Candida glabrata: Review of Epidemiology, Pathogenesis, and Clinical Disease with Comparison to C. albicans (original) (raw)
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Candida Glabrata: An emerging threat for the Immunocompromised
2010
Background: Fungal infections cause a significant amount of morbidity and mortality among immuno compromised population. Various fungal agents are responsible but candida are one the most frequently isolated ones. Recently, a redistribution of candida species has been observed that has highlighted a non Candida albicans species i.e. Candida glabrata. High frequency of Candida glabrata exhibits high resistance rates and it has emerged as a difficult to treat pathogen. The objective of this study was to identify the various strains of fungi and their sensitivity in immuno compromised patients. Material & Methods: This was a cross-sectional study in which immunocompromised patients were screened for fungal infections on the basis of conventional and API 20-C methods. In this study 165 cases were inducted that included cases on dialysis, chemotherapy for malignancies, those with transplant and receiving immunosuppressive therapy and were positive for fungal infections. Results: Candida glabrata was isolated from 39(23.6%) cases and of these isolates, 13% were resistant to fluconazole. Conclusion: Apart from Candida albicans, Candida glabrata is another difficult to treat fungal agent in immunocompromised patients.
Candida glabrata Antifungal Resistance and Virulence Factors, a Perfect Pathogenic Combination
Pharmaceutics
In recent years, a progressive increase in the incidence of invasive fungal infections (IFIs) caused by Candida glabrata has been observed. The objective of this literature review was to study the epidemiology, drug resistance, and virulence factors associated with the C. glabrata complex. For this purpose, a systematic review (January 2001–February 2021) was conducted on the PubMed, Scielo, and Cochrane search engines with the following terms: “C. glabrata complex (C. glabrata sensu stricto, C. nivariensis, C. bracarensis)” associated with “pathogenicity” or “epidemiology” or “antibiotics resistance” or “virulence factors” with language restrictions of English and Spanish. One hundred and ninety-nine articles were found during the search. Various mechanisms of drug resistance to azoles, polyenes, and echinocandins were found for the C. glabrata complex, depending on the geographical region. Among the mechanisms found are the overexpression of drug transporters, gene mutations that ...
Combined antifungal therapy in a murine infection by Candida glabrata
Journal of Antimicrobial Chemotherapy, 2006
To develop proper treatments for patients who do not respond to current antifungal treatments, we tested new combinations of antifungal drugs for treating disseminated infections by Candida glabrata in a murine model. Methods: Mice were rendered neutropenic by intraperitoneal cyclophosphamide and intravenous 5-fluorouracil administration. The animals were infected intravenously with 2 • 10 8 cfu of C. glabrata. The efficacies of micafungin combined with amphotericin B, fluconazole or flucytosine, and of amphotericin B combined with fluconazole were evaluated by survival and tissue burden reduction. Results and Conclusions: Micafungin plus amphotericin B was the most effective combination at reducing tissue burden. Micafungin at 10 mg/kg combined with amphotericin B at 0.75, 1.5 or 3 mg/kg prolonged survival with respect to the monotherapies, but only the second combination showed a synergistic effect in reducing fungal load in spleen and kidney. Amphotericin B at 1.5 mg/kg combined with micafungin at 5, 10 or 20 mg/kg reduced tissue burden with respect to the monotherapies, but the effects of the three combinations were very similar. These results suggest that amphotericin B in combination with micafungin is promising for the treatment of disseminated C. glabrata infections.
In Vitro Activities of Six Antifungal Drugs Against Candida glabrata Isolates: An Emerging Pathogen
Background: Candida glabrata is a pathogenic yeast with several unique biological features and associated with an increased incidence rate of candidiasis. It exhibits a great degree of variation in its pathogenicity and antifungal susceptibility. Objectives: The aim of the present study was to evaluate the in vitro antifungal susceptibilities of the following six antifungal drugs against clinical C. glabrata strains: amphotericin B (AmB), ketoconazole (KTZ), fluconazole (FCZ), itraconazole (ITZ), voriconazole (VCZ), and caspofungin (CASP). Materials and Methods: Forty clinical C. glabrata strains were investigated using DNA sequencing. The in vitro antifungal susceptibility was determined as described in clinical laboratory standard institute (CLSI) documents (M27-A3 and M27-S4). Results: The sequence analysis of the isolate confirmed as C. glabrata and deposited on NCBI GenBank under the accession number no. KT763084-KT763123. The geometric mean MICs against all the tested strains were as follows, in increasing order: CASP (0.17 g/mL), VCZ (0.67 g/mL), AmB (1.1 g/mL), ITZ (1.82 g/mL), KTZ (1.85 g/mL), and FCZ (6.7 g/mL). The resistance rates of the isolates to CASP, FCZ, ITZ, VZ, KTZ, and AmB were 5%, 10%, 72.5%, 37.5%, 47.5%, and 27.5%, respectively. Conclusions: These findings confirm that CASP, compared to the other antifungals, is the potent agent for treating candidiasis caused by C. glabrata. However, the clinical efficacy of these novel antifungals remains to be determined.
