RESUMO
A 37-year-old immunocompetent man was admitted to the emergency department due to recurrent pain and oedema of his right knee. Two months earlier, he had undergone surgery to repair his meniscus. Arthroscopic joint lavage was performed and Candida dubliniensis was recovered in culture. The authors describe the first case of septic arthritis caused by Candida dubliniensis.
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A estomatite protética é uma doença oral que resulta em processo inflamatório crônico da mucosa de suporte de uma prótese dentária, frequentemente associada à infecção por Candida. O tratamento da estomatite protética é dificultado pelo desenvolvimento de resistência das cepas de Candida aos fármacos antifúngicos. Neste cenário, este estudo teve como objetivo avaliar o efeito da terapia fotodinâmica antimicrobiana (TFDa) mediada por curcumina livre (CUR) e nanopartículas de ferro revestidas de curcumina (NpFeCUR) sobre Candida spp. Para isso, o estudo foi dividido em 2 etapas. Na etapa 1, os efeitos da TFDa mediada por NpFeCUR foi estudado sobre células planctônicas e biofilmes monoespécie da cepa de C. albicans SC5314. Após o tratamento com TFDa, as células viáveis foram quantificadas por contagem de Unidades Formadoras de Colônias (UFC). Os resultados dessa etapa demonstraram que a TFDa mediada por NpFeCUR não foi capaz de reduzir a viabilidade fúngica em culturas planctônicas e em biofilmes. Na etapa 2, foi avaliado o efeito da TFDa mediada por CUR sobre biofilmes formados a partir de amostras clínicas de estomatite protética. Essas amostras foram coletadas de 5 pacientes com estomatite protética e analisadas quanto à presença de Candida spp. pelo método de Gram e semeadura em Chromagar Candida. As espécies de Candida foram identificadas por meio de espectrometria de massa (MALDI-TOF). A seguir, a TFDa foi testada sobre biofilmes monoespécies das espécies de Candida isoladas e sobre os biofilmes microcosmos. Após a TFDa, as células viáveis foram determinadas pela contagem de UFC em meios de cultura não seletivo e seletivos para leveduras, estreptococos, estafilococos e estreptococos do grupo mutans. Nos resultados da etapa 2, foi encontrada a presença de Candida nas amostras clínicas de 3 pacientes (P1, P2 e P3). Nas amostras P1 e P3, foi identificada a espécie C. dubliniensis, já na amostra P2 foi encontrada C. albicans. Os biofilmes monoespécies dessas cepas apresentaram redução em torno de 3,0 log10 UFC após o tratamento com TFDa. Para os biofilmes microcosmos, a redução do número de UFC causada pela TFDa variou entre as amostras dos pacientes e os meios de cultura, sendo capaz de inibir o crescimento de microrganismos totais, leveduras, estreptococos, estreptococos do grupo mutans e estafilococos. Conclui-se que a TFDa mediada por NpFeCUR não apresentou atividade antifúngica contra C. albicans. Já a TFDa mediada por CUR foi eficaz na redução das espécies de Candida e biofilmes provenientes de lesões de estomatite protética.(AU)
Prosthetic stomatitis is an oral disease that results in a chronic inflammatory process of the supporting mucosa of a dental prosthesis, often associated with Candida infection. The treatment of prosthetic stomatitis is complicated by the development of resistance in Candida strains to antifungal drugs. In this scenario, this study aimed to evaluate the effect of antimicrobial photodynamic therapy (aPDT) mediated by free curcumin (CUR) and curcumin-coated iron nanoparticles (FeCUR NPs) on Candida spp. For this purpose, the study was divided into 2 stages. In stage 1, the effects of aPDT mediated by FeCUR NPs were studied on planktonic cells and monospecies biofilms of the C. albicans SC5314 strain. After aPDT treatment, viable cells were quantified by Colony-Forming Units (CFU) counting. The results of this stage demonstrated that aPDT mediated by FeCUR NPs was unable to reduce fungal viability in planktonic cultures and biofilms. In stage 2, the effect of aPDT mediated by CUR on biofilms formed from clinical samples of prosthetic stomatitis was evaluated. These samples were collected from 5 patients with prosthetic stomatitis and analyzed for the presence of Candida spp. by Gram staining and seeding on Chromagar Candida. Candida species were identified using mass spectrometry (MALDI-TOF). Subsequently, aPDT was tested on monospecies biofilms of the isolated Candida species and on microcosm biofilms. After aPDT, viable cells were determined by CFU counting on non-selective and selective culture media for yeasts, streptococci, staphylococci, and mutans group streptococci. In the results of stage 2, Candida was found in clinical samples from 3 patients (P1, P2, and P3). In P1 and P3 samples, C. dubliniensis was identified, while C. albicans was found in the P2 sample. Monospecies biofilms of these strains showed a reduction of around 3.0 log10 CFU after aPDT treatment. For microcosm biofilms, the reduction in CFU caused by aPDT varied between patient samples and culture media, being able to inhibit the growth of total microorganisms, yeasts, streptococci, mutans group streptococci, and staphylococci. It is concluded that aPDT mediated by FeCUR NPs did not exhibit antifungal activity against C. albicans. On the other hand, aPDT mediated by CUR was effective in reducing Candida species and biofilms from prosthetic stomatitis lesions.(AU)
Assuntos
Fotoquimioterapia , Estomatite sob Prótese , Candida albicans , Biofilmes , Curcumina , Nanopartículas Magnéticas de Óxido de FerroRESUMO
