Species distribution and antifungal drug susceptibilities of yeasts isolated from the blood samples of patients with candidemia

Lindberg, Erika; Hammarström, Helena; Ataollahy, Nasser; Kondori, Nahid

doi:10.1038/s41598-019-40280-8

Cited by 75 publications

(64 citation statements)

References 21 publications

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“…All fluconazole‐resistant C glabrata had a non‐WT susceptibility to voriconazole. While confirming recent findings that fluconazole resistance is uncommon in NCAC species, 40‐42 we documented the (acquired or intrinsic) azole resistance of pathogenic Candida species as a cause of breakthrough candidaemia. This was not the case for CVC‐related candidaemia ( P = .51), even though CVCs are well‐recognised causes of breakthrough candidaemia in patients with cancer 14 .…”

Section: Discussionsupporting

confidence: 90%

Candidaemia in haematological malignancy patients from a SEIFEM study: Epidemiological patterns according to antifungal prophylaxis

Posteraro

Carolis

Criscuolo

et al. 2020

Mycoses

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Background Candidaemia is an important infectious complication for haematological malignancy patients. Antifungal prophylaxis reduces the incidence of candidaemia but may be associated with breakthrough candidaemia. Objective To analyse the Candida species’ distribution and relative antifungal susceptibility profiles of candidaemia episodes in relation to the use of antifungal prophylaxis among Italian SEIFEM haematology centres. Methodology This multicentre retrospective observational SEIFEM study included 133 single‐species candidaemia episodes of haematological malignancy patients for whom antifungal susceptibility testing results of blood Candida isolates were available between 2011 and 2015. Each participating centre provided both clinical and microbiological data. Results Non‐Candida albicans Candida (NCAC) species were the mostly isolated species (89, 66.9%), which accounted for C parapsilosis (35, 26.3%), C glabrata (16, 12.0%), C krusei (14, 10.5%), C tropicalis (13, 9.8%) and uncommon species (11, 8.3%). C albicans caused the remaining 44 (33.1%) episodes. Excluding 2 C albicans isolates, 23 of 25 fluconazole‐resistant isolates were NCAC species (14 C krusei, 6 C glabrata, 2 C parapsilosis and 1 C tropicalis). Fifty‐six (42.1%) of 133 patients developed breakthrough candidaemia. Systemic antifungal prophylaxis consisted of azoles, especially fluconazole and posaconazole, in 50 (89.3%) of 56 patients in whom a breakthrough candidaemia occurred. Interestingly, all these patients tended to develop a C krusei infection (10/56, P = .02) or a fluconazole‐resistant isolate’s infection (14/50, P = .04) compared to patients (4/77 and 10/77, respectively) who did not have a breakthrough candidaemia. Conclusions Optimisation of prophylactic strategies is necessary to limit the occurrence of breakthrough candidaemia and, importantly, the emergence of fluconazole‐resistant NCAC isolates’ infections in haematological malignancy patients.

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Section: Discussionsupporting

confidence: 90%

Candidaemia in haematological malignancy patients from a SEIFEM study: Epidemiological patterns according to antifungal prophylaxis

Posteraro

Carolis

Criscuolo

et al. 2020

Mycoses

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“…In accordance with other studies [17-19, 24, 25, 30, 32, 35, 36], C. albicans was the most common cause of candidaemia in the whole hospital, but the proportion of non-C. albicans infections was higher than that of C. albicans infections. Moreover, the proportions of C. glabrata in surgical, internal medicine and paediatric wards were the highest, which is different from other studies in China [18,19,[35][36][37] but similar to other studies in other countries [4,22,27,29,32]. This may be due to the large number of elderly patients and the increasing use of azole antifungal agents.…”

Section: Discussioncontrasting

confidence: 87%

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpaitents in a tertiary teaching hospital in China

