Candida dubliniensis

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Candida dubliniensis
Candida dubliniensis.jpg
Gram stain of Candida dubliniensis cells (1000-fold magnification)
Scientific classification OOjs UI icon edit-ltr.svg
Domain: Eukaryota
Kingdom: Fungi
Division: Ascomycota
Class: Saccharomycetes
Order: Saccharomycetales
Family: Saccharomycetaceae
Genus: Candida
Species:
C. dubliniensis
Binomial name
Candida dubliniensis
Sullivan et al. (1995)

Candida dubliniensis is a fungal opportunistic pathogen originally isolated from AIDS patients. It is also occasionally isolated from immunocompetent individuals. It is of the genus Candida , very closely related to Candida albicans but forming a distinct phylogenetic cluster in DNA fingerprinting. It is most commonly isolated from oral cavities, [1] and is also occasionally found in other anatomical sites.

Contents

Prevalence and epidemiology

Candida dubliniensis is cosmopolitan (found around the world), and has been described as a separate species in 1995. [2] Retrospective studies have shown that previously it had been commonly identified as Candida albicans, with which C. dubliniensis is closely related and shares a number of characteristics.

One test for distinguishing C. dubliniensis from C. albicans, is laboratory culture of the organism at 42 °C. Most C. albicans strains grow at this temperature, [3] whereas most C. dubliniensis isolates do not. [2] There are also significant differences in the conditions that lead to the formation of chlamydospores between C. albicans and C. dubliniensis, although they are otherwise phenotypically very similar. [2]

The Memorial Sloan-Kettering Cancer Center conducted several studies, both retrospective and prospective. In 974 germ-tube positive yeasts, 22 isolates (2.3%) from 16 patients were C. dubliniensis. All individuals were immunologically compromised with either malignancy or AIDS, and the isolates came from a variety of different sites. C. dubliniensis was also isolated from the mouths of 18% of patients with diabetes and who use insulin. [4]

Antifungal susceptibility

In one study, all 20 C. dubliniensis isolates tested were susceptible to itraconazole, ketoconazole and amphotericin B. [5]

Fluconazole

Many isolates of C. dubliniensis are sensitive to fluconazole. In one study, sixteen of twenty isolates were sensitive to fluconazole, while four were resistant. [5] It has been hypothesized that C. dubliniensis possesses the ability to rapidly develop resistance to fluconazole, especially in patients on long-term therapy. [5]

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Candidiasis is a fungal infection due to any species of the genus Candida. When it affects the mouth, in some countries it is commonly called thrush. Signs and symptoms include white patches on the tongue or other areas of the mouth and throat. Other symptoms may include soreness and problems swallowing. When it affects the vagina, it may be referred to as a yeast infection or thrush. Signs and symptoms include genital itching, burning, and sometimes a white "cottage cheese-like" discharge from the vagina. Yeast infections of the penis are less common and typically present with an itchy rash. Very rarely, yeast infections may become invasive, spreading to other parts of the body. This may result in fevers along with other symptoms depending on the parts involved.

Vaginitis, also known as vulvovaginitis, is inflammation of the vagina and vulva. Symptoms may include itching, burning, pain, discharge, and a bad smell. Certain types of vaginitis may result in complications during pregnancy.

<i>Candida albicans</i> Species of fungus

Candida albicans is an opportunistic pathogenic yeast that is a common member of the human gut flora. It can also survive outside the human body. It is detected in the gastrointestinal tract and mouth in 40–60% of healthy adults. It is usually a commensal organism, but it can become pathogenic in immunocompromised individuals under a variety of conditions. It is one of the few species of the genus Candida that cause the human infection candidiasis, which results from an overgrowth of the fungus. Candidiasis is, for example, often observed in HIV-infected patients. C. albicans is the most common fungal species isolated from biofilms either formed on (permanent) implanted medical devices or on human tissue. C. albicans, C. tropicalis, C. parapsilosis, and C. glabrata are together responsible for 50–90% of all cases of candidiasis in humans. A mortality rate of 40% has been reported for patients with systemic candidiasis due to C. albicans. By one estimate, invasive candidiasis contracted in a hospital causes 2,800 to 11,200 deaths yearly in the US. Nevertheless, these numbers may not truly reflect the true extent of damage this organism causes, given new studies indicating that C. albicans can cross the blood–brain barrier in mice.

<i>Cryptococcus neoformans</i> Species of yeast

Cryptococcus neoformans is an encapsulated yeast belonging to the class Tremellomycetes and an obligate aerobe that can live in both plants and animals. Its teleomorph is a filamentous fungus, formerly referred to Filobasidiella neoformans. In its yeast state, it is often found in bird excrement. Cryptococcus neoformans can cause disease in apparently immunocompetent, as well as immunocompromised, hosts.