The oral cavity constitutes a unique ecosystem with highly variable ecological niches that harbor a great variety of microorganisms, including yeasts. Molecular methods are currently considered the gold standard for identifying species, although they involve limitations associated with the disruption of yeast cell walls to release the genomic DNA (gDNA) for amplification. AIM: The aim of this study was to compare the performance of different methods for extracting gDNA from Candida albicans and Candida dubliniensis, subsequently amplifying DNA by PCR. MATERIALS AND METHOD: Fifty-two isolates (16 C. albicans and 36 C. dubliniensis) were obtained from subgingival biofilm of HIV+ patients with clinical signs of periodontal disease. The study evaluated 6 gDNA extraction methods and two PCR amplification methods. Furthermore, the presence of alleles of HWP1 gene was determined in C. albicans. RESULTS: Comparisons of six methods show statistically significant differences (p <0.001) except for C. albicans in two of them. For C. dubliniensis, statistical differences were observed in all comparisons. Commercial methods were more efficient for concentrating gDNA than in-house methods, and both PCRs were effective. Ten heterozygous C. albicans isolates for this allele were positive for the HWP1-1 / HWP1-2 allele, one was homozygous for Wild Type HWP1-1 allele, and 5 were homozygous for novel/rare HWP1-2 allele. CONCLUSIONS: This study aims to provide simple, inexpensive strategies for phenotypic identification and molecular confirmation of Candida albicans and Candida dubliniensis for non-reference laboratories with low complexity and/or low budgets.
La cavidad oral constituye un ecosistema único con nichos ecológicos muy variables, capaz de albergar una gran variedad de microorganismos, incluidas las levaduras. Los métodos moleculares son considerados actualmente los métodos de identificación definitivos ya que a diferencia de los anteriores, nos brindan una correcta sensibilidad y especificidad. Sin embargo, existen limitaciones asociadas con la ruptura de las paredes celulares de estas levaduras para liberar el ADN genómico (gADN) necesario para la amplificación. OBJETIVO: El objetivo de este estudio fue comparar el rendimiento de diferentes métodos de extracción de gADN de Candida albicans y Candida dubliniensis, amplificando posteriormente por PCR. Materiales y Método: Se estudiaron 52 aislamientos, 16/52 de Candida albicans y 36/52 de Candida dubliniensis obtenidos de biofilm subgingival de pacientes VIH+ con signos clínicos de enfermedad periodontal. Se evaluaron seis métodos de extracción de gADN y la posterior amplificación se realizó por dos técnicas de PCR. Además en C. albicans se determinó la presencia de alelos para el gen HWP1. RESULTADOS: Las comparaciones de seis métodos son estadísticamente significativas (p<0,001) excepto para C. albicans en dos de ellos. Para C. dubliniensis se observaron diferencias estadísticas en todas las comparaciones. Los métodos comerciales mostraron una mayor eficiencia en la concentración de gADN que los métodos caseros y ambos fueron efectivos en las dos PCR. 10 aislados de C. albicans resultaron positivos para el alelo HWP1-1/HWP1-2, siendo heterocigotos para este alelo. Solo un aislamiento fue homocigoto para el alelo HWP1-1 de tipo salvaje y 5 eran homocigotos para el alelo HWP1-2 nuevo/raro. CONCLUSIONES: Este estudio tiene como objetivo proporcionar estrategias simples y económicas para la identificación fenotípica y confirmación molecular de Candida albicans y Candida dubliniensis para laboratorios de no referencia con baja complejidad y/o bajo presupuesto económico.
Assuntos
Candida albicans , Ecossistema , Humanos , Candida albicans/genética , Argentina , DNA , GenômicaRESUMO
ABSTRACT The oral cavity constitutes a unique ecosystem with highly variable ecological niches that harbor a great variety of microorganisms, including yeasts. Molecular methods are currently considered the gold standard for identifying species, although they involve limitations associated with the disruption of yeast cell walls to release the genomic DNA (gDNA) for amplification. Aim: The aim of this study was to compare the performance of different methods for extracting gDNA from Candida albicans and Candida dubliniensis, subsequently amplifying DNA by PCR. Materials and Method: Fifty-two isolates (16 C. albicans and 36 C. dubliniensis) were obtained from subgingival biofilm of HIV+ patients with clinical signs of periodontal disease. The study evaluated 6 gDNA extraction methods and two PCR amplification methods. Furthermore, the presence of alleles of HWP1 gene was determined in C. albicans. Results: Comparisons of six methods show statistically significant differences (p<0.001) except for C. albicans in two of them. For C. dubliniensis, statistical differences were observed in all comparisons. Commercial methods were more efficient for concentrating gDNA than in-house methods, and both PCRs were effective. Ten heterozygous C. albicans isolates for this allele were positive for the HWP1-1 / HWP1-2 allele, one was homozygous for Wild Type HWP1-1 allele, and 5 were homozygous for novel/rare HWP1-2 allele. Conclusions: This study aims to provide simple, inexpensive strategies for phenotypic identification and molecular confirmation of Candida albicans and Candida dubliniensis for non-reference laboratories with low complexity and/or low budgets.