Zeng

Ding

Tian

et al. 2020

Preprint

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Background: There are no current national estimates of the candidaemia burden in China, and epidemiological candidaemia data from the underdeveloped region of China are lacking. Methods: A 7-year retrospective study was carried out to analyse the prevalence, species distribution, antifungal susceptibility, risk factors and inpatient mortality of candidaemia among paediatric and adult patients in a regional tertiary teaching hospital in China. Results: During the seven-year study period, a total of 201 inpatients with candidaemia were identified. The median age of the patients was 65 years (range, 1 day to 92 years), and 114 of the patients (56.7%) were male. The mean annual incidence of candidaemia was 0.26 cases per 1,000 admissions (0.42 cases per 1,000 paediatric admissions vs 0.24 cases per 1,000 adult admissions, P<0.05). Candida albicans was the most common fungal species (81/201, 40.3%) in all patients, Candida glabrata was the most common fungal species (18/35, 51.4%) in paediatric patients. Most isolates were susceptible to flucytosine (99.0%) and amphotericin B (99.0%), and the activity of antifungal agents against Candida species was no significant difference in satisfaction between paediatric and adult patients(P>0.05). The all-cause mortality rate was 20.4% (paediatric patients: 11.4% vs adult patients:22.3%, P>0.05). Fewer univariate predictors of poor outcomes were identified for paediatric patients than for adult patients (4 vs 11 predictors). Respiratory dysfunction and septic shock were independent predictors of 30-day mortality for all patients. Conclusions: The epidemiological data of candidaemia in paediatric and adult patients are only different in the distributions of Candida species and the mean annual incidence of candidaemia. Flucytosine and amphotericin B can be used as first-choice agents when no antifungal susceptibility test results are available.

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“…colonise the oral cavity, urogenital, or gastrointestinal tract as harmless commensals (Huffnagle & Noverr, ), but can also cause disease ranging from superficial mucosal to systemic infections with dissemination throughout the body and infection of internal organs (Odds, ). Candida albicans is the most prevalent cause of systemic candidiasis, followed by Candida glabrata and other non‐ albicans Candida species (Horn et al, ; Lindberg, Hammarstrom, Ataollahy, & Kondori, ).…”

Section: Introductionmentioning

confidence: 99%

Fungal biotin homeostasis is essential for immune evasion after macrophage phagocytosis and virulence

Sprenger

Hartung

Allert

et al. 2020

Cellular Microbiology

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Biotin is an important cofactor for multiple enzymes in central metabolic processes.While many bacteria and most fungi are able to synthesise biotin de novo, Candida spp. are auxotrophic for this vitamin and thus require efficient uptake systems to facilitate biotin acquisition during infection. Here we show that Candida glabrata and Candida albicans use a largely conserved system for biotin uptake and regulation, consisting of the high-affinity biotin transporter Vht1 and the transcription factor Vhr1. Both species induce expression of biotin-metabolic genes upon in vitro biotin depletion and following phagocytosis by macrophages, indicating low biotin levels in the Candida-containing phagosome. In line with this, we observed reduced intracellular proliferation of both Candida cells pre-starved of biotin and deletion mutants lacking VHR1 or VHT1 genes. VHT1 was essential for the full virulence of C. albicans during systemic mouse infections, and the lack of VHT1 led to reduced fungal burden in C. glabrata-infected brains and C. albicans-infected brains and kidneys. Together, our data suggest a critical role of Vht1-mediated biotin acquisition for C. glabrata and C. albicans during intracellular growth in macrophages and systemic infections. K E Y W O R D S biotin, Candida albicans, Candida glabrata, macrophage, metabolism, virulence

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Species distribution and antifungal drug susceptibilities of yeasts isolated from the blood samples of patients with candidemia

Cited by 75 publications

References 21 publications

Candidaemia in haematological malignancy patients from a SEIFEM study: Epidemiological patterns according to antifungal prophylaxis

Candidaemia in haematological malignancy patients from a SEIFEM study: Epidemiological patterns according to antifungal prophylaxis

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpaitents in a tertiary teaching hospital in China

Fungal biotin homeostasis is essential for immune evasion after macrophage phagocytosis and virulence

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