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1.
Braz. j. biol ; 84: e255080, 2024. tab, graf
Article in English | LILACS-Express | MEDLINE, LILACSEXPRESS, LILACS, VETINDEX | ID: biblio-1364503

ABSTRACT

Abstract In the current context of emerging drug-resistant fungal pathogens such as Candida albicans and Candida parapsilosis, discovery of new antifungal agents is an urgent matter. This research aimed to evaluate the antifungal potential of 2-chloro-N-phenylacetamide against fluconazole-resistant clinical strains of C. albicans and C. parapsilosis. The antifungal activity of 2-chloro-N-phenylacetamide was evaluated in vitro by the determination of the minimum inhibitory concentration (MIC), minimum fungicidal concentration (MFC), inhibition of biofilm formation and its rupture, sorbitol and ergosterol assays, and association between this molecule and common antifungal drugs, amphotericin B and fluconazole. The test product inhibited all strains of C. albicans and C. parapsilosis, with a MIC ranging from 128 to 256 µg.mL-1, and a MFC of 512-1,024 µg.mL-1. It also inhibited up to 92% of biofilm formation and rupture of up to 87% of preformed biofilm. 2-chloro-N-phenylacetamide did not promote antifungal activity through binding to cellular membrane ergosterol nor it damages the fungal cell wall. Antagonism was observed when combining this substance with amphotericin B and fluconazole. The substance exhibited significant antifungal activity by inhibiting both planktonic cells and biofilm of fluconazole-resistant strains. Its combination with other antifungals should be avoided and its mechanism of action remains to be established.


Resumo No atual contexto de patógenos fúngicos resistentes emergentes tais como Candida albicans e Candida parapsilosis, a descoberta de novos agentes antifúngicos é uma questão urgente. Esta pesquisa teve como objetivo avaliar o potencial antifúngico da 2-cloro-N-fenilacetamida contra cepas clínicas de C. albicans e C. parapsilosis resistentes a fluconazol. A atividade antifúngica da substância foi avaliada in vitro através da determinação da concentração inibitória mínima (CIM), concentração fungicida mínima (CFM), ruptura e inibição da formação de biofilme, ensaios de sorbitol e ergosterol, e associação entre esta molécula e antifúngicos comuns, anfotericina B e fluconazol. O produto teste inibiu todas as cepas de C. albicans e C. parapsilosis, com uma CIM variando de 128 a 256 µg.mL-1, e uma CFM de 512-1,024 µg.mL-1. Também inibiu até 92% da formação de biofilme e causou a ruptura de até 87% de biofilme pré-formado. A 2-cloro-N-fenilacetamida não promoveu atividade antifúngica pela ligação ao ergosterol da membrana celular fúngica, tampouco danificou a parede celular. Antagonismo foi observado ao combinar esta substância com anfotericina B e fluconazol. A substância exibiu atividade antifúngica significativa ao inibir tanto as células planctônicas quanto o biofilme das cepas resistentes ao fluconazol. Sua combinação com outros antifúngicos deve ser evitada e seu mecanismo de ação deve ser estabelecido.

2.
Article | IMSEAR | ID: sea-214966

ABSTRACT

With increasing use of antibacterial and cytotoxic drugs, lethal invasive Candidiasis is on the rise, with almost half of the cases being caused by non albicans Candida species (NAC). Frequent use of azoles for empirical therapy has also led to their increased resistance. We wanted to characterise Candida species isolated from various clinical specimens and assess their susceptibility pattern to Fluconazole and Voriconazole.METHODSA total of 100 consecutive Candida species isolated from various clinical specimens in our institute from January 2016 to December 2016 were included in the study. Standard yeast identification protocol and CHROM agar were used for speciation and their antifungal susceptibility pattern was found by disc diffusion method.RESULTSOut of the 100 isolates, C. tropicalis was the predominant isolate (47%), followed by C. albicans (31%), C. parapsilosis (16%) and C. krusei (6%). Females (57%) were more affected and maximum number of patients was above 60 years (24%). Diabetes mellitus (21%) was the major predisposing factor for Candida, followed by broad spectrum antibiotic therapy (14%). Isolates were more susceptible to Voriconazole (99%) than Fluconazole (87%). NAC spp. showed more resistance to Fluconazole (17.4%) than C. albicans (3.3%). Only one isolate of C. krusei (16.6%) showed resistance to Voriconazole.CONCLUSIONSDue to the increasing incidence of azole resistant NAC spp., the species level identification of Candida species, along with their anti-fungal susceptibility patterns can help the clinicians in formulating a treatment protocol and can help in decreasing the mortality and morbidity.

