TY - GEN T1 - Deciphering the epidemiology of invasive candidiasis in the intensive care unit: is it possible? A1 - Soulountsi, Vasiliki A1 - Schizodimos, Theodoros A1 - Kotoulas, Serafeim Chrysovalantis Y1 - 2021/12// KW - Antifungal resistance KW - Candida albicans KW - Candida auris KW - Candidemia KW - Intra-abdominal candidiasis KW - Invasive candidiasis PB - Springer Science and Business Media Deutschland GmbH JF - Infection VL - 49 IS - 6 SP - 1107 EP - 1131 DO - 10.1007/s15010-021-01640-7 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Soulountsi, Schizodimos, Kotoulas - 2021 - Deciphering the epidemiology of invasive candidiasis in the intensive care unit is it possibl.pdf N2 - Invasive candidiasis (IC) has emerged in the last decades as an important cause of morbidity, mortality, and economic load in the intensive care unit (ICU). The epidemiology of IC is still a difficult and unsolved enigma for the literature. Accurate estimation of the true burden of IC is difficult due to variation in definitions and limitations inherent to available case-finding methodologies. Candidemia and intra-abdominal candidiasis (IAC) are the two predominant types of IC in ICU. During the last two decades, an increase in the incidence of candidemia has been constantly reported particularly in the expanding populations of elderly or immunosuppressed patents, with a parallel change in Candida species (spp.) distribution worldwide. Epidemiological shift in non-albicans spp. has reached worrisome trends. Recently, a novel, multidrug-resistant Candida spp., Candida auris, has globally emerged as a nosocomial pathogen causing a broad range of healthcare-associated invasive infections. Epidemiological profile of IAC remains imprecise. Though antifungal drugs are available for Candida infections, mortality rates continue to be high, estimated to be up to 50%. Increased use of fluconazole and echinocandins has been associated with the emergence of resistance to these drugs, which affects particularly C. albicans and C. glabrata. Crucial priorities for clinicians are to recognize the epidemiological trends of IC as well as the emergence of resistance to antifungal agents to improve diagnostic techniques and strategies, develop international surveillance networks and antifungal stewardship programmes for a better epidemiological control of IC. ER - TY - JOUR T1 - CLSI. Performance Standards for Antifungal Susceptibility Testing of Yeasts. : Clinical and Laboratory Standards Institute. A1 - Wayne, PA Y1 - 2020/// JF - CLSI supplement M60 VL - 2nd ed ER - TY - JOUR T1 - Candida auris: A Decade of Understanding of an Enigmatic Pathogenic Yeast A1 - Kean, Ryan A1 - Brown, Jason A1 - Gulmez, Dolunay A1 - Ware, Alicia A1 - Ramage, Gordon Y1 - 2020/// KW - biofilms KW - candida auris KW - in vivo models KW - pathogenicity JF - Journal of Fungi VL - 6 IS - 1 SP - 30 EP - 30 DO - 10.3390/jof6010030 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Kean et al. - 2020 - Candida auris A Decade of Understanding of an Enigmatic Pathogenic Yeast.pdf N2 - Candida auris is an enigmatic yeast that continues to stimulate interest within the mycology community due its rapid and simultaneous emergence of distinct clades. In the last decade, almost 400 manuscripts have contributed to our understanding of this pathogenic yeast. With dynamic epidemiology, elevated resistance levels and an indication of conserved and unique pathogenic traits, it is unsurprising that it continues to cause clinical concern. This mini-review aims to summarise some of the key attributes of this remarkable pathogenic yeast. ER - TY - JOUR T1 - Antifungal resistance in Candida A1 - Acosta-altamirano, Gustavo A1 - Mart, Erick Y1 - 2020/// KW - 5-fluorocytosine KW - amphotericin b KW - antifungal resistance KW - candida auris KW - caspofungin JF - Centers for Disease Control and Prevention SP - 1 EP - 16 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Acosta-altamirano, Mart - 2020 - Antifungal resistance in Candida.pdf ER - TY - CHAP T1 - Candida species. A1 - Edwards J. Y1 - 2020/// JF - Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. chapter 256 ET - 9° SP - 3087 EP - 3102 ER - TY - JOUR T1 - Candidemia en Colombia A1 - Valencia, AV A1 - Páez, AL A1 - Sampedro, ME A1 - Ávila, C A1 - Cardona, JC A1 - Mesa, C Y1 - 2020/// KW - candidemia KW - candidemia in colombia KW - candidemia is a frequent KW - candidiasis KW - candidiasis invasiva KW - cause of infection KW - colombia KW - especially in intensive care KW - in colombia KW - infecciones fúngicas invasivas KW - micosis KW - unidad de cuidados intensivos KW - units JF - Biomédica VL - 40 IS - 1 SP - 1 EP - 33 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Valencia et al. - 2020 - Candidemia en Colombia.pdf N2 - Introducción. Estudiar los triatominos en sus ecotopos naturales tiene gran significado en la epidemiología de la enfermedad de Chagas. La recolección de insectos vivos y su establecimiento en insectarios permite realizar incontables estudios. Por ello se necesitan métodos efectivos para la captura de triatominos silvestres, especialmente especies intrusas como Rhodnius prolixus. Objetivo. Comparar cuatro métodos para la captura de triatominos en palmas para medir su efectividad. Materiales y métodos. El estudio se realizó en la localidad de Maní, departamento de Casanare, Colombia, con predominio de A. butyracea. Se compararon cuatro metodologías en 67 palmas: trampas con cebo vivo, búsqueda directa en palmas, tala y disección. Resultados. Los métodos fueron efectivos para recolectar juveniles y adultos. La tala y la búsqueda manual mostraron los mayores índices de infestación (100% y 83,33%). La trampa Angulo mostró mayores índices de hacinamiento (4,93), densidad (3,76), rango de abundancia (1-13) e índice adulto /ninfa (0,22). La tala y disección fue el método que significativamente recolectó más triatominos en comparación con los otros (p<0,002), seguido de la trampa Angulo. No se observaron diferencias en la captura de los estadios ninfales entre los métodos evaluados (p>0,05). Conclusiones. Aunque la tala fue el mejor método para la recolección del mayor número de triatominos, los métodos con el cebo vivo con adhesivos o refugios para atrapar los insectos fueron es una buena alternativa. Entre ellos la trampa Angulo mostró mejores resultados y evita la exposición del investigador al riesgo yla intervención de ecotopos naturales. ER - TY - JOUR T1 - Candida auris: Epidemiology, biology, antifungal resistance, and virulence A1 - Du, Han A1 - Bing, Jian A1 - Hu, Tianren A1 - Ennis, Craig L. A1 - Nobile, Clarissa J. A1 - Huang, Guanghua Y1 - 2020/// JF - PLoS Pathogens VL - 16 IS - 10 SP - 1 EP - 18 SN - 1111111111 DO - 10.1371/journal.ppat.1008921 UR - http://dx.doi.org/10.1371/journal.ppat.1008921 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Du et al. - 2020 - Candida auris Epidemiology, biology, antifungal resistance, and virulence.pdf N2 - First described in 2009 in Japan, the emerging multidrug-resistant fungal pathogen Candida auris is becoming a worldwide public health threat that has been attracting considerable attention due to its rapid and widespread emergence over the past decade. The reasons behind the recent emergence of this fungus remain a mystery to date. Genetic analyses indicate that this fungal pathogen emerged simultaneously in several different continents, where 5 genetically distinct clades of C. auris were isolated from distinct geographical locations. Although C. auris belongs to the CTG clade (its constituent species translate the CTG codon as serine instead of leucine, as in the standard code), C. auris is a haploid fungal species that is more closely related to the haploid and often multidrug-resistant species Candida haemulonii and Candida lusitaniae and is distantly related to the diploid and clinically common fungal pathogens Candida albicans and Candida tropicalis. Infections and outbreaks caused by C. auris in hospitals settings have been rising over the past several years. Difficulty in its identification, multidrug resistance properties, evolution of virulence factors, associated high mortality rates in patients, and long-term survival on surfaces in the environment make C. auris particularly problematic in clinical settings. Here, we review progress made over the past decade on the biological and clinical aspects of C. auris. Future efforts should be directed toward understanding the mechanistic details of its biology, epidemiology, antifungal resistance, and pathogenesis with a goal of developing novel tools and methods for the prevention, diagnosis, and treatment of C. auris infections. ER - TY - JOUR T1 - Identification of drug resistant candida