Mycological Profile of Candida tropicalis and its Virulence Factors from Candidemia Patients at A Tertiary Care Facility

Candida tropicalis is the fourth main infective agent of Candida species in several developing nations and leads to the greatest fatality rate among the non-albicans Candida (NAC) species that cause candidemia. Seventy clinically known Candida isolates are isolated in positively flagged blood samples from BacT/ALERT 3D from various wards. Virulence factors like hemolysin production, coagulase activity, phospholipase activity, and biofilm formation were studied and antifungal susceptibility testing was and Minimum Inhibitory Concentration (MIC) values were interpreted. Of the total 70 clinical Candida isolates, the most predominant organism isolated was found to be C. tropicalis 27 (38.57%) which is succeeded by 19 (27.14%) C. albicans, 13 (18.57%) C. parapsilosis, 6 (8.57%) C. glabrata, and 5 (7.14%) C. krusei respectively. Among the70 Candida isolates, 49 (70%) showed hemolysin production, 43 (61.42%) isolates demonstrated phospholipase activity, 34 (48.57%) showed coagulase activity and 55 (78.57%) isolates showed biofilm production by crystal violet assay. A high level of Fluconazole resistance has been observed in 23 (32.85%) Candida isolates in comparison with other antimicrobials utilized in this study. The higher MIC value of: ≥ 64 µg/mL Fluconazole was shown by 4 (57.14%) isolates of C. tropicalis by broth microdilution method. The interpretation of various virulence factors and antifungal drug resistance were seen mostly among NAC species, thus hence signifying its pivotal role in immunocompromised individual treatment

Evaluation of Epidemiological Pattern of Candida Species Associated with Candidemia from A Tertiary Care Facility in South India

Candidemia ranks the 4th most prevalence cause of bloodstream infections and stands out as the primary cause of invasive fungal infections among hospitalized patients. Its incidence varies globally from 0.33 to 6.51 episodes per 1000 admissions, representing a major public health burden due to its increasing incidence and high mortality rates. The present research work has been conducted to identify the distribution of Candida species among septicemic patients and to determine the patterns of antifungal susceptibility of Candida species isolates from them in a tertiary care center in South India. Among the 88 Candida isolates, 13 (14.8%) were speciated and identified as C. albicans and 75 (85.2%) were Candida non-albicans. Of them, C. tropicalis (42%) ranks more prevalent. The distribution of virulence factors among 88 Candida isolates revealed that 49 isolates (55.7%) exhibited phospholipase activity, hemolysin production was detected in 68.2% of isolates, biofilm production was demonstrated in 73.9% isolates and coagulase activity was observed in 46.7% isolates. In the present study, Candida species were most sensitive to Amphotericin B (94.3%), which is followed by Caspofungin (93.2%), Voriconazole (92%), Micafungin (90.9%), and the least was observed with Flucytosine (78.4%) and Fluconazole (71.5%). Thus, in order to improve treatment responses, the insights acquired from this research will aid in clinical management and the development of antifungal stewardship recommendations

Monitoring the Spectrum of Candidemia and its Anti-fungal Resistance in A Tertiary Care Centre – An Emerging Global Alarm

Candidemia is caused by healthcare-associated bloodstream infections ranking as a fifth cause especially in the United States as well as in European countries among intensive care units (ICUs). Despite ongoing advances in diagnostics and medical interventions, it remains associated with high mortality rates, along with the prolonged duration of hospitalization and elevated health care costs. The aim of the study is to characterize Candida species and to investigate the antifungal resistance pattern from blood samples in a Tertiary Care centre. 53 known Candida isolates from blood samples of various wards and ICUs were collected. All isolates are processed and speciated by the conventional identification method demonstrating its various virulence factors phenotypically and AFST patterns were studied. In the present study, among 53 Candida isolates, 25 (47.16%) C. tropicalis is a predominant pathogen followed by 11 (20.75%) C. parapsilosis, 9 (16.98%) C. albicans, 4 (7.54%) C. glabrata and 4 (7.54%) C. krusei. Phospholipase activity was observed in 30 (56.60%) isolates, 36 (67.92%) showed hemolysin production. AFST showed 15 (28.30%) isolates being resistant to Fluconazole and 2 (3.77%) showed resistance to Amphotericin B. The prevalence of candidemia was high, the fatality rate was alarming and non-albicans Candida species were predominant and fluconazole was the least effective drug owing to the high level of resistance

