Candida catenulata Fungemia in a Cancer Patient (original) (raw)
Related papers
Candida guilliermondii Fungemia in Patients with Hematologic Malignancies
Journal of Clinical Microbiology, 2006
The microbiological, clinical, and epidemiological features of most non-Candida albicans Candida species are well known, but much less is known about species such as Candida guilliermondii, an uncommon pathogen causing a variety of deep-seated infections in immunocompromised hosts. To characterize C. guilliermondii fungemia in patients with hematological malignancies and its susceptibility to antifungal drugs, all cases of C. guilliermondii fungemia diagnosed in our department between 1983 and 2005 were retrospectively analyzed and the literature was reviewed. C. guilliermondii caused 29/243 (11.7%) candidemia episodes diagnosed during the study period. Central venous catheters were the documented sources of candidemia in 19/29 episodes (65.5%), and invasive tissue infections were documented in 2 (6.9%). In the remaining eight, the catheter was not removed and the source of the fungemia remained obscure. Seven episodes ended in death, but only one could be attributed to invasive C. guilliermondii infection. Molecular typing data reveal no evidence of common infection sources. Isolates displayed high rates of in vitro susceptibility to amphotericin B (100%), voriconazole (95%), and fluconazole (90%) and lower rates of in vitro susceptibility to flucytosine (86%), itraconazole (76%), and caspofungin (33%). Our literature review confirms that C. guilliermondii is a significantly more frequent cause of candidemia among cancer patients compared with the general hospital population. It accounted for <1% of the total number of Candida bloodstream isolates reported in the articles we reviewed, with higher rates in Europe (1.4%) and Asia (1.8%) compared with North America (0.3%).
Candidaemia and cancer: patients are not all the same
BMC Infectious Diseases, 2006
Background Most of the studies about invasive Candida infections in cancer patients have focused on haematological patients. The aim of this study was to provide information about risk factors for candidaemia in patients with solid tumours. Methods Retrospective cohort study. During a 9-year period (1995–2003) we reviewed all cases of candidaemia that affected cancer patients in Santa Casa Complexo Hospitalar, Brazil. Results During the period of study, 210 patients had the diagnosis of candidaemia in our medical centre, and 83 of these patients had cancer (39.5%). The majority of patients with cancer had solid tumours (77.1%), mostly in the alimentary tract. Most of solid cancers were non-metastatic (71.9%). Major diagnoses in patients with haematological neoplasia were acute leukaemia (n = 13), high grade non-Hodgkin lymphoma (n = 5) and Hodgkin's disease (n = 1). Non-Candida albicans species caused 57.8% of the episodes of candidaemia in patients with cancer, mainly in patients with haematological malignancies (p = 0.034). Neutropenia and treatment with corticosteroids were more frequent in the haematological group, in comparison with patients with solid tumours. Only 22.2% of patients with solid tumours were neutropenic before candidaemia. Nonetheless, the presence of ileus and the use of anaerobicides were independent risk factors for candidaemia in patients with solid cancers. The overall mortality in cancer patients with candidaemia was 49.4%. We then compared 2 groups of adult patients with candidaemia. The first was composed of non-neutropenic patients with solid tumours, and the second group included patients without cancer. We found that central venous catheters and gastrointestinal surgery were independently associated with candidaemia in patients with solid tumour. Conclusion Cancer patients with candidaemia seem to have very different predisposing factors to acquire the infection when stratified according to baseline diseases. This study provides some useful clinical information regarding risk for candidaemia in patients with solid tumours.
