Salient findings of the cases of candidemia caused by <i>Candida dubliniensis</i> and antifungal susceptibility profile of the isolate.

<p>Note: Particulars of three blood culture positive patients were not complete, hence not included in the Table. Abbreviations: CVC, central venous catheter; TPN, total parenteral nutrition; UTI, urinary tract infection.</p

Occurrence of <i>C. dubliniensis</i> among bloodstream isolates of <i>Candida</i> spp.

<p>Occurrence of <i>C. dubliniensis</i> among bloodstream isolates of <i>Candida</i> spp.</p

Antifungal susceptibility profile of <i>Candida dubliniensis</i> isolates.

*<p>Geometric mean for flucytosine resistant isolates was calculated at 32 µg/ml. The numbers of the resistant isolates for the three periods were 10, 29, and 21, respectively. Numbers in parentheses indicate isolates with MIC ≥8 µg/ml <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0032952#pone.0032952-Pfaller1" target="_blank">[23]</a>.</p>a<p>Number of isolates tested.</p

MIC50, MIC90, MIC range and geometric mean of five antifungal agents for 56 <i>C</i>. <i>auris</i> isolates by Etest.

<p>MIC50, MIC90, MIC range and geometric mean of five antifungal agents for 56 <i>C</i>. <i>auris</i> isolates by Etest.</p

Increasing prevalence, molecular characterization and antifungal drug susceptibility of serial <i>Candida auris</i> isolates in Kuwait

<div><p><i>Candida auris</i> is an emerging yeast pathogen of global significance. Its multidrug-resistant nature and inadequacies of conventional identification systems pose diagnostic and therapeutic challenges. This study investigated occurrence of <i>C</i>. <i>auris</i> in clinical specimens in Kuwait and its susceptibility to antifungal agents. Clinical yeast strains isolated during 3.5-year period and forming pink-colored colonies on CHROMagar Candida were studied by wet mount examination for microscopic morphology and Vitek 2 yeast identification system. A simple species-specific PCR assay was developed for molecular identification and results were confirmed by PCR-sequencing of rDNA. Antifungal susceptibility testing of one isolate from each patient was determined by Etest. The 280 isolates forming pink-colored colonies on CHROMagar Candida, were identified by Vitek 2 as <i>Candida haemulonii</i> (n = 166), <i>Candida utilis</i> (n = 49), <i>Candida kefyr</i> (n = 45), <i>Candida guilliermondii</i> (n = 9), <i>Candida famata</i> (n = 6) and <i>Candida conglobata</i> (n = 5). Species-specific PCR and PCR-sequencing of rDNA identified 166 <i>C</i>. <i>haemulonii</i> isolates as <i>C</i>. <i>auris</i> (n = 158), <i>C</i>. <i>haemulonii</i> (n = 6) and <i>Candida duobushaemulonii</i> (n = 2). <i>C</i>. <i>auris</i> isolates originated from diverse clinical specimens from 56 patients. Of 56 <i>C</i>. <i>auris</i> isolates tested, all were resistant to fluconazole, 41/56 (73%) and 13/56 (23%) were additionally resistant to voriconazole and amphotericin B, respectively. Eleven (20%) isolates were resistant to fluconazole, voriconazole and amphotericin B. One isolate was resistant to caspofungin and micafungin. Increasing isolation of <i>C</i>. <i>auris</i> in recent years from diverse clinical specimens including bloodstream shows that <i>C</i>. <i>auris</i> is an emerging non-<i>albicans Candida</i> species in Kuwait causing a variety of infections. Inability of conventional identification methods to accurately identify this pathogen and multidrug-resistant nature of many strains calls for a greater understanding of its epidemiology, risk factors for acquiring <i>C</i>. <i>auris</i> infection and management strategies in high-risk patients. This is the first comprehensive study on the emergence of this multidrug-resistant yeast from Kuwait and the Middle East.</p></div

Origin of 158 <i>C</i>. <i>auris</i> isolates in diverse clinical specimens obtained from 56 patients in Kuwait.

<p>Origin of 158 <i>C</i>. <i>auris</i> isolates in diverse clinical specimens obtained from 56 patients in Kuwait.</p

Additional file 1: of Whole Transcriptome Analysis of Pre-invasive and Invasive Early Squamous Lung Carcinoma in Archival Laser Microdissected Samples

Figure S1. Laser microdissection of FFPE PSCC and ISCC. (DOC 2651 kb

Additional file 2: Table S1. of Increased peri-ductal collagen micro-organization may contribute to raised mammographic density

Breast extracellular matrix (ECM) proteomic data. This table shows the ECM proteins detected in our mass spectrometry analysis of human breast tissue, plus those identified by mass spectrometry in rat mammary tumours, and the ECM of tumours resulting from the in vivo growth of the MD-MBA-231 breast cancer line. Green boxes indicate proteins that were identified in the analyses, red boxes show proteins not identified. The differences in expression may arise because completely different samples have been used, e.g., human vs rat, and normal human breast tissue vs a cancer line model. (DOC 124 kb

Additional file 1: Figure S1. of Increased peri-ductal collagen micro-organization may contribute to raised mammographic density

Coherence of collagen organization in patients with low vs high mammographic density (MD). a, b Polarised Picrosirius red images (×20) of peri-ductal stroma in an individual with low MD (a) and high MD (b). c, d Areas assessed by OrientationJ in individuals with low MD (c) and high MD (d). Colour coding is indicative of angle of collagen orientation. d Coherency values for six individuals with low vs six with high MD. (EPS 47751 kb

Additional file 3: Table S2. of Increased peri-ductal collagen micro-organization may contribute to raised mammographic density

Peptide frequencies for individual proteins identified in the mass spectrometry analysis. This table includes accession number, gene name and raw expression values for low and high mass spectrometry (MD) samples. (DOC 208 kb