Clinical trial · Observational

Efflux Pump Mediated Azole Resistance in Candida Albicans

Efflux Pump Mediated Azole Resistance in Candida Albicans Among Neutropenic Patients With Haematological Malignancies

NCT03659162CI-TRIAL-00034724unknownClinicalTrials.gov clinicaltrialsPublishedExplore in graph →

Summary

Brief summary (as posted)

Candida albicans is the major fungal pathogen causing infections in humans, ranging from superficial mucosal infection to systemic mycoses. In recent years, Candida infections have increased disproportionately as a result of the increased number of compromised host populations, such as patients with AIDS, diabetes and various cancers, and organ-transplant recipients. Severe oro-pharyngeal candidiasis afflicts many AIDS patients and is a significant infection in cancer patients being treated with chemotherapy and/or radiotherapy.

Conditions

Conditions (1)

Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.

Condition (as posted)	Mapped entity	Match	Confidence
Fungal Infection	—	UNRESOLVED	—

Interventions

Interventions (1)

Intervention	Type	Mapped drug	Match
Azole Antifungal	Drug	—	UNRESOLVED

Design

Arms and outcomes

Arms (1)

label
neutropenic cancer patient recieving azoles .
description
neutropenic cancer patients that undergoing chemotherapy with prophylaxis with azoles and exhibit recurrent fungal infection so appropriate clinical specimen will taken for isolation \& identification of causative agent \& it's antimicrobial profile then identification of the mechanism of resistance by invitro technique then confirmed by real time pcr.
interventionNames
1. Drug: Azole Antifungal

Primary outcomes (1)

measure
characterize the clinical Candida albicans strains isolated from neutropenic patients with Hematological Malignancies.
timeFrame
3 months
description
isolation \& identification of of Candida albicans by culturing on Sabouraud's Dextrose Agar (SDA) and CHROM Agar Candida then determination of antifungal susceptibility testing by Disk Diffusion test and determination of MIC by broth microdilution method to identify resistant Candida albicans strains to decrease hazard to these high risk group of patients.

Secondary outcomes (3)

Eligibility

Eligibility (as posted)

Sex: All

Show eligibility criteria text

Inclusion Criteria:

* Patients suffered from neutropenia. Patients with absolute neutrophiles count less than 500 cells / ml . 7 days or more from start of chemotherapy. Also neutropenic patients presented during relapse after first remission of hematological malignancies.

Presence of resistance to at least one azole derivatives.

Exclusion Criteria:

* Patient who have contraindication to Azoles

References

Publications (10)

BACKGROUNDPfaffl MW. A new mathematical model for relative quantification in real-time RT-PCR. Nucleic Acids Res. 2001 May 1;29(9):e45. doi: 10.1093/nar/29.9.e45. PMID 11328886
BACKGROUNDBeck-Sague C, Jarvis WR. Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980-1990. National Nosocomial Infections Surveillance System. J Infect Dis. 1993 May;167(5):1247-51. doi: 10.1093/infdis/167.5.1247. PMID 8486965
BACKGROUNDDavies AN, Brailsford SR, Beighton D. Oral candidosis in patients with advanced cancer. Oral Oncol. 2006 Aug;42(7):698-702. doi: 10.1016/j.oraloncology.2005.11.010. Epub 2006 Mar 9. PMID 16527512
BACKGROUNDSoysa NS, Samaranayake LP, Ellepola AN. Antimicrobials as a contributory factor in oral candidosis--a brief overview. Oral Dis. 2008 Mar;14(2):138-43. doi: 10.1111/j.1601-0825.2006.01357.x. PMID 18302673
BACKGROUNDShao PL, Huang LM, Hsueh PR. Recent advances and challenges in the treatment of invasive fungal infections. Int J Antimicrob Agents. 2007 Dec;30(6):487-95. doi: 10.1016/j.ijantimicag.2007.07.019. Epub 2007 Oct 24. PMID 17961990
BACKGROUNDRogers PD, Barker KS. Genome-wide expression profile analysis reveals coordinately regulated genes associated with stepwise acquisition of azole resistance in Candida albicans clinical isolates. Antimicrob Agents Chemother. 2003 Apr;47(4):1220-7. doi: 10.1128/AAC.47.4.1220-1227.2003. PMID 12654650
BACKGROUNDCannon RD, Lamping E, Holmes AR, Niimi K, Baret PV, Keniya MV, Tanabe K, Niimi M, Goffeau A, Monk BC. Efflux-mediated antifungal drug resistance. Clin Microbiol Rev. 2009 Apr;22(2):291-321, Table of Contents. doi: 10.1128/CMR.00051-08. PMID 19366916
Pina-Vaz C, Rodrigues AG, Costa-de-Oliveira S, Ricardo E, Mardh PA. Potent synergic effect between ibuprofen and azoles on Candida resulting from blockade of efflux pumps as determined by FUN-1 staining and flow cytometry. J Antimicrob Chemother. 2005 Oct;56(4):678-85. doi: 10.1093/jac/dki264. Epub 2005 Aug 22.