auris A1 - Kordalewska, Milena A1 - Perlin, David S. Y1 - 2019/// KW - Antifungal drug resistance KW - Candida KW - Candida auris KW - Detection KW - Diagnostics KW - Identification JF - Frontiers in Microbiology VL - 10 IS - AUG DO - 10.3389/fmicb.2019.01918 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Kordalewska, Perlin - 2019 - Identification of drug resistant candida auris.pdf N2 - Candida auris is a multidrug resistant yeast, recognized as a cause of invasive infections and health care associated outbreaks around the world. C. auris is of great public health concern, due to its propensity for drug resistance, mode and pace of its transmission, and the possibility that biologic and epidemiologic factors could exacerbate worldwide emergence of C. auris infections. Currently, outbreak response is complicated by limited treatment options and inadequate disinfection strategies, as well as by issues (misidentification, long turnaround time) associated with application of commonly used diagnostic tools. Misdiagnosis of C. auris is common since many diagnostic platforms available in clinical and public health laboratories depend on reference databases that have not fully incorporated C. auris. Moreover, the correlation between minimal inhibitory concentration values (MICs) and clinical outcomes is poorly understood resulting in the absence of C. auris-specific breakpoints. New, accurate and fast diagnostic methods have emerged to facilitate effective patient management and improve infection control measures, ultimately reducing the potential for C. auris transmission. This review provides an overview of available C. auris detection/identification and antifungal susceptibility determination methods and discusses their advantages and limitations. A special emphasis has been placed on culture-independent methods that have recently been developed and offer faster turnaround times. ER - TY - JOUR T1 - Combined Antifungal Resistance and Biofilm Tolerance: the Global Threat of Candida auris A1 - Kean, Ryan A1 - Ramage, Gordon Y1 - 2019/// KW - amr KW - antifungal resistance KW - antimicrobial resistance KW - biofilms KW - candida KW - continue to pose a KW - emergence of the pathogenic KW - escalating rates of KW - global threat KW - he emergence of new KW - microbial pathogens combined with KW - mycology is acutely aware KW - of this since the KW - the field of medical KW - tolerance KW - yeast candida JF - mSphere VL - 4 IS - 4 SP - 1 EP - 10 DO - 10.1128/msphere.00458-19 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Kean, Ramage - 2019 - Combined Antifungal Resistance and Biofilm Tolerance the Global Threat of Candida auris.pdf N2 - The enigmatic yeast Candida auris has emerged over the last decade and rapidly penetrated our consciousness. The global threat from this multidrug-resistant yeast has generated a call to arms from within the medical mycology community. Over the past decade, our understanding of how this yeast has spread globally, its clinical importance, and how it tolerates and resists antifungal agents has expanded. This review highlights the clinical importance of antifungal resistance in C. auris and explores our current understanding of the mechanisms associated with azole, polyene, and echinocandin resistance. We also discuss the impact of phenotypic tolerance, with particular emphasis on biofilm-mediated resistance, and present new pipelines of antifungal drugs that promise new hope in the management of C. auris infection. ER - TY - JOUR T1 - Review on Antifungal Resistance Mechanisms in the Emerging Pathogen Candida auris A1 - Chaabane, Farid A1 - Graf, Artan A1 - Jequier, Léonard A1 - Coste, Alix T. Y1 - 2019/// KW - Candida auris KW - MIC KW - antifungal resistance KW - biofilm KW - emerging pathogen KW - outbreaks JF - Frontiers in Microbiology VL - 10 IS - November SP - 1 EP - 8 DO - 10.3389/fmicb.2019.02788 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Chaabane et al. - 2019 - Review on Antifungal Resistance Mechanisms in the Emerging Pathogen Candida auris.pdf N2 - Candida auris is an emerging multi-drug resistant yeast, that causes major issues regarding patient treatment and surface disinfection in hospitals. Indeed, an important proportion of C. auris strains isolated worldwide present a decreased sensitivity to multiple and sometimes even all available antifungals. Based on recent tentative breakpoints by the CDC, it appears that in the USA about 90, 30, and < 5% of isolates have been resistant to fluconazole, amphotericin B, and echinocandins, respectively. To date, this has lead to a low therapeutic success. Furthermore, C. auris is prone to cause outbreaks, especially since it can persist for weeks in a nosocomial environment and survive high-end disinfection procedures. In this review, we describe the molecular resistance mechanisms to antifungal drugs identified so far in C. auris and compare them to those previously discovered in other Candida species. Additionally, we examine the role that biofilm formation plays in the reduced antifungal sensitivity of this organism. Finally, we summarize the few insights on how this yeast survives on hospital surfaces and discuss the challenge it presents regarding nosocomial environment disinfection. ER - TY - JOUR T1 - Changes in the epidemiological landscape of invasive candidiasis A1 - Lamoth, Frederic A1 - Lockhart, Shawn R. A1 - Berkow, Elizabeth L. A1 - Calandra, Thierry Y1 - 2018/01// PB - Oxford University Press JF - Journal of Antimicrobial Chemotherapy VL - 73 SP - i4 EP - i13 DO - 10.1093/jac/dkx444 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Lamoth et al. - 2018 - Changes in the epidemiological landscape of invasive candidiasis.pdf N2 - The epidemiology of invasive candidiasis has evolved in recent years, warranting a review of the changes and the implications for current and future diagnosis and treatment. The overall burden of invasive candidiasis remains high, particularly in the expanding populations of patients at risk of opportunistic infection, such as the elderly or immunosuppressed. Progressive shifts from Candida albicans to non-albicans Candida spp. have been observed globally. The recent emergence of novel, multiresistant species, such as Candida auris, amplifies the call for vigilance in detection and advances in treatment. Among the current treatment options, fluconazole is still widely used throughout the world. Increased resistance to fluconazole, both acquired and naturally emerging, has been observed. Resistance to echinocandins is presently low but this may change with increased use. Improvement of diagnostic techniques and strategies, development of international surveillance networks and implementation of antifungal stewardship programmes represent major challenges for a better epidemiological control of invasive candidiasis. ER - TY - JOUR T1 - Candida infections and therapeutic strategies: Mechanisms of action for traditional and alternative agents A1 - Santos, Giselle C.de Oliveira A1 - Vasconcelos, Cleydlenne C. A1 - Lopes, Alberto J.O. A1 - Cartágenes, Maria do S.de Sousa A1 - Filho, Allan K.D.B. A1 - do Nascimento, Flávia R.F. A1 - Ramos, Ricardo M. A1 - Pires, Emygdia R.R.B. A1 - de Andrade, Marcelo S. A1 - Rocha, Flaviane M.G. A1 - Monteiro, Cristina de Andrade Y1 - 2018/// KW - Alternative antifungal drugs KW - Antifungals KW - Candida KW - Candida infections KW - Resistance JF - Frontiers in Microbiology VL - 9 IS - JUL SP - 1 EP - 23 DO - 10.3389/fmicb.2018.01351 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Santos et al. - 2018 - Candida infections and therapeutic strategies Mechanisms of action for traditional and alternative agents.pdf N2 - The Candida genus comprises opportunistic fungi that can become pathogenic when the immune system of the host fails. Candida albicans is the most important and prevalent species. Polyenes, fluoropyrimidines, echinocandins, and azoles are used as commercial antifungal agents to treat candidiasis. However, the presence of intrinsic and developed resistance against azole antifungals has been extensively documented among several Candida species. The advent of original and re-emergence of classical fungal diseases have occurred as a consequence of the development of the antifungal resistance phenomenon. In this way, the development of new satisfactory therapy for fungal diseases persists as a major challenge of present-day medicine. The design of original drugs from traditional medicines provides new promises in the modern clinic. The urgent need includes the development of alternative drugs that are more efficient and tolerant than those traditional already in use. The identification of new substances with potential antifungal effect