1.A clinical analysis of 27 patients with candidemia.
Hyoung Shik SHIN ; Kyong Ran PECK ; Hyun Ju PAE ; Mun Hyun JUNG ; Myoung Don OH ; Kang Won CHOE
Korean Journal of Infectious Diseases 1991;23(4):257-263
No abstract available.
Candidemia*
;
Humans
2.Budding Yeast Cells in Peripheral Blood Smear: Clue to Candidemia.
Sung Yeon CHO ; Hyojin CHAE ; Myungshin KIM ; Dong Gun LEE ; Hee Je KIM
Infection and Chemotherapy 2016;48(4):342-343
No abstract available.
Candidemia*
;
Saccharomycetales*
3.Risk factors for candidemia in the neonatal intensive care unit of the Philippines General Hospital from October 2003 to August 2006: A case-control study
Novette Regina M. Morales-Lagunzad ; Jacinto Blas V. Mantaring
Pediatric Infectious Disease Society of the Philippines Journal 2010;11(1):44-50
Candidemia is a major cause of nosocomial morbidity and mortality in neonates. Prompt diagnosis and treatment is crucial. Risk factor analyses have been conducted worldwide, but limited local data are available. This study was conducted to help pediatricians practicing locally decide when to suspect if a neonate has candidemia; therefore, helping them in the judicious use of empirical antifungal therapy.
Objective: To determine if there was a difference in the risk factors among neonates with candidemia and those without it, who were admitted at the Neonatal Intensive Care Unit of the Philippine General Hospital from October 2003 to August 2006. Methods: Neonates admitted within the mentioned period, surviving at least on the third day of life, and had at least one blood culture on or after day 3 of life were included in the study. A retrospective review of records was performed to identify the presence or absence of known risk factors for candidemia. The outcome of interest was the presence of candidemia. Each variable was analyzed initially using the bivariate analysis chi-square. Cut-off value for inclusion into multivariate analysis was p<0.25. Multivariate analysis, through backward elimination, was done to narrow down independent variables (p value for retention <0.25).
Results: One hundred thirty-eight neonates (69 cases and 69 controls) were included. Based on bivariate analysis, patients exhibiting the following characteristics showed increased risk for candidemia: birth weights of 1250 to 1499g (OR: 3.24; 95% CI: 1.04-10.07) and 1500 to 2449g (OR: 3.84; 95% CI 1.31-11.27); pediatric aging < 28 weeks (OR: 1.42; 95% CI: 1.07-8.5) and 28 to 32 weeks (OR: 1.89; 95% CI: 0.74-4.84); central vascular access (OR: 0.52; 95% CI: 0.26-1.03); prolonged broad-spectrum antibiotic use (OR: 2.0; 95% CI: 0.95-4.2); and increased hospital stay (OR: 0.5; 95% CI: 0.24-1.05). Intralipid use was also associated with candidemia, but was excluded due to insufficient data available. In the multivariate analysis, only patients with birth weights of 1500 to 2449g (OR: 3.65; 95% CI: 1.24-10.77) and 1250 to 1499g (OR: 3.24; 95% CI: 1.04-10.07) qualified. A clinical predictive model in diagnosing candidemia was not possible due to insufficient variables available. Conclusion: Based on the study, infants with lower birth weights (<2500 g) were at most risk for developing subsequent candida infection.
Human
;
CANDIDEMIA
;
SEPSIS
4.Candida Species Isolated from Clinical Specimens and Medical Personnel.
Jong Hee SHIN ; Woo Hyun LIM ; Dong Hyeon SHIN ; Soon Pal SUH ; Dong Wook RYANG
Korean Journal of Infectious Diseases 1999;31(6):481-486
BACKGROUND: The frequency of bloodstream infection by Candida species has dramatically increased in recent years. Many of bloodstream infections caused by candida arise from an endogenous source of mucosal colonization, as well as exogenously from the hospital environment. We analyzed the prevalence of Candida species isolated from blood cultures, and compared it to those of all other clinical specimens, and those of the hospital environment. METHODS: Identification of Candida species was performed on isolates from blood cultures (159 strains), from cultures of clinical specimens other than bloods (1,609 strains) and from cultures of the hospital environment (30 strains). All candida isolates were recovered between January 1997 and June 1998 at Chonnam University Hospital. Candida surveillance cultures of the hands and nares of 77 medical personnel were performed using CHROMagar Candida. RESULTS: Among the Candida species isolated from the blood cultures, C. parapsilosis was the most frequently isolated (35.2%), followed by C. albicans (29.6%), C. glabrata (9.4%), and C. tropicalis (8.8%). The Candida species frequently isolated from clinical specimens other than bloods were C. albicans (52.6%), C. glabrata (19.1%), and C. tropicalis (15.3%). While C. parapsilosis was not frequently isolated from clinical specimens other than blood (3.4%), it was the most frequent Candida species isolated from the hands of medical personnel. Sixteen (20.8%) out of 77 medical personnel were found to harbor C. parapsilosis on their hands. CONCLUSION: These results suggest that it is possible that most of the Candida species causing bloodstream infections are from mucosal colonized strains, but that C. parapsilosis may be acquired from exogenous sources.