RESUMEN La cavidad oral constituye un ecosistema único con nichos ecológicos muy variables, capaz de albergar una gran variedad de microorganismos, incluidas las levaduras. Los métodos moleculares son considerados actualmente los métodos de identificación definitivos ya que a diferencia de los anteriores, nos brindan una correcta sensibilidad y especificidad. Sin embargo, existen limitaciones asociadas con la ruptura de las paredes celulares de estas levaduras para liberar el ADN genómico (gADN) necesario para la amplificación. Objetivo: El objetivo de este estudio fue comparar el rendimiento de diferentes métodos de extracción de gADN de Candida albicans y Candida dubliniensis, amplificando posteriormente por PCR. Materiales y Método: Se estudiaron 52 aislamientos, 16/52 de Candida albicans y 36/52 de Candida dubliniensis obtenidos de biofilm subgingival de pacientes VIH+ con signos clínicos de enfermedad periodontal. Se evaluaron seis métodos de extracción de gADN y la posterior amplificación se realizó por dos técnicas de PCR. Además en C. albicans se determinó la presencia de alelos para el gen HWP1. Resultados: Las comparaciones de seis métodos son estadísticamente significativas (p<0,001) excepto para C. albicans en dos de ellos. Para C. dubliniensis se observaron diferencias estadísticas en todas las comparaciones. Los métodos comerciales mostraron una mayor eficiencia en la concentración de gADN que los métodos caseros y ambos fueron efectivos en las dos PCR. 10 aislados de C. albicans resultaron positivos para el alelo HWP1-1/HWP1-2, siendo heterocigotos para este alelo. Solo un aislamiento fue homocigoto para el alelo HWP1-1 de tipo salvaje y 5 eran homocigotos para el alelo HWP1-2 nuevo/raro. Conclusiones: Este estudio tiene como objetivo proporcionar estrategias simples y económicas para la identificación fenotípica y confirmación molecular de Candida albicans y Candida dubliniensis para laboratorios de no referencia con baja complejidad y/o bajo presupuesto económico.
RESUMO
Candida spp. cause fungal infection that affects patients' oral health. This study aimed to evaluate the isolated and synergistic antifungal effect of Rosa centifolia L., Curcuma longa L., Rosmarinus officinalis L., and Punica granatum L. glycolic extracts against Candida albicans, Candida dubliniensis, Candida tropicalis, and Candida krusei planktonic and biofilm forms. The plant extracts were chemically characterized and the main compounds were quantified by high-performance liquid chromatography (HPLC-DAD) analysis. The minimum inhibitory and minimum fungicidal concentrations of the extracts were determined, and antibiofilm activity was evaluated by MTT assay. Data were analyzed by one-way ANOVA and Tukey's tests, and by Kruskal-Wallis and Dunn's tests, considering a significance level of 5%. The main compounds identified in each of the extracts were: p-coumaric acid (2153.22 µg/100 mL) in the rosemary extract, gallotannins (4318.31 µg/100 mL) in the pomegranate extract, quercetin derivatives (3316.50 µg/100 mL) in the extract of white roses, and curcumin (135.09 µg/100 mL) in the turmeric extract. The combination of R. centifolia and C. longa glycolic extracts was effective against C. albicans, C. dubliniensis, and C. tropicalis biofilms over different periods (p < 0.05). The combination of R. officinalis and P. granatum glycolic extracts was effective against C. albicans and C. krusei biofilms after 30 min, and against C. tropicalis after 24 h, with all combinations showing an average reduction of 50% in cell viability (p < 0.05). In conclusion, the combined plant extracts have antifungal and antibiofilm action against Candida spp. in different concentrations and times of action.