The Crucial Role of Diet in Managing Gestational Diabetes Mellitus: A review

Gestational Diabetes Mellitus (GDM) is the type of diabetes that occurs temporarily during pregnancy when the body is unable to produce enough insulin to control elevated blood sugar levels. Dietary intervention has emerged as a cornerstone in GDM management, focusing on regulating blood sugar levels and promoting a healthy pregnancy. Diet management of GDM is based on several fundamental principles. The first and most important step is managing carbohydrates focusing on the composition, type, and amount of carbohydrate intake. Consuming complex carbohydrates with lots of fiber is preferred to maintain stable blood sugar levels. To achieve all nutritional requirements, lean proteins and healthy fats should be included in meal planning. GDM dietary recommendations emphasize portion control and knowledge of the glycemic index of foods, which encourage more precise blood sugar regulation.  A holistic lifestyle approach to GDM, which combines dietary changes with regular physical activity, stress management, and other factors, is also highlighted by recent studies. Food orders and split meal plans are essential in GDM management and should be followed by GDM patients even after delivery. The interconnection of many lifestyle factors in achieving the best blood sugar control and maternal well-being is acknowledged comprehensively. GDM patients who practice healthier dietary and lifestyle choices are less prone to have type 2 diabetes after delivery. In conclusion, the importance of diet in ensuring a favourable pregnancy outcome for mothers with GDM is emphasized in this review, along with the necessity of continued research and multidisciplinary cooperation for improving GDM care. Healthcare professionals and patients can work towards better results in managing GDM by becoming aware of the most recent advancements in dietary management. DOI: https://doi.org/10.52783/jchr.v14.i2.430

Therapeutic and Diagnostic Approaches by using Nanotechnology in SARS-CoV-2 Infections

Severe Acute Respiratory Syndrome Corona Virus-2 infection is a universal threat in recent days, hence early diagnosis and treatment play a pivotal role in controlling the spread thereby preventing them to become endemic. A newer promising approach by Nanotechnology plays an essential role in targeting the specific pathogens for therapeutic and diagnosis of Viral infection. Certain Nano platforms like Microneedle array delivered Virus S1 subunit vaccines, spike protein nanoparticles, Lumazine synthase Nanoparticles, Silver Nanoparticles, Self-Assembling Protein Nanoparticles against Viral therapy are the upcoming applications as a therapeutic approach. Nucleic acid amplification techniques and Surface-enhanced Raman Spectroscopy shows a high specificity with the immunoassay strategy. In recent days, Colloidal Gold – Nanoparticles and silicon nanoparticles have been widely used as a point of care for quick detection of IgG and IgM antibodies obtained from the virus as a diagnostic approach. Additionally, the Nanoparticles serve as a significant improvement in Personal Protective Equipment and protect against exposure to the virus. As a result of repurposing as well as for the development of the drug, apparently, Nanoparticles themselves and their concomitant therapy or their carriers will be advantageous in making a therapeutic and diagnostic approach against Severe Acute Respiratory Syndrome Corona Virus-2 infections

Association of Robust Anti-SARS-CoV-2 Trajectories among Communities with and without COVID-19 Infection

Globally, 767 million people have been affected by SARS-CoV-2 infection and nearly a population of 6.94 million were deceased as per the World Health Organization (WHO) as of June 7, 2023. In India, the spreading of infections is now being restricted by the use of BBV-152 (CovaxinTM) and ChAdOx1-nCOV (CovishieldTM) vaccines. The present study comprises 327 candidates and Chemiluminescent microparticle immunoassay (CMIA) was used as a quantitative analytical tool to detect IgG and IgM antibodies. Out of 327 candidates, 177 (54.1%) were vaccinated and 150 (45.9%) were non-vaccinated. Among vaccinated and non-vaccinated candidates, 49 (27.7%%) and 44 (29.3%) had a history of infection, respectively; meanwhile, most of the study participants were immunized with CovishieldTM (n=145, 81.9%) and 18.1% (n=32) were immunized with CovaxinTM. There were insignificant differences observed among immunized as well as non-immunized study participants in considering median age, gender, age categories, IgM levels, or IgM seropositivity. Predictably, there was an important variation in IgG median values and IgG positivity noticed among the immunized and non-immunized categories as well as between populations with and without preceding infections. Our research is hence coherent with prospective requirements for booster shots to assist in controlling the rate of infections and fatality rates together throughout the pandemic conditions

