Clinical impact of Candida respiratory tract colonization and acute lung infections in critically ill patients with COVID-19 pneumonia. (May 2022)

• Record Type: Journal Article
• Authors: Erami, Mahzad; Raiesi, Omid; Momen-Heravi, Mansooreh; Getso, Muhammad Ibrahim; Fakhrehi, Mojtaba; Mehri, Narges; Yarahmadi, Mohammad; Amiri, Sasan; Raissi, Vahid; Hashemi, Seyed Jamal
• Is Part Of: Microbial pathogenesis. Volume 166(2022)
• Publication Date: 2022-05
• Subjects: COVID-19 -- SARS-CoV-2 -- Candida -- Bronchoalveolar lavage -- Mechanical ventilation -- Antifungal agents; Pathogenic microorganisms -- Periodicals; Pathology, Molecular -- Periodicals; Communicable Diseases -- microbiology -- Periodicals; Communicable Diseases -- parasitology -- Periodicals; Micro-organismes pathogènes -- Périodiques; Pathologie moléculaire -- Périodiques; Electronic journals; 616.9041
• DOI: 10.1016/j.micpath.2022.105520
• Languages: English
• ISSNs: 0882-4010

Abstract

Abstract: Coronavirus disease 2019 (COVID-19), which is attributable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been causing a worldwide health issue. Airways colonization by Candida spp. is prevalent among patients on automatic ventilation in intensive care units (ICUs). This research aimed to ascertain the risk factors and roles of Candida spp. respiratory tract colonization, and Candida lung infection during the progression of COVID-19 pneumonia in critically ill patients. In total, Candida spp. were recovered in 69 from 100 immunosuppressed patients with COVID-19. Bronchoscopy was used to collect the Bronchoalveolar lavage (BAL) specimens. For the identification of Candida spp. PCR sequencing was done using the ITS1 and ITS4 primers. The amplification of the HWP1 gene was conducted to identify the Candida albicans complex. The antifungal activities of fluconazole, itraconazole, voriconazole, amphotericin B and caspofungin against Candida spp. were evaluated using the Clinical and Laboratory Standards Institute M60. In 63.77% of the patients, Candida respiratory colonization at D0 and D14 had no impact on the severity of COVID-19. In comparison to C. albicans strains, Candida respiratory disorder with C. glabrata had influenced the severity of COVID-19 for critically ill patients following adjustment for the risk factors of COVID-19 ( P < 0.05). Amphotericin B and caspofungin showed superior activity against all Candida spp. All antifungal agents showed 100% sensitivity against the two C. africana strains. Our observation on patients who used automatic ventilation, respiratory colonization by Candida spp. was not seen to influence the infection or death caused by COVID-19. Amphotericin B and caspofungin showed superior activity against all Candida spp. and were recommended for the treatment regime of pulmonary candidiasis associated with COVID-19 infection. Although " Candida pneumonia" is rarely being reported in critically ill patients, Candida airway colonization mainly by Candida albicans is common especially among patients with diabetes, malignancies, and kidney disorders. Highlights: Candida spp. were recovered in 69 Bronchoalveolar lavage (BAL) specimens of 100 immunosuppressed patients with COVID-19. Candida airways colonization by C. albicans is common in COVID-19 patients with diabetes, malignancies, and kidney diseases. In 63.77% of the patients, Candida respiratory colonization at D0 and D14 had no impact on the severity of COVID-19. Candida respiratory disorder with C. glabrata had influenced the severity of COVID-19 for critically ill patients. Amphotericin B and caspofungin showed superior activity against all Candida spp.