Oropharyngeal candidiasis in hospitalised COVID-19 patients from Iran: Species identification and antifungal susceptibility pattern

Mohammadreza Salehi; Kazem Ahmadikia; Shahram Mahmoudi; Saeed Kalantari; Saeidreza Jamalimoghadamsiahkali; Alireza Izadi; Mohammad Kord; Seyed Ali Dehghan Manshadi; Arash Seifi; Fereshteh Ghiasvand; Nasim Khajavirad; Saeedeh Ebrahimi; Amirhossein Koohfar; Teun Boekhout; Sadegh Khodavaisy

doi:10.1111/myc.13137

Oropharyngeal candidiasis in hospitalised COVID-19 patients from Iran: Species identification and antifungal susceptibility pattern

Mohammadreza Salehi, Kazem Ahmadikia, Shahram Mahmoudi, Saeed Kalantari, Saeidreza Jamalimoghadamsiahkali, Alireza Izadi, Mohammad Kord, Seyed Ali Dehghan Manshadi, Arash Seifi, Fereshteh Ghiasvand, Nasim Khajavirad, Saeedeh Ebrahimi, Amirhossein Koohfar, Teun Boekhout, Sadegh Khodavaisy

Research output: Contribution to journal/periodical › Article › Scientific › peer-review

107 Citations (Scopus)

Abstract

BACKGROUND: Emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. Apparently, the novel coronavirus (SARS-CoV-2) is armed by special abilities to spread and dysregulate the immune mechanisms. The likelihood of oropharyngeal candidiasis (OPC) development in COVID-19 patients with a list of attributable risk factors for oral infections has not yet been investigated.

OBJECTIVES: We here aim to investigate the prevalence, causative agents and antifungal susceptibility pattern of OPC in Iranian COVID-19 patients.

PATIENTS AND METHODS: A total of 53 hospitalised COVID-19 patients with OPC were studied. Relevant clinical data were mined. Strain identification was performed by 21-plex PCR and sequencing of the internal transcribed spacer region (ITS1-5.8S-ITS2). Antifungal susceptibility testing to fluconazole, itraconazole, voriconazole, amphotericin B, caspofungin, micafungin and anidulafungin was performed according to the CLSI broth dilution method.

RESULTS: In 53 COVID-19 patients with OPC, cardiovascular diseases (52.83%) and diabetes (37.7%) were the principal underlying conditions. The most common risk factor was lymphopaenia (71%). In total, 65 Candida isolates causing OPC were recovered. C albicans (70.7%) was the most common, followed by C glabrata (10.7%), C dubliniensis (9.2%), C parapsilosis sensu stricto (4.6%), C tropicalis (3%) and Pichia kudriavzevii (=C krusei, 1.5%). Majority of the Candida isolates were susceptible to all three classes of antifungal drugs.

CONCLUSION: Our data clarified some concerns regarding the occurrence of OPC in Iranian COVID-19 patients. Further studies should be conducted to design an appropriate prophylaxis programme and improve management of OPC in critically ill COVID-19 patients.

Original language	English
Pages (from-to)	771-778
Number of pages	8
Journal	Mycoses
Volume	63
Issue number	8
DOIs	https://doi.org/10.1111/myc.13137
Publication status	Published - Aug 2020

Keywords

Adult
Aged
Aged, 80 and over
Antifungal Agents/pharmacology
COVID-19
Candida/classification
Candidiasis, Oral/complications
Coronavirus Infections/complications
Female
Humans
Iran
Male
Microbial Sensitivity Tests
Middle Aged
Pandemics
Phenotype
Pneumonia, Viral/complications
Time Factors

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10.1111/myc.13137

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Salehi, M., Ahmadikia, K., Mahmoudi, S., Kalantari, S., Jamalimoghadamsiahkali, S., Izadi, A., Kord, M., Dehghan Manshadi, S. A., Seifi, A., Ghiasvand, F., Khajavirad, N., Ebrahimi, S., Koohfar, A., Boekhout, T., & Khodavaisy, S. (2020). Oropharyngeal candidiasis in hospitalised COVID-19 patients from Iran: Species identification and antifungal susceptibility pattern. Mycoses, 63(8), 771-778. https://doi.org/10.1111/myc.13137

