Esta especie se puede manejar en un laboratorio que cumpla las normas de biocontención del nivel 2. Objectives: To isolate, identify, and determine the prevalence of Candida and other yeasts of clinical importance in Aseer region, Saudi Arabia. Methods: This is a cross-sectional study involving retrospective analysis of 6100 samples submitted to the Microbiology Laboratory, Aseer Central Hospital, Abha, Saudi Arabia between 2011 and 2012, and prospective isolation and identification of 84 isolates recovered from various clinical specimens presented to the Microbiology Laboratory between 2012 and 2013 using the classic morphological schemes and the Vitek 2 automated system. Conclusions: Along with the commonly encountered Candida albicans, Candida parapsilosis, Candida tropicalis, and Candida lusitaniae were detected with significant rates. Fungal diseases notably those due to candida have become an increasing risk to human health.
The VITEK 2 device handled card automatically from filling, sealing then transferring them into the connected incubator (35°C). Figure 1 - Growth of Candida albicans on sabouraud dextrose agar A) Colonies with white to cream colored, smooth, glabrous, and yeast-like in appearance. Discussion.Candida is an important opportunistic fungus, once barriers are broken down, infection and dissemination may occur with fatal consequences. The limitations of this study are represented by the fact that neither risk factors nor the in vitro sensitivity profiles of the isolates have been determined. The present study showed the implication of yeasts notably Candida in causing clinical diseases in different body systems especially the urinary tract. From the Department of Microbiology (Hamid, Joseph, Abdelrahim, Fadul, Al-Hakami), College of Medicine, King Khalid University and the Microbiology Laboratory (Assiry, Haimour, Al-Abed), Aseer Central Hospital, Abha, Kingdom of Saudi Arabia. Saudi Medical Journal is copyright under the Berne Convention and the International Copyright Convention. Candida parapsilosis es mas resistente a la caspofungina, micafungina y anidulafungina pero no las otras dos especies del grupo. Candida parapsilosis: a review of its epidemiology, clinical aspects, typing and antimicrobial susceptibility.
Many other Candida species and some other pathogenic yeasts have been detected for the first time in the region. This research was approved by the Research Ethics Committee, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Fungal cultures were carried out on sabouraud dextrose agar (SDA) and Brain Heart Infusion Agar + 5% sheep blood (BHIA) plates. Eighty-one of the totally isolated 84 yeasts were successfully identified using the Vitek 2 system.
B) Microscopic appearance of Candida albicans showing spherical to subspherical budding yeast-like cells or blastoconidia (Safranin stain x 100). The clinical signs and symptoms are nonspecific, and the routine laboratory methods are insufficient.
However, in the retrospective study, the isolation of 143 Candida species was successful, but obviously our routine microscopic and colony morphology characterization practice were not sufficient to reveal species names other than C.
Future microbiological screening studies should consider these yeasts, the need for their early diagnosis, and determining their in vitro antimicrobial sensitivities to facilitate correct treatment.
Dannaoui E, Desnos-Ollivier M, Garcia-Hermoso D, Grenouillet F, Cassaing S, Baixench MT, et al. Antibiotics exposure, risk factors, and outcomes with Candida albicans and non-Candida albicans candidemia. Effectiveness of a 20% Miswak extract against a mixture of Candida albicans and Enterococcus faecalis. On the contrary, Candida infections manifest in a variety of forms ranging from superficial skin conditions, onychomycosis, oral, vaginal infections to fatal invasive illnesses that involve vital body organs such as heart, lungs, and central nervous system.1,2 Candidiasis, notably candidemia continues to be a major cause of morbidity and mortality in the health care settings. Inoculated plates were incubated at 30°C and examined daily for up to 10 days for yeast growth. The VITEK 2 automated system was used for confirming identities of Candida species following protocols described by the manufacturer (bioMerieux Inc., Durham, NC 27712, USA).
Yeasts were tentatively recognized on the basis of their morphologies, which are: colonies with white to cream colored, smooth, glabrous, and yeast-like in appearance (Figure 1A). This insufficiency is at least true when it comes to identifying the unknown “species level”. When data collected from Aseer Central hospital (2011-2012) was compared with the study from India17 with the same period, we observed that there are some variations. Clinicians are informed to consider empiric treatment in risk groups notably among those with the prolonged antibiotic (bacterial) therapy, frequent surgical interventions, frequent instrumentation, the immune-compromised patients, and the extensive use of intensive care facilities.1,6 In all these patients at risk, cultures should be rationally performed. Epidemiology, management, and risk factors for death of invasive Candida infections in critical care: a multicenter, prospective, observational study in France (2005-2006). Risk factors for invasive fungal disease in critically ill adult patients: a systematic review.
