First outbreak of C. auris infections in South America
September 22 2016
C. auris has been increasingly reported in tertiary care hospitals, principally from India, Kuwait and South Africa. Now, 6 years after the first identifications in Asia, the first outbreak of C. auris in South America has been reported. Bloodstream isolates of C. auris were obtained from 18 critically ill patients admitted to a medical centre in Maracaibo, Venezuela centre over a 16 month period.. 13 paediatric patients (8 of whom were preterm neonates) and 5 adult patients were included and each had been admitted to the intensive care unit, exposed to antibiotics and multiple invasive medical procedures before developing fungemia.
Micafungin shown to be effective for candiduria
September 20 2016
Addressing a common problem in hospitals, Gabardi and colleagues show that intravenous micafungin eradicates candiduria in 75% of patients.
A recent shift in the epidemiology of candidiasis has been noted with an increase in the frequency of urinary tract infections (UTIs) caused by non-albicans Candida spp. commonly resistant to fluconazole. Echinocandins have fungicidal activity against Candida and penetrate well into the renal parenchyma. However, these agents achieve poor concentrations in the urine and are generally considered ineffective in the treatment of Candida UTIs.
In this retrospective analysis performed in two tertiary-care academic medical centers, 33 hospitalized patients with candiduria or Candida UTI who received micafungin and had follow-up urine cultures were evaluated. The most commonly recovered species were C. albicans (n=13) and C. glabrata (n=10). Twenty-five patients (75%) had an indwelling urinary catheter. UTI was diagnosed in 16 (48%). Only 3 (10%) had concomitant Candida bloodstream infection. Micafungin was used for a mean duration of 6 days.
Diagnosing coccidioidal meningitis using CSF (1,3)-beta-D-glucan testing
September 14 2016
Diagnosing coccidioidal meningitis is challenging, due to infrequent positive test results and often a delayed positivity. If left untreated, the mortality is 90% in 1 year and 100% in 2 years. Currently, diagnosis depends on isolating coccidioides from a cerebral spinal fluid (CSF) sample, but this test is only positive in around 1/3 of patients. A positive result for anti-coccidioidal antibodies in CSF provides a presumptive diagnosis, but the result may often be negative in the earlier stages of disease. β-glucan levels in CSF may be another avenue to explore, as there is no reason for β-glucan to be present in the CSF in the absence of invasive fungal diseases.
In a recent study therefore, the diagnostic performance of β-glucan levels in CSF samples was assessed in the context of suspected coccidioides meningitis.
World’s first e-Learning Fungal Microscopy Course is launched
September 06 2016
Experts in Manchester have now developed the world’s first Fungal Microscopy online course. It is aimed at doctors, clinical scientists and laboratory technologists across the world, and because it is online students in poorer countries where the need for information is greatest will now be able to learn how to recognize most pathogenic fungi. The course will teach not only how to rapidly and accurately diagnose life-threatening fungal infections, but also how to set up direct microscopy in a diagnostic laboratory. It is available now at www.microfungi.net.
Dr. David Denning, Professor of Infectious Disease in Global Health at The University of Manchester – and one of the course designers stated: ”The global prevalence of fungal diseases is increasing due to increases in susceptible patients (cancer therapies, organ transplantation, asthma, chronic lung diseases) and international travel. Very few diagnostics are as rapid as microscopy and it is inexpensive. Our course will enable any microbiologists and pathologists to rapidly diagnose most fungal infections in minutes, saving lives.”
Characterization of Candidemia from a Brazilian Surveillance Program
September 01 2016
A major surveillance study in 16 hospitals across five regions of Brazil has recently been conducted, in order to assess the incidence, species distribution, frequency of antifungal resistance and risk factors for bloodstream infections due to Candida species. In other regions the incidence varies highly, but appears to be stable or increasing, despite advances in the medical support of these critically ill patients. The epidemiology has already been studied extensively in the United States and Europe, but there is a lack of data in Latin America and in particular a lack of data on echinocandin resistance.