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Modi D, Dessureault S, Greene J. Diagnosis and Treatment Challenges of Candida guilliermondii in Immunocompromised Patients: A Case Study in a Neutropenic AML Patient. Case Rep Infect Dis 2024; 2024:7806235. [PMID: 39077031 PMCID: PMC11286315 DOI: 10.1155/2024/7806235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 07/31/2024] Open
Abstract
Although fungal infections causing intestinal perforation and necrosis are rare, they can be particularly dangerous in immunosuppressed patients, often leading to increased mortality rates and poor prognoses. Candida species are typically surface fungi, but in patients with compromised immune systems, they can invade the small intestine and cause angioinvasive infections. A case study involving a 30-year-old female with acute myeloid leukemia (AML) illustrates this phenomenon. The patient was presented with symptoms of abdominal pain, fever, diarrhea, recurrent episodes of intestinal necrosis, hematomas due to thrombocytopenia, and subsequent postoperative enterocutaneous fistulas. Extensive testing ruled out other possible causes of intestinal necrosis and enteritis, including Crohn's and CMV diseases. Candida guilliermondi was ultimately identified in blood cultures from the periphery, peritoneal fluid, and intestinal biopsy of respected sections, indicating that it was responsible for intestinal invasion and necrosis. The patient was then treated with amphotericin B, cefepime, and metronidazole. This case highlights the potential severity of fungal infections in immunosuppressed patients, particularly Candida species, and the importance of prompt diagnosis and appropriate treatment.
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Affiliation(s)
- Dhruvi Modi
- Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India
| | - Sophie Dessureault
- GI Tumor ProgramMoffitt Cancer Centerand Department of Oncologic SciencesUniversity of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - John Greene
- Division of Infectious Diseases and Tropical MedicineInternal Medicine Department at Moffitt Cancer Center, Tampa, Florida, USA
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Glushakova A, Kachalkin A, Rodionova E. The role of fruits as reservoirs for resistant and virulent strains of opportunistic yeasts. World J Microbiol Biotechnol 2023; 39:313. [PMID: 37733093 DOI: 10.1007/s11274-023-03758-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023]
Abstract
Strains of the Candida parapsilosis and Meyerozyma guilliermondii species complexes isolated from the internal tissues of 26 fruit species from 21 countries were evaluated for their susceptibility to conventional antifungal compounds (fluconazole, voriconazole, amphotericin B) and hydrolytic activity. A total of 144 strains were studied. Resistance to at least one of the antifungal compounds tested was found in 26.4% of the endophytic strains examined. Most of the strains were insensitive to fluconazole. Multiresistance was detected only in two strains of C. parapsilosis sensu stricto from tropical apples. Phospholipase production and proteolytic and hemolytic activities were significantly higher in endophytes from tropical fruits. Resistant and virulent strains of opportunistic yeasts can thus spread worldwide via purchased fruit, which can harm people with a weakened immune status and children whose immune systems are not yet fully developed.
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Affiliation(s)
- Anna Glushakova
- Soil Science Faculty, Lomonosov Moscow State University, 119991, Moscow, Russia.
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia.