at low concentrations or in combination is also a possibility. The present review briefly examines the infections caused by Candida species and focuses on the mechanisms of action associated with the traditional agents used to treat those infections, as well as the current understanding of the molecular basis of resistance development in these fungal species. In addition, this review describes some of the promising alternative molecules and/or substances that could be used as anticandidal agents, their mechanisms of action, and their use in combination with traditional drugs. ER - TY - JOUR T1 - Candida auris: A review of the literature A1 - Jeffery-Smith, Anna A1 - Taori, Surabhi K. A1 - Schelenz, Silke A1 - Jeffery, Katie A1 - Johnson, Elizabeth M. A1 - Borman, Andrew A1 - Manuel, Rohini A1 - Browna, Colin S. Y1 - 2018/// KW - Candida auris KW - Emerging infection KW - Nosocomial transmission JF - Clinical Microbiology Reviews VL - 31 IS - 1 SP - 1 EP - 18 DO - 10.1128/CMR.00029-17 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Jeffery-Smith et al. - 2018 - Candida auris A review of the literature.pdf N2 - The emerging pathogen Candida auris has been associated with noso- comial outbreaks on five continents. Genetic analysis indicates the simultaneous emergence of separate clades of this organism in different geographical locations. Invasive infection and colonization have been detected predominantly in patients in high-dependency settings and have garnered attention due to variable antifungal resistance profiles and transmission within units instituting a range of infection pre- vention and control measures. Issues with the identification of C. auris using both phe- notypic and molecular techniques have raised concerns about detecting the true scale of the problem. This review considers the literature available on C. auris and highlights the key unknowns, which will provide direction for further work in this field. ER - TY - GEN T1 - The continuous changes in the aetiology and epidemiology of invasive candidiasis: from familiar Candida albicans to multiresistant Candida auris A1 - Quindós, Guillermo A1 - Marcos-Arias, Cristina A1 - San-Millán, Rosario A1 - Mateo, Estibaliz A1 - Eraso, Elena Y1 - 2018/09// KW - Aetiology KW - Candida KW - Candida albicans KW - Candida auris KW - Candida krusei KW - Candida parapsilosis KW - Candidiasis KW - Epidemiology KW - Fluconazole KW - Resistance PB - Springer JF - International Microbiology VL - 21 IS - 3 SP - 107 EP - 119 DO - 10.1007/s10123-018-0014-1 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Quindós et al. - 2018 - The continuous changes in the aetiology and epidemiology of invasive candidiasis from familiar Candida albicans.pdf N2 - Recent changes in the aetiology and epidemiology of invasive candidiasis have serious implications for current and future diagnosis, treatment and prognosis. The aim of the current review was to discuss the epidemiology of invasive candidiasis, the distribution of Candida species in different regions of the world, the medical concerns of the changing aetiology and the emergence of antifungal resistance. Overall burden of invasive candidiasis remains high, especially in vulnerable persons, such as the elderly, immunosuppressed or debilitated patients. Moreover, there is a progressive shift in the aetiology of invasive candidiasis from Candida albicans to other species of Candida, probably related to the increased use of azole drugs with a clear trend towards increased antifungal resistance. Finally, the emergence and rise of multiresistant species, such as Candida auris or Candida glabrata, is a major threat making necessary invasive candidiasis worldwide surveillances. These changes have serious implications for the diagnosis, treatment and prognosis of invasive candidiasis. Updated knowledge of the current local epidemiology of invasive candidiasis is critical for the clinical management. ER - TY - JOUR T1 - Comparative study of Candida spp. isolates: Identification and echinocandin susceptibility in isolates obtained from blood cultures in 15 hospitals in Medellín, Colombia A1 - Berrio, Indira A1 - Maldonado, Natalia A1 - De Bedout, Catalina A1 - Arango, Karen A1 - Cano, Luz Elena A1 - Valencia, Yorlady A1 - Jiménez-Ortigosa, Cristina A1 - Perlin, David S. A1 - Gómez, Beatriz L. A1 - Robledo, Carlos A1 - Robledo, Jaime Y1 - 2018/// KW - Candida KW - Candidaemia KW - Echinocandin susceptibility KW - FKS silent mutations KW - MALDI-TOF/MS KW - Molecular identification JF - Journal of Global Antimicrobial Resistance VL - 13 SP - 254 EP - 260 DO - 10.1016/j.jgar.2017.11.010 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Berrio et al. - 2018 - Comparative study of Candida spp. isolates Identification and echinocandin susceptibility in isolates obtained fr.pdf N2 - Objectives: Invasive candidiasis has a high impact on morbidity and mortality in hospitalised patients. Accurate and timely methods for identification of Candida spp. and determination of echinocandin susceptibility have become a priority for clinical microbiology laboratories. Methods: This study was performed to compare matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS) identification with sequencing of the D1/D2 region of the rRNA gene complex 28 subunit in 147 Candida spp. isolates obtained from patients with candidaemia. Antimicrobial susceptibility testing was performed by broth microdilution (BMD) and Etest. Sequencing of the FKS1 and FKS2 genes was performed. Results: The most common species isolated were Candida albicans (40.8%), followed by Candida parapsilosis (23.1%) and Candida tropicalis (17.0%). Overall agreement between the results of identification by MALDI-TOF/MS and molecular identification was 99.3%. Anidulafungin and caspofungin susceptibility by the BMD method was 98.0% and 88.4%, respectively. Susceptibility to anidulafungin and caspofungin by Etest was 93.9% and 98.6%, respectively. Categorical agreement between Etest and BMD was 91.8% for anidulafungin and 89.8% for caspofungin, with lower agreements in C. parapsilosis for anidulafungin (76.5%) and C. glabrata for caspofungin (40.0%). No mutations related to resistance were found in the FKS genes, although 54 isolates presented synonymous polymorphisms in the hotspots sequenced. Conclusions: MALDI-TOF/MS is a good alternative for routine identification of Candida spp. isolates. DNA sequencing of the FKS genes suggested that the isolates analysed were susceptible to echinocandins; alternatively, unknown resistance mechanisms or limitations related to antifungal susceptibility tests may explain the resistance found in a few isolates. ER - TY - JOUR T1 - Candida auris: A review of the literature A1 - Jeffery-Smith, Anna A1 - Taori, Surabhi K. A1 - Schelenz, Silke A1 - Jeffery, Katie A1 - Johnson, Elizabeth M. A1 - Borman, Andrew A1 - Manuel, Rohini A1 - Browna, Colin S. Y1 - 2018/// KW - Candida auris KW - Emerging infection KW - Nosocomial transmission JF - Clinical Microbiology Reviews VL - 31 IS - 1 SP - 1 EP - 18 DO - 10.1128/CMR.00029-17 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Jeffery-Smith et al. - 2018 - Candida auris A review of the literature(2).pdf N2 - The emerging pathogen Candida auris has been associated with noso- comial outbreaks on five continents. Genetic analysis indicates the simultaneous emergence of separate clades of this organism in different geographical locations. Invasive infection and colonization have been detected predominantly in patients in high-dependency settings andhave garnered attention due to variable antifungal re sistance profiles and transmission within units instituting a range of infection pre- vention and control measures. Issues with the identification of C. auris using both phe- notypic and molecular techniques have raised concerns about detecting the true scale of the problem. This review considers the literature available on C. auris and highlights the key unknowns, which will provide direction for further work in this field. ER - TY - JOUR T1 - Invasive candidiasis A1 - Pappas, Peter G. A1 - Lionakis, Michail S. A1 - Arendrup, Maiken Cavling A1 - Ostrosky-Zeichner, Luis A1 - Kullberg, Bart Jan Y1 - 2018/// PB - Macmillan Publishers Limited JF - Nature Reviews Disease Primers VL - 4 IS - May SP - 1 EP - 20 DO - 10.1038/nrdp.2018.26 UR - http://dx.doi.org/10.1038/nrdp.2018.26 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Pappas et al. - 2018 - Invasive candidiasis.pdf N2 - Invasive candidiasis is an important health-care-associated fungal infection that can be caused by several Candida spp.; the most common species is Candida albicans, but the prevalence of these organisms varies considerably depending on