Epidemiology and outcomes of candidemia in 2019 patients: data from the prospective antifungal therapy alliance registry. Epidemiology and management of Candidaemia: a retrospective, multicentre study in five hospitals in the UK. Rate, risk factors and outcomes of catheter-related bloodstream infection in a paediatric intensive care unit in Saudi Arabia. Prevalence and antimicrobial resistance of health care associated bloodstream infections at a general hospital in Saudi Arabia. The epidemiology of Candida colonization and invasive candidiasis in a surgical intensive care unit where fluconazole prophylaxis is utilized: follow-up to a randomized clinical trial. Epidemiology of Candida blood stream infections: experience of a tertiary care centre in North India.
Distribution and epidemiology of Candida species causing fungemia at a Saudi Arabian hospital, 1996-2004.
Candida species bloodstream infection: epidemiology and outcome in a single institution from 1991 to 2008. Hamid, Department of Microbiology, College of Medicine, King Khalid University, PO Box 641, Abha, Kingdom of Saudi Arabia. Saudi Medical Journal is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC).
Moreover, the epidemiology of Candida infection is changing.4,5 Candida species are frequently encountered as part of the human commensal flora. Microscopically, they exhibit spherical to subspherical large yeast-like cells with budding, blastoconidia, and pseudohyphae, or both (Figure 1B). This deficiency has been averted when the Vitek 2 identification system was applied in the prospective analysis of the 84 samples. Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work. Colonization mostly paves the way to candidemia and is considered an independent risk factor for the development of candidemia.1,4 The frequency of nosocomial bloodstream infections by Candida species has risen dramatically in the past 2 decades. Of these, 20 are carbohydrate assimilation; 4 are phosphatase, urea, nitrate, and actidione tests.
This, in most of the known yeast with clear cut profile, led to a correct identification of the unknown yeast.
The latter enabled us to uncover many species of the genus Candida and other yeasts as well. It has been found that more than two-thirds of patients with invasive candidiasis in ICUs have candidemia.
When a test result is recorded as “low discrimination,” this means that the result is doubtful. Of these isolates, the non-albicans Candida species constituted about half of the isolates and death from these invasive ICU infections was notable.1 There is a lack of sufficient literature showing in a systematic way, the incidence of fungal infections in the Kingdom of Saudi Arabia. In such cases, supplementary tests were carried out manually to resolve such uncertain findings. These supplementary tests were: microscopic detection of blastospores or arthrospores, apiculated cells, capsule, carotenoid pigment, convoluted colony, hyphae or pseudohyphae, sporangia, growth at 37°C, and growth without oil. Out of the 6100 various clinical specimens, 143 (2.35%) revealed the presence of Candida spp.
Secondly, a prospective analysis was undertaken, which included the isolation and identification of strains presented to the laboratory from October 2012 to November 2013. This was carried out using initial phenotypic identification based on morphological and culture characteristics8 followed by confirmation using the Vitek 2 automated system. Samples included in this study were the ones with complete clinical records, requests from the relevant wards, and samples that met the criteria of submission. Acknowledgment.The authors would like to thank the staff of Aseer Central Hospital and College of Medicine, King Khalid University for facilitating the completion of this study.
The VITEK 2 device handled card automatically from filling, sealing then transferring them into the connected incubator (35°C). Figure 1 - Growth of Candida albicans on sabouraud dextrose agar A) Colonies with white to cream colored, smooth, glabrous, and yeast-like in appearance. Discussion.Candida is an important opportunistic fungus, once barriers are broken down, infection and dissemination may occur with fatal consequences. The limitations of this study are represented by the fact that neither risk factors nor the in vitro sensitivity profiles of the isolates have been determined. The present study showed the implication of yeasts notably Candida in causing clinical diseases in different body systems especially the urinary tract. From the Department of Microbiology (Hamid, Joseph, Abdelrahim, Fadul, Al-Hakami), College of Medicine, King Khalid University and the Microbiology Laboratory (Assiry, Haimour, Al-Abed), Aseer Central Hospital, Abha, Kingdom of Saudi Arabia. Saudi Medical Journal is copyright under the Berne Convention and the International Copyright Convention. Candida parapsilosis es mas resistente a la caspofungina, micafungina y anidulafungina pero no las otras dos especies del grupo. Candida parapsilosis: a review of its epidemiology, clinical aspects, typing and antimicrobial susceptibility.
Many other Candida species and some other pathogenic yeasts have been detected for the first time in the region. This research was approved by the Research Ethics Committee, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Fungal cultures were carried out on sabouraud dextrose agar (SDA) and Brain Heart Infusion Agar + 5% sheep blood (BHIA) plates. Eighty-one of the totally isolated 84 yeasts were successfully identified using the Vitek 2 system.
B) Microscopic appearance of Candida albicans showing spherical to subspherical budding yeast-like cells or blastoconidia (Safranin stain x 100). The clinical signs and symptoms are nonspecific, and the routine laboratory methods are insufficient.
However, in the retrospective study, the isolation of 143 Candida species was successful, but obviously our routine microscopic and colony morphology characterization practice were not sufficient to reveal species names other than C.
Future microbiological screening studies should consider these yeasts, the need for their early diagnosis, and determining their in vitro antimicrobial sensitivities to facilitate correct treatment.
