BACKGROUND

Candida infections range from oral candidiasis to candida endophthalmitis, peritonitis and candidemia. Invasive fungal disease or disseminated candidiasis is highly fatal among children. There are no studies done in the pediatric population to detect early candida infection to help identify those who will benefit from early and prompt medical treatment.

OBJECTIVE

This study determined the value of Candida scoring (CS) as a predictive tool for invasive candidiasis among pediatric patients admitted in the intensive care units of a tertiary referral center.

METHODS

This was a retrospective cross sectional study where 4184 charts of pediatric patients and admitted in the ICU between January 2018 to December 2020 were reviewed. Patients were scored upon admission, after 3 days, after 1 week and weekly thereafter until discharge or demise. The scoring tool used was developed by Leon et al., and uses four variables: presence of sepsis, use of total parenteral nutrition (TPN), presence of multifocal colonization and presence of surgery. Data collected for Candida scores were presented as frequencies and percentages.

RESULTS

There were 396 patients enrolled in this study and 25.7% were treated for candida infection. Majority were newborns where 78.7% had a CS >3, which is statistically significant, p =3 which is statistically significant. Among intubated patients, 84% had a CS of >3 and all patients on TPN had a CS of >3, both of which are significant. CS could correctly predict 64.6% of patients who will likely have candida infection.

CONCLUSION

Candida scoring is a tool that can be used in patients at high risk of developing Candida infection. In this study, a CS of >3 can be used to predict Candida infection in the ICU.

Candidemia ; Candidiasis, Invasive

Candidiasis is an acute or chronic infection caused most commonly by Candida albicans and occasionally by other species of the genus Candida. The superficial cutaneous candidiasis is varied; oral Candidiasis, perieche, candidal vulvovaginitis, candidal balanitis, candidal intertrigo, erosio interdigitalis blastomycetica, perianal candidiasis, candidal paronychia, candidal onychia, chronic mucocutaneous candidiasis, congenital cutaneous candidiasis, and candidid. Diagnosis can be made by typical appearance of the clinical lesions and the presence of satellite vesicopustules. This can be confirmed by KOH examination and culture of skin scrapings. Treatment is the correction of predisposing factors, topical therapy of imidazoles and/or systemic administration of itraconazole or fluconazole.
Balanitis ; Candida ; Candida albicans ; Candidiasis ; Candidiasis, Chronic Mucocutaneous ; Candidiasis, Cutaneous* ; Candidiasis, Oral ; Causality ; Diagnosis ; Fluconazole ; Imidazoles ; Intertrigo ; Itraconazole ; Male ; Paronychia ; Skin ; Vulvovaginitis

No abstract available.
Candidiasis, Cutaneous*

Recurrent vaginal candidiasis is one of the most common reasons for patients visiting their primary care doctors. Majority of the cases are caused by Candida albicans. Controlling of risk factors such as diabetes mellitus, used of broad spectrum antibiotics, contraceptive pills and steroid therapy helps in managing recurrent vaginal candidiasis. Initial 14-day course of oral azoles and followed by 6 months maintenance are effective in treating majority of the cases. Failure to treat recurrent vaginal candidiasis can lead to various bio-psycho-social complications.
*Candidiasis, Vulvovaginal ; Recurrence

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

BACKGROUNDIt is uncertain whether genotypes of Candida albicans (C. albicans) are associated with colonizing body locations or variant conditions of infection. The aim of this study was to investigate whether there are significant associations between strain genotypes and body sites of infection and to determine the potential pathogenesis of cutaneous candidiasis at multiple locations.

METHODSA total of 151 strains of C. albicans were isolated from 74 infant patients with cutaneous candidiasis and 61 female patients with vaginal candidiasis. Patients were grouped according to the body sites and underlying conditions of infection. Genotypes were identified by polymerase chain reaction (PCR) of the 25S rDNA and PCR-restriction fragment length polymorphism (RFLP) of ALT repeats digested with EcoRI and Clal.

RESULTSTen genotypes were detected. There were significant differences in genotype frequencies between the two groups. However, we found no clear association between genotypes and the sites of cutaneous infection or the underlying conditions of vaginal candidiasis (VVC). In addition, strains of C. albicans from multiple cutaneous locations of the same patient had identical genotypes.

CONCLUSIONSPopulations of C. albicans from patients with cutaneous and vaginal candidiasis were genetically different. However, the lack of genetic difference between strains from different body sites with cutaneous infections or from different underlying conditions for VVC suggests no evidence of genotype selection for different skin surfaces or patients with different underlying conditions for VVC.

