Candidaemia in cancer patients and in children in a neonatal intensive care unit

The species most frequently found in the group of neonates wasC. parapsilosis, its incidence reaching 48%. Other yeasts isolated from blood wereC. albicans (41%),C. tropicalis (7%),C. krusei andC. pseudotropicalis (2% each). Six yeast species (C. albicans 44%,C. parapsilosis 28%,C. tropicalis 11%,C. krusei 8%,C. guilliermondii 6%,C. lusitaniae 3%) were detected in cancer patients. The presence of an intravenous catheter as a possible risk in the development of candidaemia was identified in all neonates and in 69% of cancer patients.C. krusei candidaemia was associated with prophylactic fluconazole therapy.     

The role of galectin‐3 in phagocytosis of Candida albicans and Candida parapsilosis by human neutrophils

Candida albicans causes the majority of invasive candidiasis in immunocompromised adults while Candida parapsilosis is a leading cause of neonatal candidiasis. While much work has focused on how the immune system recognizes and responds to C. albicans, less is known about host interaction with C. parapsilosis. This study investigates the human neutrophil phagocytic response to these species. Neutrophils underwent phagocytosis of C. parapsilosis yeast and C. albicans hyphae much more efficiently than C. albicans yeast. Treatment of neutrophils with a galectin‐3 (gal3) blocking antibody inhibited phagocytosis of C. parapsilosis yeast and C. albicans hyphae, but not C. albicans yeast. The majority of neutrophil gal3 was expressed intracellularly and was secreted from neutrophils after treatment with C. parapsilosis mannan. When neutrophils were treated with exogenous gal3, phagocytosis of both C. albicans and C. parapsilosis yeast increased. Exposure of neutrophils to C. parapsilosis yeast increased phagocytosis of C. albicans yeast and was inhibited by gal3 blocking antibody. Taken together, these data indicate that gal3 secreted from neutrophils may act as a pro‐inflammatory autocrine/paracrine signal in neutrophil phagocytosis and suggest that gal3 has a unique role in neutrophil response to C. parapsilosis yeast and C. albicans hyphae distinct from C. albicans yeast.     

Candida species isolated from cerebrospinal fluid

In the period from November 1998 to June 2001 13 cases of nosocomial meningitis were reported.Candida albicans was isolated from 54% of the patients (7);C. parapsilosis from 23% (3);C. tropicalis from 15% (2) andC. krusei from 8% (1).C. albicans was isolated from the cerebrospinal fluid (CSF) of five children with the following diagnoses: nonspecified tumor of the central nervous system, Hodgkin's disease, meningitis, suspect neuroinfection, and sepsis. Examination of CSF allowed us to detect 2 strains ofC. albicans from adult patients, one after neurosurgery because of a brain tumor and one with a vascular disease of the brain.C. parapsilosis was found in CSF from two premature children and one child with epilepsy. Two isolates ofC. tropicalis were obtained from both blood and the CSF of a child from the neonatal intensive care unit and from a child from pediatric oncology with multiple malignant neoplasms. Only one strain ofC. krusei was found in the oral cavity and CSF of a patient after neurosurgery performed after head trauma.     

In Vitro Activities of New Triazole Antifungal Agents, Posaconazole and Voriconazole, Against Oral Candida Isolates from Patients Suffering from Denture Stomatitis

Denture stomatitis is often treated with antifungal agents but recurrences or new episodes are common, and certain episodes can be resistant. New triazoles, such as posaconazole and voriconazole, may represent useful alternatives for management. In vitro activities of amphotericin B, nystatin, miconazole, fluconazole, itraconazole, posaconazole and voriconazole against 150 oral Candida (101 C. albicans, 18 C. tropicalis, 12 C. glabrata, 11 C. guilliermondii, 4 C. parapsilosis, 2 Saccharomyces cerevisiae, 1 C. dubliniensis and 1 C. krusei) from 100 denture wearers were tested by the CLSI M27-A3 method. Resistant isolates were retested by Sensititre YeastOne and Etest. Most antifungal agents were very active. However, 4 C. glabrata (33.3%), 2 C. tropicalis (11.1%), 6 C. albicans (5.6%) and 1 C. krusei were resistant to itraconazole. Posaconazole was active against 143 yeast isolates (95.3%): 6 C. albicans (5.9%) and 1 C. tropicalis (5.6%) were resistant. Geometric mean MICs were 0.036 μg/ml for C. parapsilosis, 0.062 μg/ml for C. albicans, 0.085 μg/ml for C. tropicalis, 0.387 μg/ml for C. guilliermondii and 0.498 μg/ml for C. glabrata. Voriconazole was active against 148 isolates (98.7%) with geometric mean MICs ranging from 0.030 μg/ml for C. parapsilosis, 0.042 μg/ml for C. albicans, 0.048 μg/ml for C. tropicalis, 0.082 μg/ml for C. guilliermondii, to 0.137 μg/ml for C. glabrata. Only 2 C. albicans (2%) were resistant to voriconazole showing cross-resistance to other azoles. Posaconazole and voriconazole have excellent in vitro activities against all Candida isolates and could represent useful alternatives for recalcitrant or recurrent candidiasis.     