Assuntos
Antifúngicos , Glicóis , Humanos , Antifúngicos/química , Candida , Candida albicans , Candida tropicalis , Extratos Vegetais/química , Testes de Sensibilidade Microbiana , BiofilmesRESUMO
Candida spp. resistant to commercially available antifungals are often isolated from patients with oral candidiasis, a situation that points to the need for the development of new therapies. Thus, we evaluated the activity of Fusarium oxysporum-based silver nanoparticles (AgNPs) on Candida spp. isolated from denture stomatitis lesions. Candida isolates were molecularly identified and submitted to susceptibility assays using AgNPs and commercial fungicides. The interference on biofilm formation and the mechanisms of action of AgNPs on Candida spp. were also investigated. Scanning electron microscopy was used to evaluate the morphology of AgNP-treated Candida. Candida albicans was the most frequent species isolated from denture stomatitis cases. All Candida spp. were susceptible to AgNPs at low concentrations, except Candida parapsilosis. AgNPs caused surface damage, cell disruption, and biofilm formation inhibition. The ergosterol supplementation protected C. albicans against the AgNP action. AgNPs are effective against Candida spp. and can be faced as a promising new therapeutic agent against oral candidiasis.
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We examine how a complex transcription network composed of seven 'master' regulators and hundreds of target genes evolved over a span of approximately 70 million years. The network controls biofilm formation in several Candida species, a group of fungi that are present in humans both as constituents of the microbiota and as opportunistic pathogens. Using a variety of approaches, we observed two major types of changes that have occurred in the biofilm network since the four extant species we examined last shared a common ancestor. Master regulator 'substitutions' occurred over relatively long evolutionary times, resulting in different species having overlapping but different sets of master regulators of biofilm formation. Second, massive changes in the connections between the master regulators and their target genes occurred over much shorter timescales. We believe this analysis is the first detailed, empirical description of how a complex transcription network has evolved.
Assuntos
Biofilmes , Candida albicans/fisiologia , Evolução Molecular , Redes Reguladoras de Genes/fisiologia , Candida albicans/genéticaRESUMO
[This corrects the article DOI: 10.3389/fmicb.2019.00357.].
RESUMO
Species from the genus Candida are among the most important human fungal pathogens. Several of them are frequent commensals of the human microbiota but are also able to cause a variety of opportunistic infections, especially when the human host becomes immunocompromised. By far, most of the research to understand the molecular underpinnings of the pathogenesis of these species has focused on Candida albicans, the most virulent member of the genus. However, epidemiological data indicates that related Candida species are also clinically important. Here, we describe the generation of a set of strains and plasmids to genetically modify C. dubliniensis and C. tropicalis, the two pathogenic species most closely related to C. albicans. C. dubliniensis is an ideal model to understand C. albicans pathogenesis since it is the closest species to C. albicans but considerably less virulent. On the other hand, C. tropicalis is ranked among the four most common causes of infections by Candida species. Given that C. dubliniensis and C. tropicalis are obligate diploids with no known conventional sexual cycle, we generated strains that are auxotrophic for at least two amino acids which allows the tandem deletion of both alleles of a gene by complementing the two auxotrophies. The strains were generated in two different genetic backgrounds for each species - one for which the genomic sequence is available and a second clinically important one. In addition, we have adapted plasmids developed to delete genes and epitope/fluorophore tag proteins in C. albicans so that they can be employed in C. tropicalis. The tools generated here allow for efficient genetic modification of C. dubliniensis and C. tropicalis, and thus facilitate the study of the molecular basis of pathogenesis in these medically relevant fungi.
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The purpose of this study was to evaluate the effectiveness of anti-microbial photodynamic therapy (aPDT) mediated by curcumin (Cur) associated with LED light against biofilms of Candida dubliniensis, and further, investigate cellular uptake and drug penetration through the biofilms under confocal laser scanning microscopy (CLSM). Four C. dubliniensis strains were tested: three clinical isolates from HIV-positive patients and one reference strain (CBS 7987). Biofilms were treated with three Cur concentrations (20.0, 30.0, and 40.0 µM). All samples were incubated in the dark for 20 min and exposed to a 5.28 J/cm2 of LED light fluence. Additional samples of each strain were treated either with Cur or LED light only. Control samples had neither Cur nor light. After aPDT, results were read using the XTT salt reduction method. The data were statistically analyzed by two-way ANOVA followed by Games-Howell post-hoc test (α = 0.05). Confocal laser scanning microscopy was used to verify both the uptake of Cur by yeast cells and its penetration through the biofilm. The results showed that aPDT promoted significant reduction on the metabolism of the biofilm-organized cells of C. dubliniensis. Further, while Cur was rapidly taken up by C. dubliniensis cells, a longer time interval was required to allow Cur penetration into biofilm cells. Based on these results, aPDT associating LED and Cur presents promising potential on fungal control of biofilms of C. dubliniensis.
