Biofilm: The invisible culprit in catheter-induced candidemia

Candidemia is the most common form of invasive fungal infection associated with several risk factors, and one of them is the use of medical devices, to which microbial biofilms can attach. Candidemia related to the use of peripheral intravascular and central venous catheters (CVC) is referred to as Candida catheter-related bloodstream infection, with more than 90% being related to CVC usage. The infection is associated with a higher morbidity and mortality rate than nosocomial bacterial infections. Candida spp. can protect themselves from the host immune system and antifungal drugs because of the biofilm structure, which is potentiated by the extracellular matrix (ECM). Candida albicans and Candida parapsilosis are the most pathogenic species often found to form biofilms associated with catheter usage. Biofilm formation of C. albicans includes four mechanisms: attachment, morphogenesis, maturation and dispersion. The biofilms formed between C. albicans and non-albicans spp. differ in ECM structure and composition and are associated with the persistence of colonization to infection for various catheter materials and antifungal resistance. Efforts to combat Candida spp. biofilm formation on catheters are still challenging because not all patients, especially those who are critically ill, can be recommended for catheter removal; also to be considered are the characteristics of the biofilm itself, which readily colonizes the permanent medical devices used. The limited choice and increasing systemic antifungal resistance also make treating it more difficult. Hence, alternative strategies have been developed to manage Candida biofilm. Current options for prevention or therapy in combination with systemic antifungal medications include lock therapy, catheter coating, natural peptide products and photodynamic inactivation

Albendazole increases serum retinol concentration in primary schoolchildren with low serum retinol

Background Soil-transmitted helminth (STH) infection is still a health problem in Indonesia. Vitamin A deficiency (VAD) is often found together with STH. The effect of the deworming program on the vitamin A status of primary school children is unknown. The objective of this study was to evaluate the effect of albendazole on serum retinol concentrations in primary school children. Methods An experimental study of pre-post test design without control was carried out on 118 children from grades 3-5 at one primary school in North Jakarta, from July to September 2014. Flotac examination was used to determine STH infections and high performance liquid chromatography was performed to measure serum retinol concentration. Stool and blood samples were taken twice: before and three weeks after treatment with albendazole 400 mg single dose for three consecutive days given to all children either infected or uninfected. Paired t-test was used to analyze the data. Results Of the 118 children, the prevalence of STH was 71.2%. The prevalence of low retinol serum (<1.05 mmol/L) was 17 (17.2%) and of mild VAD was 2 (2.0%). Albendazole given in 3 consecutive days could not increase serum retinol concentrations (p=0.055). Serum retinol concentration significantly increased after albendazole treatment in children with low retinol serum at baseline (p=0.001). Conclusions In children with low serum retinol concentration, treatment with albendazole increased retinol concentration. Integrated deworming and vitamin A supplementation strategies should be evaluated in this population

Albendazole therapy reduces serum zinc in elementary school children with Ascaris lumbricoides infections

Background Soil-transmitted helminth (STH) infection can cause malnutrition and vice versa, and decrease serum zinc concentrations. No previous studies were found on the effect of STH treatment on serum zinc concentrations in elementary school children. The objective of this study was to evalaute the effect of STH treatment on serum zinc concentration in elementary school children in Jakarta. Methods A pre-experimental study (one group pre and post) was conducted on 3rd - 5th grade students in one elementary school in North Jakarta. FLOTAC examination was used to determine infection status and STH intensity, while serum zinc concentrations were measured by atomic absorption spectrometry. All children were given albendazole 400 mg for three consecutive days. Stool and blood samples were collected before and three weeks after treatment with albendazole. A paired t test was used to analyze the data. Results The STH prevalence was 63.4%; these were mainly Ascaris lumbricoides and Trichuris trichiura infections. Before treatment, children infected with A.lumbricoides and T.trichiura had significantly higher serum zinc concentrations (p=0.028; p=0.014). After treatment, children with A.lumbricoides had significantly lower serum zinc concentrations (p=0.039), while children with T.trichiura had slightly lower serum zinc concentrations (p=0.659) than before treatment. Conclusions Albendazole treatment produces lower serum zinc concentration in elementary school children with A.lumbricoides infections. A profound understanding of the interaction between helminth infections and zinc may assist in guiding integrated and sustainable intervention strategies among affected children throughout the world

Albendazole increases serum retinol concentration in primary schoolchildren with low serum retinol

Background\ud Soil-transmitted helminth (STH) infection is still a health problem in Indonesia. Vitamin A deficiency (VAD) is often found together with STH. The effect of the deworming program on the vitamin A status of primary school children is unknown. The objective of this study was to evaluate the effect of albendazole on serum retinol concentrations in primary school children.\ud \ud Methods\ud An experimental study of pre-post test design without control was carried out on 118 children from grades 3-5 at one primary school in North Jakarta, from July to September 2014. Flotac examination was used to determine STH infections and high performance liquid chromatography was performed to measure serum retinol concentration. Stool and blood samples were taken twice: before and three weeks after treatment with albendazole 400 mg single dose for three consecutive days given to all children either infected or uninfected. Paired t-test was used to analyze the data. \ud \ud Results\ud Of the 118 children, the prevalence of STH was 71.2%. The prevalence of low retinol serum (<1.05 mmol/L) was 17 (17.2%) and of mild VAD was 2 (2.0%). Albendazole given in 3 consecutive days could not increase serum retinol concentrations (p=0.055). Serum retinol concentration significantly increased after albendazole treatment in children with low retinol serum at baseline (p=0.001). \ud \ud Conclusions\ud In children with low serum retinol concentration, treatment with albendazole increased retinol concentration. Integrated deworming and vitamin A supplementation strategies should be evaluated in this population