3.
Braz. j. infect. dis ; 24(1): 7-12, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089323

ABSTRACT

ABSTRACT Background: This study aims to explore the epidemiology, clinical profile and strain characteristics of cryptococcosis from 2013 to 2017 in a major teaching hospital in China. Methods: Trends in antifungal drug susceptibility of 217 consecutive non-repetitive cryptococcal isolates collected from patients of an university hospital in China were analyzed between 2013 and 2017. Of those, 98 isolates were conserved for identification by internal transcribed spacer (ITS) sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) system. Multilocus sequence typing (MLST) was used to designate molecular types. Clinical characteristics of the 98 patients with cryptococcosis during the period of 2013-2017 were retrospectively evaluated. Results: There was a trend for gradual increase in the MIC range of fluconazole was from 2013 to 2017. The conserved 98 clinical cryptococcal isolates included 97 C. neoformans and one C. gattii, and 90 (91.8%) isolates belonged to ST5 genotype VNI. Out of the 98 patients with cryptococcosis, 28 (28.6%) were HIV-infected and 32 (32.7%) had no underlying diseases. HIV-infected patients had higher mortality than HIV-uninfected patients (28.6% vs 14.3%, p = 0.147). Conclusions: Most of the patients with cryptococcosis were not HIV-infected in this study, while patients with HIV had a higher mortality. Reduced susceptibility to fluconazole was observed among C. neoformans isolates, most of them belonged to ST5 genotype VNI having an impact on the effective dose of fluconazole.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cryptococcosis/microbiology , Cryptococcosis/epidemiology , Hospitals, University/statistics & numerical data , Time Factors , Microbial Sensitivity Tests , China/epidemiology , Cross-Sectional Studies , Retrospective Studies , Statistics, Nonparametric , Cryptococcosis/drug therapy , Cryptococcus neoformans/isolation & purification , Cryptococcus neoformans/drug effects , Cryptococcus neoformans/genetics , Cryptococcus gattii/isolation & purification , Cryptococcus gattii/drug effects , Cryptococcus gattii/genetics , Multilocus Sequence Typing , Genotype , Antifungal Agents/therapeutic use
4.
Article | IMSEAR | ID: sea-201712

ABSTRACT

Background: Candidemia causing increased mortality rates and emergence of antifungal drug resistance needs an urgent intervention to salvage immunocompromised and severely ill patients. This study aimed to isolate and identify Candida species and evaluate their antifungal susceptibility profile from blood stream infections in children.Methods: Fungal cultures from blood recovered positive for yeasts were subcultured on Sabouraud dextrose agar. Suspected purified colonies of Candida were confirmed and identified upto species level by both conventional and automated techniques. Antifungal susceptibility testing of isolates was evaluated using agar based E-test method for fluconazole, voriconazole and caspofungin on Mueller-Hinton agar supplemented with 2% glucose.Results: Total of 43 isolates of Candida species were recovered from blood samples. Non albicans Candida species accounted for 88.30% of cases; whereas 11.60% of cases were caused by C. albicans, C. tropicalis (39%) was the most frequent isolate recovered in candidemia patients followed by C. parapsilosis (18%), C. albicans (12%), C. glabrata (12%), C. kefyr (9%), C. pelliculosa (5%), and C. krusei (5%). Antifungal susceptibility results revealed Caspofungin demonstrated good activity against all Candida spp. C. parapsilosis followed by C. tropicalis and C. glabrata demonstrated high resistance to fluconazole. For voriconazole, maximum resistance was shown by C. tropicalis as compared to others.Conclusions: Candidemia is a threatening prognostic sign in children and an important entity in our hospital. Identification of Candidaspecies and antifungal sensitivity testing is a must to select a suitable and effective antifungal therapy to abrogate the emerging resistance to antifungals.

5.
Article | IMSEAR | ID: sea-211490

ABSTRACT

Background: The cases of dermatophytoses have increased over the past few decades. Dermatophytoses affect the outer layers of skin, nails and hairs without tissue invasion. These infections are mostly not dangerous but, are important as public health problem particularly in the immunocompromised. The increased use of antifungal drugs for prolonged periods may lead to acquired antifungal resistance among previously susceptible strains. With this background present study was conducted to know the susceptibility pattern of dermatophytes.Methods: A total 35 isolates of dermatophytes isolated from clinically suspected cases of dermatophytoses were examined. Broth microdilution method M38-A2 approved protocol of CLSI (2008) for filamentous fungi was followed for determining the susceptibility of dermatophyte species to antifungal agents- itraconaole, fluconazole and ketoconazole.Results: Itraconazole minimum inhibitory concentrations (MIC) varied from 0.0156 to 1 µg/ml for all dermatophytes. T. rubrum species showed higher MIC range for Ketoconazole than T. mentagrophytes and T. tonsurans. Fluconazole had poor susceptibility for all dermatophytes by having higher MIC values.Conclusions: The MIC values observed in present study will help clinician to select an appropriate antifungal agent with minimal side effects. The data from present study can be useful as reference for future studies covering large no. of isolates and more drugs.