Assuntos
Anti-Infecciosos/farmacologia , Biofilmes/efeitos dos fármacos , Candida/fisiologia , Curcumina/farmacologia , Fotoquimioterapia , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Contagem de Colônia Microbiana , Humanos , Microscopia Confocal , Plâncton/efeitos dos fármacosRESUMO
BACKGROUND: Vulvovaginal candidiasis (VVC) is a vulvovaginitis commonly diagnosed in gynecology care. In recent years, the taxonomy of the most important pathogenic Candida species, such as Candida albicans have undergone significant changes. AIMS: This study examined the prevalence of C. albicans, Candida africana, and Candida dubliniensis in vaginal specimens from 210 pregnant women suffering from vulvovaginitis or having asymptomatic colonization. METHODS: Phenotypic and molecular methods were used for the identification of the species. RESULTS: During the studied period, 55 isolates of Candida or other yeasts were obtained from specimens collected from 52 patients suffering from vulvovaginitis (24.8%). C. albicans was the predominant Candida species in 42 isolates (80.7%), either alone or in combination with other species of the genus (5.7%, n=3). Additionally, nine isolates of C. albicans (50%) were obtained from asymptomatic patients (n=18). C. dubliniensis was the causative agent in 2 (3.8%) cases of VVC, and was also isolated in one asymptomatic patient. Molecular assays were carried out using specific PCR to amplify the ACT1-associated intron sequence of C. dubliniensis. The amplification of the HWP1 gene also correctly identified isolates of the species C. albicans and C. dubliniensis. No C. africana was isolated in this work. Some C. albicans isolates were either homozygous or heterozygous at the HWP1 locus. The distribution of heterozygous and homozygous C. albicans isolates at the HWP1 locus was very similar among patients suffering from VVC and asymptomatic patients (p=0.897). CONCLUSIONS: The presence of C. albicans and C. dubliniensis, and the absence of C. africana in pregnant is noteworthy.
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Candida/isolamento & purificação , Candidíase Vulvovaginal/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Adulto , Argentina/epidemiologia , Doenças Assintomáticas , Candida albicans/isolamento & purificação , Candidíase Vulvovaginal/microbiologia , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Criança , Feminino , Humanos , Imunocompetência , Técnicas de Tipagem Micológica , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Prevalência , Especificidade da Espécie , Vagina/microbiologia , Adulto JovemRESUMO
ABSTRACT INTRODUCTION: This study evaluated the susceptibilities of oral candidiasis-derived Candida albicans, fluconazole-resistant (FR) Candida dubliniensis, and fluconazole-susceptible (FS) C. dubliniensis to synthetic antiseptics [chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), and triclosan (TRC)] and natural compounds (carvacrol, eugenol and thymol). METHODS: Susceptibility tests were performed based on the M27-A3 reference method. The fluconazole-resistant C. dubliniensis strains were obtained after prolonged in vitro exposure to increasing fluconazole concentrations. The geometric mean values for minimum inhibitory concentrations and minimum fungicidal concentrations were compared among the groups. RESULTS: Fluconazole-susceptible C. dubliniensis was more sensitive to CPC and TRC than FR C. dubliniensis and C. albicans were. However, eugenol and thymol were more active against FR C. dubliniensis. The fungicidal activities of CHX and TRC were similar for the three groups, and FR C. dubliniensis and C. albicans had similar sensitivities to CPC. CONCLUSIONS: The resistance of C. dubliniensis to fluconazole affects its sensitivity the synthetic antiseptics and natural compounds that were tested.
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Humanos , Candida/efeitos dos fármacos , Fluconazol/farmacologia , Anti-Infecciosos Locais/farmacologia , Antifúngicos/farmacologia , Timol/farmacologia , Triclosan/farmacologia , Candida/isolamento & purificação , Candida/classificação , Candida albicans/efeitos dos fármacos , Eugenol/farmacologia , Testes de Sensibilidade Microbiana , Cetilpiridínio/farmacologia , Clorexidina/farmacologiaRESUMO
ABSTRACT The aim of this study was to assess a collection of yeasts to verify the presence of Candida dubliniensis among strains isolated from the oral mucosa of AIDS pediatric patients which were initially characterized as Candida albicans by the traditional phenotypic method, as well as to evaluate the main phenotypic methods used in the discrimination between the two species and confirm the identification through genotypic techniques, i.e., DNA sequencing. Twenty-nine samples of C. albicans isolated from this population and kept in a fungi collection were evaluated and re-characterized. In order to differentiate the two species, phenotypic tests (Thermotolerance tests, Chromogenic medium, Staib agar, Tobacco agar, Hypertonic medium) were performed and genotypic techniques using DNA sequencing were employed for confirmation of isolated species. Susceptibility and specificity were calculated for each test. No phenotypic test alone was sufficient to provide definitive identification of C. dubliniensis or C. albicans, as opposed to results of molecular tests. After amplification and sequencing of specific regions of the 29 studied strains, 93.1% of the isolates were identified as C. albicans and 6.9% as C. dubliniensis. The Staib agar assay showed a higher susceptibility (96.3%) in comparison with other phenotypic techniques. Therefore, genotypic methods are indispensable for the conclusive identification and differentiation between these species.