geographical location. The spectrum of disease of invasive candidiasis ranges from minimally symptomatic candidaemia to fulminant sepsis with an associated mortality exceeding 70%. Candida spp. are common commensal organisms in the skin and gut microbiota, and disruptions in the cutaneous and gastrointestinal barriers (for example, owing to gastrointestinal perforation) promote invasive disease. A deeper understanding of specific Candida spp. virulence factors, host immune response and host susceptibility at the genetic level has led to key insights into the development of early intervention strategies and vaccine candidates. The early diagnosis of invasive candidiasis is challenging but key to the effective management, and the development of rapid molecular diagnostics could improve the ability to intervene rapidly and potentially reduce mortality. First-line drugs, including echinocandins and azoles, are effective, but the emergence of antifungal resistance, especially among Candida glabrata, is a matter of concern and underscores the need to administer antifungal medications in a judicious manner, avoiding overuse when possible. A newly described pathogen, Candida auris, is an emerging multidrug-resistant organism that poses a global threat. ER - TY - JOUR T1 - Candida auris: An emerging multidrug-resistant pathogen A1 - Sears, David A1 - Schwartz, Brian S. Y1 - 2017/// KW - Candida auris KW - Healthcare-associated KW - Infection control KW - Multidrug-resistance KW - Outbreak PB - International Society for Infectious Diseases JF - International Journal of Infectious Diseases VL - 63 SP - 95 EP - 98 DO - 10.1016/j.ijid.2017.08.017 UR - http://dx.doi.org/10.1016/j.ijid.2017.08.017 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Sears, Schwartz - 2017 - Candida auris An emerging multidrug-resistant pathogen.pdf N2 - Candida aurisis an emerging multidrug-resistant pathogen that can be difficult to identify using traditional biochemical methods. C. auris is capable of causing invasive fungal infections, particularly among hospitalized patients with significant medical comorbidities. Echinocandins are the empiric drugs of choice for C. auris, although not all isolates are susceptible and resistance may develop on therapy. Nosocomial C. auris outbreaks have been reported in a number of countries and aggressive infection control measures are paramount to stopping transmission. ER - TY - JOUR T1 - Emerging multidrug-resistant Candida species A1 - Colombo, Arnaldo L. A1 - Júnior, João N.De Almeida A1 - Guinea, Jesus Y1 - 2017/// KW - Candida auris KW - Candida glabrata KW - antifungal resistance KW - candidemia KW - multidrug antifungal resistance JF - Current Opinion in Infectious Diseases VL - 30 IS - 6 SP - 528 EP - 538 SN - 0000000000000 DO - 10.1097/QCO.0000000000000411 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Colombo, Júnior, Guinea - 2017 - Emerging multidrug-resistant Candida species.pdf N2 - Purpose of review To describe the epidemiology, strategies for early detection, and clinical management of infections caused by the most commonly found multidrug-resistant (MDR) Candida spp. Recent findings Increasing numbers of reports describing invasive infections by MDR Candida auris and Candida glabrata has been reported in medical centers worldwide. Summary We checked all papers published along the last 10 years describing epidemiological, diagnostic, and clinical aspects of infections by MDR Candida spp., with emphasis on C. auris and C. glabrata spp. C. auris has been reported in 15 countries and multidrug resistance rates is usually above 30%. Horizontal transmission is a great concern regarding C. auris. C. glabrata ranks the second most reported Candida spp. in deep-seated infections from United States and some European Centers, although multidrug resistance rates above 10% are restricted to some US centers. Candida haemulonii complex isolates with poor susceptibility to azoles and amphotericin B have been isolated in superficial and deep-seated infections, whereas Candida guilliiermondii complex isolates with poor susceptibility to azoles and echinocandins have been recovered from catheter-related bloodstream infections. Other potential MDR Candida species are Candida krusei, Candida lusitaniae, Candida kefyr, Yarrowia (Candida) lypolitica, and Candida rugosa. ER - TY - JOUR T1 - Invasive infections with multidrug-resistant yeast Candida auris, Colombia A1 - Morales-López, Soraya E. A1 - Parra-Giraldo, Claudia M. A1 - Ceballos-Garzón, Andrés A1 - Martínez, Heidys P. A1 - Rodríguez, Gerson J. A1 - Álvarez-Moreno, Carlos A. A1 - Rodríguez, José Y. Y1 - 2017/// JF - Emerging Infectious Diseases VL - 23 IS - 1 SP - 162 EP - 164 DO - 10.3201/eid2301.161497 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Morales-López et al. - 2017 - Invasive infections with multidrug-resistant yeast Candida auris, Colombia.pdf N2 - Candida auris is an emerging multidrug-resistant fungus that causes a wide range of symptoms. We report finding 17 cases of C. auris infection that were originally misclassified but correctly identified 27.5 days later on average. Patients with a delayed diagnosis of C. auris had a 30-day mortality rate of 35.2%. ER - TY - JOUR T1 - Epidemiology and microbiologic characterization of nosocomial candidemia from a Brazilian national surveillance program A1 - Doi, André Mario A1 - Pignatari, Antonio Carlos Campos A1 - Edmond, Michael B. A1 - Marra, Alexandre Rodrigues A1 - Camargo, Luis Fernando Aranha A1 - Siqueira, Ricardo Andreotti A1 - Da Mota, Vivian Pereira A1 - Colombo, Arnaldo Lopes Y1 - 2016/// JF - PLoS ONE VL - 11 IS - 1 SP - 1 EP - 9 DO - 10.1371/journal.pone.0146909 L1 - file:///C:/Users/Alexander Salinas/OneDrive - Universidad del rosario/Documentos/urosario/metodologia de investigacion/Trabajo de investigación/Epidemiology and Microbiologic brazil.pdf N2 - Candidemia is a growing problemin hospitals all over the world. Despite advances in the medical support of critically ill patients, candidiasis leads to prolonged hospitalization, and has a crude mortality rate around 50%.We conducted a multicenter surveillance study in 16 hospitals distributed across five regions of Brazil to assess the incidence, species distribution, antifungal susceptibility, and risk factors for bloodstreaminfections due to Candida species. From June 2007 to March 2010, we studied a total of 2,563 nosocomial bloodstream infection (nBSI) episodes. Candida spp. was the 7th most prevalent agent. Most of the patients were male, with a median age of 56 years. A total of 64 patients (46.7%) were in the ICU when candidemia occurred. Malignancies were the most common underlying condition (32%). The crude mortality rate of candidemia during the hospital admission was 72.2%. Non-albicans species of Candida accounted for 65.7%of the 137 yeast isolates. C. albicans (34.3%), Candida parapsilosis (24.1%), Candida tropicalis (15.3%) and Candida glabrata (10.2%) were the most prevalent species. Only 47 out of 137 Candida isolates were sent to the reference laboratory for antifungal susceptibility testing. All C. albicans, C. tropicalis and C. parapsilosis isolates were susceptible to the 5 antifungal drugs tested. Among 11 C. glabrata isolates, 36% were resistant to fluconazole, and 64%SDD. All of them were susceptible to anidulafungin and amphotericin B.We observed that C. glabrata is emerging as a major player among non-albicans Candida spp. and fluconazole resistance was primarily confined to C. glabrata and C. krusei strains. Candida resistance to echinocandins and amphotericin B remains rare in Brazil. Mortality rates remain increasingly higher than that observed in the Northern Hemisphere countries, emphasizing the need for improving local practices of clinical management of candidemia, including early diagnosis, source control and precise antifungal therapy. ER - TY - JOUR T1 - First report of Candida auris in America: Clinical and microbiological aspects of 18 episodes of candidemia A1 - Calvo, Belinda A1 - Melo, Analy S.A. A1 - Perozo-Mena, Armindo A1 - Hernandez, Martin A1 - Francisco, Elaine Cristina A1 - Hagen, Ferry A1 - Meis, Jacques F. A1 - Colombo, Arnaldo Lopes Y1 - 2016/// KW - Amplified fragment length polymorphism KW - Candida auris KW - Candidemia KW - Candidemia outbreak KW - Fluconazole resistance KW - Venezuela PB - Elsevier Ltd JF - Journal of Infection VL - 73 IS - 4 SP - 369 EP - 374 DO - 10.1016/j.jinf.2016.07.008 UR - http://dx.doi.org/10.1016/j.jinf.2016.07.008 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Calvo et al. - 2016 - First report of Candida auris in America Clinical and microbiological aspects of 18 episodes of candidemia.pdf N2 - Objectives Characterization of a hospital