Candida albicans

Candida albicans
Types of infection
Clinical manifestation
Diagnosis

1. Candida albicans Muhammad Mubashar Noor 04051813035 Microbiology BS 6th

2. Commensal yeast Opportunistic pathogenic yeast Species name,  albicans , comes from the Latin word for “white.” Phylum Ascomycota Family Sachharomycetaceae Commonly cause an infection known as Candidiasis Candida albicans Muhammad Mubashar Noor 1

3. There are several different types of infections caused by Candida albicans Urinary yeast infection Genital yeast infection (Genital Candidiasis) Oral thrush (Oropharyngeal Candidiasis) Mucocutaneous candidiasis Invasive Candidiasis Types of  Candida albicans  infections Muhammad Mubashar Noor 2

4. Candida  species are the most common cause of fungal urinary tract infections (UTIs).  Candida  UTIs can occur in the lower portion of the urinary tract or in some cases can ascend up to the kidneys. Many people with a  Candida  UTI don’t have symptoms. If symptoms are present, they can include: an increased need to urinate a painful or burning sensation while urination abdominal or pelvic pain blood in urine Urinary yeast infection Muhammad Mubashar Noor 3

5. Candida albicans  is the most common cause of genital yeast infections. Normally, a type of bacteria called  Lactobacillus  keeps the amount of  Candida  in the genital area under control. However, when Lactobacillus levels are disrupted due to  pregnancy, diabetes, use of some medicines, lubricants, or spermicides, or a weakened immune system  Candida  can overgrow and cause an infection. Three out of four adult women will get at least one yeast infection during their lifetime. This occurs when too much yeast grows in the vagina. (Men also can get a genital yeast infection, but it's much less common). Genital Yeast Infection (Genital Candidiasis) Muhammad Mubashar Noor 4

6. Symptoms of a genital  Candida  infection can include: A burning feeling while urinating An itchy or painful feeling in or around the vagina Redness, irritation, or swelling around the vagina A rash around the vagina A rash on the penis Candida  species can also infect the male genitals, often if their partner has a vaginal  Candida  infection. The infection may be asymptomatic but can cause an itchy or burning rash around the head of the penis. Genital Yeast Infection (Genital Candidiasis) Muhammad Mubashar Noor 5

7. When the candida yeast spreads in the mouth and throat, it can cause an infection called thrush. It’s most common in newborns, the elderly and people with weakened immune systems. Also, more likely to get it are adults who Are being treated for cancer Take medications like corticosteroids and wide-spectrum antibiotics The symptoms include: White or yellow patches on the tongue, lips, roof of mouth, and inner cheeks Redness or soreness in the mouth and throat Cracking at the corners of the mouth Pain when swallowing, if it spreads to the throat Oral thrush (Oropharyngeal Candidiasis) Muhammad Mubashar Noor 6

8. Candida  species can also infect skin and mucus membranes. Candida albicans is most often the cause of a fungal skin infection, although other  Candida  strains can also cause it. Areas that are warm, moist, or sweaty provide good environments for yeast to thrive. The most common symptom of a  Candida  skin infection is a red rash that forms in the affected area. In some cases, blister-like lesions can form. The skin may also become thickened or produce a white substance that has a curd-like appearance. Mucocutaneous candidiasis Muhammad Mubashar Noor 7

9. If Candida yeast enters the bloodstream or body (usually through medical equipment or devices), it can travel to the heart, brain, blood, eyes, and bones. This can cause a serious, life-threatening infections which include Candidemia Endocarditis Endophthalmitis Fungal meningitis Invasive Candidiasis Muhammad Mubashar Noor 8

10. E pidemiology Over 75% of women suffer from C. albicans infection, usually vulvovaginal candidiasis, in their lifetimes, and 40-50% of them will have additional occurrences(s). Interestingly, C. albicans is the 4th leading cause for nosocomial infections in patients' bloodstreams. This could result in an extremely life-threatening, systemic infection in hospital patients with a mortality rate of 30 %. Muhammad Mubashar Noor 9

11. Risk factor Babies with a nappy rash People with a metabolic disorder, including diabetics Overweight people Pregnant women People who work in wet conditions. People who are HIV-positive or suffer from another type o f immunodeficiency Neutropenia Muhammad Mubashar Noor 10

12. Clinical Manifestations of Candida Candidias i s Muc o cutaneous manifestations Cutaneous manife s ta t ions Systemic manifesta t ions Infectious diseases Allergic diseases Muhammad Mubashar Noor 11

13. Mucocutaneous Manifestations Muco c ut a n e ous manifestations Oral candidiasis Angular cheilitis Oesophagitis Vulvovaginitis, Chronic mucocutaneous candidiasis (CMC) Ocular candidiasis Muhammad Mubashar Noor 12