Assuntos
Humanos , Criança , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Candida/genética , Candidíase Bucal/microbiologia , DNA Fúngico/genética , Candida albicans/genética , Candida albicans/isolamento & purificação , Candida/classificação , Candida/isolamento & purificação , Genótipo , Mucosa Bucal/microbiologia , Técnicas de Tipagem Micológica , Fenótipo , Reação em Cadeia da PolimeraseRESUMO
BACKGROUND: Candida endophthalmitis is related to immunosuppression state, intravenous catheters, invasive procedures and parenteral feeding. It is estimated that between 2% and 10% of endophthalmitis are endogenous, within fungal etiology the most frequently isolated microorganism is Candida albicans. The infection by C. dubliniensis is reported in less than 2 % of the cases of infection by Candida at systemic level and few reported cases of endophthalmitis. The clinical presentation is poor vision , vitritis, cottony deposits, chorioretinitis, and necrosis. The confirmatory diagnosis must be made with vitreous culture and the treatment is based on combination of vitrectomy and intravitreal antifungal. CLINICAL CASE: It is reported a case of a patient with enterocutaneous fistula, long hospital stay with parental nutrition that cause endophthalmitis without immunosuppression. CONCLUSIONS: Endogenous endophthalmitis by C. dubliniensis is barely documented in the literature. Candida endophthalmitis should always be considered in patients with risk factors, in order to provide timely diagnosis and appropriate management, yet the prognosis in these patients is poor for function and organ preservation and for life from complications involving these patients from associated pathologies.
Introducción: los casos de endoftalmitis por Candida se relacionan con estados de inmunodepresión, catéteres intravenosos, procedimientos invasivos y alimentación parenteral. Se estima que entre el 2 % y el 10 % de las endoftalmitis son endógenas. Dentro de la etiología fúngica, Candida albicans es el microorganismo más frecuentemente aislado. La infección por C. dubliniensis se reporta en menos del 2 % de los casos de infección por Candida a nivel sistémico y hay pocos casos reportados de endoftalmitis. La presentación clínica consiste en baja visual, vitreítis, depósitos algodonosos, coriorretinitis y necrosis retiniana. El diagnóstico confirmatorio se debe realizar con cultivo vítreo y el tratamiento se basa en la combinación de antifúngicos intravítreos y vitrectomía. Caso clínico: se trata paciente con fistula enterocutánea larga estancia intrahospitalaria con NPT que cursa con endoftalmitis bilateral sin inmunodepresión. Conclusiones: la endoftalmitis por Candida siempre debe tomarse en cuenta en pacientes con factores de riesgo para poder brindar un diagnóstico oportuno y un adecuado manejo. Aun así, el pronóstico en estos pacientes es malo para la función, la conservación del órgano y para la vida debido a las complicaciones por patologías asociadas.
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Candidíase/diagnóstico , Endoftalmite/diagnóstico , Infecções Oculares Fúngicas/diagnóstico , Candidíase/etiologia , Candidíase Cutânea/complicações , Endoftalmite/etiologia , Infecções Oculares Fúngicas/etiologia , Feminino , Dermatoses do Pé/complicações , Humanos , México , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
BACKGROUND: Candida dubliniensis is a germ tube and chlamydoconidia producing Candida species that may be misidentified as Candida albicans. Molecular-based methods are the most reliable techniques for C. albicans and C. dubliniensis differentiation. However, accurate, quick and inexpensive phenotypic tests are needed to be used in low-complexity mycology laboratories. AIMS: To evaluate colony morphotypes on Sabouraud-triphenyltetrazolium agar as a tool for C. dubliniensis and C. albicans differentiation. METHODS: The morphology of 126 C. albicans and C. dubliniensis strains was evaluated and compared with their identification by molecular methods. RESULTS: The method showed 100% sensitivity and specificity when color and the presence or absence of large white mycelial halo was evaluated. CONCLUSIONS: Colony morphotype on Sabouraud-triphenyltetrazolium agar should be considered as a new tool to differentiate C. dubliniensis and C. albicans.
Assuntos
Candida/crescimento & desenvolvimento , Técnicas de Tipagem Micológica , Candida albicans/crescimento & desenvolvimento , Cor , Meios de Cultura , Micélio/ultraestrutura , Oxirredução , Sensibilidade e Especificidade , Especificidade da Espécie , Sais de TetrazólioRESUMO
AIMS: To evaluate the antifungal activity and to analyse the structure-activity relationship of eleven natural phenolic compounds against four Candida species which are resistant to fluconazole. METHODS AND RESULTS: Four different species of Candida isolates were used: Candida albicans, Candida krusei, Candida tropicalis and Candida dubliniensis. The phenolic compound carvacrol showed the highest anti-Candida bioactivity, followed by thymol and isoeugenol. The obtained minimum inhibitory concentration (MIC) values obtained were used in a quantitative structure-activity relationship (QSAR) analysis where the electronic, steric, thermodynamic and topological descriptors served as dependent variables. According to the descriptors obtained in this QSAR study, the antifungal activity of phenols has a first action specific character which is based on their interaction with plasma or mitochondrial membranes. The second action is based on a steric descriptor-the maximal and minimal projection of the area-which could explain the inability of some phenolic compounds to be biotransformed to quinones methylene by Candida species. CONCLUSIONS: According to the descriptors obtained in this QSAR study, the anti-Candida activity of ortho-substituted phenols is due to more than one action mechanism. The anti-Candida activity of phenolic compounds can be predicted by their molecular properties and structural characteristics. SIGNIFICANCE AND IMPACT OF THE STUDY: These results could be employed to predict the anti-Candida activity of new phenolic compounds in the search for new alternatives or complementary therapies to combat against candidiasis.
Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Fluconazol/farmacologia , Fenóis/farmacologia , Antifúngicos/química , Candida/isolamento & purificação , Cimenos , Farmacorresistência Fúngica , Eugenol/análogos & derivados , Eugenol/farmacologia , Humanos , Monoterpenos/farmacologia , Fenóis/química , Relação Quantitativa Estrutura-Atividade , Timol/farmacologiaRESUMO
Introduction Candida dubliniensis, a new species of Candida that has been recovered from several sites in healthy people, has been associated with recurrent episodes of oral candidiasis in AIDS and HIV-positive patients. This species is closely related to C. albicans. The enzymatic activity of C. dubliniensis in response to oxidative stress is of interest for the development of drugs to combat C. dubliniensis. Methods Fluconazole- and amphotericin B-resistant strains were generated as described by Fekete-Forgács et al. (2000). Superoxide dismutase (SOD) and catalase assays were performed as described by McCord and Fridovich (1969) and Aebi (1984), respectively. Results We demonstrated that superoxide dismutase (SOD) and catalase activities were significantly higher (p<0.05) in the fluconazole- and amphotericin B-resistant strains of C. dubliniensis and C. albicans than in the sensitive strains. The catalase and SOD activities were also significantly (p<0.01) higher in the sensitive and resistant C. albicans strains than in the respective C. dubliniensis strains. Conclusions These data suggest that C. albicans is better protected from oxidative stress than C. dubliniensis and that fluconazole, like amphotericin B, can induce oxidative stress in Candida; oxidative stress induces an adaptive response that results in a coordinated increase in catalase and SOD activities. .
Assuntos
Anfotericina B/farmacologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candida/enzimologia , Catalase/metabolismo , Farmacorresistência Fúngica , Fluconazol/farmacologia , Superóxido Dismutase/metabolismo , Candida albicans/efeitos dos fármacos , Candida albicans/enzimologia , Candida/classificação , Testes de Sensibilidade MicrobianaRESUMO
As espécies do gênero Candida são causadoras de diversas infecções fúngicas e, nos últimos anos, tem sido desenvolvidas novas tecnologias para auxiliar nos diagnósticos microbiológicos. Dentre as técnicas está a espectroscopia infravermelha junto com a análise estatística multivariada. O objetivo deste trabalho é comparar dois métodos: estatístico (análise multivariada) e não-estatístico (ajuste de curva), utilizando os espectros infravermelhos de Candida albicans, Candida dubliniensis e Candida parapsilosis para testar o potencial do uso de Análise Estatística Multivariada para discriminação de espectros de micro-organismos. Para isso foram obtidos, utilizando o Spectrum Spotlight 400 da PerkinElmer, 54 espectros infravermelhos, sendo 18 de cada espécie, na faixa de 4000 a 1000 cm-1, com resolução de 4 cm-1, no modo de transmissão, a 20 ºC. A análise dos espectros foi realizada através de três métodos: (1) inspeção visual direta dos espectros; (2) análise estatística multivariada; (3) ajuste de curva para a determinação de estruturas secundárias de proteínas. Na região de 1200 a 1000 cm-1, os espectros apresentam diferenças que podem ser percebidas numa inspeção visual direta. Uma banda próxima de 1070 cm-1 e outra próxima de 1045 cm-1 apresentam intensidades relativas diferentes para os três espectros. Por outro lado, as bandas da amida I, na região de 1710 a 1590 cm-1, apresentam aspectos visuais semelhantes com máximo em 1651 cm-1 para os espectros dos três micro-organismos. Esse fato torna possível submeter a análise estatística multivariada a um teste de sua capacidade de diferenciar três espectros de Candida. A análise estatística multivariada foi aplicada aos 54 espectros para investigar as regiões de 4000 a 1000 cm-1 com exceção da região de 2600 a 2300 cm-1 e de 1710 a 1590 cm-1 que corresponde a das bandas da amida I. A técnica selecionada foi a análise por componentes principais (PCA, Principal Componente Analysis), utilizando os primeiros quatro componentes principais, em conjunto com a técnica hierárquica de análise de agrupamento (HCA, Hierarchical Clustering Analysis) segundo o método de Ward. Foi utilizado para esta análise o software MINITAB 15 e o resultado mostra uma clara discriminação dos espectros dos três micro-organismos nas duas regiões consideradas. Adicionalmente foi obtido o espectro médio de cada micro-organismo nas bandas da amida I na região de 1710 a 1590 cm-1. Os três espectros médios assim obtidos foram analisados pelo método de ajuste de curva que não é estatístico para determinar as estruturas secundárias de proteínas. Para esta análise o software ORIGIN 7.5 foi utilizado e os resultados obtidos mostram estruturas conformacionais diferentes nos três micro-organismos. Esses resultados confirmam a discriminação obtida através da análise estatística multivariada e visual. Pode-se concluir que as análises estatísticas multivariadas baseadas em análise por componentes principais e análise de agrupamento com uso do algoritmo Ward é potencialmente útil para discriminar micro-organismos através de seus espectros infravermelhos. Além disso, as análises mostram que as bandas da amida I dos espectros infravermelhos de Candida albicans, Candida dubliniensis e Candida parapsilosis fornecem um conjunto de dados cuja estrutura de agrupamento é conhecida e que pode ser útil para testar e validar algoritmos estatísticos de análise de agrupamento.