Candida*
;
Candidemia
;
Colon
;
Hand
;
Jeollanam-do
;
Prevalence
5.Direct Presumptive Identification of Candida species from Blood Cultures Using CHROMagar Candida.
Jong Hee SHIN ; Deok CHO ; Soo Hyun KIM ; Dong Euk BYUN ; F S NOLTE ; Dong Wook RYANG
Korean Journal of Clinical Pathology 1997;17(1):128-136
BACKGROUND: CHROMagar Candida is a new differential medium that allows selective isolation and identification of clinically significant yeasts. We evaluated the use of this medium to identify Candida species directly from positive blood culture bottles. METHODS: A total of 152 positive blood culture bottles (51 Candida albicans, 29 Candida troficalis, 28 Candida parapsilosis, 26 Candida glabrata, 10 Candida krusei, 4 Candida pelliculosa. 1 Candida guilliermonidii, 3 C. albicans plus C. glabrata) were directly subcultures to CHROMagar (Hardy diagnostics. USA) and incubated for 48 h. Colony appearance on CHROMagar was assessed independently by three observers. RESULTS: CHROMagar correctly identified 95.4%, 92 1% and 91.4% of Candida app. from blood cultures by the three observers. respectively. There was 91.4% agree cent between the observers. Expected colony appearance on CHROMagar was 100% for C. albicans. 97.7% for C. tropicalis, 96.7% for C. krusei, 94 9% for C. glabrata but 88.1% for C. parapsilosis. Three mixed candidemias, not detected by conventional methods, were detected by CHROMagar. CONCLUSIONS: CHROMagar permits earlier recognition of major Cardida app. in positive blood cultures and more reliable detection of mixed candidemias.
Candida albicans
;
Candida glabrata
;
Candida*
;
Candidemia
;
Yeasts
6.Antifungal Susceptibilities to Fulconazole and Itraconazole for Candida Species Recovered from Blood Cultures over a 5-Year Period.
Jong Hee SHIN ; Woo Hyun LIM ; Dong Hyeon SHIN ; Soon Pal SUH ; Dong Wook RYANG
Korean Journal of Infectious Diseases 2000;32(3):179-185
BACKGROUND: Fluconazole and itraconazole, the azole-derivative antifungal agents, have been commonly used for the treatment of candidiasis. We studied the comparative activities of fluconazole and itraconazole against isolates of Candida species recovered from blood cultures in Chonnam National University Hospital between 1994 and 1998. METHODS: One hundred twenty-four bloodstream isolates of Candida species (32 C. albicans, 36 C. parapsilosis, 19 C. tropicalis, 12 C. glabrata, 10 C. pelliculosa, 7 C. guilliermondii, 5 C. lipolytica, and 3 others) from 124 patients were tested. Minimal inhibitory concentrations (MICs) of fluconazole (0.12~64microgram/mL) and itraconazole (0.03~16 microgram/mL) for each isolate were determined by the NCCLS broth macrodilution method. RESULTS: Fluconazole MICs were >64 microgram/mL for 4.8% (6/124) of the isolates and 16~32 microgram/mL for the 8.9% (11/124) isolates. Itraconazole MICs were >1 microgram/mL for 16% (16/124) and 0.25~0.5 microgram/mL for 21.0% (26/124) of the isolates. Candida species for which the fluconazole MICs were higher, were in general more resistant to itraconazole (P<0.05). There were species-related differences in MIC50:those for C. albicans, C. parapsilosis and C. tropicalis were lower than those for other species. MICs of fluconazole and itraconazole for each species did not change during the 5-year period, but resistance to fluconazole (>64 microgram/mL) or itraconazole (> 1 microgram/mL) was observed in 4.5% (2/44) of isolates obtained from 1994 to 1996, and increased to 17.5% (14/80) of isolates recovered in 1997 to 1998 (P<0.05). CONCLUSION: This data showed that itraconazole MICs were proportionally higher for Candida isolates with high fluconazole MICs, and Candida species with fluconazole or itraconazole resistance increased in the latter two years, although MICs of fluconazole and itraconazole for each species did not change during the 5-year span.
Antifungal Agents
;
Candida*
;
Candidemia
;
Candidiasis
;
Fluconazole
;
Humans
;
Itraconazole*
;
Jeollanam-do
7.Systemic Candidemia after Orthotopic Liver Transplantation.
Joon Bong CHANG ; Jae Won JOH ; Yeon Ho PARK ; Woo Yong LEE ; Sung Joo KIM ; Suk Koo LEE ; Kyung Ran PECK ; Jae Hoon SONG ; Mi Kyung KIM ; Young Hye KOH ; Yong Il KIM ; Byung Boong LEE
The Journal of the Korean Society for Transplantation 1998;12(1):123-
The survival rate after liver transplantation has greatly improved. However, complications such as infection and rejection remain major causes of mortality and morbidity. The fungal infections are associated with high mortality rates, despite having a relatively lower incidence, compared with bacterial and viral infections. Difficulty in establishing an early diagnosis, lack of effective therapy, difficult management of certain antifungal agent, limited data for antifungal prophylaxis presents remaining problems.3) We report our experience with one case of syatemic candidemia after orthotopic liver transplantation.
