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Biomedical subjects

E W Cross

Publications and source records attributed to E W Cross.

5 recordsLinked to original sources
PubMed2001

Prospective study of Candida species in patients at a comprehensive cancer center.

Since most nosocomial systemic yeast infections arise from the endogenous flora of the patient, we prospectively evaluated the species stratification and antifungal susceptibility profile of Candida spp. associated with heavy colonization and systemic infection in patients at Memorial Sloan-Kettering Cancer Center in New York. A total of 349 Candida isolates were obtained from 223 patients during the later half of 1998. Cancer was the most common underlying disease, occurring in 91% of the patients, including 61.8% with organ and 23.7% with hematological malignancies; 4.4% of the patients had AIDS. Candida albicans was the predominant species (67.3%); among 114 non-albicans Candida spp., C. glabrata (45.6%) was the most frequent, followed by C. tropicalis (18.4%), C. parapsilosis (16.6%), and C. krusei (9.6%). The overall resistance to triazole-based agents among all yeast isolates was 9.4 and 10.8% for fluconazole and itraconazole, respectively. A total of 5% of C. albicans strains were resistant to triazole antifungals, whereas 30.8 and 46.2% of C. glabrata strains were resistant to fluconazole (MIC > or = 64 microg/ml) and itraconazole (MIC > or = 1 microg/ml), respectively. A significant association was observed between prior treatment with triazole and isolation of fluconazole-resistant C. albicans (P = 0.005, OR 36), although this relationship was not seen in C. glabrata isolates (P = 0.4). This study reinforces the importance of periodic, prospective surveillance of clinical fungal isolates to determine appropriate prophylactic, empiric, and preemptive antifungal therapy for the highly susceptible patient population.

Antifungal Agents↗
PubMed2000

Cross-Resistance of clinical isolates of Candida albicans and Candida glabrata to over-the-counter azoles used in the treatment of vaginitis.

Antifungal drug resistance in Candida spp. continues to increase in response to the widespread application of triazole therapeutics among immunosuppressed patients. Azole-based over-the-counter (OTC) antifungal agents used to treat vaginitis have the potential to exacerbate this problem by contributing to the selection of highly resistant strains of Candida in otherwise healthy women. In this study, we show that fluconazole-resistant (MIC > 64 microg/mL) blood stream isolates of Candida albicans and Candida glabrata obtained from cancer patients were cross-resistant to the root drugs miconazole, clotrimazole, and tioconazole (found in several over-the-counter products), but remained susceptible to butoconazole. We also provide evidence that spontaneous mutants of Candida glabrata selected for resistance to clotrimazole were cross-resistant to other azolebased drugs, including fluconazole. Our findings demonstrate cross-resistance of Candida strains to fluconazole and OTC azole antifungals, and support the notion that OTC drugs can promote azole resistance in Candida spp.

Antifungal Agents↗
PubMed2000

Rapid identification of Candida dubliniensis using a species-specific molecular beacon.

Candida dubliniensis is an opportunistic fungal pathogen that has been linked to oral candidiasis in AIDS patients, although it has recently been isolated from other body sites. DNA sequence analysis of the internal transcribed spacer 2 (ITS2) region of rRNA genes from reference Candida strains was used to develop molecular beacon probes for rapid, high-fidelity identification of C. dubliniensis as well as C. albicans. Molecular beacons are small nucleic acid hairpin probes that brightly fluoresce when they are bound to their targets and have a significant advantage over conventional nucleic acid probes because they exhibit a higher degree of specificity with better signal-to-noise ratios. When applied to an unknown collection of 23 strains that largely contained C. albicans and a smaller amount of C. dubliniensis, the species-specific probes were 100% accurate in identifying both species following PCR amplification of the ITS2 region. The results obtained with the molecular beacons were independently verified by random amplified polymorphic DNA analysis-based genotyping and by restriction enzyme analysis with enzymes BsmAI and NspBII, which cleave recognition sequences within the ITS2 regions of C. dubliniensis and C. albicans, respectively. Molecular beacons are promising new probes for the rapid detection of Candida species.

Candida↗
PubMed1992

AIDS: legal implications for managers.

As the incidence of acquired immunodeficiency syndrome (AIDS) escalates, its consequences increasingly will affect the workplace. Dietitians with management responsibilities will be called upon to make decisions concerning the rights of both employees and clients or patrons. They must be knowledgeable about AIDS-related legislation and its implementation in organizations and businesses. A major legal protection for workers with AIDS is the Vocational Rehabilitation Act, which prohibits discrimination against individuals on the basis of physical or mental disabilities. The Employee Retirement Income Security Act and the Comprehensive Omnibus Budget Reconciliation Act provide legal protections related to employee benefit programs. The National Labor Relations Act provides protection for all employees, including those infected with the AIDS virus. Current medical evidence indicates that AIDS is not transmitted through casual contact. Therefore, the presence of AIDS-infected individuals in the workplace does not violate the provisions of the Occupational Safety and Health Act. More recently, the Americans with Disabilities Act was amended to prohibit employers from removing workers from food-handling positions solely because of infection with AIDS. This review of legislation and litigation indicates that coworker and public fears, as well as management concerns about productivity and costs, are inadequate defenses against discrimination claims. Employees with AIDS are protected legally against adverse employment decisions motivated by their disease.

Acquired Immunodeficiency Syndrome↗