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title = "Oropharyngeal candidiasis in hospitalised COVID-19 patients from Iran: Species identification and antifungal susceptibility pattern",

abstract = "BACKGROUND: Emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. Apparently, the novel coronavirus (SARS-CoV-2) is armed by special abilities to spread and dysregulate the immune mechanisms. The likelihood of oropharyngeal candidiasis (OPC) development in COVID-19 patients with a list of attributable risk factors for oral infections has not yet been investigated.OBJECTIVES: We here aim to investigate the prevalence, causative agents and antifungal susceptibility pattern of OPC in Iranian COVID-19 patients.PATIENTS AND METHODS: A total of 53 hospitalised COVID-19 patients with OPC were studied. Relevant clinical data were mined. Strain identification was performed by 21-plex PCR and sequencing of the internal transcribed spacer region (ITS1-5.8S-ITS2). Antifungal susceptibility testing to fluconazole, itraconazole, voriconazole, amphotericin B, caspofungin, micafungin and anidulafungin was performed according to the CLSI broth dilution method.RESULTS: In 53 COVID-19 patients with OPC, cardiovascular diseases (52.83%) and diabetes (37.7%) were the principal underlying conditions. The most common risk factor was lymphopaenia (71%). In total, 65 Candida isolates causing OPC were recovered. C albicans (70.7%) was the most common, followed by C glabrata (10.7%), C dubliniensis (9.2%), C parapsilosis sensu stricto (4.6%), C tropicalis (3%) and Pichia kudriavzevii (=C krusei, 1.5%). Majority of the Candida isolates were susceptible to all three classes of antifungal drugs.CONCLUSION: Our data clarified some concerns regarding the occurrence of OPC in Iranian COVID-19 patients. Further studies should be conducted to design an appropriate prophylaxis programme and improve management of OPC in critically ill COVID-19 patients.",

keywords = "Adult, Aged, Aged, 80 and over, Antifungal Agents/pharmacology, COVID-19, Candida/classification, Candidiasis, Oral/complications, Coronavirus Infections/complications, Female, Humans, Iran, Male, Microbial Sensitivity Tests, Middle Aged, Pandemics, Phenotype, Pneumonia, Viral/complications, Time Factors",

author = "Mohammadreza Salehi and Kazem Ahmadikia and Shahram Mahmoudi and Saeed Kalantari and Saeidreza Jamalimoghadamsiahkali and Alireza Izadi and Mohammad Kord and {Dehghan Manshadi}, {Seyed Ali} and Arash Seifi and Fereshteh Ghiasvand and Nasim Khajavirad and Saeedeh Ebrahimi and Amirhossein Koohfar and Teun Boekhout and Sadegh Khodavaisy",

note = "{\textcopyright} 2020 Blackwell Verlag GmbH.",

year = "2020",

month = aug,

doi = "10.1111/myc.13137",

language = "English",

volume = "63",

pages = "771--778",

journal = "Mycoses",

issn = "0933-7407",

publisher = "John Wiley and Sons Ltd",

number = "8",

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Salehi, M, Ahmadikia, K, Mahmoudi, S, Kalantari, S, Jamalimoghadamsiahkali, S, Izadi, A, Kord, M, Dehghan Manshadi, SA, Seifi, A, Ghiasvand, F, Khajavirad, N, Ebrahimi, S, Koohfar, A, Boekhout, T & Khodavaisy, S 2020, 'Oropharyngeal candidiasis in hospitalised COVID-19 patients from Iran: Species identification and antifungal susceptibility pattern', Mycoses, vol. 63, no. 8, pp. 771-778. https://doi.org/10.1111/myc.13137

