive by DD as with the Vitek 2 system.…”

Section: Speciation Of Candida Isolatesmentioning

confidence: 90%

“…The predominant Candida spp. isolated from patients with invasive candidiasis worldwide was C. albicans 1 . However, new threats have emerged in recent decades leading to the increased incidence of non-albicans Candida spp.…”

Section: Introductionmentioning

confidence: 99%

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Speciation and Antifungal Susceptibility of Clinical Non-albicans Candida isolated from Patients in a Tertiary Care Centre in Egypt

Dahroug,

Salem,

Tarek

et al. 2023

Egyptian Journal of Medical Microbiology

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Background: There has been a significant rise in morbidity and mortality due to infections caused by Candida spp. with an upsurge in the incidence of non-albicans Candida (NAC), where the clinical outcome is affected by their decreased susceptibility to azoles. Accurate identification is an important step that leads to selecting a suitable antifungal agent. Objectives: This study aimed to identify the main NAC clinical spp. in the hospital setting and to determine the antifungal susceptibility. Methodology: 133 isolates of Candida were identified by culture on Sabouraud Dextrose Agar, Gram stain, and germ tube test. Isolates were then subcultured on HiCrome chromogenic agar medium, and identification was confirmed using Vitek 2 automated compact system. NAC isolates antifungal susceptibility was detected using disk diffusion method and Vitek 2 compact system. Results: The majority of the Candida isolates (75%) were identified as NAC spp. with C. glabrata predominance (96%). HiCrome showed a sensitivity of 97% compared to Vitek 2 system. Disk diffusion showed high sensitivity when tested with amphotericin B, fluconazole, voriconazole and caspofungin of 100%, 95.2%, 100%, and 92.86% respectively compared to Vitek 2. Conclusion: This study confirms the substantial shift in Candida spp. from albicans to NAC. HiCrome chromogenic agar medium could be used as a rapid method for identification of the common NAC spp. Disk diffusion represents a reliable alternative method for routine antifungal susceptibly testing in the absence of automated systems.

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Section: Resultsmentioning

confidence: 99%

Section: Speciation Of Candida Isolatesmentioning

confidence: 90%

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Speciation and Antifungal Susceptibility of Clinical Non-albicans Candida isolated from Patients in a Tertiary Care Centre in Egypt

Dahroug,

Salem,

Tarek

et al. 2023

Egyptian Journal of Medical Microbiology

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Characterization and susceptibility of non-albicans Candida isolated from various clinical specimens in Lebanese hospitals

Husni

Zerdan²,

Samaha³

et al. 2023

Front. Public Health

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BackgroundInvasive fungal infections have presented a challenge in treatment. In the past, it was known that the frontrunner in such infections is Candida albicans with little emphasis placed on non-albicans Candida species (NAC). Studies worldwide have shown a rise in fungal infections attributed to non-albicans Candida species. The aim of this study is to describe the epidemiology of NAC infections along with an overview of resistance in Lebanese hospitals.MethodsThis is a two-year observational multi-central descriptive study. Between September 2016 and May of 2018, a total of 1000 isolates were collected from 10 different hospitals distributed all over the country. For the culture, Sabouraud Dextrose Agar was used. Antifungal Susceptibility was evaluated by determining the Minimum Inhibitory Concentration (MIC) in broth (microdilution) of the different antifungal treatments.ResultsOut of the 1000 collected isolates, Candida glabrata, being the most isolated species (40.8%), followed by Candida tropicalis: 231(23.1%), Candida parapsilosis: 103(10.3%), and other NAC species at lower percentage. Most of these isolates (88.67%) were susceptible to posaconazole, 98.22% were susceptible to micafungin, and 10% were susceptible to caspofungin.ConclusionThe change of etiology of fungal infections involving a significant increase in NAC cases is alarming due to the different antifungal susceptibility patterns and the lack of local guidelines to guide the treatment. In this context, proper identification of such organisms is of utmost importance. The data presented here can help in establishing guidelines for the treatment of candida infections to decrease morbidity and mortality. Future surveillance data are needed.

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Antifungal Use and Resistance in a Lower–Middle-Income Country: The Case of Lebanon

Hassoun,

Kassem,

Hamze

et al. 2023

Antibiotics

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Antimicrobial resistance is a serious threat, particularly in low- and middle-income countries (LMICs). Antifungal resistance is often underestimated in both healthcare and non-clinical settings. In LMICs, it is believed that the inappropriate use of antifungals, limited surveillance systems, and low diagnostic capacities are significant drivers of resistance. Like other LMICs, Lebanon lacks antifungal use and resistance surveillance programs, and the impact of antifungal resistance in the country remains unclear, especially during the unfolding economic crisis that has severely affected medical care and access to safe food and water. Interestingly, the widespread use of antifungals in medicine and agriculture has raised concerns about the development of antifungal resistance in Lebanon. In this light, we aimed to survey available antifungal drugs in the country and evaluate susceptibility patterns of prevalent fungal species to guide empiric treatments and develop antifungal stewardship programs in Lebanon. We noted that the economic crisis resulted in significant increases in antifungal drug prices. Additionally, a comprehensive literature search across PubMed, ScienceDirect, and Google Scholar databases identified 15 studies on fungal infections and antifungal resistance conducted from 1998 to 2023 in Lebanon. While data on antifungal resistance are limited, 87% of available studies in Lebanon focused on candidiasis, while the remaining 13% were on aspergillosis. Overall, we observed a marked antimicrobial resistance among Candida and Aspergillus species. Additionally, incidences of Candida auris infections have increased in Lebanese hospitals during the COVID-19 pandemic, with a uniform resistance to fluconazole and amphotericin-B. Taken together, a One Health approach, reliable diagnostics, and prudent antifungal use are required to control the spread of resistant fungal pathogens in healthcare and agricultural settings.

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First Case of Identification of Candida kefyr and Pichia kluyveri in Lebanese Water

Cited by 3 publications

References 53 publications

Speciation and Antifungal Susceptibility of Clinical Non-albicans Candida isolated from Patients in a Tertiary Care Centre in Egypt

Speciation and Antifungal Susceptibility of Clinical Non-albicans Candida isolated from Patients in a Tertiary Care Centre in Egypt

Characterization and susceptibility of non-albicans Candida isolated from various clinical specimens in Lebanese hospitals

Antifungal Use and Resistance in a Lower–Middle-Income Country: The Case of Lebanon

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