Evaluation of distribution of different species of Candida in cancer patients
Background and objectives: patients undergoing Chemotherapy are severely susceptible to infections due to a compromised immune system and also their oral cavity is a great place for microorganisms and fungi to grow. The aim of this study was to determine the distribution of different strains of Candida from oral lesions of these patients. Methods and Materials: This descriptive study was performed on 128 patients undergoing chemotherapy in teaching hospitals of Yazd, which was three weeks pass receiving their first medicine. Oral samples were prepared from swabs and then cultured in Sabouraud dextrose agar culture media for evaluation of yeast growth, colonization, and identification of species. Samples were examined under the microscope and recorded. Finally, the data were analyzed by SPSS17 software, Chi-square, and Man-Whitney tests. Results:128 patients participated in this study, which included 45 males (35.15%) and 83 females (64.85%) with an average age of 40.16 ± 19.95 years. 84 patients (62.65%) had candida in their oral cavity, of which 79 were candida albicans and 5 were Non-albicans Candida. No significant correlation was found between the type of candidates, type of cancer and the frequency of Candida albicans with the age and sex of the patients (P-value <0.05). Conclusion: Based on the results of this study, the prevalence of Candida albicans in patients undergoing chemotherapy is higher than Non-albicans Candida. Patients with leukemia are more susceptible to Candida infections.
Candidaemia in cancer patients and in children in a neonatal intensive care unit
Folia Microbiologica, 2001
The species most frequently found in the group of neonates was C. parapsilosis, its incidence reaching 48 %. Other yeasts isolated from blood were C. albicans (41%), C. tropicalis (7 %), C. krusei and C. pseudotropicalis (2 % each). Six yeast species (C. albicans 44 %, C. parapsilosis 28 %, C. tropicalis 11%, C. krusei 8 %, C. guilliermondii 6 %, C. lusitaniae 3 %) were detected in cancer patients. The presence of an intravenous catheter as a possible risk in the development of candidaemia was identified in all neonates and in 69 % of cancer patients. C. krusei candidaemia was associated with prophylactic fluconazole therapy.
Archives of Internal Medicine, 2000
Background: Candida krusei is inherently resistant to fluconazole and is emerging as a frequent cause of fungemia in patients with hematologic malignant neoplasms. Objective: To determine the risk and prognostic factors associated with C krusei fungemia in comparison with Candida albicans fungemia in patients with cancer. Methods: Retrospective study of 57 cases of C krusei fungemia occurring at the M. D. Anderson Cancer Center, Houston, Tex, from 1989 to 1996. The C krusei cases were compared with 57 cases of C albicans fungemia with respect to demographics, underlying cancer, Acute Physiology and Chronic Health Evaluation II score, immunosuppression status, chemotherapy, and the use of central venous catheters, as well as fluconazole prophylaxis.
Non-Candida Yeasts Fungemia in Cancer Patients
Background: This study examined the characteristics and risk factors associated with non-Candida fungemia. It is important to diagnose early and distinguish from Candida species because of the high mortality rate in non-Candida yeast fungemia. Materials and Methods: We performed a retrospective analysis of patients with cancer from 1999 to 2014 at Moffitt Cancer Center in Tampa, Florida with a positive blood cultures for non-Candida yeast.Nine patients were identified. Types of malignancy included both hematological and solid tumors. All patients received cytotoxic chemotherapy and were on prophylactic antifungal therapy. Five patients were diagnosed with Trichosporon species. Risk factors included prolonged neutropenia, hematological malignancy, hematopoietic stem cell transplantation (HSCT), chemotherapy and immunosuppressive therapy. We found a very high mortality rate in patients with non-Candida yeast fungemia with refractory and end-stage cancer. This demonstrated the need for early identification of non-Candida fungemia. In addition, many of these patients had prolonged neutropenia and a refractory malignancy as significant risk factors. Results: There were 9 patients with positive blood cultures for non-Candida yeasts in our study. The most common non-Candida yeasts were Trichosporon species. The majority of the patients had a hematological malignancy. All patients received cytotoxic chemotherapy, and most of them were refractory to treatment with end-stage hematological malignancy. Prolonged neutropenia was found in the majority of the patients receiving chemotherapy. All patients were receiving potent antifungal therapy, such as liposomal amphotericin B, micafungin, posaconazole, or voriconazole, either alone or in combination, when breakthrough infection occurred. The central venous catheter was removed in all patients. However, prolonged fungemia persisted in all patients despite removal. We found a very high mortality rate in patients with non-Candida yeast fungemia with refractory malignancy. Yeast-related sepsis was the cause of death in most of the patients. Ongoing neutropenia was found at the time of death in most of the patients with yeast-related death. Conclusions: Non-Candida yeast fungemia is rare but associated with significant mortality. They usually occurred as breakthrough fungemia while on antifungal prophylaxis. Thus, in vitro susceptibility testing should be performed on all isolates, and antifungal therapy should be modified or broadened pending identification and susceptibly results. Without resolution of neutropenia and oncologic control of the malignancy, outcomes are poor.
