Multilocus sequence typing for Candida albicans isolates from candidemic patients: comparison with Southern blot hybridization and pulsed-field gel electrophoresis analysis.
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Management of fungal infections in the intensive care unit: a survey of UK practice.
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Evaluation of the Cica Fungi Test Candida, a novel serum Candida mannan antigen kit, and its comparison with Cand-Tec in candidemia patients.
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The Cica Fungi Test Candida is a novel immunoassay test that is used in Japan to detect Candida mannan antigens. A total of 130 samples from 89 cases in which the beta-D-glucan assay (MK method) was positive were collected between July 2007 and August 2008 at Nagasaki University Hospital, and the Cica Fungi Test Candida and Cand-Tec were performed. Diagnosis of candidemia was based on a positive culture for Candida spp. from blood or other sterile clinical specimens. A total of 19 samples from 16 cases with candidemia, and 111 samples from 73 cases without microbiological evidence of candidemia, were obtained. The sensitivity and specificity of the Cica Fungi Test and Cand-Tec were 63.2 and 95.5%, and 52.6 and 50.5%, respectively. The Cica Fungi Test showed significantly higher specificity than Cand-Tec (P<0.01). The beta-D-glucan assay values were significantly higher in the candidemia samples than in the non-candidemia samples (P=0.0003), a result that was well correlated with the Cica Fungi Test (P=0.0005). The Cica Fungi Test was thus found to be more reliable and specific than Cand-Tec, and the combined evaluation with the beta-D-glucan assay was more efficient for diagnosis of candidemia. (+info)
Candidemia in children after complex congenital heart defects surgery treated with caspofungin--our own experience and a review of literature.
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BACKGROUND: Invasive fungal infections due to Candida species constitute an increasing clinical problem. There are no guidelines for the management of candidemia in children undergoing surgical procedures for congenital heart defects (CHD). The aim of the study was to draw attention to the problem of candidemia in children who are operated on due to congenital heart defects. MATERIAL/METHODS: We retrospectively analyzed medical documentation of 307 children with congenital heart defects treated in 1 clinical centre in Poland, from whom we selected those diagnosed with candidemia during the postoperative period. Next, we analyzed in detail the clinical course of invasive candidiasis in each individual and we performed an analysis of risk factors that lead to candidemia. RESULTS: In the analyzed period, among 307 children who underwent surgical procedures, we observed 2 cases of candidemia (0.65%) which were effectively cured with caspofungin. No adverse effects were observed after treatment with the drug. CONCLUSIONS: Candidemia in children who undergo surgical treatment of congenital heart defects is an important factor that can influence final clinical results. Caspofungin may be an effective therapeutic option when treating candidemia in children after extensive cardiosurgical procedures. (+info)
Candidemic complications in patients with intravascular catheters colonized with Candida species: an indication for preemptive antifungal therapy?
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Calcineurin controls drug tolerance, hyphal growth, and virulence in Candida dubliniensis.
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Combination antifungal therapy with voriconazole for persistent candidemia in very low birth weight neonates.
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The purpose of this article is to report our experience with intravenous voriconazole therapy in the treatment of persistent Candida septicemia in very low birth weight (VLBW) neonates. Candidiasis was defined if an infant had a positive blood culture. Ten VLBW newborns developed Candida sepsis, and candidemia persisted in 6 of them despite 3 to 21 days of antifungal therapy with amphotericin B, either conventional or liposomal, and fluconazole. After the addition of voriconazole, clearance of Candida was achieved within 3-7 days of treatment. Antifungal therapy combination with liposomal amphotericin B and voriconazole was continued for at least two weeks after two negative cultures 48 hours apart. We conclude that considering the hazardous effects of Candida infections in preterm newborns, voriconazole can be added to the treatment of fungal sepsis in newborns who still have persistent candidemia despite conventional antifungal management. More clinical information is needed before voriconazole can be used as a first-line drug in antifungal therapy in newborns. (+info)
Quantitation of Candida CFU in initial positive blood cultures.
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