| | - Aleksey Kachalkin
- Soil Science Faculty, Lomonosov Moscow State University, 119991, Moscow, Russia
- G.K. Skryabin Institute of Biochemistry and Physiology of Microorganisms of RAS, Pushchino, 142290, Russia
| | - Evgenia Rodionova
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia
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Tolaj I, Gashi V, Bunjaku G, Mehmeti M, Fejza H. Facial Cellulitis Caused by Candida Guilliermondi in an Immunocompetent Patient: A Rare Case Report. Eur J Case Rep Intern Med 2023; 10:003883. [PMID: 37305001 PMCID: PMC10253253 DOI: 10.12890/2023_003883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 06/13/2023] Open
Abstract
Background Candida cellulitis is a rare disease, primarily reported in immunocompromised patients. Atypical Candida spp. infections are increasing, largely due to the growing number of immunocompromised patients. This case report describes a 52-year-old immunocompetent patient with facial cellulitis caused by Candida guilliermondi. Candida guilliermondi has not previously been reported as a cause of facial cellulitis in either immunocompromised or immunocompetent patients. Case presentation A 52-year-old, otherwise healthy, male patient presented with facial cellulitis that did not respond to intravenous antibiotics. Culture of the drained pus revealed Candida guilliermondi. The patient was successfully treated with intravenous fluconazole. Conclusion This case highlights the possibility of atypical Candida spp. causing deep facial infections in immunocompetent patients. Candida guilliermondi has not been previously reported as a cause of facial cellulitis in either immunocompromised or immunocompetent patients. Healthcare providers should consider atypical Candida spp. infections in the differential diagnosis of deep facial infections in both immunocompromised and immunocompetent patients. LEARNING POINTS Candida guilliermondi can cause facial cellulitis in immunocompetent patients. This has not been previously reported.Atypical Candida spp. infections should be considered in the differential diagnosis of deep facial infections in both immunocompromised and immunocompetent patients.Healthcare providers should be aware of the increasing incidence of non-Candida albicans Candida species infections, especially in immunocompromised patients.
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Affiliation(s)
- Ilir Tolaj
- Department of Infectious Diseases, Medical Faculty, University of Pristina, Pristina, Kosovo
| | - Visar Gashi
- University Clinical Center, Infectious Disease Department, Pristina, Kosovo
| | - Gramoz Bunjaku
- University Clinical Center, Infectious Disease Department, Pristina, Kosovo
| | - Murat Mehmeti
- University Clinical Center, Infectious Disease Department, Pristina, Kosovo
| | - Hajrullah Fejza
- UBT, University for Business and Technology, Pristina, Kosovo
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Babamahmoodi F, Rezai MS, Ahangarkani F, Mohammadi Kali A, Alizadeh-Navaei R, Alishahi A, Najafi N, Haddadi A, Davoudi A, Azargon L, Daftarian Z, Kordi S, Abbasi K. Multiple Candida strains causing oral infection in COVID-19 patients under corticosteroids and antibiotic therapy: An observational study. Front Cell Infect Microbiol 2022; 12:1103226. [PMID: 36619762 PMCID: PMC9816329 DOI: 10.3389/fcimb.2022.1103226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction The occurrence of oral candidiasis (OC) is expected in patients with COVID-19, especially those with moderate to severe forms of infection who are hospitalized and may be on long-term use of broad-spectrum antibiotics or prolonged corticosteroid therapy. We aimed to characterize clinical conditions, the prevalence profile of Candida species, and outcomes of COVID-19 patients with OC. Methods In this observational study, oral samples were obtained from COVID-19 patients suspected of OC admitted to Razi teaching hospital. Patients with OC were monitored daily until discharge from the hospital. Species identification was performed by a two-step multiplex assay named YEAST PLEX, which identifies 17 clinically important uncommon to common yeast strains. Results Among the 4133 patients admitted with COVID-19, 120 (2.90%) suffered from OC. The onset of signs and symptoms of OC in patients was, on average (2.92 ± 3.596 days) with a range (of 1-29 days). The most common OC presentation was white or yellow macules on the buccal surface or the tongue. In (39.16%) of patients suffering from OC multiple Candida strains (with two or more Candida spp.) were identified. The most common Candida species were C. albicans (60.57%), followed by C. glabrata (17.14%), C. tropicalis (11.42%), C. kefyr (10.83%) and C. krusei (3.42%). Notably, OC caused by multiple Candida strains was more predominant in patients under corticosteroid therapy (P <0.0001), broad-spectrum antibiotics therapy (P = 0.028), and those who used nasal corticosteroid spray (P <0.0001). The majority of patients who recovered from OC at the time of discharge were patients with OC by single Candida species (P = 0.049). Discussion Use of corticosteroids and antimicrobial therapy in COVID-19 patients increases risk of OC by multiple Candida strains.
