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Crl:CD1(ICR) BR adult mice were fed chow containing Candida albicans or regular chow. Both groups were subsequently given either antibiotics acting mainly against Gram-positive organisms or normal saline for 10 days. Stool cultures were performed before, at the end, and one week after discontinuation of treatment to determine the effects on the stool yeast concentration. Candida colonized mice treated with vancomycin, teicoplanin, linezolid, quinupristin-dalfopristin or telithromycin had higher colony counts of yeast in their stools than control Candida fed mice treated with saline. This increase was not statistically significant. Mice fed regular chow treated with the study drugs or saline did not have any yeasts in their stools. Dissemination of Candida was not observed in the visceral organs of any mouse. [ABSTRACT FROM AUTHOR]

We evaluated the effect of three carbapenems on gut colonization of mice by Candida albicans . A total of 150 Crl:CD1 (ICR) BR mice were fed chow containing C. albicans or regular chow. Both groups were subsequently treated either with one carbapenem or with normal saline for 10 days. Stool cultures to determine colonization by C. albicans were performed immediately before, at the end, and one week after the end of treatment. Candida -colonized mice that received carbapenems had substantially higher C. albicans concentrations than control animals fed C. albicans , especially if they received ertapenem. Mice fed regular chow and treated with the study antibiotics or saline did not have Candida in their stools. Candida was not detected in the internal organs of any group of mice. [ABSTRACT FROM AUTHOR]

Descending mediastinitis occurs as a complication of oropharyngeal or cervical infections and its delayed diagnosis and treatment are associated with high mortality. A rare case of an odontogenic infection in a diabetic patient, complicated by Candida parapsilosis and Candida krusei parapharyngeal space infection, descending mediastinitis and aspiration pneumonia is described. Isolate identification was based on colonial and microscopic morphological characteristics and carbohydrate assimilation test results. The patient was successfully treated with surgical drainage and debridement, broad spectrum antibacterials and liposomal amphotericin B followed by prolonged oral voriconazole therapy.

Invasive fungal infections, such as invasive aspergillosis (IA) represent a major threat to immunocompromised patients, especially patients with hematological malignancies or who receive hematopoietic stem cell transplantation. Hence, prevention of IA is a critical strategy that requires a clear understanding of the mould's environmental sources and how it is transmitted to immunocompromised patients. Knowledge of the exposure, mechanisms of transmission, and host susceptibility to IA are vital in selecting appropriate preventive strategies to those settings where infection is more likely to occur. Among the strategies to reduce the incidence of IA is the maintenance of high quality air, i.e. air with low spore counts in hospital areas visited by patients at risk. Housing patients in laminar airflow facilities with high-energy particulate air-filtered rooms helps prevent IA, but it is only realistic and cost-effective for the highest-risk groups and for limited time periods. Air filtration is a costly preventive strategy of questionable value when done with portable filtration units. Moreover, air control measures outside the hospital are extremely difficult to implement and this is important since the majority of cases of IA after allogeneic stem cell transplantation occurs during the post-engraftment period. For these reasons, targeted antifungal prophylaxis remains the most promising of the potential prevention strategies against IA. Many older and newer antifungal agents have been used for this purpose. Amphotericin B, being the oldest and most widely used antifungal, has been used prophylactically in various doses and schedules, but has largely been replaced by its lipid and liposomal formulations that have improved safety profile. Although prophylactic fluconazole prevents candidiasis, this drug has no activity against moulds, including Aspergillus spp. On the other hand itraconazole appears to prevent IA in those patients who can tolerate the drug, since its poor tolerability limits its use. The newer extended spectrum triazole posaconazole has been used in prophylactic trials with encouraging results in selected populations of patients at risk. Voriconazole, another extended spectrum triazole that has emerged as the treatment of choice for IA has been used as secondary prophylaxis in immunocompromised patients with history of IA. Echinocandins, such as caspofungin and micafungin appear to be extremely safe and effective for primary and secondary prophylaxis of IA. Patients undergoing transplantation for hematological malignancies from mismatched or unrelated donors are clearly at higher risk of IA compared to patients undergoing autologous transplantation, since among other risk factors they frequently receive moderate doses of corticosteroids for extended periods for Graft vs. Host Disease (GvHD), a well-known risk factor for IA. Hence, results of studies in specific populations should be analyzed with caution and prophylaxis should be applied to similar patients, because antifungals are not devoid of side effects and overuse selects for resistant fungi. In conclusion, more studies are clearly needed to better define patient populations who will clearly benefit from prophylactic antifungal therapy against IA.