Candida tropicalis: its prevalence, pathogenicity and increasing resistance to fluconazole

Journal of Medical Microbiology - Tập 59 Số 8 - Trang 873-880 - 2010
Rajendra J. Kothavade1, Madhulika Kabra2, Arvind G Valand3, Mehroo H Panthaki4
1Microbiology Section, WQA Laboratory, EPCOR, 9469 Rossdale Rd NW, Edmonton, AB T5K 0S5, Canada
2Department of Dermatology, Grant Medical College and Sir J. J. Group of Hospitals, Mumbai 400 008, India
3Department of Pathology, Grant Medical College and Sir J. J. Group of Hospitals, Mumbai 400 008, India
4Department of Immunocytobiology and Pathology, Sir H. N. Hospital and Medical Research Centre, Mumbai 400 004, India

Tóm tắt

Candida tropicalishas been identified as the most prevalent pathogenic yeast species of theCandida-non-albicansgroup. Historically,Candida albicanshas been the major species responsible for causing candidiasis in immunocompromised and immunocompetent patients. However, infections (candidiasis) due toC. tropicalishave increased dramatically on a global scale thus proclaiming this organism to be an emerging pathogenic yeast. The reasons for this organism's dominance and its resistance to fluconazole have been difficult to elucidate. In addition, the mechanism of this organism's pathogenicity and the consequent immune response remain to be clarified. This paper describes certain predisposing factors potentially responsible for these characteristics and presents a ‘root cause analysis' to explain the increasing prevalence ofC. tropicalisin developed and undeveloped countries, as well as the organism's acquired drug resistance. Control measures against fluconazole resistance in clinical management have also been discussed.

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Tài liệu tham khảo

Anil, 2003, Brief exposure to antimycotics reduces the extracellular phospholipase activity of Candida albicans and Candida tropicalis, Chemotherapy, 49, 243, 10.1159/000072448

Antonopoulou, 2009, Fenticonazole activity measured by the methods of the European Committee on Antimicrobial Susceptibility Testing and CLSI against 260 Candida vulvovaginitis isolates from two European regions and annotations on the prevalent genotypes, Antimicrob Agents Chemother, 53, 2181, 10.1128/AAC.01413-08

Barchiesi, 2000, Experimental induction of fluconazole resistance in Candida tropicalis ATCC 750, Antimicrob Agents Chemother, 44, 1578, 10.1128/AAC.44.6.1578-1584.2000

Barnett, 1990, Yeasts: Characteristics and Identification

Bodey, 1984, Candidiasis in cancer patients, Am J Med, 77, 13

Borg, 1990, Demonstration of fungal proteinase during phagocytosis of Candida albicans and Candida tropicalis, J Med Vet Mycol, 28, 3, 10.1080/02681219080000021

Borg-von Zepelin, 1998, The expression of the secreted aspartyl proteinases Sap4 to Sap6 from Candida albicans in murine macrophages, Mol Microbiol, 28, 543, 10.1046/j.1365-2958.1998.00815.x

Brun, 2004, Mechanisms of azole resistance in petite mutants of Candida glabrata, Antimicrob Agents Chemother, 48, 1788, 10.1128/AAC.48.5.1788-1796.2004

Buesching, 1979, Evaluation of the modified API 20C system for identification of clinically important yeasts, J Clin Microbiol, 9, 565, 10.1128/jcm.9.5.565-569.1979

Cantorna, 1990, Mucosal and systemic candidiasis in congenitally immunodeficient mice, Infect Immun, 58, 1093, 10.1128/IAI.58.4.1093-1100.1990

Capobianco, 1992, Application of a fluorogenic substrate in the assay of proteolytic activity and in the discovery of a potent inhibitor of Candida albicans aspartic proteinase, Anal Biochem, 204, 96, 10.1016/0003-2697(92)90145-W

Clark, 1995, Predictors of HIV progression in women, J Acquir Immune Defic Syndr Hum Retrovirol, 9, 43, 10.1097/00042560-199505010-00007

Davis, 2007, Epidemiology, risk factors, and outcomes of Candida albicans versus non- albicans candidemia in nonneutropenic patients, Ann Pharmacother, 41, 568, 10.1345/aph.1H516

Dixon, 2004, Disseminated Candida tropicalis in a patient with chronic mucocutaneous candidiasis, South Med J, 97, 788, 10.1097/00007611-200408000-00024

Ellis, 2002, Invasive fungal infections: evolving challenges for diagnosis and therapeutics, Mol Immunol, 38, 947, 10.1016/S0161-5890(02)00022-6

Fromtling, 1987, Candida tropicalis infection in normal, diabetic, and neutropenic mice, J Clin Microbiol, 25, 1416, 10.1128/JCM.25.8.1416-1420.1987

Fung, 2002, Fungal infections in liver transplantation, Transpl Infect Dis, 4, 18, 10.1034/j.1399-3062.4.s3.3.x

Gokce, 2007, Acid proteinase, phospholipase, and biofilm production of Candida species isolated from blood cultures, Mycopathologia, 164, 265, 10.1007/s11046-007-9053-4