Evolutionary Position of n-Alkane-assimilating Yeast Candida maltosa Shown by Nucleotide Sequence of Small-subunit Ribosomal RNA Gene

We clarified the evolutionary position of Candida maltosa, an n-alkane-assimilating yeast, by sequencing the nucleotides of the small-subunit ribosomal RNA gene. Phylogenetic analyses showed the close evolutionary relationships of C. maltosa with C. tropicalis, C. viswanathii, C. albicans, C. parapsilosis, and C. guilliermondii, forming a sub-group within this genus.     

The frequency of Candida species in onychomycosis

Mycological investigation of 108 nail specimens taken from a total of 41 patients examined over three years included direct microscopy and repeated cultures. A higher incidence of onychomycosis of the fingernails (75%) was observed in women while afflictions of the toenails (71%) prevailed in men. The highest prevalence of onychomycosis was found in patients between 50 and 70 years of age.Candida albicans was the dominant organism causing onychomycosis (prevalence rate 60.9%), followed byC. parapsilosis (19.6%),C. tropicalis (9.8),C. krusei (4.9),C. guilliermondii andC. zeylanoides (2.4% each).     

Etiología de la candidiasis en pediatría: análisis comparativo con el paciente adulto

BackgroundCandida spp. represents a group of commensal yeasts that can act as pathogens and cause candidiasis in different anatomical locations.AimsThe aim of this study was to perform an epidemiological and comparative analysis between the isolates of Candida spp. in clinical specimens during a three year-period (2010-2012) from children (0-14 years) and adults (15-99 years) in the Valencian Community (RedMIVA).MethodsThe microbiological surveillance network of Valencian Community was used as the information source.Results and conclusionsCandida was isolated in 52,436 patients (1,604 [3.1%] children and 50,832 [96.9%] adults). Candida albicans was significantly (p < 0.05) the predominant species in both age groups, and in almost every type of clinical specimen. The distribution of other species varied depending on the sample type and age group. In blood specimens, Candida parapsilosis followed by C. albicans, Candida famata and Candida lusitaniae were the main species found in children, whereas C. albicans followed by C. parapsilosis, Candida glabrata and Candida tropicalis were the predominant species in adults. In sterile fluids, urine and lower respiratory tract samples, C. parapsilosis was the second most prevalent species in the children group, while C. glabrata and C. tropicalis were the main second species in adults.     

In vitro susceptibility to 5-fluorocytosine and nystatin of common clinical yeast isolates

The sensitivity to nystatin, 5-fluorocytosine (5-FC) or both was studied for 131 clinical isolates of Candida albicans, 47 of Candida parapsilosis, 34 of Candida tropicalis, 7 of Candida guilliermondii, 28 of Torulopsis glabrata and 1 of Torulopsis Candida.All strains were inhibited by concentrations of nystatin within the usual range of sensitivity except one strain of T. glabrata and another of T. Candida whose minima inhibitory concentrations (MICs) were respectively 250 U/ml and > 20000 U/ml.In respect to 5-FC it was found, after 7 days of incubation at 37 °C, the following frequencies of resistance: C. albicans 28/106 (26%), C. parapsilosis 11/47 (23%), C. tropicalis 24/34 (71%), C. guilliermondii 1/7, T. glabrata 1/28 (4%) and T. candida 0/1. It was particularly striking the activity of 5-FC against T. glabrata.     

Hemolytic Factor Production by Clinical Isolates of Candida Species

Most cases of fungal bloodstream infections (BIs) are attributed to Candida albicans; however, non-Candida albicans Candida species have recently been identified as common pathogens. Although hemolytic factor is known to be putative virulence factor contributing to pathogenicity in Candida species, its production is poorly evaluated. The present study was undertaken to analyze the production of hemolytic factor by C. albicans (10), C. tropicalis (13), and C. parapsilosis (8) isolates associated with BIs. Data of hemolysis zones on plate assay revealed that the majority of C. albicans isolates produced mild hemolytic activity whereas the majority of C. tropicalis produced strong activity. None of the tested C. parapsilosis isolates exhibited hemolysis on plate assay. We also evaluated the hemolytic activity in the cell-free broth. There were no significant differences (P > 0.05) in the secreted hemolytic activity among intra-species isolates. Different levels of secreted hemolytic factor were observed for Candida species, where C. tropicalis exhibited the highest production of hemolytic factor (P < 0.05) followed by C. albicans and C. parapsilosis. Inhibition of hemolysis (up to 89.12 %) from culture supernatant, following incubation with the lectin Concanavalin A (Con A), was observed for all three Candida species. This finding suggests that the secreted hemolytic factor of C. tropicalis and C. parapsilosis may be a mannoprotein, similar to that described for C. albicans.     

The fungicidal activity of novel nanoemulsion (X8W60PC) against clinically important yeast and filamentous fungi

Surfactant nanoemulsions are water in oil preparations that proved to have a broad spectrum biocidal activity against a variety of microorganisms including Gram-positive and Gram-negative bacteria, spores and enveloped viruses. These preparations are non-toxic to the skin, mucous membrane and gastrointestinal tissues at biocidal concentrations. In this study, 0.1% of the nanoemulsion designated X8W₆₀PC has shown fungicidal activity against yeast including Candida albicans and C. tropicalis in 15 minutes. C. tropicalis was more sensitive than C. albicans, which required a longer time or a higher concentration of the nanoemulsion to achieve killing. Neutral to slightly alkaline pH was more effective in killing the yeast cells than acidic pH. Using the minimum inhibitory concentration assay, 0.08% of the nanoemulsion was inhibitory to C. albicans, and parapsilosis and filamentous fungi including Microsporum gypseum,Trichophyton mentagrophytes,Trichophyton rubrum,Aspergillus fumigatus andFusarium oxysporum.None of the individual ingredients was as effective a fungicidal as the nanoemulsion at equivalent concentration. This shows that the nanoemulsion structure is an important factor in the anti-fungal activity. The X8W₆₀PC has great potential as a topical anti-fungal agent and further investigation into the mechanism of fungicidal action is warranted.This revised version was published online in October 2005 with corrections to the Cover Date.     

Hongos blastosporados de los esputos

Resumen De 100 esputos que proporcionaron cultivos de hongos blastosporados (o levaduri formes) 84% contenían diversas especies deCandida y 16% deTorulopsis. El estudio de 54 cepas deCandida arrojó la siguiente distribucion por especies:C. albicans 57,40%,C. tropicalis 20,37%,C. Krusei 12,96%,C. parapsilosis 3,70% yC. Guilliermondi, Czeylanoides yC. lipolytica (probable) cada una representada por 1,85%. Las dos cepas deTorulopsis estudiadas, fueron clasificadas comoT. pulcherrima.Creemos que la flora del esputo representa, como la de las materias fecales, una     

Identification and in vitro antifungal susceptibility testing of 200 clinical isolates of <Emphasis Type="Italic">Candida</Emphasis> spp. responsible for fingernail infections

A total of 200 samples of Candida spp. that are responsible for fingernail infections were isolated in Belo Horizonte, MG, Brazil from April 2004 to May 2005. The samples were identified by routine microbiological techniques and had the following distribution: Candida parapsilosis (40.5%), C. albicans (31.5%), C. tropicalis (26%), and C. guilliermondii (2%). We performed in vitro susceptibility tests with ciclopiroxolamine, terbinafine, ketoconazole, itraconazole, and fluconazole using the CLSI (Clinical and Laboratory Standards Institute) and EUCAST (European Committee on Antibiotic Susceptibility Testing) methodologies. The percentages of agreement between the two methodologies varied from 48 to 100% (the percentage increased to more than 60% for the majority of the samples). Percentages of agreement between the methodologies lower than 60% were seen with ketoconazole (57%) and itraconazole (48%) for samples of C. albicans and with fluconazole (54%) for samples of C. tropicalis. In general, we observed higher agreement between the values of the MICs obtained with both methodologies for ciclopiroxolamine and terbinafine for all tested species. With azoles, lower percentages of agreement between the methodologies were observed for samples C. albicans and C. tropicalis.     

Identification of <Emphasis Type="Italic">Candida</Emphasis> Species Isolated from Bovine Mastitic Milk and Their In Vitro Hemolytic Activity in Western Turkey

In this study, identification of 207 Candida isolates, previously isolated from mastitic bovine quarter milk samples at the level of genus, was made using API 20 C AUX system. The most frequently isolated species were Candida krusei (34.8%), followed by Candida rugosa (16.4%), Candida kefyr (12.6%), Candida albicans (10.1%), and Candida tropicalis (9.2%). Less common isolates were Candida zeylanoides (5.8%), Candida parapsilosis (4.3%), Candida guilliermondii (3.4%), Candida famata (1.9%), and Candida glabrata (1.5%). Additionally, in vitro hemolytic activity of all Candida strains were also examined in the present study. C. krusei (72 isolates), C. kefyr (26), C. albicans (21), C. tropicalis (19), C. zeylanoides (12), and C. glabrata (3) demonstrated both alpha and beta hemolysis at 48-h postinoculation. Only alpha hemolysis was detected in C. rugosa (34), C. guilliermondii (7), and C. famata (4), while C. parapsilosis (9) did not show any hemolytic activity after incubation for 72 h. Statistically significant difference (P < 0.001) was determined between the beta-hemolytic activities of Candida strains. The hemolytic activities of C. zeylanoides, C. albicans and C. kefyr were higher than other strains. This is the first study to describe variable hemolysis types exhibited by different Candida strains isolated from bovine mastitic milk in Turkey.     

On the intestinal yeast flora of free living hippopotami(Hippopotamus amphibius), wart hogs(Phacochoerus aethiopicus) and bush pigs(Potamochoerus choeropotamus)

Summary From the faeces of 35 free-living hippopotami (Hippopotamus amphibius), sampled in south Mozambique, 13 yeast isolates were obtained, distributed as shown (in brackets) among the following species:Candida guilliermondii (3),C. tropicalis (2),C. krusei (2),C. brumptii (1),Debaryomyces globosus (2),Trichosporon cutaneum (1), not identified (2). From the caecal contents of 9 free-living wart hogs (Phacochoerus aethiopicus), shot in north Mozambique 5 isolates were obtained:C. albicans (2),C. lusitaniae (2),C. parapsilosis (1). From the caecal contents of 9 free-living bush pigs (Potamochoerus choeropotamus), shot in north Mozambique, 18 isolates were obtained:C. krusei (6),C. tropicalis (5),Pichia fermentans (2),C. slooffii (2),C. albicans (1),Torulopsis glabrata (1),Trichosporon cutaneum (1). The low total yeast indices of the hippopotami (0.37) and the wart hogs (0.56) are believed to be correlated with the type of diet of these animals (rich in cellulose, poor in starch and simple carbohydrates). The bush pigs, which like the domestic pig, use a diet rich in starch and simple carbohydrates, had a very high total yeast index (2.00).Candida slooffii an obligate saprophyte of the digestive tract of domestic swine was found in two of the bush pig samples.     