outbreak of Candida auris candidemia that involved 18 critically ill patients in Venezuela. Method Bloodstream isolates of C. auris obtained from 18 patients admitted at a medical center in Maracaibo, between March, 2012 and July, 2013 were included. Species identification was confirmed by ITS rDNA sequencing. Isolates were subsequently typed by amplified fragment length polymorphism fingerprinting (AFLP). Susceptibility testing was performed according to CLSI. Clinical data were collected from all cases by using a standard clinical form. Results A total of 13 critically ill pediatric and 5 adult patients, with a median age of 26 days, were included. All were previously exposed to antibiotics and multiple invasive medical procedures. Clinical management included prompt catheter removal and antifungal therapy. Thirteen patients (72%) survived up to 30 days after onset of candidemia. AFLP fingerprinting of all C. auris isolates suggested a clonal outbreak. The isolates were considered resistant to azoles, but susceptible to anidulafungin and 50% of isolates exhibited amphotericin B MIC values of >1 μg/ml. Conclusions The study demonstrated that C. auris is a multiresistant yeast pathogen that can be a source of health-care associated infections in tertiary care hospitals with a high potential for nosocomial horizontal transmission. ER - TY - JOUR T1 - Candida infections among neutropenic patients. A1 - Mohammadi, Rasoul A1 - Foroughifar, Elham Y1 - 2016/// KW - Candida species KW - Candidiasis KW - Neutropenic patients JF - Caspian journal of internal medicine VL - 7 IS - 2 SP - 71 EP - 7 UR - http://www.ncbi.nlm.nih.gov/pubmed/27386056 UR - http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4913707 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Mohammadi, Foroughifar - 2016 - Candida infections among neutropenic patients.pdf N2 - BACKGROUND Systemic candidiasis is a major complication in neutropenic cancer patients undergoing treatment. Most systemic fungal infections emerge from endogenous microflora so the aim of the present study was to identify Candida species isolated from the different regions of body in neutropenic patients in compare with the control group. METHODS A total of 309 neutropenic cancer patients and 584 patients without cancer (control group) entered in the study. Molecular identification of clinical isolates was performed by PCR-RFLP technique. RESULTS Twenty-two out of 309 patients had candidiasis (7.1%). Male to female ratio was 1/1 and age ranged from 23 to 66 years. Colorectal cancer and acute myeloid leukemia (AML) were the most common cancers. Candida albicans was the most prevalent Candida species among neutropenic patients (50%) and control group (57.9%). Mortality rate in cancer patients was 13.6% in comparison with control group (5.2%). CONCLUSION Since candidiasis is an important cause of morbidity and mortality in neutropenic patients, precise identification of Candida species by molecular techniques can be useful for the appropriate selection of antifungal drugs particularly in high risk patients. ER - TY - JOUR T1 - Análisis de Costo-Efectividad de Anidulafungina en el Tratamiento de la Candidiasis Invasiva en Colombia A1 - Diaz, JA A1 - Urrego-Novoa, JR A1 - Moreno, JA A1 - Huerfano, C A1 - Prieto, VA Y1 - 2015/// JF - Value in Health VL - 18 IS - 7 SP - A870 EP - A870 DO - 10.1016/j.jval.2015.09.010 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Diaz et al. - 2015 - Análisis de Costo-Efectividad de Anidulafungina en el Tratamiento de la Candidiasis Invasiva en Colombia.pdf ER - TY - JOUR T1 - Invasive Candidiasis A1 - Kullberg, Bart Jan A1 - Arendrup, Maiken C. ED - Campion, Edward W. Y1 - 2015/10// JF - New England Journal of Medicine VL - 373 IS - 15 SP - 1445 EP - 1456 DO - 10.1056/NEJMra1315399 UR - http://www.nejm.org/doi/10.1056/NEJMra1315399 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Kullberg, Arendrup - 2015 - Invasive Candidiasis.pdf ER - TY - JOUR T1 - Current methods for identifying clinically important cryptic Candida species A1 - Criseo, Giuseppe A1 - Scordino, Fabio A1 - Romeo, Orazio Y1 - 2015/// KW - Candida africana KW - Candida albicans KW - Candida glabrata KW - Candida parapsilosis KW - Cryptic Candida species KW - Molecular identification KW - Pathogenic yeasts PB - Elsevier B.V. JF - Journal of Microbiological Methods VL - 111 SP - 50 EP - 56 DO - 10.1016/j.mimet.2015.02.004 UR - http://dx.doi.org/10.1016/j.mimet.2015.02.004 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Criseo, Scordino, Romeo - 2015 - Current methods for identifying clinically important cryptic Candida species.pdf N2 - In recent years, the taxonomy of the most important pathogenic Candida species (Candida albicans, Candida parapsilosis and Candida glabrata) has undergone profound changes due to the description of new closely-related species. This has resulted in the establishment of cryptic species complexes difficult to recognize in clinical diagnostic laboratories. The identification of these novel Candida species seems to be clinically relevant because it is likely that they differ in virulence and drug resistance. Nevertheless, current phenotypic methods are not suitable to accurately distinguish all the species belonging to a specific cryptic complex and therefore their recognition still requires molecular methods. Since traditional mycological techniques have not been useful, a number of molecular based methods have recently been developed. These range from simple PCR-based methods to more sophisticated real-time PCR and/or MALDI-TOF methods. In this article, we review the current methods designed for discriminating among closely related Candida species by highlighting, in particular, the limits of the existing phenotypic tests and the development of rapid and specific molecular tools for their proper identification. ER - TY - JOUR T1 - Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America A1 - Pappas, Peter G. A1 - Kauffman, Carol A. A1 - Andes, David R. A1 - Clancy, Cornelius J. A1 - Marr, Kieren A. A1 - Ostrosky-Zeichner, Luis A1 - Reboli, Annette C. A1 - Schuster, Mindy G. A1 - Vazquez, Jose A. A1 - Walsh, Thomas J. A1 - Zaoutis, Theoklis E. A1 - Sobel, Jack D. Y1 - 2015/// KW - azoles KW - candidemia KW - echinocandins KW - fungal diagnostics KW - invasive candidiasis JF - Clinical Infectious Diseases VL - 62 IS - 4 SP - e1 EP - e50 SN - 1058-4838 DO - 10.1093/cid/civ933 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Pappas et al. - 2015 - Clinical Practice Guideline for the Management of Candidiasis 2016 Update by the Infectious Diseases Society of A.pdf N2 - It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances. ER - TY - JOUR T1 - Epidemiology and outcome of candidaemia in patients with oncological and haematological malignancies: RESULTS from a population-based surveillance in Spain A1 - Puig-Asensio, M. A1 - Ruiz-Camps, I. A1 - Fernández-Ruiz, M. A1 - Aguado, J. M. A1 - Muñoz, P. A1 - Valerio, M. A1 - Delgado-Iribarren, A. A1 - Merino, P. A1 - Bereciartua, E. A1 - Fortún, J. A1 - Cuenca-Estrella, M. A1 - Almirante, B. A1 - Padilla, Belén A1 - Muñoz, Patricia A1 - Guinea, Jesús A1 - Paño, José Ramón A1 - García, Julio A1 - García, Carlos A1 - Fortún, Jesús A1 - Martín, Pilar A1 - Gómez, Elia A1 - Ryan, Pablo A1 - Campelo, Carolina A1 - Santos, Ignacio de los A1 - Buendía, Buenaventura A1 - Pérez, Beatriz A1 - Alonso, Mercedes A1 - Sanz, Francisca A1 - Aguado, José María A1 - Merino, Paloma A1 - González, Fernando A1 - Gorgolas, Miguel A1 - Gadea, Ignacio A1 - Losa, Juan Emilio A1 - Delgado-Iribarren, Alberto A1 - Ramos, Antonio A1 - Romero, Yolanda A1 - Sánchez, Isabel A1 - Zaragoza, Oscar A1 - Cuenca-Estrella, Manuel A1 - Rodriguez-Baño, Jesús A1 - Suarez, Ana Isabel A1 - Loza, Ana A1 - Aller, Ana Isabel A1 - Martín-Mazuelos, Estrella A1 - Ruiz, Maite A1 - Garnacho-Montero, José A1 - Ortiz, Carlos A1 - Chávez, Mónica A1 - Maroto, Fernando L. A1 - Salavert, Miguel A1 - Pemán, Javier A1 - Blanquer, José A1 - Navarro, David A1 - Camarena, Juan José A1 - Zaragoza, Rafael A1 - Abril, Vicente A1 - Gimeno, Concepción A1 - Hernáez, Silvia A1 - Ezpeleta, Guillermo A1 - Bereciartua, Elena A1 - Hernández, José L. A1 - Montejo, Miguel A1 - Rivas, Rosa Ana A1 - Ayarza, Rafael A1 - Planes, Ana A1 - Almirante, Benito A1 - Mensa, José A1 - Almela, Manel A1 - Gurgui, Mercè A1 - Sánchez-Reus, Ferran A1 - Martinez-Montauti, Joaquin A1 - Sierra, Montserrat A1 - Horcajada, Juan Pablo A1 - Sorli, Luisa A1 - Gómez, Julià A1 - Gené, Amadeu A1 - Urrea, Mireia Y1 - 2015/// KW - Antifungal agents KW - Cancer KW - Candidiasis KW - Drug resistance KW - Epidemiology KW - Fluconazole KW - Haematological malignancies PB - Elsevier Ltd JF - Clinical