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Affiliation(s)
- Farhang Babamahmoodi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Sadegh Rezai
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Ahangarkani
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran,*Correspondence: Fatemeh Ahangarkani,
| | - Ali Mohammadi Kali
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alishahi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran,Research Committee, Mazandaran University of Medical Sciences, Sari, Iran,Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Narges Najafi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Azam Haddadi
- Department of Endodontics, Faculty of Dentistry, Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Davoudi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Leila Azargon
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Daftarian
- Northbay Medical Center, Vacaville Center for Primary Care, Vacaville, CA, United States
| | - Shirafkan Kordi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kiana Abbasi
- Department of Microbiology, Zanjan Branch, Islamic Azad University, Zanjan, Iran
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Pinto TN, Kohn A, da Costa GL, Oliveira LMA, Pinto TCA, Oliveira MME. Candida guilliermondii as an agent of postpartum subacute mastitis in Rio de Janeiro, Brazil: Case report. Front Microbiol 2022; 13:964685. [PMID: 36212821 PMCID: PMC9537450 DOI: 10.3389/fmicb.2022.964685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
Candida spp. can cause mild-to-severe human infections. Certain species have been described as the etiologic agent of human mastitis, inflammation of the breast tissue. Mastitis affects millions of lactating women and can be a source of disease transmission to the infant. In this work, we report the detection of the unusual etiologic agent of human mastitis, Candida guilliermondii, isolated from the milk of a puerperal woman with subacute mastitis in Rio de Janeiro, Brazil. Species identification was performed by MALDI-TOF MS and genetic sequencing. The patient had a full recovery after antifungal therapy.
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Affiliation(s)
- Tatiane Nobre Pinto
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alana Kohn
- Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Laura M. A. Oliveira
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tatiana C. A. Pinto
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Manoel M. E. Oliveira
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- *Correspondence: Manoel M. E. Oliveira, ;
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Willaert RG, Kayacan Y, Devreese B. The Flo Adhesin Family. Pathogens 2021; 10:pathogens10111397. [PMID: 34832553 PMCID: PMC8621652 DOI: 10.3390/pathogens10111397] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 12/14/2022] Open
Abstract
The first step in the infection of fungal pathogens in humans is the adhesion of the pathogen to host tissue cells or abiotic surfaces such as catheters and implants. One of the main players involved in this are the expressed cell wall adhesins. Here, we review the Flo adhesin family and their involvement in the adhesion of these yeasts during human infections. Firstly, we redefined the Flo adhesin family based on the domain architectures that are present in the Flo adhesins and their functions, and set up a new classification of Flo adhesins. Next, the structure, function, and adhesion mechanisms of the Flo adhesins whose structure has been solved are discussed in detail. Finally, we identified from Pfam database datamining yeasts that could express Flo adhesins and are encountered in human infections and their adhesin architectures. These yeasts are discussed in relation to their adhesion characteristics and involvement in infections.