Review Pathogenesis and Antifungal Drug Resistance of the Human Fungal Pathogen Candida glabrata
2011
Candida glabrata is a major opportunistic human fungal pathogen causing superficial as well as systemic infections in immunocompromised individuals and several other patient cohorts. C. glabrata represents the second most prevalent cause of candidemia and a better understanding of its virulence and drug resistance mechanisms is thus of high medical relevance. In contrast to the diploid dimorphic pathogen C. albicans, whose ability to undergo filamentation is considered a major virulence trait, C. glabrata has a haploid genome and lacks the ability to switch to filamentous growth. A major impediment for the clinical therapy of C. glabrata infections is its high intrinsic resistance to several antifungal drugs, especially azoles. Further, the development of antifungal resistance, particularly during prolonged and prophylactic therapies is diminishing efficacies of therapeutic interventions. In addition, C. glabrata harbors a large repertoire of adhesins involved in the adherence to host epithelia. Interestingly, genome plasticity, phenotypic switching or the remarkable ability to persist and survive inside host immune cells further contribute to the pathogenicity of C. glabrata. In this comprehensive review, we want to emphasize and discuss the mechanisms underlying virulence and drug resistance of C. glabrata, and discuss its ability to escape from the host immune surveillance or persist inside host cells.
LITERATURE REVIEW: CANDIDA GLABRATA (Atena Editora)
LITERATURE REVIEW: CANDIDA GLABRATA (Atena Editora), 2023
Introduction: Candida Glabrata, species of the Candida group, called non-albicans, is responsible for several infections that are difficult to treat. It is opportunistic and targets immunocompromised individuals. The diagnosis is made through the analysis of vaginal discharge, followed by a treatment that guarantees the improvement of symptoms. Goals: This review aims to expose conclusions about the pathogen Candida Glabrata and elucidate the management of cases. Methods: This is an integrative literature review. It included selected research between 1991 and 2020, a total of 17 studies. Inclusion and exclusion criteria were selected and the search was carried out through databases of renowned platforms. Results: The various types of Candida are commensal beings and are part of the vaginal microbiota, however, when there is an imbalance in immunity, they proliferate, causing symptoms. Glabrata became known for its aggressiveness and resistance to treatment with Fluconazole. Its diagnosis is made through clinical examination and laboratory tests of vaginal discharge that confirm the type of Candida that the individual has, helping in the correct treatment.Conclusion: Candida Glabrata is still a diagnostic hypothesis not explored by health professionals, due to the lack of information on the subject. It is considered a saprophyte of the vagina and presents a clinical picture when there is an immunological imbalance in the patient. Furthermore, it is resistant to treatment with Fluconazole and responds well to the use of Flucytosine. It is necessary to demystify the subject so that patients receive adequate care.
Current Medical Mycology
Background and Purpose: Candida glabrata is the second cause of candidiasis. The mortality rate of C. glabrata infections is about 40%; accordingly, it may be life threatening, especially in immunocompromised hosts. Regarding this, the current study was conducted to evaluate the regional patterns of the antifungal susceptibility of clinical C. glabrata isolated from the patients referring to the health centers located in Ahvaz, Iran. Materials and Methods: In this study, a total of 30 clinical strains of C. glabrata isolates were recovered from different body sites (i.e., vagina, mouth, and urine). Phenotypic characteristics and molecular methods were used to identify the isolates. The minimum inhibitory concentration (MIC) was determined according to the European Committee on Antimicrobial Susceptibility Testing. Results: Our findings demonstrated that 20%, 80%, and 6.7% of the isolates were resistant to amphotericin B, terbinafine, and posaconazole, respectively, while all the iso...