Microbiology and Infection VL - 21 IS - 5 SP - 491.e1 EP - 491.e10 SN - 1198-743X DO - 10.1016/j.cmi.2014.12.027 UR - http://dx.doi.org/10.1016/j.cmi.2014.12.027 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Puig-Asensio et al. - 2015 - Epidemiology and outcome of candidaemia in patients with oncological and haematological malignancies RESULT.pdf N2 - A prospective, population-based surveillance on candidaemia was implemented in five metropolitan areas of Spain from May 2010 to April 2011. We aimed to describe the distribution and susceptibility pattern of Candida species, and to evaluate risk factors for mortality in patients with oncological (solid tumours) and haematological malignancies. Adults (≥16 years) with cancer were included in the present report. Impact of therapeutic strategies on 7- and 30-day mortality were analysed by logistic regression, adjusting for propensity score by inverse weighting probability of receiving early antifungal treatment and catheter removal. We included 238 (32.6%) patients (195 oncological, 43 haematological). Compared with oncological patients, haematological patients were more likely to have received chemotherapy (53.5% versus 17.4%, p<0.001) or corticosteroids (41.9% versus 21%, p<0.001), and have neutropenia (44.2% versus 1.5%, p<0.001). Overall, 14.8% of patients developed breakthrough candidaemia. Non- albicans Candida species (71.1% versus 55.6%, p 0.056) and Candida tropicalis (22.2% versus 7.6%, p 0.011) were more frequent in haematological patients. Based on EUCAST breakpoints, 27.6% of Candida isolates were non-susceptible to fluconazole. Resistance to echinocandins was negligible. Mortality at 7 and 30 days was 12.2% and 31.5%, respectively, and did not differ significantly between the patient groups. Prompt antifungal therapy together with catheter removal (≤48 hours) was associated with lower mortality at 7 days (adjusted OR 0.05; 95% CI 0.01-0.42) and 30 days (adjusted OR 0.27; 95% CI 0.16-0.46). In conclusion, non- albicans species are emerging as the predominant isolates, particularly in haematological patients. Prompt, adequate antifungal treatment plus catheter removal may lead to a reduction in mortality. ER - TY - JOUR T1 - Clinical and epidemiological characteristics and risk factors for mortality in patients with candidemia in hospitals from Bogotá, Colombia A1 - Cortés, Jorge Alberto A1 - Reyes, Patricia A1 - Gómez, Carlos Hernando A1 - Cuervo, Sonia Isabel A1 - Rivas, Pilar A1 - Casas, Christian A. A1 - Sánchez, Ricardo Y1 - 2014/// KW - Candida KW - Candidemia KW - Candidemia/epidemiology KW - Candidemia/mortality KW - Candidemia/therapy KW - Colombia KW - Fluconazole PB - Elsevier Editora Ltda JF - Brazilian Journal of Infectious Diseases VL - 18 IS - 6 SP - 631 EP - 637 DO - 10.1016/j.bjid.2014.06.009 UR - http://dx.doi.org/10.1016/j.bjid.2014.06.009 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Cortés et al. - 2014 - Clinical and epidemiological characteristics and risk factors for mortality in patients with candidemia in hospit.pdf N2 - Background: Bloodstream infection by Candida species has a high mortality in Latin American countries. The aim of this study was to describe the characteristics of patients with documented bloodstream infections caused by Candida species in third level hospitals and determine the risk factors for in-hospital-mortality. Methods: Patients from seven tertiary-care hospitals in Bogotá, Colombia, with isolation of a Candida species from a blood culture were followed prospectively from March 2008 to March 2009. Epidemiologic information, risk factors, and mortality were prospectively collected. Isolates were sent to a reference center, and fluconazole susceptibility was tested by agar-based E-test. The results of susceptibility were compared by using 2008 and 2012 breakpoints. A multivariate analysis was used to determinate risk factors for mortality. Results: We identified 131 patients, with a median age of 41.2 years. Isolates were most frequently found in the intensive care unit (ICU). Candida albicans was the most prevalent species (66.4% of the isolates), followed by C. parapsilosis (14%). Fluconazole resistance was found in 3.2% and 17.6% of the isolates according to the 2008 and 2012 breakpoints, respectively. Fluconazole was used as empirical antifungal therapy in 68.8% of the cases, and amphotericin B in 22%. Hospital crude mortality rate was 35.9%. Mortality was associated with age and the presence of shock at the time of Candida detection. Fluconazole therapy was a protective factor for mortality. Conclusions: Candidemia is associated with a high mortality rate. Age and shock increase mortality, while the use of fluconazole was shown to be a protective factor. A higher resistance rate with new breakpoints was noted. ER - TY - JOUR T1 - World Medical Association Declaration of Helsinki A1 - Association, World Medical Y1 - 2013/// SP - 2013 EP - 2016 DO - 10.1001@Jama.2013.281053 N2 - HELSINKI ER - TY - JOUR T1 - Incidencia y prevalencia de candidemia en pacientes críticamente enfermos en Colombia A1 - Cortés, Jorge A. A1 - Jaimes, Jesús A. A1 - Leal, Aura L. Y1 - 2013/// KW - Candidiasis KW - Candidiasis/epidemiology KW - Cross infection KW - Fungemia/epidemiology KW - Hospitals KW - Incidence KW - Intensive care units/statistics & Numerical data KW - Prevalence JF - Revista Chilena de Infectologia VL - 30 IS - 6 SP - 599 EP - 604 DO - 10.4067/S0716-10182013000600004 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Cortés, Jaimes, Leal - 2013 - Incidencia y prevalencia de candidemia en pacientes críticamente enfermos en Colombia.pdf N2 - Introduction: Candidemia is an infectious complication with high morbidity and mortality in intensive care patients. Objective: The aim of this study was to determine the incidence and prevalence of candidemia in critically ill patients in Colombian hospitals between 2004 and 2008. Materials and Methods: Data from microbiologically confirmed candidemia cases, ICU stay and admissions were retrospectively recorded in 7 Colombian hospitals between 2004 and 2008. Time series analysis was performed with monthly incidence (number of cases of candidemia in relation to the number of patient-days) and prevalence (number of cases of candidemia in relation to the number of admissions) for each institution and the whole group. Results: 382 cases of candidemia were identified, with an incidence of 2,3 cases per 1.000 patient-days in ICU, and a prevalence of 1,4%. There was a trend to increased incidence (0,0066 additional cases per 1.000 ICU-days per month) and prevalence (0,0016 additional cases por 100 patients per month) of candidemia. This increase of candidemia cases was due to a rise of non- albicans Candida species, which corresponded to 44% of total isolates. Discusion and Conclusions: Candidemia cases in colombian ICUs are increasing, especially those caused by non albicans Candida species. ER - TY - JOUR T1 - Epidemiology of Candidemia in Latin America: A Laboratory-Based Survey A1 - Nucci, Marcio A1 - Queiroz-Telles, Flavio A1 - Alvarado-Matute, Tito A1 - Tiraboschi, Iris Nora A1 - Cortes, Jorge A1 - Zurita, Jeannete A1 - Guzman-Blanco, Manuel A1 - Santolaya, Maria Elena A1 - Thompson, Luis A1 - Sifuentes-Osornio, Jose A1 - Echevarria, Juan I. A1 - Colombo, Arnaldo L. Y1 - 2013/// JF - PLoS ONE VL - 8 IS - 3 DO - 10.1371/journal.pone.0059373 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Nucci et al. - 2013 - Epidemiology of Candidemia in Latin America A Laboratory-Based Survey.pdf N2 - Background: The epidemiology of candidemia varies depending on the geographic region. Little is known about the epidemiology of candidemia in Latin America. Methods: We conducted a 24-month laboratory-based survey of candidemia in 20 centers of seven Latin American countries. Incidence rates were calculated and the epidemiology of candidemia was characterized. Results: Among 672 episodes of candidemia, 297 (44.2%) occurred in children (23.7% younger than 1 year), 36.2% in adults between 19 and 60 years old and 19.6% in elderly patients. The overall incidence was 1.18 cases per 1,000 admissions, and varied across countries, with the highest incidence in Colombia and the lowest in Chile. Candida albicans (37.6%), C. parapsilosis (26.5%) and C. tropicalis (17.6%) were the leading agents, with great variability in species distribution in the different countries. Most isolates were highly susceptible to fluconazole, voriconazole, amphotericin B and anidulafungin. Fluconazole was the most frequent agent used as primary treatment (65.8%), and the overall 30-day survival was 59.3%. Conclusions: This first large epidemiologic study of candidemia in Latin America showed a high