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

Onderzoeksoutput: Bijdrage aan wetenschappelijk tijdschrift/periodieke uitgave › Artikel › Wetenschappelijk › peer review

129 Citaten (Scopus)

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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.

Originele taal-2	Engels
Pagina's (van-tot)	771-778
Aantal pagina's	8
Tijdschrift	Mycoses
Volume	63
Nummer van het tijdschrift	8
DOI's	https://doi.org/10.1111/myc.13137
Status	Gepubliceerd - aug. 2020

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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

@article{bf60dc70e67a481987f040f880a2629d,

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 = "Wiley-Blackwell",

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, nr. 8, blz. 771-778. https://doi.org/10.1111/myc.13137

Oropharyngeal candidiasis in hospitalised COVID-19 patients from Iran: Species identification and antifungal susceptibility pattern. / Salehi, Mohammadreza; Ahmadikia, Kazem; Mahmoudi, Shahram et al.
In: Mycoses, Vol. 63, Nr. 8, 08.2020, blz. 771-778.

Onderzoeksoutput: Bijdrage aan wetenschappelijk tijdschrift/periodieke uitgave › Artikel › Wetenschappelijk › peer review

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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

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