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Fulltext A Review of Studies on Candida Species in Peninsular Malaysia

Farooq H, Monowar T, Latt SS, Chinni SV, Zainol NH, Sabesan GS

Adv Biomed Res, 2022;11:98.
PMID: 36660752 DOI: 10.4103/abr.abr_3_22

Data on the epidemiology and the antifungal susceptibility of Candida species infections in Malaysia is still limited. The study aimed to review and compare studies reporting the prevalence of Candida species and antifungal susceptibility of Candida infections in Peninsular Malaysia. Data from 22 studies published between 2009 and 2018. Data was collected using National Center for Biotechnology Information and Google Scholar using the keywords "Candida and Malaysia." Around 19 Candida species were identified in a total of 35,608 Candida isolates analyzed in these studies. In most studies examined, C. albicans (66.3%) was the predominant species, followed by C. glabrata (11.7%), C. parapsilosis (10.7%), C. tropicalis (9.5%), and C. krusei (1.19%). Vaginal swabs yielded the most isolates, followed by the respiratory system, urine, blood, oral, pus, and other locations. The demographic, racial, and gender data were recorded only in two studies. Totally, eight studies examined 396 isolates for antifungal susceptibility to common antifungal medications. The average antifungal susceptibility of isolates and efficacy of drugs in these studies ranged between 45 and 99% for most common antifungal drugs. Caspofungin had the highest susceptibility at 99%, whereas itraconazole had the lowest at only 45%. Overall, this review provided a comprehensive summary of all the current research on predominant Candida species in Peninsular Malaysia.
Fulltext Epidemiology and molecular identification of mixed yeast isolates in Malaysia: A way forward

Farooq H, Monowar T, V Chinni S, Swe Latt S, Hasliza Zainol N, Shankar Sabesan G

Curr Med Mycol, 2022 Sep;8(3):35-38.
PMID: 37051557 DOI: 10.18502/cmm.8.3.11209

BACKGROUND AND PURPOSE: Invasive candidiasis is one of the most common systemic mycoses, and studies have shown mixed yeast infections. Malaysia lacks mixed yeast culture data.
MATERIALS AND METHODS: Yeast isolates were collected in Sultan Abdul Halim Hospital, North Malaysia, from October 2020 to October 2021. Chromogenic Candida differential agar media and PCR-RFLP were used to identify yeast species.
RESULTS: A total of 206 yeast isolates were collected from different body sites of patients. The majority of the yeast isolates (n=104) were obtained from the urine. Other isolates were extracted from blood (n=52), vaginal swabs (n=45), ear discharge (n=2), tracheal aspirate (n=2), tissue (n=2), skin (n=1), nail (n=1), sputum (n=1), and cerebrospinal fluid (n=1). In total, 200 yeast samples were identified as single species, and six isolates were a mixture of Candida species.
CONCLUSION: Malaysia lacks accurate epidemiological data on mixed yeast infections. We identified all samples to the species level, including mixed yeast cultures, using the MspI enzyme and PCR-RFLP.
Fulltext Molecular epidemiology of clinically relevant single and mixed species in a Malaysian tertiary care hospital

Farooq H, Sabesan GS, Monowar T, V Chinni S, Zainol NH, Latt S, et al.

Curr Med Mycol, 2023 Jun;9(2):23-28.
PMID: 38375519 DOI: 10.18502/cmm.2023.345062.1432

BACKGROUND AND PURPOSE: The increasing rate of opportunistic infections caused by Candida and other yeasts is becoming a major health concern worldwide. However, systematic data on the epidemiology and the yeast species infections in Malaysia is still limited. In this regard, the present research aimed to identify pathogenic yeasts utilizing an economically practical and easily available molecular technique and evaluate the prevalence of pathogenic yeasts in a Malaysian tertiary care hospital.
MATERIALS AND METHODS: Yeast isolates were collected from Sultan Abdul Halim Hospital, Kedah, Malaysia, from October 2020 to October 2021. Molecular identification of the isolates was performed by one enzyme-based polymerase chain reaction-restriction fragment length polymorphism method.
RESULTS: Candida albicans was the most prevalent species, accounting for 120 isolates (59%) in total. The most prevalent non-albicans Candida species were C. tropicalis (n=33, 16%), C. krusei (Pichia kudriavzevii) (n=12, 5.8%), C. glabrata (n=12, 5.8%), and C. parapsilosis (n=6, 3%). Other unusual Candida species were C. guilliermondii (2), C. metapsilosis (2), C. orthopsilosis (1), C. lusitaniae (1), C. rugosa (1), C. haemulonii (1), C. bracarensis (1), and C. dubliniensis (1). Moreover, Talaromyces marneffei (1), Kodamaea ohmeri (1), Cryptococcus neoformans (3), and Cryptococcus laurentii (1) were among the other yeasts identified.
CONCLUSION: The Molecular technique used in this study identified 96% of isolates, including mixed species. According to the findings, the most prevalent species are C. albicans, C. tropicalis, C. krusei, and C. glabrata.
Fulltext Case report of a rare fungal infection Kodamaea ohmeri in COVID-19 patient in North Malaysian hospital

Farooq H, Sabesan GS, Monowar T, Chinni SV, Zainol NH

Indian J Pathol Microbiol, 2024 Jul 01;67(3):654-657.
PMID: 38391359 DOI: 10.4103/ijpm.ijpm_972_22

Kodamaea ohmeri is a rare opportunistic pathogen belonging to Saccharomycetes family. This yeast was also formerly known as Yamadazyma ohmeri or Pichia ohmeri . This opportunistic pathogen causes illness that typically affects people with impaired immune system. In this report, we discuss a fatal case involving a woman in her late 30s who was admitted to the hospital on the sixth day of her sickness after being given a COVID-19 Category 5A diagnosis. For COVID-19, she received subcutaneous heparin, cefuroxime, and intravenous corticosteroids. She was diagnosed with secondary bacterial and fungal infections in the ICU. Multiple antibiotics and antifungal were given to treat bacterial and fungal infections. An unusual fungus, Kodamaea ohmeri , was isolated from the clinical sample. On day 36, she succumbed to her infection in the ICU. The cause of death was multidrug-resistant sepsis with multiple organ failures due to COVID-19 infection, worsened by an embolism and trachea damage during a tracheostomy. To effectively manage K. ohmeri , clinicians and microbiologists must identify and be aware of this emerging human opportunistic pathogen, which can co-infect debilitated patients such as COVID-19 patients, for effective management.