Farnesol Sensitivity of Serum Induced Yeast to Hyphae Morphogenesis: A Study on Fifty Clinical Isolates of Candida albicans

Aim: Objective of this study was to examine farnesol sensitivity of yeast to hyphae dimorphism in clinical isolates of Candida albicans. Study Design: Variations in virulence attributes contribute to variations in pathogenicity of C. albicans. Ability to switch from yeast to hyphae morphology is an important virulence factor. Farnesol, a quorum sensing molecule is known to play an important role in the regulation of C. albicans morphogenesis. Analysis of farnesol susceptibility of yeast to hyphae conversion may reveal a factor responsible for variation in pathogenicity among clinical isolates of C. albicans. Place and Duration of Study: SCG Medical College & SGGS Memorial Hospital, and School of Life Sciences, SRTM University, Nanded, India. Duration of this study was, December 2008 to December 2010. Methodology: Fifty clinical isolates of C. albicans were recovered from body fluids (such as, sputum, blood, urine, vaginal swab, tracheal swab, throat swab, feces, pus and cerebrospinal fluid, etc.) of patients with different clinical manifestations, in the tertiary care center hospital. Presumptive identification of C. albicans was done on HiCHROM agar- Candida, while confirmation was done by Germ tube formation assay, Carbohydrate assimilation and Corn meal agar test. Serum induced yeast to hyphae morphogenesis in C. albicans was performed in 96 well plates. Recent methodology of micro broth dilution was used for farnesol susceptibility testing in fifty clinical isolates. Results: Farnesol prevented hyphae formation in a concentration dependent manner, in the range 25 to 400 μM. Inhibition of ≥ 50% hyphae was considered as significant reduction in morphogenesis. MIC70 for farnesol mediated inhibition of morphogenesis in C. albicans was at 200 μM. Mean values for percentage inhibition of morphogenesis in fifty strains was compared by analysis of variance (ANOVA). P = 0.05 was considered significant. Conclusion: Susceptibility of yeast to hyphae morphogenesis to the quorum sensing molecule farnesol, varied significantly among clinical isolates of C. albicans. We hypothesize that variation in farnesol sensitivity may be a factor responsible for variable dissemination and infection ability of C. albicans

Sensitization of <it>Candida albicans</it> biofilms to various antifungal drugs by cyclosporine A

<p>Abstract</p> <p>Background</p> <p>Biofilms formed by <it>Candida albicans</it> are resistant towards most of the available antifungal drugs. Therefore, infections associated with <it>Candida</it> biofilms are considered as a threat to immunocompromised patients. Combinatorial drug therapy may be a good strategy to combat <it>C. albicans</it> biofilms.</p> <p>Methods</p> <p>Combinations of five antifungal drugs- fluconazole (FLC), voriconazole (VOR), caspofungin (CSP), amphotericin B (AmB) and nystatin (NYT) with cyclosporine A (CSA) were tested <it>in vitro</it> against planktonic and biofilm growth of <it>C. albicans</it>. Standard broth micro dilution method was used to study planktonic growth, while biofilms were studied in an <it>in vitro</it> biofilm model. A chequerboard format was used to determine fractional inhibitory concentration indices (FICI) of combination effects. Biofilm growth was analyzed using XTT-metabolic assay.</p> <p>Results</p> <p>MICs of various antifungal drugs for planktonic growth of <it>C. albicans</it> were lowered in combination with CSA by 2 to 16 fold. Activity against biofilm development with FIC indices of 0.26, 0.28, 0.31 and 0.25 indicated synergistic interactions between FLC-CSA, VOR-CSA, CSP-CSA and AmB-CSA, respectively. Increase in efficacy of the drugs FLC, VOR and CSP against mature biofilms after addition of 62.5 μg/ml of CSA was evident with FIC indices 0.06, 0.14 and 0.37, respectively.</p> <p>Conclusions</p> <p>The combinations with CSA re<it>s</it>ulted in increased susceptibility of biofilms to antifungal drugs. Combination of antifungal drugs with CSA would be an effective prophylactic and therapeutic strategy against biofilm associated <it>C. albicans</it> infections.</p

Use of nitroglycerin and verapamil solution by organ bath technique in preparation of left internal thoracic artery for coronary artery bypass surgery

Background: The aim of this prospective study was to compare the effect of application of nitroglycerin and verapamil solution (GV) by organ bath technique with other methods of applications and solutions on the free blood flow of LITA. The technique was not described for in situ graft before. Method: The patients were randomly assigned to four groups: group I (n_32, GV solution by organ bath technique), group II (n_30, papaverine solution by organ bath technique), group III (n_29, topical GV solution) or group IV (n_29, topical papaverine solution). In each patient, pedicled LITA was harvested; thereafter applied with the randomized different methods and solutions. The free flow from the distal end of the divided LITA was measured for 15 s under controlled hemodynamic conditions after harvesting (Flow 1). The flow of LITA was measured again just prior to anastomosing the conduit (Flow 2). Result: The mean blood flow in LITA was 56.2 ± 5.0 ml/min before application of solutions. After application, the mean blood flow in group I:102.3 ± 7.0 ml/min, in group II: 92.7 ± 3.4 ml/min, and in group III: 88.6 ± 2.2 ml/min and in group IV: 81.4 ± 2.1. Proportional increases in blood flow observed in group I (82.6%) > group II (65.1%) > group III (57.6) > group IV (44.8%) (p < 0.05). Conclusions: GV solution by organ bath technique is effective and superior in comparison to use of papaverine using organ bath technique or topical spray of GV or papaverine solution

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN