ABSTRACT
Candida spp. colonization in neonates occurs due to vertical or horizontal transmission. Preliminary studies determined that Candida albicans is the principal agent of these infections. In order to establish nosocomial transmission, 26 Candida albicans strains isolated from patients with candidosis hospitalized during a 18-month period in 2 neonatal intensive care units (NICU) from a pediatric hospital were studied. Fourteen isolates from patients and health care workers, involved in possible outbreaks of an intensive care unit (UCI) and a NICU from another pediatric hospital were also studied. All Candida albicans strains were genotyped by Southern blot hybridization with 27A. Isolates for outbreak confirmation were also hybridized with another specific Candida albicans probe, Ca3. Hybridization patterns demonstrated horizontal transmission in all the units studied. In a NICU, transmission among 4 patients during a 10-month period could be established and in the other NICU, 3 cases of transmission among 2 patients each were demonstrated in periods of 2 to 20 days. The outbreak studies showed the same strain isolated from 2 nurses and from one patient at the NICU and at the ICU identical strains were found in 3 patients. In this study, hybridization with Ca3 in addition to 27A probe did not increase discrimination power among isolates. Genotypic analysis allows, not only, determination of transmission and persistence of strains during prolonged periods or in sporadic outbreaks, but also facilitates necessary epidemiological decisions for optimizing nosocomial fungal infection control measures.
Subject(s)
Humans , Infant, Newborn , Candidiasis/transmission , Cross Infection/transmission , Disease Transmission, Infectious , Candida albicans , Candidiasis/microbiology , Cross Infection/microbiology , Intensive Care Units, NeonatalABSTRACT
A multicenter study was performed between April and September 1998 with the participation of 12 medical centers located in 8 different provinces and in the capital city of Argentina. The aim of this study was to determine the species distribution and the antifungal susceptibility profile of isolates causing nosocomial fungal infections. All the fungal isolates obtained were sent to the Mycology Department for reference identification and antifungal susceptibility testing. Eighty-nine isolates were received from different clinical specimens. The distribution of species obtained was C. albicans (50.6), C. tropicalis (22.5), C. parapsilosis (20.2), C. krusei (3.4), C. glabrata (2.2) and Debaryomyces hansenii (1.1). Most of the isolates (85/88) had MICs for amphotericin B < or = 1 microgram/ml, C. krusei showed resistance to fluconazole but was dose dependent susceptible to itraconazole, C. glabrata (2/2) were resistant against both drugs, most of the isolates of C. albicans, C. tropicalis and C. parapsilosis were susceptible to these triazole drugs. These data showed a different distribution of Candida species compared with results obtained in other countries. The low frequency of appearance of C. krusei and C. glabrata in our country suggests a reduced selective pressure by triazoles.
Subject(s)
Humans , Candidiasis/epidemiology , Cross Infection/epidemiology , Antifungal Agents/pharmacology , Argentina , Candidiasis/microbiology , Fluconazole , Incidence , Cross Infection/microbiology , Itraconazole , Microbial Sensitivity TestsABSTRACT
Se comunica el primer aislamiento de Candida Dubliniensis en Argentina. La cepa fue aislada a partir de una lesión oral de un paciente de 32 años de edad con SIDA, durante un episodio de una candidiasis orofaríngea recurrente multitratada. Las características fenotípicas y genotípicas fueron coincidentes con las descriptas anteriormente por Sullivan y col. quienes describieron esta nueva especie por primera vez
Subject(s)
Humans , Adult , Male , Candida/classification , Candida/isolation & purification , Candidiasis, Oral/diagnosis , Candidiasis, Oral/etiology , Acquired Immunodeficiency Syndrome/complications , ArgentinaABSTRACT
Se realizó un estudio retrospectivo de las candidiasis en pacientes pediátricos hospitalizados y en adultos HIV positivos provenientes de 5 instituciones de la ciudad de Bunnos Aires, ciudad de La Plata y partidos del conurbano bonaerense, durante el período 1993-1995. Se determinó la frecuencia de aparición de las especies de levaduras y su perfil de sensibilidad a los antifúngicos de uso sistémico con el objeto de obtener datos actualizados de esta patología. Candida albicans fue el agente etiológico en el 87 o/o de los 214 pacientes adultos HIV positivos con candidiasis orofaríngeas estudiados y en el 50 o/o de los 209 pacientes pediátricos hospitalizados. En este último grupo el 28 o/o de estas infecciones se debió a Candida parapsilosis y el 18 o/o a Candida tropicalis, mientras que sólo el 2 y el 4 o/o de las candidiasis orales fueron causadas por estos microorganismos. La recuperación de Candida krusei y Candida glabrata, especies intrínsecamente resistentes a los azoles, se vio incrementada en la población expuesta al tratamiento con fluconazol. En ambos grupos se observó un bajo número de levaduras resistentes a la anfotericina B, en cambio para las drogas azólicas se detectó un mayor porcentaje de aislamientos resistentes, en especial al fluconazol: 13 o/o en los pacientes pediátricos y 34 o/o en los pacientes HIV positivos