TY - JOUR

T1 - Oropharyngeal candidiasis in hospitalised COVID-19 patients from Iran

T2 - Species identification and antifungal susceptibility pattern

AU - Salehi, Mohammadreza

AU - Ahmadikia, Kazem

AU - Mahmoudi, Shahram

AU - Kalantari, Saeed

AU - Jamalimoghadamsiahkali, Saeidreza

AU - Izadi, Alireza

AU - Kord, Mohammad

AU - Dehghan Manshadi, Seyed Ali

AU - Seifi, Arash

AU - Ghiasvand, Fereshteh

AU - Khajavirad, Nasim

AU - Ebrahimi, Saeedeh

AU - Koohfar, Amirhossein

AU - Boekhout, Teun

AU - Khodavaisy, Sadegh

PY - 2020/8

Y1 - 2020/8

N2 - BACKGROUND: Emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. Apparently, the novel coronavirus (SARS-CoV-2) is armed by special abilities to spread and dysregulate the immune mechanisms. The likelihood of oropharyngeal candidiasis (OPC) development in COVID-19 patients with a list of attributable risk factors for oral infections has not yet been investigated.OBJECTIVES: We here aim to investigate the prevalence, causative agents and antifungal susceptibility pattern of OPC in Iranian COVID-19 patients.PATIENTS AND METHODS: A total of 53 hospitalised COVID-19 patients with OPC were studied. Relevant clinical data were mined. Strain identification was performed by 21-plex PCR and sequencing of the internal transcribed spacer region (ITS1-5.8S-ITS2). Antifungal susceptibility testing to fluconazole, itraconazole, voriconazole, amphotericin B, caspofungin, micafungin and anidulafungin was performed according to the CLSI broth dilution method.RESULTS: In 53 COVID-19 patients with OPC, cardiovascular diseases (52.83%) and diabetes (37.7%) were the principal underlying conditions. The most common risk factor was lymphopaenia (71%). In total, 65 Candida isolates causing OPC were recovered. C albicans (70.7%) was the most common, followed by C glabrata (10.7%), C dubliniensis (9.2%), C parapsilosis sensu stricto (4.6%), C tropicalis (3%) and Pichia kudriavzevii (=C krusei, 1.5%). Majority of the Candida isolates were susceptible to all three classes of antifungal drugs.CONCLUSION: Our data clarified some concerns regarding the occurrence of OPC in Iranian COVID-19 patients. Further studies should be conducted to design an appropriate prophylaxis programme and improve management of OPC in critically ill COVID-19 patients.

AB - BACKGROUND: Emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. Apparently, the novel coronavirus (SARS-CoV-2) is armed by special abilities to spread and dysregulate the immune mechanisms. The likelihood of oropharyngeal candidiasis (OPC) development in COVID-19 patients with a list of attributable risk factors for oral infections has not yet been investigated.OBJECTIVES: We here aim to investigate the prevalence, causative agents and antifungal susceptibility pattern of OPC in Iranian COVID-19 patients.PATIENTS AND METHODS: A total of 53 hospitalised COVID-19 patients with OPC were studied. Relevant clinical data were mined. Strain identification was performed by 21-plex PCR and sequencing of the internal transcribed spacer region (ITS1-5.8S-ITS2). Antifungal susceptibility testing to fluconazole, itraconazole, voriconazole, amphotericin B, caspofungin, micafungin and anidulafungin was performed according to the CLSI broth dilution method.RESULTS: In 53 COVID-19 patients with OPC, cardiovascular diseases (52.83%) and diabetes (37.7%) were the principal underlying conditions. The most common risk factor was lymphopaenia (71%). In total, 65 Candida isolates causing OPC were recovered. C albicans (70.7%) was the most common, followed by C glabrata (10.7%), C dubliniensis (9.2%), C parapsilosis sensu stricto (4.6%), C tropicalis (3%) and Pichia kudriavzevii (=C krusei, 1.5%). Majority of the Candida isolates were susceptible to all three classes of antifungal drugs.CONCLUSION: Our data clarified some concerns regarding the occurrence of OPC in Iranian COVID-19 patients. Further studies should be conducted to design an appropriate prophylaxis programme and improve management of OPC in critically ill COVID-19 patients.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Antifungal Agents/pharmacology

KW - COVID-19

KW - Candida/classification

KW - Candidiasis, Oral/complications

KW - Coronavirus Infections/complications

KW - Female

KW - Humans

KW - Iran

KW - Male

KW - Microbial Sensitivity Tests

KW - Middle Aged

KW - Pandemics

KW - Phenotype

KW - Pneumonia, Viral/complications

KW - Time Factors

U2 - 10.1111/myc.13137

DO - 10.1111/myc.13137

M3 - Article

C2 - 32609906

SN - 0933-7407

VL - 63

SP - 771

EP - 778

JO - Mycoses

JF - Mycoses

IS - 8

ER -

Oropharyngeal candidiasis in hospitalised COVID-19 patients from Iran: Species identification and antifungal susceptibility pattern

Abstract

Keywords

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