González-Gravina, 2007, Oral Candidiasis in children and adolescents with cancer. Identification of Candida spp, Med Oral Patol Oral Cir Bucal, 12, E419

Gronemeyer, 1982, Purulent pericarditis complicating systemic infection with Candida tropicalis, Am J Clin Pathol, 77, 471, 10.1093/ajcp/77.4.471

Gruber, 2003, HIV-1 and its transmembrane protein gp41 bind to different Candida species modulating adhesion, FEMS Immunol Med Microbiol, 37, 77, 10.1016/S0928-8244(03)00110-X

Hsueh, 2005, Antifungal susceptibilities of clinical isolates of Candida species, Cryptococcus neoformans , and Aspergillus species from Taiwan: Surveillance of Multicenter Antimicrobial Resistance in Taiwan program data from 2003, Antimicrob Agents Chemother, 49, 512, 10.1128/AAC.49.2.512-517.2005

Husain, 2003, Changes in the spectrum and risk factors for invasive candidiasis in liver transplant recipients: prospective, multicenter, case-controlled study, Transplantation, 75, 2023, 10.1097/01.TP.0000065178.93741.72

Imam, 1990, Hierarchical pattern of mucosal Candida infections in HIV-seropositive women, Am J Med, 89, 142, 10.1016/0002-9343(90)90291-K

Jacobs, 1990, Antifungal Drug Therapy: a Complete Guide for the Practitioner, 32

Jorge, 1993, Oral candidiasis established in the sialoadenectomised rat, J Oral Pathol Med, 22, 54, 10.1111/j.1600-0714.1993.tb00042.x

Joseph-Horne, 1997, Molecular mechanisms of azole resistance in fungi, FEMS Microbiol Lett, 149, 141, 10.1111/j.1574-6968.1997.tb10321.x

Kao, 1999, The epidemiology of candidemia in two United States cities: results of a population-based active surveillance, Clin Infect Dis, 29, 1164, 10.1086/313450

Khazim, 2006, Candida albicans osteomyelitis of the spine: progressive clinical and radiological features and surgical management in three cases, Eur Spine J, 15, 1404, 10.1007/s00586-005-0038-z

Kirkpatrick, 1989, Chronic mucocutaneous candidiasis, Eur J Clin Microbiol Infect Dis, 8, 448, 10.1007/BF01964059

Kirkpatrick, 1971, Chronic mucocutaneous candidiasis: model building in cellular immunity, Ann Intern Med, 74, 955, 10.7326/0003-4819-74-6-955

Kontoyiannis, 2001, Risk factors for Candida tropicalis fungemia in patients with cancer, Clin Infect Dis, 33, 1676, 10.1086/323812

Kothari, 2009, Epidemiology of Candida bloodstream infections in a tertiary care institute in India, Indian J Med Microbiol, 27, 171, 10.4103/0255-0857.49440

Kothavade, 1998, Evaluation of phospholipase activity of Candida albicans and its correlation with pathogenicity in mice, J Med Microbiol, 47, 99, 10.1099/00222615-47-2-99

Krasner, 2002, Concepts of microbial disease. In The Microbial Challenge: Human–Microbe Interactions , chapter 6, 103

Krawczyk, 2009, PCR melting profile (PCR MP) – a new tool for differentiation of Candida albicans strains, BMC Infect Dis, 9, 177, 10.1186/1471-2334-9-177

Myerowitz, 1977, Disseminated candidiasis: changes in incidence, underlying diseases, and pathology, Am J Clin Pathol, 68, 29, 10.1093/ajcp/68.1.29

Myoken, 2004, Clinical significance of breakthrough fungemia caused by azole-resistant Candida tropicalis in patients with hematologic malignancies, Haematologica, 89, 378

Ng, 1998, Candida biotypes isolated from clinical specimens in Malaysia, Mycopathologia, 144, 135, 10.1023/A:1007069029385

Nissapatorn, 2003, AIDS-related opportunistic infections in Hospital Kuala Lumpur, Jpn J Infect Dis, 56, 187

Nucci, 2007, Candidemia due to Candida tropicalis : clinical, epidemiologic, and microbiologic characteristics of 188 episodes occurring in tertiary care hospitals, Diagn Microbiol Infect Dis, 58, 77, 10.1016/j.diagmicrobio.2006.11.009

Odds, 1988, Chronic mucocutaneous candidiosis, In Candida and Candidosis, 104

Okumura, 2007, Isolation and characterization of a novel acid proteinase, tropiase from Candida tropicalis IFO 0589, Nippon Ishinkin Gakkai Zasshi, 48, 19, 10.3314/jjmm.48.19

Parthiban, 2008, Candida tropicalis spondylodiskitis in a patient with carcinoma of sigmoid colon: a case report, Cases J, 1, 66, 10.1186/1757-1626-1-66

Paya, 1993, Fungal infections in solid-organ transplantation, Clin Infect Dis, 16, 677, 10.1093/clind/16.5.677

Perfect, 2004, Antifungal resistance: the clinical front, Oncology (Williston Park), 18 (Suppl. 13), S15