incidence of candidemia, high percentage of children, typical species distribution, with C. albicans, C. parapsilosis and C. tropicalis accounting for the majority of episodes, and low resistance rates. © 2013 Nucci et al. ER - TY - JOUR T1 - Candidemia among adults in Soweto, South Africa, 1990-2007 A1 - Kreusch, Adrian A1 - Karstaedt, Alan S. Y1 - 2013/// KW - Adults KW - Africa KW - Candidemia KW - HIV KW - Trauma PB - International Society for Infectious Diseases JF - International Journal of Infectious Diseases VL - 17 IS - 8 SP - e621 EP - e623 DO - 10.1016/j.ijid.2013.02.010 UR - http://dx.doi.org/10.1016/j.ijid.2013.02.010 L1 - file:///C:/Users/Alexander Salinas/OneDrive - Universidad del rosario/Documentos/urosario/metodologia de investigacion/Trabajo de investigación/Candidemia among adults in Soweto.pdf N2 - Background: Studies on candidemia occurring among adults in Southern African are limited. We aimed to document the epidemiology of candidemia among adults in Soweto. Methods: This was a retrospective hospital-based study in three discrete periods, involving 9 years, from 1990 to 2007. Results: Two hundred and sixty-six patients were identified. Case rates were 2.8 cases/10 000 admissions in 1998-2002 and 3.6 episodes/10 000 hospitalizations in 2005-2007. In 1990, Candida albicans caused 62% and Candida tropicalis caused 23% of episodes. In 2005-2007, major species were C. albicans (46%), Candida parapsilosis (25%), and Candida glabrata (23%), with little change compared to 1998-2002. Major predisposing conditions were abdominal surgery (43%), HIV infection (19% in 2005-2007), trauma (16%), diabetes mellitus (12%), and cancer (8%). General wards superseded intensive care as the major diagnostic setting in 2005-2007. The crude mortality was 60%. Among 22 HIV-infected patients with a median CD4 cell count of 68/μl, three were of community-onset. C. albicans caused 73% of cases. Five patients had another predisposing condition and five had central venous catheters. The mortality was 73%. Conclusions: Soweto has a pattern of Candida species different from other continents. HIV infection and trauma were important predisposing conditions. © 2013 International Society for Infectious Diseases. ER - TY - JOUR T1 - Candida and Host Determinants of Susceptibility to Invasive Candidiasis A1 - Lionakis, Michail S. A1 - Netea, Mihai G. Y1 - 2013/// JF - PLoS Pathogens VL - 9 IS - 1 SN - 1553-7374 (Electronic)\r1553-7366 (Linking) DO - 10.1371/journal.ppat.1003079 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Lionakis, Netea - 2013 - Candida and Host Determinants of Susceptibility to Invasive Candidiasis.pdf ER - TY - JOUR T1 - Emerging and Emerged Pathogenic Candida Species: Beyond the Candida albicans Paradigm A1 - Papon, Nicolas A1 - Courdavault, Vincent A1 - Clastre, Marc A1 - Bennett, Richard J. Y1 - 2013/// JF - PLoS Pathogens VL - 9 IS - 9 SN - 1553-7374 (Electronic) 1553-7366 (Linking) DO - 10.1371/journal.ppat.1003550 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Papon et al. - 2013 - Emerging and Emerged Pathogenic Candida Species Beyond the Candida albicans Paradigm.pdf N2 - OBJECTIVES: This study was intended to analyse the clinical characteristics and outcomes of patients with infections due to Candida guilliermondii complex and evaluate in vitro susceptibilities of the isolates.\n\nMETHODS: We searched the Mycology Database of the National Taiwan University Hospital and identified patients with infections due to C. guilliermondii complex from 2001 to 2010. Isolates were identified to species level by two yeast identification systems and restriction fragment length polymorphism of the riboflavin synthetase gene. MICs of nine antifungal agents were determined using the Sensititre YeastOne system (Trek Diagnostic Systems) and were interpreted by breakpoints (BPs) for three echinocandins and epidemiological cut-off values (ECVs) for the other agents.\n\nRESULTS: Fifty-two patients with infections due to C. guilliermondii complex were evaluated. The majority (90%, n = 47) of the isolates were C. guilliermondii, followed by Candida fermentati (10%, n = 5). Among them, 42 (81%) were isolated from blood cultures. Among the 52 patients, 27 (52%) had underlying malignancy and 15 (29%) had undergone abdominal surgery. The 30 day mortality rates among patients with C. guilliermondii and C. fermentati infections were 45% and 60%, respectively. Among C. guilliermondii isolates, 98%, 100% and 98% were susceptible to caspofungin, micafungin and anidulafungin, respectively, by BPs. Nearly all (96%-100%) C. guilliermondii isolates belonged to wild-type for the other agents by ECVs. All five C. fermentati were susceptible to three echinocandins and belonged to wild-type for the other agents.\n\nCONCLUSIONS: The currently used antifungal agents exhibited good in vitro activities against C. guilliermondii complex isolates. ER - TY - JOUR T1 - Candida albicans pathogenicity A1 - Mayer, François L A1 - Wilson, Duncan A1 - Hube, Bernhard Y1 - 2013/// KW - Candida albicans KW - candidiasis KW - fitness attributes KW - pathogenicity KW - virulence factors JF - Virulence VL - 4 IS - 2 SP - 119 EP - 128 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Mayer, Wilson, Hube - 2013 - Candida albicans pathogenicity.pdf N2 - The polymorphic fungus Candida albicans is a member of the normal human microbiome. In most individuals, C. albicans resides as a lifelong, harmless commensal. Under certain circumstances, however, C. albicans can cause infections that range from superficial infections of the skin to life-threatening systemic infections. Several factors and activities have been identified which contribute to the pathogenic potential of this fungus. Among them are molecules which mediate adhesion to and invasion into host cells, the secretion of hydrolases, the yeast-to-hypha transition, contact sensing and thigmotropism, biofilm formation, phenotypic switching and a range of fitness attributes. Our understanding of when and how these mechanisms and factors contribute to infection has significantly increased during the last years. In addition, novel virulence mechanisms have recently been discovered. In this review we present an update on our current understanding of the pathogenicity mechanisms of this important human pathogen. Introduction ER - TY - JOUR T1 - Changes in incidence and antifungal drug resistance in candidemia: Results from population-based laboratory surveillance in Atlanta and Baltimore, 2008-2011 A1 - Cleveland, Angela Ahlquist A1 - Farley, Monica M. A1 - Harrison, Lee H. A1 - Stein, Betsy A1 - Hollick, Rosemary A1 - Lockhart, Shawn R. A1 - Magill, Shelley S. A1 - Derado, Gordana A1 - Park, Benjamin J. A1 - Chiller, Tom M. Y1 - 2012/// JF - Clinical Infectious Diseases VL - 55 IS - 10 SP - 1352 EP - 1361 DO - 10.1093/cid/cis697 L1 - file:///C:/Users/Alexander Salinas/OneDrive - Universidad del rosario/Documentos/urosario/metodologia de investigacion/Trabajo de investigación/Changes in Incidence and Antifungal Drug usa.pdf N2 - Background. Candidemia is common and associated with high morbidity and mortality; changes in population-based incidence rates have not been reported. Methods. We conducted active, population-based surveillance in metropolitan Atlanta, Georgia, and Baltimore City/County, Maryland (combined population 5.2 million), during 2008-2011. We calculated candidemia incidence and antifungal drug resistance compared with prior surveillance (Atlanta, 1992-1993; Baltimore, 1998-2000). Results. We identified 2675 cases of candidemia with 2329 isolates during 3 years of surveillance. Mean annual crude incidence per 100 000 person-years was 13.3 in Atlanta and 26.2 in Baltimore. Rates were highest among adults aged ≥65 years (Atlanta, 59.1; Baltimore, 72.4) and infants (aged <1 year; Atlanta, 34.3; Baltimore, 46.2). In both locations compared with prior surveillance, adjusted incidence significantly declined for infants of both black and white race (Atlanta: black risk ratio [RR], 0.26 [95 confidence interval CI,. 17-.38]; white RR: 0.19 [95 CI,. 12-.29]; Baltimore: black RR, 0.38 [95 CI,. 22-.64]; white RR: 0.51 [95 CI:. 