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Candida Auris
microorganisms Review Candida auris: Epidemiology, Diagnosis, Pathogenesis, Antifungal Susceptibility, and Infection Control Measures to Combat the Spread of Infections in Healthcare Facilities Suhail Ahmad * and Wadha Alfouzan Department of Microbiology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait; [email protected] * Correspondence: [email protected]; Tel.: +965-2463-6503 Abstract: Candida auris, a recently recognized, often multidrug-resistant yeast, has become a sig- nificant fungal pathogen due to its ability to cause invasive infections and outbreaks in healthcare facilities which have been difficult to control and treat. The extraordinary abilities of C. auris to easily contaminate the environment around colonized patients and persist for long periods have recently re- sulted in major outbreaks in many countries. C. auris resists elimination by robust cleaning and other decontamination procedures, likely due to the formation of ‘dry’ biofilms. Susceptible hospitalized patients, particularly those with multiple comorbidities in intensive care settings, acquire C. auris rather easily from close contact with C. auris-infected patients, their environment, or the equipment used on colonized patients, often with fatal consequences. This review highlights the lessons learned from recent studies on the epidemiology, diagnosis, pathogenesis, susceptibility, and molecular basis of resistance to antifungal drugs and infection control measures to combat the spread of C. auris Citation: Ahmad, S.; Alfouzan, W. Candida auris: Epidemiology, infections in healthcare facilities. Particular emphasis is given to interventions aiming to prevent new Diagnosis, Pathogenesis, Antifungal infections in healthcare facilities, including the screening of susceptible patients for colonization; the Susceptibility, and Infection Control cleaning and decontamination of the environment, equipment, and colonized patients; and successful Measures to Combat the Spread of approaches to identify and treat infected patients, particularly during outbreaks. -
Candida Species Identification by NAA
Candida Species Identification by NAA Background Vulvovaginal candidiasis (VVC) occurs as a result of displacement of the normal vaginal flora by species of the fungal genus Candida, predominantly Candida albicans. The usual presentation is irritation, itching, burning with urination, and thick, whitish discharge.1 VVC accounts for about 17% to 39% of vaginitis1, and most women will be diagnosed with VVC at least once during their childbearing years.2 In simplistic terms, VVC can be classified into uncomplicated or complicated presentations. Uncomplicated VVC is characterized by infrequent symptomatic episodes, mild to moderate symptoms, or C albicans infection occurring in nonpregnant and immunocompetent women.1 Complicated VVC, in contrast, is typified by severe symptoms, frequent recurrence, infection with Candida species other than C albicans, and/or occurrence during pregnancy or in women with immunosuppression or other medical conditions.1 Diagnosis and Treatment of VVC Traditional diagnosis of VVC is accomplished by either: (i) direct microscopic visualization of yeast-like cells with or without pseudohyphae; or (ii) isolation of Candida species by culture from a vaginal sample.1 Direct microscopy sensitivity is about 50%1 and does not provide a species identification, while cultures can have long turnaround times. Today, nucleic acid amplification-based (NAA) tests (eg, PCR) for Candida species can provide high-quality diagnostic information with quicker turnaround times and can also enable investigation of common potential etiologies -
Candida & Nutrition
Candida & Nutrition Presented by: Pennina Yasharpour, RDN, LDN Registered Dietitian Dickinson College Kline Annex Email: [email protected] What is Candida? • Candida is a type of yeast • Most common cause of fungal infections worldwide Candida albicans • Most common species of candida • C. albicans is part of the normal flora of the mucous membranes of the respiratory, gastrointestinal and female genital tracts. • Causes infections Candidiasis • Overgrowth of candida can cause superficial infections • Commonly known as a “yeast infection” • Mouth, skin, stomach, urinary tract, and vagina • Oropharyngeal candidiasis (thrush) • Oral infections, called oral thrush, are more common in infants, older adults, and people with weakened immune systems • Vulvovaginal candidiasis (vaginal yeast infection) • About 75% of women will get a vaginal yeast infection during their lifetime Causes of Candidiasis • Humans naturally have small amounts of Candida that live in the mouth, stomach, and vagina and don't cause any infections. • Candidiasis occurs when there's an overgrowth of the fungus RISK FACTORS WEAKENED ASSOCIATED IMUMUNE SYSTEM FACTORS • HIV/AIDS (Immunosuppression) • Infants • Diabetes • Elderly • Corticosteroid use • Antibiotic use • Contraceptives • Increased estrogen levels Type 2 Diabetes – Glucose in vaginal secretions promote Yeast growth. (overgrowth) Treatment • Antifungal medications • Oral rinses and tablets, vaginal tablets and suppositories, and creams. • For vaginal yeast infections, medications that are available over the counter include creams and suppositories, such as miconazole (Monistat), ticonazole (Vagistat), and clotrimazole (Gyne-Lotrimin). • Your doctor may prescribe a pill, fluconazole (Diflucan). The Candida Diet • Avoid carbohydrates: Supporters believe that Candida thrives on simple sugars and recommend removing them, along with low-fiber carbohydrates (eg, white bread). -
