Ocular candidiasis: a review

Shah, Chirag P.; McKey, Joanna; Spirn, Marc J.; Maguire, Joseph I.

doi:10.1136/bjo.2007.133405

Cited by 101 publications

(65 citation statements)

References 29 publications

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“…31 In our earlier publication, we have described that of 12 patients with Candida keratitis who responded to medical therapy, eight were treated with natamycin and that natamycin may be administered for keratitis caused by Candida species. Over 88% (38/43) of isolates were susceptibile to caspofungin.…”

Section: Discussionmentioning

confidence: 99%

Candida Species From Eye Infections: Drug Susceptibility, Virulence Factors, and Molecular Characterization

Ranjith

Sontam

Sharma

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To determine the type of Candida species in ocular infections and to investigate the relationship of antifungal susceptibility profile to virulence factors.METHODS. Fifty isolates of yeast-like fungi from patients with keratitis, endophthalmitis, and orbital cellulitis were identified by Vitek-2 compact system and DNA sequencing of ITS1-5.8S-ITS2 regions of the rRNA gene, followed by phylogenetic analysis for phenotypic and genotypic identification, respectively. Minimum inhibitory concentration of six antifungal drugs was determined by E test/microbroth dilution methods. Phenotypic and genotypic methods were used to determine the virulence factors.RESULTS. Phylogenetic analysis showed the clustering of all isolates into eight distinct groups with a major cluster formed Candida parapsilosis (n ¼ 21), which was the most common species by both Vitek 2 and DNA sequencing. Using v 2 test no significant difference was noted between the techniques except that Vitek 2 did not identify C. viswanathii, C. orthopsilosis, and two non-Candida genera. Of 43 tested Candida isolates high susceptibility to amphotericin B (39/43, 90.6%) and natamycin (43/43, 100%) was noted. While none of the isolates produced coagulase, all produced esterase and catalase. The potential to form biofilm was detected in 23/43 (53.4%) isolates. Distribution of virulence factors by heat map analysis showed difference in metabolic activity of biofilm producers from nonbiofilm producers. CONCLUSIONS.Identified by Vitek 2 and DNA sequencing methods C. parapsilosis was the most common species associated with eye infections. Irrespective of the virulence factors elaborated, the Candida isolates were susceptible to commonly used antifungal drugs such as amphotericin B and natamycin.

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Section: Discussionmentioning

confidence: 99%

Candida Species From Eye Infections: Drug Susceptibility, Virulence Factors, and Molecular Characterization

Ranjith

Sontam

Sharma

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…1 The leading cause of bacterial endogenous endophthalmitis is grampositive species in western countries (gram-negative species in Asian countries), and the leading cause of fungal endogenous endophthalmitis is Candida (followed by aspergillosis). [2][3][4][5][6] Endogenous endophthalmitis associated with hematogenous infections has been recognized for over a century, 7 more commonly among patients with fungemia than bacteremia, 8,9 but with wide variation in reported incidence rates-ranging from 12% to 26% incidence of retinal lesions in bacteremic patients [10][11][12] and from 0 to 78% incidence of chorioretinitis or endophthalmitis in patients with candidemia [13][14][15][16][17][18] -in studies with tens to hundreds of patients with hematogenous infections. 6 Clinical signs include infiltrative chorioretinitis and overlying vitritis (classic for candida endophthalmitis, though uncommon), as well as nonspecific findings such as cotton-wool spots, retinal hemorrhages, and whitecentered Roth spot hemorrhages.…”

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confidence: 99%

Risk Factors Predictive of Endogenous Endophthalmitis Among Hospitalized Patients With Hematogenous Infections in the United States

Vaziri

Pershing

Albini

et al. 2015

American Journal of Ophthalmology

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“…range from infection limited to chorioretinal structures through to involvement of the entire globe. The estimated incidence of endogenous Candida endophthalmitis varies tremendously (5)(6)(7). The most common causative fungal pathogen is Candida albicans, although a range of Candida species have also been documented (5).…”

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confidence: 99%

Pharmacokinetics and Pharmacodynamics of Anidulafungin for Experimental Candida Endophthalmitis: Insights into the Utility of Echinocandins for Treatment of a Potentially Sight-Threatening Infection

Livermore

Felton

Abbott

et al. 2013

Antimicrob Agents Chemother

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c Candida chorioretinitis and endophthalmitis are relatively common manifestations of disseminated candidiasis. Anidulafungin is increasingly used for the treatment of disseminated candidiasis, but its efficacy for Candida endophthalmitis is not known. A nonneutropenic model of hematogenous Candida endophthalmitis was used. Anidulafungin at 5, 10, and 20 mg/kg was initiated at 48 h postinoculation. The fungal densities in the kidney and vitreous humor were determined. Anidulafungin concentrations in the plasma and vitreous humor were measured using high-performance liquid chromatography (HPLC). A pharmacokineticpharmacodynamic model was used to link anidulafungin concentrations with the observed antifungal effect. The area under the concentration-time curve (AUC) associated with stasis was determined in the both the kidney and the vitreous humor. The results were bridged to humans to identify likely dosages that are associated with significant antifungal activity within the eye. Inoculation of Candida albicans resulted in logarithmic growth in both the vitreous humor and the kidney. The pharmacokinetics of anidulafungin were linear. There was dose-dependent penetration of the anidulafungin into the vitreous humor. The exposure-response relationships in the kidney and vitreous were completely discordant. AUCs of 270 and 100 were required for stasis in the eye and kidney, respectively. The currently licensed regimen results in an AUC for an average patient that is associated with stasis in the kidney but minimal antifungal activity in the eye. We conclude that anidulafungin penetrates the eye in a dosedependent manner and that dosages higher than those currently licensed are required to achieve significant antifungal activity in the eye.

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Ocular candidiasis: a review

Cited by 101 publications

References 29 publications

Candida Species From Eye Infections: Drug Susceptibility, Virulence Factors, and Molecular Characterization

Candida Species From Eye Infections: Drug Susceptibility, Virulence Factors, and Molecular Characterization

Risk Factors Predictive of Endogenous Endophthalmitis Among Hospitalized Patients With Hematogenous Infections in the United States

Pharmacokinetics and Pharmacodynamics of Anidulafungin for Experimental Candida Endophthalmitis: Insights into the Utility of Echinocandins for Treatment of a Potentially Sight-Threatening Infection

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