Candida albicans ; classification ; genetics ; Candidiasis, Cutaneous ; virology ; Candidiasis, Vulvovaginal ; virology ; Female ; Genotype ; Humans ; Infant ; Infant, Newborn ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length

Background: Vulvovaginal Candidiasis (VVC) is one of the frequent infections of the female genital tract and is the second most common cause of vaginal infections after bacterial vaginosis. According to the Centers for Disease Control and Prevention, azoles are the first‑line treatment for VVC. Among the azoles available in the Philippines, only miconazole and clotrimazole are recommended for both pregnant and non‑pregnant women. Objective: Compare the effect of miconazole versus clotrimazole in the treatment of vulvovaginal candidiasis among patients seen at the out‑patient department in a tertiary hospital Materials and Methods: This involved review of the records of patients diagnosed with VVC in a tertiary medical center from 2016 to 2020. All records of women, pregnant and non‑pregnant, wherein single‑dose 1200 mg miconazole or 6‑day 100 mg clotrimazole given vaginally were included Results: Eleven out of the 316 records (3.46%) remained symptomatic after treatment, about 18.1% (2/161) from those who used miconazole and 81.8% (9/155) from those treated with clotrimazole (p 0.027). In terms of failure rate, for miconazole it was 1.2% (2/161), whereas for clotrimazole it was 5.8% (9/155). None of the charts were found to have recorded adverse reaction to the given treatment Conclusion Single‑dose miconazole intravaginal regimen has a higher clinical cure rate than the 6‑day clotrimazole intravaginal treatment. Thereby, single‑dose intravaginal miconazole has the potential to improve patient compliance and treatment outcome at a lower cost
Clotrimazole ; Miconazole ; Vaginitis ; Candidiasis, Vulvovaginal

This survey was done on 79 out-patients in order to investigate the present status of cutaneous candidiasis in clinical and mycological aspects in dermatologic clinic of Korea University Hospital from January, 1982 to July1983. Among the 79 specimens, 56 strains of candida species were identified by KOli mount, Sabourauds dextrose agar culture, sugar assimilation test, sugar fermentation test a.nd corn meal agar with Tween 80 culture. Following results were obtained. 1. The incidence of cutaneous candiasis was l. 6A (79 cases among 4, 963 outpatients). 2. The cutaneous candidiasis was more frequent in fcmale than in male(1: 1. 7) 3. The cutaneous candidiasis had its highest in.cidence during first decade (45 .6%). 4 Candidal intertrigo was the commonest type of the infection (51. 9%,) 5. Thrush, diaper candidiasis and candidal intertrigo were common during first. decade, and candidal paronychia and candidal onychia were common during third decade. 6, Positive rate on KOH mount was 60. 8% Nail (38. 5%) and periungal area (42.9%) should low positive rate. 7. Positive culture rate on Sabourauds dextrose agar of Candida species was 70. 9% (56 cases). 8 Candida species isolated from cutaneous lesions were Candida albicans (52 case) and Candida trapicalis(2 cases). Two species could not be identified.
Agar ; Candida ; Candida albicans ; Candidiasis ; Candidiasis, Cutaneous* ; Candidiasis, Oral ; Fermentation ; Glucose ; Humans ; Incidence ; Intertrigo ; Korea ; Meals ; Outpatients ; Paronychia ; Polysorbates ; Zea mays

Chronic mucocutaneous candidiasis (CMC) consists of several clinical syndrome characterized by chronic, treatment-resistant, superficial candidal infections of skin, nails and oropharynx. The patients with CMC usually have other manifestations including non-candidal infections, endocrinopathies and autoimmune diseases. These findings suggest that patients with CMC have multiple or complex abnormalities in their immune systems, especially of cell mediated immunity. The scrofuloderma or scrofuloderma-like BCGitis is used to describe the skin reaction and enlargement of regional lymph node with suppuration. In contrast to chronic mucocutaneous candidiasis, BCGitis does not suggest underlying host immune defect in most cases. In our knowledge, there is no report about scrofuloderma-like BCGitis and chronic mucocutaneous candidiasis occurring in the same patient. Herein, we report a case of chronic mucocutaneous candidiasis associated with scrofuloderma-like BCGitis.
Autoimmune Diseases ; Candidiasis, Chronic Mucocutaneous ; Humans ; Immune System ; Immunity, Cellular ; Lymph Nodes ; Nails ; Oropharynx ; Skin ; Suppuration ; Tuberculosis, Cutaneous

We purified enolase from Candida albicans KNIH10 strain which was isolated from a clinical specimen in Korea. The purified enolase was used to detect anti-Candida antibodies in sera of patients with invasive candidiasis. For purification of enolase from the crude extract prepared by French pressure at 20,000 PSI, the fast performance liquid chromatography (FPLC) using DEAE-sepharose column was used. The elutes at 0.3-0.4 M NaCl in FPLC was purified with homogenity in SDS-PAGE and its enzymatic activity was confirmed in sera of invasive candidiasis with candidemia patient by immunoblotting. The purified enolase indicated no siggnal (100% specificity) in 40 normal human sera and 75% (6/8) sensitivity in sera of candidemic patients with suspicious invasive candidiasis by immunoblotting.
Antibodies ; Candida albicans* ; Candida* ; Candidemia ; Candidiasis, Invasive ; Chromatography, Liquid ; Electrophoresis, Polyacrylamide Gel ; Humans ; Immunoblotting ; Immunologic Tests* ; Korea* ; Phosphopyruvate Hydratase*