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Fluconazole is an antifungal medication used for a number of fungal infections. This includes candidiasis, blastomycosis, coccidioidomycosis, cryptococcosis, histoplasmosis, dermatophytosis, and tinea versicolor. It is also used to prevent candidiasis in those who are at high risk such as following organ transplantation, low birth weight babies, and those with low blood neutrophil counts. It is given either by mouth or by injection into a vein.

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<span class="mw-page-title-main">Fungemia</span> Internal, blood-borne infection by fungi, including yeasts.

Fungemia is the presence of fungi or yeasts in the blood. The most common type, also known as candidemia, candedemia, or systemic candidiasis, is caused by Candida species; candidemia is also among the most common bloodstream infections of any kind. Infections by other fungi, including Saccharomyces, Aspergillus and Cryptococcus, are also called fungemia. It is most commonly seen in immunosuppressed or immunocompromised patients with severe neutropenia, cancer patients, or in patients with intravenous catheters. It has been suggested that otherwise immunocompetent patients taking infliximab may also be at a higher risk for fungemia.

Pichia kudriavzevii is a budding yeast involved in chocolate production. P. kudriavzevii is an emerging fungal nosocomial pathogen primarily found in the immunocompromised and those with hematological malignancies. It has natural resistance to fluconazole, a standard antifungal agent. It is most often found in patients who have had prior fluconazole exposure, sparking debate and conflicting evidence as to whether fluconazole should be used prophylactically. Mortality due to P. kudriavzevii fungemia is much higher than the more common C. albicans. Other Candida species that also fit this profile are C. parapsilosis, C. glabrata, C. tropicalis, C. guillermondii and C. rugosa.

<i>Nakaseomyces glabratus</i> Species of fungus

Nakaseomyces glabratus is a species of haploid yeast of the genus Nakaseomyces, previously known as Candida glabrata. Despite the fact that no sexual life cycle has been documented for this species, N. glabratus strains of both mating types are commonly found. C. glabrata is generally a commensal of human mucosal tissues, but in today's era of wider human immunodeficiency from various causes, N. glabratus is often the second or third most common cause of candidiasis as an opportunistic pathogen. Infections caused by N. glabratus can affect the urogenital tract or even cause systemic infections by entrance of the fungal cells in the bloodstream (Candidemia), especially prevalent in immunocompromised patients.

<span class="mw-page-title-main">Esophageal candidiasis</span> Medical condition

Esophageal candidiasis is an opportunistic infection of the esophagus by Candida albicans. The disease usually occurs in patients in immunocompromised states, including post-chemotherapy and in AIDS. However, it can also occur in patients with no predisposing risk factors, and is more likely to be asymptomatic in those patients. It is also known as candidal esophagitis or monilial esophagitis.

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Candida auris is a species of fungus that grows as yeast. It is one of the few species of the genus Candida which cause candidiasis in humans. Often, candidiasis is acquired in hospitals by patients with weakened immune systems. C. auris can cause invasive candidiasis (fungemia) in which the bloodstream, the central nervous system, and internal organs are infected. It has attracted widespread attention because of its multiple drug resistance. Treatment is also complicated because it is easily misidentified as other Candida species.

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<i>Candida tropicalis</i> Species of fungus

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References

  1. Gilfillan, G. D.; Sullivan, D. J.; Haynes, K.; Parkinson, T.; Coleman, D. C.; Gow, N. A. R (1998). "Candida dubliniensis: phylogeny and putative virulence factors". Microbiology. 144 (4): 829–838. doi:10.1099/00221287-144-4-829. PMID   9579058.
  2. 1 2 3 Sullivan DJ, Westerneng TJ, Haynes KA, Bennett DE, Coleman DC (1995). "Candida dubliniensis sp. nov.: phenotypic and molecular characterization of a novel species associated with oral candidosis in HIV-infected individuals". Microbiology. 141 (7): 1507–21. doi: 10.1099/13500872-141-7-1507 . PMID   7551019.
  3. Kamiyama A; Niimi M; Tokunaga M; . Nakayama H (1989). "Adansonian study of Candida albicans: intraspecific homogeneity excepting C. stellatoidea strains". J Med Vet Mycol. 27 (4): 229–241. doi:10.1080/02681218980000311. PMID   2677300.
  4. Willis AM, Coulter WA, Sullivan DJ, Coleman DC, Hayes JR, Bell PM, Lamey PJ (2000). "Isolation of C. dubliniensis from insulin-using diabetes mellitus patients". J Oral Pathol Med. 29 (2): 86–90. doi:10.1034/j.1600-0714.2000.290206.x. PMID   10718404.
  5. 1 2 3 Moran GP, Sullivan DJ, Henman MC, McCreary CE, Harrington BJ, Shanley DB, Coleman DC (March 1997). "Antifungal drug susceptibilities of oral Candida dubliniensis isolates from human immunodeficiency virus (HIV)-infected and non-HIV-infected subjects and generation of stable fluconazole-resistant derivatives in vitro". Antimicrob. Agents Chemother. 41 (3): 617–23. doi:10.1128/AAC.41.3.617. PMC   163761 . PMID   9056003.