29-.90]). Prevalence of fluconazole resistance (7) was unchanged compared with prior surveillance; 32 (1) isolates were echinocandin-resistant, and 9 (8 Candida glabrata) were multidrug resistant to both fluconazole and an echinocandin. Conclusions. We describe marked shifts in candidemia epidemiology over the past 2 decades. Adults aged ≥65 years replaced infants as the highest incidence group; adjusted incidence has declined significantly in infants. Use of antifungal prophylaxis, improvements in infection control, or changes in catheter insertion practices may be contributing to these declines. Further surveillance for antifungal resistance and efforts to determine effective prevention strategies are needed. © 2012 The Author. ER - TY - JOUR T1 - Sensibilidad a fluconazol y voriconazol de especies de Candida aisladas de pacientes provenientes de unidades de cuidados intensivos en Medellín, Colombia (2001-2007) A1 - Zuluaga Rodríguez, Alejandra A1 - de Bedout Gómez, Catalina A1 - Agudelo Restrepo, Carlos Andrés A1 - Hurtado Parra, Hans A1 - Arango Arteaga, Myrtha A1 - Restrepo Moreno, Ángela A1 - González Marín, Ángel Y1 - 2010/// KW - Antifúngicos KW - Candida spp. KW - Fluconazol KW - Prueba de disco KW - Resistencia KW - Sensibilidad KW - Voriconazol JF - Revista Iberoamericana de Micologia VL - 27 IS - 3 SP - 125 EP - 129 DO - 10.1016/j.riam.2010.04.001 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Zuluaga Rodríguez et al. - 2010 - Sensibilidad a fluconazol y voriconazol de especies de Candida aisladas de pacientes provenientes de u.pdf N2 - Background: Disseminated candidiasis is caused by different Candida species and mainly affects immunocompromised patients and those hospitalized in intensive care units (ICU). Objective: Our aim was to determine the frequency and susceptibility of Candida spp. isolates to fluconazole and voriconazole, obtained from patients hospitalized in ICU in the city of Medellin during the years 2001-2007. Methods: The agar diffusion technique based on the protocols recommended by the CLSI from the United States (M44A) was used. The Chi2 test and the Kruskal Wallis statistical methods were used to compare changes in the frequency of Candida spp. isolates and their susceptibility to azoles by year of isolation. Results: A total of 337 isolates were analyzed, 147 (43.6%) of which corresponded to Candida albicans, followed by 79 (23.4%) Candida tropicalis, 47 (13.9%) Candida parapsilosis, 32 (9.5%) Candida glabrata, 12 (3.6%) Candida guilliermondii and 11 (3.3%) Candida krusei. The remaining isolates (2.7%) were distributed among other species (Candida famata, Candida lusitaniae, Candida lipolytica, Candida pelliculosa and Candida spp.) Most of these isolates (78.3%) were susceptible; 11.9% were dose-dependent susceptible (DDS) and 9.8% resistant to fluconazole. For voriconazole, we observed that 94.1% of the isolates were susceptible, 2.4% DDS and 3.6% resistant. Conclusions: These data indicate a notable change in the species frequency, as well as a new susceptibility patterns that requires the precise identification of the causative organism and susceptibility testing in order to determine the characteristics of the isolates circulating in ICUs and then to treat them appropriately. © 2009 Revista Iberoamericana de Micología. ER - TY - JOUR T1 - Candida y candidiasis invasora: un reto continuo para su diagnóstico temprano A1 - Bedout, Catalina de A1 - Gómez, Beatriz L. Y1 - 2010/// KW - candida KW - candidiasis KW - diag- KW - diagnóstico molecular KW - nóstico convencional KW - s KW - susceptibilidad antimicóticos JF - Infectio VL - 14 IS - 94 SP - 159 EP - 171 DO - 10.1016/s0123-9392(10)70133-8 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Bedout, Gómez - 2010 - Candida y candidiasis invasora un reto continuo para su diagnóstico temprano.pdf N2 - La candidiasis invasora representa el 75% de las infecciones por hongos en pacientes hospitalizados, con una mortalidad que alcanza cifras hasta del 78%. La frecuencia de estas infecciones varía de acuerdo con el servicio de hospitalización y los factores de riesgo de los pacientes. Paralelamente, se han venido observando cambios en la epidemiología de las especies de Candida, variaciones en su prevalencia y en la resistencia a los antimicóticos según su localización geográfica. Por todo lo anterior, es imperativo establecer un diagnóstico temprano que lleve a la identificación correcta de la especie implicada de manera que se instaure un pronto y adecuado tratamiento antimicótico. El diagnóstico de la candidiasis invasora continúa siendo un reto, en el cual combinar los diferentes métodos diagnósticos, los microbiológicos, los inmunológicos y los nuevos moleculares, aún en desarrollo y validación, es la mejor estrategia para lograr un dictamen oportuno. En esta revisión se describen los métodos disponibles, sus limitaciones y las perspectivas de los que están en etapa de desarrollo y validación. En la última década se cuenta con métodos de referencia para la medición de susceptibilidad in vitro a los antimicóticos, lo cual ha permitido conocer los perfiles de sensibilidad de las diferentes especies de Candida a escala mundial y local. Invasive candidiasis represents 75% of fungal infections in hospitalized patients, with reported mortalities up to 78%. The frequency of these infections varies according to the hospital services and the risk factors of the patients. In parallel, changes in the epidemiology of the Candida species have been observed, in particular variations in their prevalence and in their resistance to antifungals according to geographic location. For these reasons it is crucial to establish an early diagnosis that identifies the pathogen to the species level in order to allow an appropriate therapeutic decision. The diagnosis of invasive candidiasis continues to be a challenge, where combining the different available methods (microbiologic, immunologic and new molecular approaches) is the best strategy to achieve a prompt and accurate diagnosis. We review the currently available assays for conventional and molecular diagnosis, their limitations, and the perspectives for assays that are now in development and validation. In the last decade, well established reference methods have become available for testing antifungal susceptibility and this has allowed worldwide and regional sensitivity profiles to be established for the different Candida species. ER - TY - JOUR T1 - Epidemiology of candidemia in Brazil: A nationwide sentinel surveillance of candidemia in eleven medical centers A1 - Colombo, Arnaldo L. A1 - Nucci, Marcio A1 - Park, Benjamin J. A1 - Nouér, Simone A. A1 - Arthington-Skaggs, Beth A1 - Da Matta, Daniel A. A1 - Warnock, David A1 - Morgan, Juliette Y1 - 2006/// JF - Journal of Clinical Microbiology VL - 44 IS - 8 SP - 2816 EP - 2823 DO - 10.1128/JCM.00773-06 L1 - file:///C:/Users/Alexander Salinas/OneDrive - Universidad del rosario/Documentos/urosario/metodologia de investigacion/Trabajo de investigación/Epidemiology of Candidemia in Brazil.pdf N2 - Candidemia studies have documented geographic differences in rates and epidemiology, underscoring the need for surveillance to monitor trends. We conducted prospective candidemia surveillance in Brazil to assess the incidence, species distribution, frequency of antifungal resistance, and risk factors for fluconazole-resistant Candida species. Prospective laboratory-based surveillance was conducted from March 2003 to December 2004 in 11 medical centers located in 9 major Brazilian cities. A case of candidemia was defined as the isolation of Candida spp. from a blood culture. Incidence rates were calculated per 1,000 admissions and 1,000 patient-days. Antifungal susceptibility tests were performed by using the broth microdilution assay, according to the Clinical and Laboratory Standards Institute guidelines. We detected 712 cases, for an overall incidence of 2.49 cases per 1,000 admissions and 0.37 cases per 1,000 patient-days. The 30-day crude mortality was 54%. C. albicans was the most common species (40.9%), followed by C. tropicalis (20.9%) and C. parapsilosis (20.5%). Overall, decreased susceptibility to fluconazole occurred in 33 (5%) of incident isolates, 6 (1%) of which were resistant. There was a linear correlation between fluconazole and voriconazole MICs (r = 0.54 and P < 0.001 [Spearman's rho]). This is the largest multicenter candidemia study conducted in Latin America and shows the substantial morbidity and mortality of candidemia in Brazil. Antifungal resistance was rare, but correlation between fluconazole and voriconazole MICs suggests cross-resistance may occur. Copyright © 2006, American Society for Microbiology. All Rights Reserved. ER - TY - JOUR T1 - Resolucion numero 8430 DE 1993. A1 - Salud, M D Y1 - 1993/// JF - Ministerio de salud SP - 1 EP - 19 DO - 10.7705/biomedica.v32i4.1526 L1 - file:///C:/Users/Alexander Salinas/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Salud - 1993 - Resolucion numero 8430 DE 1993.pdf ER - TY - JOUR T1 - The European Committee on Antimicrobial Susceptibility Testing. Overview of antifungal ECOFFs and clinical breakpoints for yeasts, moulds and dermatophytes using the EUCAST E.Def 7.3, E.Def 9.4 and E.Def 11.0 procedures. Version 3, 2022. http://www.eucast ER -