6.
Article | IMSEAR | ID: sea-187185

ABSTRACT

Background: Vulvovaginal candidiasis is a global issue of concern due to its association with economic costs, sexually transmitted infections, and ascending genital tract infection leading to several complications in both pregnant as well as non-pregnant women. It is second to bacterial vaginosis affecting approximately 50–72% of women of reproductive age group. Resistance to antifungal agents has increased during the last decade. Thus, identification of Candida up to species level and its antifungal susceptibility testing is essential in the management of Candidal infections. Aim: To determine the prevalence of various Candida species among vaginal candidiasis and to determine the antifungal susceptibility pattern of the isolates. Materials and methods: A total of 56 Candida species were isolated from 200 clinical diagnosed cases of vaginitis over 6 months period. Growth on Sabouraud dextrose agar were evaluated according to standard protocol and further processed for Candida speciation on CHROM agar. Antifungal susceptibility testing was performed using the Etest method as recommended by Clinical and Laboratory Standards Institute (CLSI) M27-A3 document. Results: Out of 200 vaginitis patients, 56 were positive for Candida species. All the isolates were speciated comprising four species – C. albicans 24 (42.8%), C. krusei 20 (35.7%), C. tropicalis 7 (12.5%), and C. glabrata 5 (8.9%). Antifungal susceptibility testing result of all Candida isolates were Lavanya V, Pavani P, Kailasanatha Reddy B. Speciation and antifungal susceptibility pattern of Candida isolates from vulvovaginitis patients attending a tertiary care hospital in South India. IAIM, 2019; 6(2): 62-68. Page 63 100% susceptible to amphotericin B, nystatin and voiconazole. C. krusei and C.glabrata isolates were showed 100% resistance to fluconazole and ketoconazole respectively. Conclusion: In the present study, C. albicans was most common species followed by C. krusei. Presumptive identification followed by confirmation of Candida species helps to initiate early appropriate antifungal treatment. The relatively higher resistance shown by Non-abicans Candida species to commonly prescribed antifungals (fluconazole and ketoconazole) emphasizes the need for routine antifungal susceptibility testing of all Candida isolates

7.
Braz. J. Pharm. Sci. (Online) ; 55: e17479, 2019. tab
Article in English | LILACS | ID: biblio-1039040

ABSTRACT

The aim of this study was to evaluate the antifungal susceptibility patterns of three antifungals, methanolic extracts and N-hexane oil of sesame seeds on C. albicans and C. glabrata, isolated from oral cavity of liver transplant recipients. The results were compared with other reports to develop a mini review as well. Candida species were isolated from liver transplant recipients. To evaluate the antifungal activity of sesame seed oil and methanolic extract, fluconazole, caspofungin and nystatin, the corresponding minimum inhibitory concentrations were determined by CLSI M27-A3 standard method. Minimum fungicidal concentration was also evaluated. The most prevalent species was C. albicans, followed by C. glabrata. Findings indicated sensitivity to antifungal agents and resistance to methanolic extract and N-hexane oil for all C. albicans and C. glabrata isolates. The rate of Candida colonization in the oral cavity of liver transplant recipients was high. Our results revealed that the methanolic and N-hexan extracts of sesame seeds are not effective on C. albicans and C. glabrata species, isolated from the patients. The sesame seed oil pulling and mouthwash cannot effectively cleanse and remove the Candida species in the mouth. Investigation of other medicinal plants or other parts of sesame like leaves and roots are suggested.


Subject(s)
Oils, Volatile/analysis , Sesamum/anatomy & histology , Antifungal Agents/adverse effects , Candida/immunology , Liver Transplantation
8.
Rev. Soc. Bras. Med. Trop ; 52: e20180480, 2019. tab, graf
Article in English | LILACS | ID: biblio-1013305

ABSTRACT

Abstract We report a rare case of subcutaneous phaeohyphomycosis caused by Cladophialophora bantiana in an immunocompetent patient in Amazonas, Brazil. This dematiaceous fungus has been mainly associated with life-threatening infections affecting the central nervous systems of immunosuppressed patients. We present the clinical, laboratory, and therapeutic aspects, and in vitro susceptibility test results for different antifungal drugs. A brief review of the cases reported in the literature over the past 20 years has also been discussed. According to the literature review, the present case is the first report of subcutaneous phaeohyphomycosis due to C. bantiana in an immunocompetent patient in Latin America.