GRAS Notice for Pichia Kudriavzevii ASCUSDY21 for Use As a Direct Fed Microbial in Dairy Cattle
GRAS Notice for Pichia kudriavzevii ASCUSDY21 for Use as a Direct Fed Microbial in Dairy Cattle Prepared for: Division of Animal Feeds, (HFV-220) Center for Veterinary Medicine 7519 Standish Place Rockville, Maryland 20855 Submitted by: ASCUS Biosciences, Inc. 6450 Lusk Blvd Suite 209 San Diego, California 92121 GRAS Notice for Pichia kudriavzevii ASCUSDY21 for Use as a Direct Fed Microbial in Dairy Cattle TABLE OF CONTENTS PART 1 – SIGNED STATEMENTS AND CERTIFICATION ................................................................................... 9 1.1 Name and Address of Organization .............................................................................................. 9 1.2 Name of the Notified Substance ................................................................................................... 9 1.3 Intended Conditions of Use .......................................................................................................... 9 1.4 Statutory Basis for the Conclusion of GRAS Status ....................................................................... 9 1.5 Premarket Exception Status .......................................................................................................... 9 1.6 Availability of Information .......................................................................................................... 10 1.7 Freedom of Information Act, 5 U.S.C. 552 .................................................................................. 10 1.8 Certification ................................................................................................................................ -
Vaginal Yeast Infection a Vaginal Yeast Infection Is an Infection of the Vagina, Most Commonly Due to the Fungus Candida Albicans
5285 Anthony Wayne Drive, Detroit, MI 48202 (P) 313-577-5041 | (F) 313-577-9581 health.wayne.edu Vaginal Yeast Infection A vaginal yeast infection is an infection of the vagina, most commonly due to the fungus Candida albicans. Causes, incidence, and risk factors Most women have a vaginal yeast infection at some time. Candida albicans is a common type of fungus. It is often found in small amounts in the vagina, mouth, digestive tracts, and on the skin. Usually it does not cause disease or symptoms. Candida and the many other germs that normally live in the vagina keep each other in balance. However, sometimes the number of Candida albicans increases, leading to a yeast infection. A yeast infection can happen if you are: • Taking antibiotics used to treat other types of infections. Antibiotics change the normal balance between germs in the vagina by decreasing the number of protective bacteria. • Pregnant • Obese • Have diabetes A yeast infection is not a sexually transmitted illness. However, some men will develop symptoms such as itching and a rash on the penis after having sexual contact with an infected partner. Having many vaginal yeast infections may be a sign of other health problems. Other vaginal infections and discharges can be mistaken for vaginal yeast infection. Symptoms • Pain with intercourse • Painful urination • Redness and swelling of the vulva • Vaginal and labial itching, burning • Abnormal Vaginal Discharge • Ranges from a slightly watery, white discharge to a thick, white, chunky discharge (like cottage cheese) Signs and Tests A pelvic examination will be done. It may show swelling and redness of the skin of the vulva, in the vagina, and on the cervix. -
Targeting the Burkholderia Cepacia Complex
viruses Review Advances in Phage Therapy: Targeting the Burkholderia cepacia Complex Philip Lauman and Jonathan J. Dennis * Department of Biological Sciences, University of Alberta, Edmonton, AB T6G 2E9, Canada; [email protected] * Correspondence: [email protected]; Tel.: +1-780-492-2529 Abstract: The increasing prevalence and worldwide distribution of multidrug-resistant bacterial pathogens is an imminent danger to public health and threatens virtually all aspects of modern medicine. Particularly concerning, yet insufficiently addressed, are the members of the Burkholderia cepacia complex (Bcc), a group of at least twenty opportunistic, hospital-transmitted, and notoriously drug-resistant species, which infect and cause morbidity in patients who are immunocompromised and those afflicted with chronic illnesses, including cystic fibrosis (CF) and chronic granulomatous disease (CGD). One potential solution to the antimicrobial resistance crisis is phage therapy—the use of phages for the treatment of bacterial infections. Although phage therapy has a long and somewhat checkered history, an impressive volume of modern research has been amassed in the past decades to show that when applied through specific, scientifically supported treatment strategies, phage therapy is highly efficacious and is a promising avenue against drug-resistant and difficult-to-treat pathogens, such as the Bcc. In this review, we discuss the clinical significance of the Bcc, the advantages of phage therapy, and the theoretical and clinical advancements made in phage therapy in general over the past decades, and apply these concepts specifically to the nascent, but growing and rapidly developing, field of Bcc phage therapy. Keywords: Burkholderia cepacia complex (Bcc); bacteria; pathogenesis; antibiotic resistance; bacterio- phages; phages; phage therapy; phage therapy treatment strategies; Bcc phage therapy Citation: Lauman, P.; Dennis, J.J. -