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Affiliation(s)
- Ronnie G. Willaert
- Research Group Structural Biology Brussels (SBB), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium;
- Alliance Research Group VUB-UGent NanoMicrobiology (NAMI), 1050 Brussels, Belgium;
- International Joint Research Group VUB-EPFL NanoBiotechnology & NanoMedicine (NANO), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Correspondence: ; Tel.: +32-2629-1846
| | - Yeseren Kayacan
- Research Group Structural Biology Brussels (SBB), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium;
- Alliance Research Group VUB-UGent NanoMicrobiology (NAMI), 1050 Brussels, Belgium;
- International Joint Research Group VUB-EPFL NanoBiotechnology & NanoMedicine (NANO), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
| | - Bart Devreese
- Alliance Research Group VUB-UGent NanoMicrobiology (NAMI), 1050 Brussels, Belgium;
- International Joint Research Group VUB-EPFL NanoBiotechnology & NanoMedicine (NANO), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
- Laboratory for Microbiology, Gent University (UGent), 9000 Gent, Belgium
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Merad Y, Derrar H, Tabouri S, Berexi-Reguig F. Candida guilliermondii Onychomycosis Involving Fingernails in a Breast Cancer Patient under Docetaxel Chemotherapy. Case Rep Oncol 2021; 14:1530-1535. [PMID: 34899247 PMCID: PMC8613606 DOI: 10.1159/000519695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 11/19/2022] Open
Abstract
Onychomycosis has been shown to have a higher incidence in cancer patients. Nail toxicity is a quite common side effect of anticancer agents. Taxotere© is a chemotherapeutic known to cause great incidence of nail change and has a role in subungual suppuration. We report on a 52-year-old woman with breast cancer admitted in our institution for onycholysis. Because of the stage and histology of breast cancer, neoadjuvant chemotherapy was initiated. The patient received 8 cycles of Taxotere and Adriamycin (AT), and she underwent a modified radical mastectomy. Three months later, the patient developed evidence of onycholysis, involving all the fingernails. We observed the following changes in nails of all the digits in both hands: onycholysis, dystrophy, oedema, and exudate. Nail scraping and purulent discharge were collected and cultured on Sabouraud medium. Physical features of the colonies and biochemical tests (Auxacolor©) revealed Candida guilliermondii as the sole etiologic agent of onychomycosis. This case details an onycholysis in a breast cancer case successfully managed solely with amorolfine lacquer. This clinical and mycological presentation should alert the clinician to the possibility of onychomycosis induced by docetaxel chemotherapy.
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Affiliation(s)
- Yassine Merad
- Department of Parasitology-Mycology, Central Laboratory, Hassani “Abdelkader University Hospital,”, Sidi Bel Abbès, Algeria
- Laboratoire de Synthèse de l'Information Environnementale, Université de Lille, Lille, France
| | - Hichem Derrar
- Department of Pulmonary and Lung Diseases, Sidi Bel Abbès, Algeria
| | - Sarah Tabouri
- Departement of Oncology, Centre Anti Cancer, Sidi Bel Abbès, Algeria
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Clinical Characteristics and Outcomes of Candidemia Caused by Meyerozyma guilliermondii Complex in Cancer Patients Undergoing Surgery. Mycopathologia 2020; 185:975-982. [PMID: 32989583 DOI: 10.1007/s11046-020-00485-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/12/2020] [Indexed: 01/05/2023]
Abstract
Although Meyerozyma guilliermondii complex is an uncommon cause of invasive candidiasis worldwide, reported cases, mainly regarding bloodstream infections, increased over years, and patients with cancer who have undergone recent surgery are most commonly affected. However, the clinical characteristics and outcomes of candidemia caused by M. guilliermondii complex remain poorly understood. A retrospective case-control study was conducted to evaluate the clinical characteristics and mortality of candidemia caused by M. guilliermondii complex in cancer patients undergoing surgery. Demographic and clinical data were collected from the hospital medical records system with a standardized data collection form and were analyzed with SPSS 20.0. Sixty-six cancer patients who have undergone recent surgery and were diagnosed with candidemia caused by M. guilliermondii complex were included in the study. Regarding the clinical manifestations, most patients' body temperatures ranged from 38 to 40 °C, with a median fever duration of 4 (IQR: 3-6) days. Multivariate analysis indicated that the presence of central venous catheter (OR: 6.68; 95% CI 2.80-15.94) and gastric tube (OR: 3.55; 95% CI 1.22-10.34) were independent risk factors for M. guilliermondii complex fungemia. The 30-day crude mortality of candidemia caused by M. guilliermondii complex was 12.1%, twice that of the control group. Moreover, increased WBC count, age ≥ 60 years, septic shock, and ICU admission were identified as predictors of mortality through univariate analysis. These findings will provide a foundation for the clinical management of candidemia caused by M. guilliermondii complex in post-surgical cancer patients.
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