Candidemia*
;
Early Diagnosis
;
Incidence
;
Liver Transplantation*
;
Liver*
;
Mortality
;
Survival Rate
8.Systemic Candidemia after Orthotopic Liver Transplantation.
Joon Bong CHANG ; Jae Won JOH ; Yeon Ho PARK ; Woo Yong LEE ; Sung Joo KIM ; Suk Koo LEE ; Kyung Ran PECK ; Jae Hoon SONG ; Mi Kyung KIM ; Young Hye KOH ; Yong Il KIM ; Byung Boong LEE
The Journal of the Korean Society for Transplantation 1998;12(1):123-
The survival rate after liver transplantation has greatly improved. However, complications such as infection and rejection remain major causes of mortality and morbidity. The fungal infections are associated with high mortality rates, despite having a relatively lower incidence, compared with bacterial and viral infections. Difficulty in establishing an early diagnosis, lack of effective therapy, difficult management of certain antifungal agent, limited data for antifungal prophylaxis presents remaining problems.3) We report our experience with one case of syatemic candidemia after orthotopic liver transplantation.
Candidemia*
;
Early Diagnosis
;
Incidence
;
Liver Transplantation*
;
Liver*
;
Mortality
;
Survival Rate
9.Usefulness of Two-Step Algorithm with Earlier Growth Detection in Anaerobic Bottle and Time to Positivity to Predict Candida glabrata Fungemia.
Jung Hyun BYUN ; Dong Hyun LEE ; Sunjoo KIM
Annals of Clinical Microbiology 2018;21(2):23-27
BACKGROUND: Fast identification of Candida glabrata is important, because empirical antifungal therapy for fungemia with C. glabrata and non-C. glabrata varies. We proposed an algorithm for rapid presumptive diagnosis to identify fungemia with C. glabrata using earlier or only growth from anaerobic bottles and longer time to positivity (TTP) in blood cultures. METHODS: Positivity and TTP using the BacT/Alert 3D system (bioMerieux Inc, USA) with resin bottles (FA Plus and FN Plus) were analyzed in 215 candidemia patients from June 2014 to June 2016 in a university-affiliated hospital in Korea. RESULTS: A higher proportion of earlier or only growth from anaerobic bottles was observed in C. glabrata (38.8%, 7/18) than in C. albicans (7.6%, 8/105), C. parapsilosis (10.5%, 4/138), and C. tropicalis (9.2%, 5/54) (P=0.006). The mean (±standard deviation) TTP for C. glabrata was 41.7 h (±16.3 h) compared with 26.7 h (±15.9 h) for C. albicans, 33.4 h (±8.4 h) for C. parapsilosis, and 23.1 h (±17.3 h) for C. tropicalis (P < 0.0001). We could predict fungemia with C. glabrata with a sensitivity of 94.4%, specificity of 63.9%, positive predictive value of 19.3%, and negative predictive value of 99.2% using a two-step algorithm: earlier or only growth from anaerobic bottles and TTP >31.4 h. CONCLUSION: This two-step algorithm in the BacT/Alert 3D system could be the basis for an initial empirical antifungal therapy for fungemia with C. glabrata prior to final identification.
Candida glabrata*
;
Candida*
;
Candidemia
;
Diagnosis
;
Fungemia*
;
Humans
;
Korea
;
Sensitivity and Specificity
10.Antifungal Drug Susceptibility.
Hanyang Medical Reviews 2006;26(4):79-85
In the past two decades standardized in vitro antifungal susceptibility testing has been developed in responsive to increasing invasive fungal infections. Until now, antifungal susceptibility testing is not considered as a routine testing procedure in many laboratories. However, cumulative antifungal susceptibility data of fungi show that, because of the fungal organisms' different susceptibilities to antifungal agents, knowledge of the infecting fungal species is highly predictive of likely susceptibility and can be used as a guide to therapy. Recently, routine use of fluconazole susceptibility testing for Candida species is becoming recognized as a useful aid in optimizing treatment of candidiasis. This testing may be particularly useful in patients with recurrent mucosal candidiasis, and candidemia or invasive candidiasis who have been previously treated with azole antifungals, those whose infections are not responding to treatment, and those with infections caused by non-albicans species of Candida. As several new antifungal drugs have been or will be licensed in the next few years, it is very important for the clinicians to choose antifungal agents appropriately, while considering changing epidemiology and susceptibility trends.
Antifungal Agents
;
Candida
;
Candidemia
;
Candidiasis
;
Candidiasis, Invasive
;
Danazol
;
Epidemiology
;
Fluconazole
;
Fungi
;
Humans