Films of Candida albicans, Candida dubliniensis and Candida parapsilosis were prepared and the infrared spectra of these films were obtained in the region 4000 to 1000 cm-1, with resolution of 4 cm-1, in the transmission mode, at 20 ºC. Fifty four spectra were obtained, 18 of each microorganism, with the PerkinElmer Spotlight 400 FT-IR, which has a microscope attached to a FT-IR spectrophotometer. The spectra were analyzed through three methods: (1) mere visual inspection; (2) multivariate statistical analysis; (3) curve-fitting for determining secondary structures of proteins. In the region 1200 to 1000 cm-1, the spectral bands show differences that can be seen by a mere visual inspection. On the other hand, the amide I bands, in the region 1710 to 1590 cm-1, have the same visual aspect for the three microorganisms. Multivariate statistical analysis was applied to analyze these amide I bands of all the 54 spectra. Principal component analysis (PCA) and techniques of hierarchical cluster analysis (HCA, Hierarchical Clustering Analysis) according to Ward's method were applied using the software MINITAB 15. The results show a clear discrimination of the three microorganisms. The average spectrum of each microorganism was obtained in the amide I band. Each average spectrum was analyzed by curve-fitting for the determination of secondary structures of proteins. The software used was the ORIGIN 7.5 and the results confirm the discrimination obtained through multivariate statistical analysis. This result shows that multivariate statistical analysis can be useful to discriminate infrared spectra of different microorganisms. Furthermore, this work shows that the amide I bands of the infrared spectra of Candida albicans, Candida dubliniensis, and Candida parapsilosis provide a set of data of known group structure that can be useful to test statistical algorithms of cluster analysis.
RESUMO
Candida dubliniensis is an emerging pathogen capable of causing superficial as well as systemic infections. Due to its close similarity to C. albcians, conventional methods based on phenotypic traits are not always reliable in identification of C. dubliniensis. In this study, we developed a PCR-restriction fragment length polymorphism (RFLP) assay to identify and discriminate between the two closely related species. The D1/D2 region of 28S rDNA was amplified by PCR and enzymatically digested by ApaI and BsiEI respectively. PCR products of both species were digested into two fragments by ApaI, but those of other yeast species were undigested. BsiEI cut the PCR products of C. albicans into two fragments but not those of C. dubliniensis. Thus two species were differentiated. We evaluated 10 reference strains representing 10 yeast species, among which C. albicans and C. dubliniensis were successfully identified. A total of 56 phenotypically characterized clinical isolates (42 C. albicans isolates and 14 C. dubliniensis isolates) were also investigated for intra-species variability. All tested isolates produced identical RFLP patterns to their respective reference strains except one initially misidentified isolate. Our method offers a simple, rapid and reliable molecular method for the identification of C. albicans and C. dubliniensis.
Assuntos
Humanos , Candidíase , Candida albicans/genética , Candida albicans/isolamento & purificação , Fenótipo , Polimorfismo Genético , Reação em Cadeia da Polimerase/métodos , Métodos , Pacientes , VirulênciaRESUMO
Candida dubliniensis is an emerging pathogen capable of causing superficial as well as systemic infections. Due to its close similarity to C. albcians, conventional methods based on phenotypic traits are not always reliable in identification of C. dubliniensis. In this study, we developed a PCR-restriction fragment length polymorphism (RFLP) assay to identify and discriminate between the two closely related species. The D1/D2 region of 28S rDNA was amplified by PCR and enzymatically digested by ApaI and BsiEI respectively. PCR products of both species were digested into two fragments by ApaI, but those of other yeast species were undigested. BsiEI cut the PCR products of C. albicans into two fragments but not those of C. dubliniensis. Thus two species were differentiated. We evaluated 10 reference strains representing 10 yeast species, among which C. albicans and C. dubliniensis were successfully identified. A total of 56 phenotypically characterized clinical isolates (42 C. albicans isolates and 14 C. dubliniensis isolates) were also investigated for intra-species variability. All tested isolates produced identical RFLP patterns to their respective reference strains except one initially misidentified isolate. Our method offers a simple, rapid and reliable molecular method for the identification of C. albicans and C. dubliniensis.