Characteristics of Candida albicans Derived From HIV‐Positive Individuals With Oral Candidiasis: Genotyping, Phenotypic Variation, Antifungal Susceptibility, and Biofilm Formation

Article

Author: Hashemzadeh, Mohammad ; Mahmoudabadi, Ali Zarei ; Fatahinia, Mahnaz ; Erfaninejad, Maryam ; Maraghi, Elham

ABSTRACTBackgroundOral candidiasis (OC) is one of the most common mucosal infections in those afflicted with HIV/AIDS. This study aimed to provide detailed information on the phenotype, genotype, antifungal susceptibility, and biofilm formation ability of oral Candida albicans isolated from HIV‐infected patients with OC.MethodsA total of 25 C. albicans isolates were collected from oral lesions of HIV‐infected patients referred to Behavioral Diseases Counseling Center affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran. The antifungal susceptibility testing was done according to CLSI M27 guideline (fourth edition). The crystal violet method was used to evaluate the biofilm formation ability of isolates. Different phenotypes were identified on yeast extract‐peptone‐dextrose agar medium supplemented with phloxine B. Genotyping analysis of the isolates was performed using high‐resolution melting (HRM) assays and ABC genotyping.ResultsThe highest and lowest susceptibility of the C. albicans isolates was found for fluconazole 24 (96%) and ITC 18 (72%), respectively. Forty‐eight percent of the isolates had high biofilm formation ability and exhibited gray cell type. The most common genotype was genotype B (52%). HRM analysis of HIS3, EF3, and CDC3 markers showed three, four, and five different groups, respectively.ConclusionInvestigating the phenotype, antifungal susceptibility and biofilm formation ability of the C. albicans isolates obtained from oral lesions of HIV‐infected patients revealed that the dominant genotypes in the current research could cause more serious infections from the oral source. We recommend further research with a larger sample size to determine the molecular epidemiology of C. albicans among HIV patients in Iran.

05 Jul 2024·European Thyroid Journal

Incidentally vs non-incidentally diagnosed papillary thyroid carcinoma: are there differences?

Article

Author: Pinheiro, Sara ; Cosme, Inês ; Leite, Valeriano ; Figueiredo, Ana

Graphical abstract

AbstractBackgroundThyroid carcinoma (TC) incidence increased over the past 50 years. The explanation for this is not consensual.ObjectiveCompare incidental vs non-incidental TC (ITC vs NITC) regarding demographic, clinical, histological data and 5-year clinical outcomes.DesignRetrospective analysis of 225 papillary TC (PTC) cases that completed a 5-year follow-up.MethodsCreated 2 groups: ITC (including the incidentalomas) and NITC (cases of palpable or visible nodules or with thyroid compressive complaints).ResultsIncluded 225 PTC (122 were ITC). There were 95 women in ITC and 78 in NITC. ITC patients were significantly older (53.3 ± 14.8 vs 47.2 ± 17.7, P = 0.006). Groups had no differences in family history of TC. ITC mean tumour size was smaller (19.1 ± 9.2 vs 28.6 ± 16.2, P < 0.01). Tumours > 20 mm comprised 36.1% of ITC and 58.2% of NITC. We found no differences in tumour multifocality, histological thyroiditis, aggressive PTC subtypes, capsule or lymph-vascular invasion and gross extrathyroidal extension. There were no differences regarding the number of patients submitted to RAI or in RAI activity. pTMN staging showed higher prevalence of T3a and T4 cases (P < 0.01), and M1 status (P = 0.025) in NITC. There were no differences in the rates of persistence of disease. Logistic regression showed that the diagnostic modality had no impact on the 5-year clinical outcome.ConclusionITC patients were older and had smaller tumours. NITC showed no worst histological features or 5-year clinical outcome. Approximately, one third of ITC had diameters > 20 mm. As even large tumours can be ITC, overdiagnosis is the most likely cause of increasing incidence of TC.

01 Jul 2024·Journal of Antimicrobial Chemotherapy

Antifungal drug penetration in soft tissue abscesses: a comparative analysis

Article

Author: Strasser, Roland ; Decosterd, Laurent Arthur ; Manuel, Oriol ; Balmpouzis, Zisis ; Mercier, Thomas ; Cancela Costa, Alicia ; Glampedakis, Emmanouil ; Da Silva Pereira Clara, Jorge ; Kritikos, Antonios ; Schaller, Fabian ; Lamoth, Frederic ; Koutsokera, Angela ; Buclin, Thierry

AbstractBackgroundInvasive fungal infections (IFIs) are severe and difficult-to-treat infections affecting immunocompromised patients. Antifungal drug penetration at the site of infection is critical for outcome and may be difficult to achieve. Data about antifungal drug distribution in infected human tissues under real circumstances of IFI are scarce.MethodsMultiple samples were obtained from soft tissue abscesses of a lung transplant patient with Candida albicans invasive candidiasis who underwent recurrent procedures of drainage, while receiving different consecutive courses of antifungal therapy [itraconazole (ITC), fluconazole, caspofungin]. Antifungal drug concentrations were measured simultaneously at the site of infection (surrounding inflammatory tissue and fluid content of the abscess) and in plasma for calculation of the tissue/plasma ratio (R). The concentration within the infected tissue was interpreted as appropriate if it was equal or superior to the MIC of the causal pathogen.ResultsA total of 30 tissue samples were collected for measurements of ITC (n = 12), fluconazole (n = 17) and caspofungin (n = 1). Variable concentrations were observed in the surrounding tissue of the lesions with median R of 2.79 (range 0.51–15.9) for ITC and 0.94 (0.21–1.37) for fluconazole. Concentrations ranges within the fluid content of the abscesses were 0.39–1.83 for ITC, 0.66–1.02 for fluconazole and 0.23 (single value) for caspofungin. The pharmacodynamic target (tissue concentration ≥ MIC) was achieved in all samples for all three antifungal drugs.ConclusionsThis unique dataset of antifungal drug penetration in infected human soft tissue abscesses suggests that ITC, fluconazole and caspofungin could achieve appropriate concentrations in soft tissue abscesses.

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Indication	Highest Phase	Country/Location	Organization	Date
Neoplasms	Preclinical	IT	University of Pisa	09 Nov 2023

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