Pfaller, 2009, Comparison of results of fluconazole and voriconazole disk diffusion testing for Candida spp. with results from a central reference laboratory in the ARTEMIS DISK Global Antifungal Surveillance Program, Diagn Microbiol Infect Dis, 65, 27, 10.1016/j.diagmicrobio.2009.05.007

Prasad, 1999, Role of yeast as nosocomial pathogens and their susceptibilities to fluconazole and amphotericin B, Indian J Med Res, 110, 11

Rhoads, 1987, Chronic vaginal candidiasis in women with human immunodeficiency virus infection, JAMA, 257, 3105, 10.1001/jama.1987.03390220103029

Roilides, 2003, Candida tropicalis in a neonatal intensive care unit: epidemiologic and molecular analysis of an outbreak of infection with an uncommon neonatal pathogen, J Clin Microbiol, 41, 735, 10.1128/JCM.41.2.735-741.2003

Rüchel, 1986, Cleavage of immunoglobulins by pathogenic yeasts of the genus Candida, Microbiol Sci, 3, 316

Rüchel, 1986, Characterization of a secretory proteinase of Candida parapsilosis and evidence for the absence of the enzyme under conditions of infection in vitro, Infect Immun, 53, 411, 10.1128/IAI.53.2.411-419.1986

Rüchel, 1991, Candidiasis visualized by proteinase-directed immunofluorescence, Virchows Arch A Pathol Anat Histopathol, 419, 199, 10.1007/BF01626348

Sandford, 1980, The value of fungal surveillance cultures as predictors of systemic fungal infections, J Infect Dis, 142, 503, 10.1093/infdis/142.4.503

Sanglard, 2002, Resistance of Candida species to antifungal agents: molecular mechanisms and clinical consequences, Lancet Infect Dis, 2, 73, 10.1016/S1473-3099(02)00181-0

Schrank, 1995, Purulent pericarditis caused by Candida species: case report and review, Clin Infect Dis, 21, 182, 10.1093/clinids/21.1.182

Shiraki, 2008, Candida albicans abrogates the expression of interferon-gamma-inducible protein-10 in human keratinocytes, FEMS Immunol Med Microbiol, 54, 122, 10.1111/j.1574-695X.2008.00457.x

Sim, 2005, Candida tropicalis arthritis of the knee in a patient with acute lymphoblastic leukaemia: successful treatment with caspofungin, Hong Kong Med J, 11, 120

Singh, 2003, Spectrum of opportunistic infections in AIDS cases, Indian J Med Sci, 57, 16

Stein, 1989, Fungal infections in the immunocompromised host, Diagn Microbiol Infect Dis, 12, 221S, 10.1016/0732-8893(89)90140-5

Stone, 1974, Candida sepsis: pathogenesis and principles of treatment, Ann Surg, 179, 697, 10.1097/00000658-197405000-00024

Tortorano, 2003, The European Confederation of Medical Mycology (ECMM) survey of candidemia in Italy: antifungal susceptibility patterns of 261 non- albicans Candida isolates from blood, J Antimicrob Chemother, 52, 679, 10.1093/jac/dkg393

Vazquez, 1995, Fungal infections in diabetes, Infect Dis Clin North Am, 9, 97, 10.1016/S0891-5520(20)30642-5

Verma, 2003, Candidaemia in patients of a tertiary health care hospital from north India, Indian J Med Res, 117, 122

Vermitsky, 2004, Azole resistance in Candida glabrata : coordinate up-regulation of multidrug transporters and evidence for a Pdr1-like transcription factor, Antimicrob Agents Chemother, 48, 3773, 10.1128/AAC.48.10.3773-3781.2004

Walsh, 1986, Pathologic features in the human alimentary tract associated with invasiveness of Candida tropicalis, Am J Clin Pathol, 85, 498, 10.1093/ajcp/85.4.498

Weinberger, 1997, Increasing fungal isolation from clinical specimens: experience in a university hospital over a decade, J Hosp Infect, 35, 185, 10.1016/S0195-6701(97)90206-1

White, 1996, Is vulvovaginal candidiasis an AIDS-related illness, Clin Infect Dis, 22, S124, 10.1093/clinids/22.Supplement_2.S124

Wingard, 1979, Candida tropicalis : a major pathogen in immunocompromised patients, Ann Intern Med, 91, 539, 10.7326/0003-4819-91-4-539

Wingard, 1980, Pathogenicity of Candida tropicalis and Candida albicans after gastrointestinal inoculation in mice, Infect Immun, 29, 808, 10.1128/iai.29.2.808-813.1980

Winston, 1999, Prophylactic fluconazole in liver transplant recipients. A randomized, double-blind, placebo-controlled trial, Ann Intern Med, 131, 729, 10.7326/0003-4819-131-10-199911160-00003

Yang, 2004, Susceptibilities of Candida species to amphotericin B and fluconazole: the emergence of fluconazole resistance in Candida tropicalis, Infect Control Hosp Epidemiol, 25, 60, 10.1086/502294