14. Cutaneous Manifestations Cutaneous Manifestations Intertrigo Paronychia and Onychomycosis Diaper dermatitis Candidial granulo m a Muhammad Mubashar Noor 13

15. Systemic Manifestations Systemic manifestations Urinary tract candidiasis Ca n didu r ia Endocarditis Pulmonary candidiasis Meningitis Candidemia and Septicemia Disseminated candidiasis Osteomyelitis End o p t halmitis Nosocomial candidiasis Muhammad Mubashar Noor 14

16. Allergic Diseases Allergic diseases Candidids Eczema Asthma Gastritis Muhammad Mubashar Noor 15

17. Specimen is collected depends on the type of infection Urine (in case of UTI) Vaginal discharge (suspected cases of vaginal thrush) CSF (when meningitis is suspected) Sputum (when oral thrush is suspected) Other exudates from mucosal surface LABORATORY DIAGNOSIS Muhammad Mubashar Noor 16

18. Microscopy and Staining Candida  yeast cells can be detected in unstained wet preparations or Gram-stained preparations of sample.  In Gram-stained smears, Candida appears as gram positive budding yeast cells and/or pseudo hyphae showing regular points of constriction. Muhammad Mubashar Noor 17

19. Candida albicans  grows well on  Sabouraud dextrose agar  and most routinely used  bacteriological media . Cream-colored pasty colonies usually appear after 24-48 hours of incubation at 25-37°C. The colonies have a distinctive yeast smell, and the budding cells can be easily seen by direct microscopy in stained or unstained preparations. In  Blood Agar ,  Candida albicans  gives white, creamy colored colonies which can be sometime mistaken for  Staphylococcus  spp.  Whenever analyzing the culture report of ‘high vaginal swab’, take extra care as the colony we are observing can be of  Candida albicans  instead of  Staphylococcus aureus  or vice versa (quick solution for this is to perform wet mount or gram staining and observing under microscope). Culture Muhammad Mubashar Noor 18

20. Culture Muhammad Mubashar Noor 19 Suspected strains of Candida isolates grown on CMA or rice starch agar and incubate at 25°C. Formation of large highly refractile, thick walled, terminal chlamydospore in 2-3 days of incubation.

21. Biochemical tests Muhammad Mubashar Noor 20 Biochemical tests are also routinely done following the initial phenotypic identification of the cultures on agar media and microscopy. Tests using single enzyme are able to detect the presence or absence of an enzyme or a biochemical reactions. Various  Candida  species can be detected by observing the changes in the indicator colour when the yeast cultures utilize 1% carbohydrates such as glucose, maltose, sucrose. Glucose and maltose is fermented with acid and gas production, sucrose and lactose is nor fermented by Candida albicans in triple sugar iron agar test.

22. Candida albicans  can be identified presumptively by a simple germ tube test. Further tests: Muhammad Mubashar Noor 21 Germ tube test Germ tube test is the confirmatory test for  Candida albicans . Germ tube formation was first reported by Reynolds and Braude and hence the germ tube test is also known as Reynolds- Braude phenomenon. This is a rapid method for identifying and differentiating  Candida albicans  from another  Candida spp.

23. Principle of Germ Tube Test Germ tubes are short outgrowths, non-septate germinating hyphae. They are ½ the width and 3 – 4 times the length of the cell from which they arise. When cells of  Candida  are incubated in serum at 37 ° C for 2-3 hours  Candida albicans  produce short, slender, tube-like structures called germ tubes. The formation of germ tubes is associated with increased synthesis of protein and ribonucleic acid. Various media like fetal bovine serum or human pooled serum may be used. Muhammad Mubashar Noor 22

24. Treatment Localized infection For infection of the skin, there is an antifungal cream or powder or prescription of antifungal drug by doctor. In case of o ral candidiasis topical treatments or oral medication is used. For vaginal yeast infections, treatment consists of antifungal medications that are administered directly into the vagina as tablets, creams, ointments, or suppositories, or administered by mouth (e.g., fluconazole ). A one-time dose of fluconazole is 90% effective in treating a vaginal yeast infection. For vaginal yeast infection in pregnancy, topical imidazole or triazole antifungals is prescribed . Blood infection I ntravenous fluconazole or an echinocandin such as caspofungin may be used. Amphotericin B can also be used Muhammad Mubashar Noor 23

25. P revention In general, Candida infections can be prevented by keeping our skin clean and dry . U s e antibiotics only as doctor prescribed F ollow a healthy lifestyle, including proper nutrition People with diabetes should try to keep their blood sugar under tight control. If anyone have HIV or another cause of recurrent episodes of thrush, then antifungal drugs such as clotrimazole can help to minimize flare-ups (but take medication by consulting with doctor). Muhammad Mubashar Noor 24