Antimicrobial Resistance: A One Health Perspective in India

One health is a collaborative, multi-sectoral, trans-disciplinary approach used to achieve optimal health and well-being outcomes that recognize the interconnections among people, animals, plants, and their shared environment. This approach is crucial because animals and people are colonized by the same bacteria species and treated with the same antibiotic classes; the technique is instrumental in fighting antibiotic resistance. The microorganism developed antibiotic-resistant genes, which were transferred to the animal and human population via the environment. Human activities speed up the organism to acquire resistance rapidly. The primary sources of antimicrobial resistance from the environment were improper sewage and hospital waste sanitation, effluents from antibiotic production units, animal husbandry waste, agricultural manure use, livestock, and aquatic sources. This study analyzed the various routes by which antimicrobial-resistant gene is transferred into humans and their pathway in India. The study concludes that implementing strict regulation and monitoring regarding the irrational use of antibiotics in animals, sewage disposal, waste disposal, and hospital infection control practices, and providing awareness to the public regarding antibiotic resistance can reduce the rate of developing antibiotic resistance to some extent along with implementing antibiotic stewardship programmes for veterinary medicine

Artificial sweeteners and their implications in diabetes: a review

Diabetes is a significant global health concern, highlighting the critical role of dietary strategies in its management and prevention. Artificial sweeteners (ASs), due to their capacity to provide sweetness without contributing to caloric intake, have emerged as a potential tool in diabetes management. This review thoroughly examines the nuanced relationship between artificial sweeteners and diabetes, addressing their benefits and potential risks. ASs have been shown to aid in weight management, a key factor in reducing diabetes risk, and do not impact immediate blood glucose levels, offering improved glucose control for individuals with diabetes. Beyond these benefits, however, artificial sweeteners may interact complexly with gut microbiota, potentially altering its composition and affecting metabolic health. This interaction introduces concerns regarding insulin sensitivity and the risk of insulin resistance, with studies reporting conflicting findings. This comprehensive review highlights the importance of a nuanced approach to understanding the implications of artificial sweeteners in diabetes management. Given the mixed evidence on their health effects, there is a clear need for further research to fully elucidate the role of artificial sweeteners in metabolic health and their suitability as part of dietary interventions for diabetes

Rise of Carbapenem-Resistant Escherichia coli and the Concerning Existence of blaNDM-1 Gene in Gut Microbiota of Rural Populations

In rural communities, the blaNDM-1 gene in the gut microbiota may be contributing to the growing issue of antibiotic resistance. This gene enables bacteria to produce enzymes that break down antibiotics, making treatments less effective. The limited healthcare resources and frequent exposure to resistant bacteria in these areas could further amplify this problem, increasing the risk of difficult-to-treat infections among the population. The objective of this study was to evaluate the antimicrobial susceptibility of Escherichia coli [E. coli] strains isolated from healthy individuals and to assess the prevalence of blaNDM-1 gene carriage. The samples were cultured and identified as gut commensal by conventional method. Then antibiotic susceptibility test using the Kirby Bauer disc diffusion method were carried out. Carbapenem-resistant organisms were isolated, and the blaNDM-1 was identified by polymerase chain reaction. This study includes 187 Healthy participants faecal samples were obtained from people in and around the Chengalpattu area. Out of 187 samples, 110 showed E. coli growth, 63 showed Enterococci species growth, and 14 showed no growth. Among the 110 E. coli isolates, 24 (21.8%) were sensitive to all drug classes, and 86 (78.2%) were multidrug resistant. Only 8(7.27%) of the 110 E. coli tested positive for carbapenem resistance. Out of 110 E. coli isolates, only (2.7%) had the blaNDM-1 gene. This study discovered that rural communities that are unlikely to be subjected to obvious antibiotic pressure had a high incidence of MDR microorganism faecal carriage. Finding resistance genes in commensal bacteria is alarming. This has the ability to spread and emerge in the environment