Skin Immunity to Candida Albicans
TREIMM 1284 No. of Pages 11 Feature Review Skin Immunity to Candida albicans Sakeen W. Kashem1 and Daniel H. Kaplan2,* Candida albicans is a dimorphic commensal fungus that colonizes healthy Trends human skin, mucosa, and the reproductive tract. C. albicans is also a predomi- Primary immunodeficiencies reveal nantly opportunistic fungal pathogen, leading to disease manifestations such as conserved IL-17 stimulating/signaling disseminated candidiasis and chronic mucocutaneous candidiasis (CMC). The pathways involved in mucocutaneous differing host susceptibilities for the sites of C. albicans infection have revealed defense against C. albicans. tissue compartmentalization with tailoring of immune responses based on the Mouse models have demonstrated site of infection. Furthermore, extensive studies of host genetics in rare cases of both innate and adaptive sources of IL-17 in response to C. albicans. CMC have identified conserved genetic pathways involved in immune recogni- tion and the response to the extracellular pathogen. We focus here on human Immunity against C. albicans is com- and mouse skin as a site of C. albicans infection, and we review established and partmentalized towards sites of infection. newly discovered insights into the cellular pathways that promote cutaneous antifungal immunity. Non-hematopoietic cells provide anti- fungal immunity in the skin. Compartmentalization of Immunity Against C. albicans Skin Infection C. albicans is the most common and well-studied of the disease-causing Candida spp., and naturally colonizes the skin, genital, and/or intestinal mucosa in up to 70% of healthy individuals [1]. Under normal circumstances, the fungus does not cause disease but the absence of appropriate immune recognition and response mechanisms can lead to the inability to control C. -
Yeast Infection Division of Disease Control What Do I Need to Know?
Division of Disease Control What Do I Need To Know? Yeast Infection (Thrush, Diaper Rash, Vaginitis) What is a yeast infection? Yeast infections are caused by a fungus called Candida albicans. These infections can present in a variety of forms. Yeast infections in women can infect the vagina, called vaginitis. Thrush causes mouth infections in young infants and can also be a presenting sign of HIV infection in adults. Candida also may be the cause of many types of diaper rash in young children. Who is at risk for a yeast infection? Anyone can get a yeast infection. What are the symptoms of a yeast infection? Candidia diaper rash: The diaper area is red. The redness is worse in the creases. Redness is often bordered by red pimples. Rash may have a shiny appearance. Sores or cracking or oozing is present in severe cases. Thrush White patches appear on the inside of cheeks and gums and tongue. Thrush usually causes no other signs or symptoms. Vaginitis Vaginal irritation, intense itchiness and vaginal discharge. How soon do symptoms appear? Incubation period is unknown. How is a yeast infection spread? The fungus is present in the intestinal tract and mucous membranes of healthy people. A warm environment allows for growth and spread. Page 1 of 2 Last Updated: 01/2016 Person-to-person transmission may occur from a woman to her infant when the mother has a yeast infection in her vagina and in breastfeeding mothers whose babies with thrush infect the mothers’ nipples. When and for how long is a person able to spread the disease? A person can spread disease as long as the infection is present. -
Yeast Infection (Candidiasis)
PROVIDER YEAST INFECTION (CANDIDIASIS) Candida can normally be found on the skin and in the mouth, throat, intestinal tract, and vagina of healthy people. In children, yeast infections are commonly found in the mouth or throat (thrush) or the diaper area. CAUSE Candida albicans, a fungus. SYMPTOMS Thrush - White, slightly raised patches on the tongue or inside the cheek. Diaper Rash - Smooth, shiny "fire engine" red rash with a raised border. Children who suck their thumbs or fingers may occasionally develop Candida infections around their fingernails. Under certain conditions, such as during antibiotic use or when skin is damaged and exposed to excessive moisture, the balance of the normal, healthy skin germs is upset. Therefore, yeast that normally live on the skin can overgrow and cause yeast infections. Most of the time these infections heal quickly, but sometimes illness can occur in infants, persons with weakened immune systems, or those taking certain antibiotics. SPREAD Rarely, by contact with skin lesions and mouth secretions of infected persons or asymptomatic carriers. Most infants who have Candida got it from their mother during childbirth. According to the Centers for Disease Control and Prevention, outbreaks of thrush in childcare settings may be the result of increased use of antibiotics rather than newly acquired Candida infections. INCUBATION Variable. For thrush in infants, it usually takes 2 to 5 days. For others, yeast infections may occur while taking antibiotics or shortly after stopping the antibiotics. CONTAGIOUS Contagious while lesions are present. Most infections occur from yeast in the PERIOD person’s own body. DIAGNOSIS Recommend parents/guardians call their healthcare provider to identify the fungus. -
Candida Auris: a Drug-Resistant Germ That Spreads in Healthcare Facilities
Candida auris: A drug-resistant germ that spreads in healthcare facilities Candida auris (also called C. auris) is a fungus that causes serious infections. Patients with C. auris infection, their family members and other close contacts, public health officials, laboratory staff, and healthcare workers can all help stop it from spreading. Why is Candida auris a problem? It causes serious infections. C. auris can cause bloodstream infections and even death, particularly in hospital and nursing home patients with serious medical problems. More than 1 in 3 patients with invasive C. auris infection (for example, an infection that affects the blood, heart, or brain) die. It’s often resistant to medicines. Antifungal medicines commonly used to treat Candida infections often don’t work for Candida auris. Some C. auris infections have been resistant to all three types of antifungal medicines. It’s becoming more common. Although C. auris was just discovered in 2009, it has spread quickly and caused infections in more than a dozen countries. It’s difficult to identify. C. auris can be misidentified as other types of fungi unless specialized laboratory technology is used. This misidentification might lead to a patient getting the wrong treatment. It can spread in hospitals and nursing homes. C. auris has caused outbreaks in healthcare facilities and can spread through contact with affected patients and contaminated surfaces or equipment. Good hand hygiene and cleaning in healthcare facilities is important because C. auris can live on surfaces for several weeks. How do I know if I have a Candida Most people who get auris infection? serious Candida infections C. -
Candida and Candidiasis—Opportunism Versus Pathogenicity: a Review of the Virulence Traits
microorganisms Review Candida and Candidiasis—Opportunism Versus Pathogenicity: A Review of the Virulence Traits Cristina Nicoleta Ciurea 1,2,* , Irina-Bianca Kosovski 2,3, Anca Delia Mare 1, Felicia Toma 1, Ionela Anca Pintea-Simon 1,2 and Adrian Man 1 1 Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, , 540139 Târgu Mures, , Romania; [email protected] (A.D.M.); [email protected] (F.T.); [email protected] (I.A.P.-S.); [email protected] (A.M.) 2 Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, , 540139 Târgu Mures, , Romania; [email protected] 3 Department of Physiopathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, , 540139 Târgu Mures, , Romania * Correspondence: [email protected] Received: 7 May 2020; Accepted: 4 June 2020; Published: 6 June 2020 Abstract: One of the most important questions in microbiology nowadays, is how apparently harmless, commensal yeasts like Candida spp. can cause a rising number of infections. The occurrence of the disease requires firstly the attachment to the host cells, followed by the invasion of the tissue. The adaptability translates into a rapid ability to respond to stress factors, to take up nutrients or to multiply under different conditions. By forming complex intracellular networks such as biofilms, Candida spp. become not only more refractive to antifungal therapies but also more prone to cause disease. The inter-microbial interactions can enhance the virulence of a strain. In vivo, the fungal cells face a multitude of challenges and, as a result, they develop complex strategies serving one ultimate goal: survival. -
Vulvovaginal Candidiasis: a Current Understanding and Burning Questions
Journal of Fungi Review Vulvovaginal Candidiasis: A Current Understanding and Burning Questions Hubertine M. E. Willems 1, Salman S. Ahmed 2, Junyan Liu 1, Zhenbo Xu 1,2 and Brian M. Peters 1,* 1 Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA; [email protected] (H.M.E.W.); [email protected] (J.L.); [email protected] (Z.X.) 2 School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China; [email protected] * Correspondence: [email protected] Received: 22 January 2020; Accepted: 19 February 2020; Published: 25 February 2020 Abstract: Candida albicans, along with other closely related Candida species, are the primary causative agents of vulvovaginal candidiasis (VVC)—a multifactorial infectious disease of the lower female reproductive tract resulting in pathologic inflammation. Unlike other forms of candidiasis, VVC is a disease of immunocompetent and otherwise healthy women, most predominant during their child-bearing years. While VVC is non-lethal, its high global incidence and profound negative impact on quality-of-life necessitates further understanding of the host and fungal factors that drive disease pathogenesis. In this review, we cover the current state of our understanding of the epidemiology, host response, fungal pathogenicity mechanisms, impact of the microbiome, and novel approaches to treatment of this most prevalent human candidal infection. We also offer insight into the latest advancements in the VVC field and identify important questions that still remain. Keywords: vaginitis; vulvovaginal; Candida; vagina; VVC; fungal; candidiasis 1. Pathology and Epidemiology of Vulvovaginal Candidiasis Vulvovaginal candidiasis (VVC), is an exceedingly common mucosal infection of the lower female reproductive tract (FRT), caused mostly by the polymorphic opportunistic fungus Candida albicans.