Investigacion de levaduras en vulva y vagina

Resumen Se estudiaron 200 mujeres de primera consulta, sin tratamiento, que asistieron a la consulta externa de Ginecología del Hospital Universitario de Caracas, con el objeto de investigar la presencia de levaduras en vulva y vagina.Se tomaron 4 muestras de cada paciente: 2 de vulva y 2 del fondo de saco vaginal. Una muestra de vulva y una de vagina se destinaron al exámen directo (en fresco y con NaoH + tinta Parker Super Quink) y las otras muestras de vulva y vagina se utilizaron para cultivo en bilis-agar y lactritmel.Se encontraron 71 casos positivos especificados así:Trichomonas vaginalis, 38 (19 %);Candida albicans, 21 (10.5 %);Candida parapsilosis, 6 (3 %);Candida tropicalis, 5 (2.5 %);Torulopsis (holmii 2,candida 1) = 3 (1.5 %);Saccharomyces delbrueckii, 2 (1 %);Debaryomyces hansenii, 1 (0.5 %);Candida tenuis, 1 (0.5 %).Para el diagnóstico de la candidiasis y/o tricomoniasis vulvovaginal las manifestaciones clínicas no tienen ningún valor. El exámen directo, cuando es positivo, con presencia de filamentos y blastosporos, confirma el diagnóstico de candidiasis; pero su negatividad no excluye la presencia deCandida albicans como habitante de la vulvovagina en mujeres aparentemente normales.Los autores recomiendan la toma de la muestra des de la vulva para la investigación deCandida albicans, lo que facilita el exámen por no hacerse necesario el uso delspeculum; en cambio, paraTrichomonas vaginalis recomiendan la toma de la muestra desde el fondo de saco vaginal.El medio bilis-agar es el más apropiado para la rápida identificación deCandida albicans en el cultivo naciente, ya que en él se forman las clamidosporas en 24–48 horas.

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The cases of 200 women, without treatment, who attended the first gynecological external consultation at the Hospital Universitario, Caracas, Venezuela, were studied for the purpose of investigating the presence of yeast — like fungi in the vulva and in the vagina.Four samples were taken from each patient: two from the vulva and two from the posterior fornix. One sample each from the vulva and from the vagina were used, in direct examination, under microscope with NaOH + Parker/Super Quink ink; the remaining vulva and vagina samples were utilized in bilis-agar and lactritmel cultivation.71 positives cases were found, specified as follows:Trichomonas vaginalis, 38 (19 %);Candida albicans, 21 (10.5 %);Candida parapsilosis, 6 (3 %);Candida tropicalis, 5 (2.5 %);Torulopsis (holmii 2,candida 1) = 3 (1.5 %);Saccharomyces delbrueckii, 2 (1 %);Debaryomyces hansenii, 1 (0.5 %);Candida tenuis, 1 (0.5 %).In the diagnosis of vulvo-vaginal candidiasis and/or trichomoniasis the clinical signs have no significance. The direct examination, when positive, with presence of mycelium and blastospores confirms the diagnosis of candidiasis. However, if negative, it does not exclude the presence ofCandida albicans as habitant of the vulvo-vagina among apparently normal women.The authors recommended the taking of samples from the vulva for the purpose of investigation ofCandida albicans, which would facilitate the examination, inasmuch as it would be unnecessary to use the speculum. On the other hand, in the examination ofTrichomonas vaginalis the taking of samples from the posterior fornix is recommended.The bilis-agar medium is the most appropriate for the rapid identification ofCandida albicans from original cultures, as clamydospores are becoming present in 24 to 48 hours.

     

Genetic relatedness of commensal strains of <Emphasis Type="Italic">Candida albicans</Emphasis> carried in the oral cavity of patients’ dental prosthesis users in Brazil

The aim of this study is to describe the degree of yeast-colonization in diabetic and hemodialysed-users of dental prostheses. Individuals (306) were examined using an oral rinse technique in order to evaluate the incidence of yeast-carriage, and genotype of C. albicans. Yeasts were isolated from 68.4% (91/133) individual’s dental prostheses users. Dental prostheses were found to be a significant factor for the yeast colonization (P < 0.05). Overall, the intensity of carriage was higher in diabetic patients as compared with health and hemodialysed individuals (P < 0.05). The isolation rates were: C. albicans (51.7%), C. parapsilosis (20.9%), C. tropicalis (14.3%), C. glabrata (6.6%), C. krusei (3.3%), C. rugosa (1.1%), and Pichia (Pichia ohmeri, 2.2%). Ready-To-Go RAPD Analysis Beads were used and primer OPJ 6 distinguished the C. albicans isolates found in prostheses users. All the isolates were grouped into 11 RAPD profiles in four main clusters and, the average S _AB for the entire collection of 47 C.␣albicans isolates were 0.779 ± 0.178. Over 85% of isolates had a similarity level higher than or equal to 0.8 reinforcing the idea that the use of dental prostheses, independently of the host’s clinical condition, probably provides the necessary conditions for these strains to gain a growth-specific advantage over others.     