Dannaoui E, Desnos-Ollivier M, Garcia-Hermoso D, Grenouillet F, Cassaing S, Baixench MT, et al. Antibiotics exposure, risk factors, and outcomes with Candida albicans and non-Candida albicans candidemia. Effectiveness of a 20% Miswak extract against a mixture of Candida albicans and Enterococcus faecalis. On the contrary, Candida infections manifest in a variety of forms ranging from superficial skin conditions, onychomycosis, oral, vaginal infections to fatal invasive illnesses that involve vital body organs such as heart, lungs, and central nervous system.1,2 Candidiasis, notably candidemia continues to be a major cause of morbidity and mortality in the health care settings. Inoculated plates were incubated at 30°C and examined daily for up to 10 days for yeast growth. The VITEK 2 automated system was used for confirming identities of Candida species following protocols described by the manufacturer (bioMerieux Inc., Durham, NC 27712, USA).
Yeasts were tentatively recognized on the basis of their morphologies, which are: colonies with white to cream colored, smooth, glabrous, and yeast-like in appearance (Figure 1A). This insufficiency is at least true when it comes to identifying the unknown “species level”. When data collected from Aseer Central hospital (2011-2012) was compared with the study from India17 with the same period, we observed that there are some variations. Clinicians are informed to consider empiric treatment in risk groups notably among those with the prolonged antibiotic (bacterial) therapy, frequent surgical interventions, frequent instrumentation, the immune-compromised patients, and the extensive use of intensive care facilities.1,6 In all these patients at risk, cultures should be rationally performed. Epidemiology, management, and risk factors for death of invasive Candida infections in critical care: a multicenter, prospective, observational study in France (2005-2006). Risk factors for invasive fungal disease in critically ill adult patients: a systematic review.
Epidemiology and outcomes of candidemia in 2019 patients: data from the prospective antifungal therapy alliance registry. Epidemiology and management of Candidaemia: a retrospective, multicentre study in five hospitals in the UK. Rate, risk factors and outcomes of catheter-related bloodstream infection in a paediatric intensive care unit in Saudi Arabia. Prevalence and antimicrobial resistance of health care associated bloodstream infections at a general hospital in Saudi Arabia. The epidemiology of Candida colonization and invasive candidiasis in a surgical intensive care unit where fluconazole prophylaxis is utilized: follow-up to a randomized clinical trial. Epidemiology of Candida blood stream infections: experience of a tertiary care centre in North India.
Distribution and epidemiology of Candida species causing fungemia at a Saudi Arabian hospital, 1996-2004.
Candida species bloodstream infection: epidemiology and outcome in a single institution from 1991 to 2008. Hamid, Department of Microbiology, College of Medicine, King Khalid University, PO Box 641, Abha, Kingdom of Saudi Arabia. Saudi Medical Journal is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC).
Moreover, the epidemiology of Candida infection is changing.4,5 Candida species are frequently encountered as part of the human commensal flora. Microscopically, they exhibit spherical to subspherical large yeast-like cells with budding, blastoconidia, and pseudohyphae, or both (Figure 1B). This deficiency has been averted when the Vitek 2 identification system was applied in the prospective analysis of the 84 samples. Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work. Colonization mostly paves the way to candidemia and is considered an independent risk factor for the development of candidemia.1,4 The frequency of nosocomial bloodstream infections by Candida species has risen dramatically in the past 2 decades. Of these, 20 are carbohydrate assimilation; 4 are phosphatase, urea, nitrate, and actidione tests.
This, in most of the known yeast with clear cut profile, led to a correct identification of the unknown yeast.
The latter enabled us to uncover many species of the genus Candida and other yeasts as well. It has been found that more than two-thirds of patients with invasive candidiasis in ICUs have candidemia.
When a test result is recorded as “low discrimination,” this means that the result is doubtful. Of these isolates, the non-albicans Candida species constituted about half of the isolates and death from these invasive ICU infections was notable.1 There is a lack of sufficient literature showing in a systematic way, the incidence of fungal infections in the Kingdom of Saudi Arabia. In such cases, supplementary tests were carried out manually to resolve such uncertain findings. These supplementary tests were: microscopic detection of blastospores or arthrospores, apiculated cells, capsule, carotenoid pigment, convoluted colony, hyphae or pseudohyphae, sporangia, growth at 37°C, and growth without oil. Out of the 6100 various clinical specimens, 143 (2.35%) revealed the presence of Candida spp.
Secondly, a prospective analysis was undertaken, which included the isolation and identification of strains presented to the laboratory from October 2012 to November 2013. This was carried out using initial phenotypic identification based on morphological and culture characteristics8 followed by confirmation using the Vitek 2 automated system. Samples included in this study were the ones with complete clinical records, requests from the relevant wards, and samples that met the criteria of submission. Acknowledgment.The authors would like to thank the staff of Aseer Central Hospital and College of Medicine, King Khalid University for facilitating the completion of this study.
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