Pathogenesis and Antifungal Drug Resistance of the Human Fungal Pathogen Candida glabrata
Pharmaceuticals, 2011
Candida glabrata is a major opportunistic human fungal pathogen causing superficial as well as systemic infections in immunocompromised individuals and several other patient cohorts. C. glabrata represents the second most prevalent cause of candidemia and a better understanding of its virulence and drug resistance mechanisms is thus of high medical relevance. In contrast to the diploid dimorphic pathogen C. albicans, whose ability to undergo filamentation is considered a major virulence trait, C. glabrata has a haploid genome and lacks the ability to switch to filamentous growth. A major impediment for the clinical therapy of C. glabrata infections is its high intrinsic resistance to several antifungal drugs, especially azoles. Further, the development of antifungal resistance, particularly during prolonged and prophylactic therapies is diminishing efficacies of therapeutic interventions. In addition, C. glabrata harbors a large repertoire of adhesins involved in the adherence to host epithelia. Interestingly, genome plasticity, phenotypic switching or the remarkable ability to persist and survive inside host immune cells further contribute to the pathogenicity of C. glabrata. In this comprehensive review, we want to emphasize and discuss the mechanisms underlying virulence and drug resistance of C. glabrata, and discuss its ability to escape from the host immune surveillance or persist inside host cells.
Candida glabrata: A Lot More Than Meets the Eye
Microorganisms, 2019
Candida glabrata is an opportunistic human fungal pathogen that causes superficial mucosal and life-threatening bloodstream infections in individuals with a compromised immune system. Evolutionarily, it is closer to the non-pathogenic yeast Saccharomyces cerevisiae than to the most prevalent Candida bloodstream pathogen, C. albicans. C. glabrata is a haploid budding yeast that predominantly reproduces clonally. In this review, we summarize interactions of C. glabrata with the host immune, epithelial and endothelial cells, and the ingenious strategies it deploys to acquire iron and phosphate from the external environment. We outline various attributes including cell surface-associated adhesins and aspartyl proteases, biofilm formation and stress response mechanisms, that contribute to the virulence of C. glabrata. We further discuss how, C. glabrata, despite lacking morphological switching and secreted proteolytic activity, is able to disarm macrophage, dampen the host inflammatory i...
Diversity and antifungal susceptibility of Norwegian Candida glabrata clinical isolates
Journal of Oral Microbiology, 2016
Background: Increasing numbers of immunocompromised patients have resulted in greater incidence of invasive fungal infections with high mortality. Candida albicans infections dominate, but during the last decade, Candida glabrata has become the second highest cause of candidemia in the United States and Northern Europe. Reliable and early diagnosis, together with appropriate choice of antifungal treatment, is needed to combat these challenging infections. Objectives: To confirm the identity of 183 Candida glabrata isolates from different human body sites using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) and VITEK † 2, and to analyze isolate protein profiles and antifungal susceptibility. The minimum inhibitory concentration (MIC) of seven antifungal drugs was determined for the isolates to elucidate susceptibility. Design: A total of 183 C. glabrata isolates obtained between 2002 and 2012 from Norwegian health-care units were analyzed. For species verification and differentiation, biochemical characterization (VITEK † 2) and mass spectrometry (MALDIÁTOF) were used. MIC determination for seven antifungal drugs was undertaken using E-tests †. Results: Using VITEK † 2, 92.9% of isolates were identified as C. glabrata, while all isolates (100%) were identified as C. glabrata using MALDI-TOF. Variation in protein spectra occurred for all identified C. glabrata isolates. The majority of isolates had low MICs to amphotericin B (51 mg/L for 99.5%) and anidulafungin (50.06 mg/L for 98.9%). For fluconazole, 18% of isolates had MICs !32 mg/L and 82% had MICs in the range ]0.016 mg/L to 532 mg/L. Conclusions: Protein profiles and antifungal susceptibility characteristics of the C. glabrata isolates were diverse. Clustering of protein profiles indicated that many azole resistant isolates were closely related. In most cases, isolates had highest susceptibility to amphotericin B and anidulafungin. The results confirmed previous observations of high MICs to fluconazole and flucytosine. MALDI-TOF was more definitive than VITEK † 2 for C. glabrata identification.