Strain differentiation of pathogenic yeasts by the killer system

High sensitivity rates to the activity of killer toxins produced by 25 species of yeasts belonging to the genera Candida, Hansenula, Pichia, Rhodotorula, Saccharomyces and Trichosporon have been observed among 112 yeast isolates (25 Cryptococcus neoformans, 29 C. glabrata, 16 C. parapsilosis, 20 C. pseudotropicalis and 22 C. tropicalis). The highest sensitivity has been observed among the C. parapsilosis isolates, the lowest in C. glabrata strains. Genera Pichia and Hansenula proved to have the greatest killer activity. A killer system, formerly used for differentiating C. albicans isolates within the species, proved to be valid as epidemiological marker when applied to 112 strains of pathogenic yeasts.     

Systemic Candida infection in University Hospital 1997–1999: the distribution of Candida biotypes and antifungal susceptibility patterns

A total of 102 Candida species were isolated from blood cultures from January 1997 to October 1999. Using assimilation of carbohydrate test, 52 (51.0%) of the Candida sp. were identified as C. parapsilosis, 25.5% (26) were C. tropicalis. C. albicans made up 11.8% (12), 6.9% (7) were C. rugosa, 3.8% (4) C. glabrata and 1% (1) C. guilliermondii. No C. dubliniensis was found in the study. In vitro antifungal susceptibility tests showed that all Candida species were sensitive to nystatin, amphotericin B and ketoconazole. Although all isolates remained sensitive to fluconazole, intermediate susceptibility was found in 3 C. rugosa isolates. Antifungal agents with high frequency of resistance were econazole, clotrimazole, miconazole and 5-fluorocytosine. Candida species found to have resistance to these antifungal agents were non-C. albicans. This revised version was published online in June 2006 with corrections to the Cover Date.     

Infecciones urinarias nosocomiales por levaduras. Estudio multicéntrico de 14 hospitales de la red de micología de la Ciudad Autónoma de Buenos Aires

BackgroundUrinary tract infections are a frequent ailment in patients in intensive care units. Candida and other yeasts cause 5-12% of these infections. The value of the finding of any yeast is controversial, and there is no consensus about which parameters are adequate for differentiating urinary infections from colonization or contamination.AimsTo analyse the epidemiological characteristics of patients with funguria, to determine potential cut-off points in cultures (to distinguish an infection from other conditions), to identify the prevalent yeast species, and to determine the value of a second urine sample.MethodsA multicentre study was conducted in intensive care units of 14 hospitals in the Buenos Aires City Mycology Network. The first and second samples of urine from every patient were cultured. The presence of white cells and yeasts in direct examination, colony counts, and the identification of the isolated species, were evaluated.ResultsYeasts grew in 12.2% of the samples. There was no statistical correlation between the number of white cells and the fungal colony-forming units. Eighty five percent of the patients had indwelling catheters. Funguria was not prevalent in women or in patients over the age of 65. Candida albicans, followed by Candida tropicalis, were the most frequently isolated yeasts. Candida parapsilosis and Candida glabrata appeared less frequently. The same species were isolated in 70% of second samples, and in 23% of the cases the second culture was negative.ConclusionsIt was not possible to determine a useful cut-off point for colony counts to help in the diagnosis of urinary infections. As in other publications, C. albicans, followed by C. tropicalis, were the most prevalent species.     

Response to Oxidative Stress in Eight Pathogenic Yeast Species of the Genus <Emphasis Type="Italic">Candida</Emphasis>

In the course of an infection, the formation of reactive oxygen species by phagocytes and the antioxidant defense mechanisms of microorganisms play a crucial role in pathogenesis. In this study, isolates representing 8 pathogenic Candida species—Candida albicans, Candida dubliniensis, Candida famata, Candida glabrata, Candida guilliermondii, Candida krusei, Candida parapsilosis and Candida tropicalis—were compared with regard to their resistance to oxidative stress in vitro. We evaluated degree of resistance, induction of oxidative damage, capacity to adapt, and induction of antioxidant enzymes. The species showed variable sensitivity to oxidative attack. C. albicans, C. glabrata, and C. krusei were more resistant to oxidative stress under the conditions tested; C. parapsilosis and C. tropicalis presented medium resistance; and C. dubliniensis, C. famata, and C. guilliermondii were more sensitive. The overall greater resistance to oxidative stress of C. albicans and C. glabrata may provide an advantage to these species, which are the major causative agents of candidiasis.