Frontiers in Cellular and Infection Microbiology, 2023
Objective: Opportunistic fungal infections by Candida species arise among cancer patients due to the weakened immune system following extensive chemotherapy. Prophylaxis with antifungal agents have developed the resistance of Candida spp. to antifungals. Accurate identification of yeasts and susceptibility patterns are main concerns that can directly effect on the treatment of patients. Methods: Over a period of three years, 325 cancer patients suspected to Candida infections were included in the current investigation. The clinical isolates were molecularly identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). All strains, were examined for in vitro susceptibility to the amphotericin B, itraconazole, fluconazole, and anidulafungin according to the CLSI M27 document. Results: Seventy-four cancer patients had Candida infections (22.7%). Candida albicans was the most common species (83.8%). Antifungal susceptibility results indicated that 100% of the Candida isolates were sensitive to amphotericin B; however, 17.6%, 9.4%, and 5.4% of clinical isolates were resistant to anidulafungin, fluconazole, and itraconazole, respectively. The findings of the present work shows a warning increase in resistance to echinocandins. Since all fluconazole resistance isolates were obtained from candidemia, we recommend amphotericin B as the first line therapy for this potentially fatal infection.
Clinical Infectious Diseases, 1999
In a surveillance study of candidemia in cancer patients that was conducted by the European Organization for Research and Treatment of Cancer, 249 episodes were noted; Candida albicans was isolated in 70% (63) of the 90 cases involving patients with solid tumors (tumor patients) and in 36% (58) of the 159 involving those with hematologic disease (hematology patients). Neutropenia in tumor patients and acute leukemia and antifungal prophylaxis in hematology patients were significantly associated with non-albicans candidemia in a multivariate analysis. Overall 30-day mortality was 39% (97 of 249). In a univariate analysis, Candida glabrata was associated with the highest mortality rate (odds ratio, 2.66). Two multivariate analyses showed that mortality was associated with older age and severity of the underlying disease. Among hematology patients, additional factors associated with mortality were allogeneic bone marrow transplantation, septic shock, and lack of antifungal prophylaxis.
Jundishapur Journal of Microbiology
Background: Candida yeast is a normal flora of the mucous membrane of the oral cavity. Various enzymes secreted by Candida species play the role of virulence factors in different Candida infections including in cancer patients. Objectives: This study aimed at comparing phospholipase, proteinase, esterase, and hemolytic activities in different Candida species isolated from the oral cavity of cancer patients and normal people. Methods: This study was conducted on 36 cancer patients and 36 healthy people. MspI restriction enzyme for PCR-RFLP method was used to identify the Candida species. The enzymatic activity index (EAI) was measured for each enzyme using the relevant protocols. Results: Candida albicans was the most frequent species with the frequency of 26 (72%) and 31 (81.1%) in cancer patients and healthy people, respectively. In healthy individuals and patients, the mean phospholipase activity of Candida isolates was 0.795 and 0.775, proteinase activity was 0.7531 and 0.7558, esterase activity was 0.6142 and 0.7186, and hemolysin activity was 0.6317 and 0.5756, respectively. Conclusions: The results showed that C. albicans was the most frequent Candida species isolated from healthy people and patients. Phospholipase, proteinase, and hemolysin activity of Candida species was higher in patients than in healthy people and hemolytic activity was significantly higher in patients than in healthy subjects (P < 0.05). However, Candida species in both groups were positive for esterase activity but the mean activity of this enzyme was significantly higher in the healthy group than in the patient group.