Subject(s)
Humans , Male , Ascomycota/isolation & purification , Phaeohyphomycosis , Phaeohyphomycosis/diagnosis , Biopsy , Brazil , Immunocompromised Host , Dermatomycoses/drug therapy , Mitosporic Fungi/isolation & purification , Phaeohyphomycosis/immunology , Phaeohyphomycosis/drug therapy , Middle Aged , Antifungal Agents/classification , Antifungal Agents/therapeutic use
9.
Rev. iberoam. micol ; 36(2): 55-60, 2019. tab
Article in English | ColecionaSUS, LILACS, ColecionaSUS, CONASS, SES-RS | ID: biblio-1121303

ABSTRACT

Background: The number of fungal infections has increased in recent years in Rio Grande do Sul (RS), Brazil. Epidemiological studies are important for proper control of infections. Aims: To evaluate the etiology of fungal infections in patients in RS, from 2003 to 2015. Methods: This is a retrospective and longitudinal study carried out at Mycology Department of Central Laboratory of RS; 13,707 samples were evaluated. The variables sex, age, site of infection, and etiologic agent were analyzed. Susceptibility of Candida to fluconazole was tested in samples collected in 2015from 51 outpatients. Results: Of the 13,707 samples, 840 cases (6.12%) of fungal infections were found and included in the analyses; female gender accounted for the 55.9% of the cases. The main fungus was Candida albicans (450 cases, 53.38%; p < 0.001). Onychomycosis was the most frequent infection in superficial mycoses. Systemic mycoses accounted for 54.05% of the cases, from which 68.8% occurred in males, mainly HIVpositive (33.11%), and the main etiologic agent in these cases was Cryptococcus neoformans (73.13%). Among 51 samples tested for susceptibility to fluconazole, 78.43% of Candida isolates were susceptible; 5.88% were susceptible in a dose-dependent manner, and 15.69% were resistant. Conclusions: C. albicans is a common cause of fungal infections in RS, accounting for half of the cases;resistance to antifungals was found in non-hospitalized patients. In addition, women seem to be moresusceptible to fungal infections than men, however men show more systemic mycoses than women. Thenails are the most common site of infection. (AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Fungi/classification , Mycoses/epidemiology , Brazil/epidemiology , Fluconazole/pharmacology , Prevalence , Retrospective Studies , Longitudinal Studies , Drug Resistance, Fungal , Fungi/drug effects
10.
Article in Chinese | WPRIM | ID: wpr-751857

ABSTRACT

Objective To investigate the clinical characteristics and associated risk factors for patients with mixed Candida/bacterial bloodstream infections (BSIs).Methods A retrospective study was conducted in the Second Affiliated hHospital of Zhejiang University School of Medicine from February 2012 to June 2015.The clinical data of cases was collected,and the clinical characteristics,the microbiology data and outcomes in patients with mixed Candida/bacterial BSIs confirmed by blood culture were compared with those with candidaemia.A Logistic regression analysis was performed to investigate the independent risk factors.Results A total of 136 candidaemia cases were analyzed including 40 cases (29.4%) of mixed Candida/boacterial BSIs and 96 cases of candidaemia.Among the 136 candidas strains,the proportion of non-albicans exceeded the albicans (50.7% vs 49.3%),although the later was still the predominant one.There was no significant difference in the distribution of candidas strains between patients with mixed Candida/bacterial BSIs and patients with candidaemia.In patients with mixed Candida/bacterial BSIs,25 strains (61.0%) of gram-positive cocci and 16 strains (39.0%) of gram-negative bacilli were isolated.Compared with patients with candidaemia,patients with mixed Candida/bacterial BSIs needed longer period of antifungal therapy [12.0 (4.0-25.0)days vs 7.0 (3.0-13.5) days,P=0.027],but the crude 30-day and 90-day mortality did not differ between the two groups (40.0% vs 32.3%;45.0% vs 36.5%;both P>0.05).Univariate analysis revealed that the prior hospital stay,ICU admission at the onset of candidaemia,blood transfusion,human albumin infusion,mechanical ventilation,linezolid use and high SOFA score were related with the occurrence of mixed Candida/bacterial BSIs (all P<0.05).Multivariate analysis showed that only high SOFA score was the independent risk factor (P=0.003).Conclusions Gram-positive cocci were the predominant species in mixed Candida/bacterial BSIs.Compared with candidaemia,mixed Candida/bacterial BSIs needs a longer ICU stay,a longer hospital stay,and a prolonged antifungal therapy.High SOFA score is the independent risk factor for mixed Candida/ bacterial BSIs.

11.
Rev. Soc. Bras. Med. Trop ; 51(4): 542-545, July-Aug. 2018. tab
Article in English | LILACS | ID: biblio-1041473

ABSTRACT

Abstract INTRODUCTION This study aims to evaluate the antifungal susceptibility of different species of Candida isolated from diabetic patients against eight antifungal agents. METHODS Susceptibility testing of 111 clinical isolates of Candida species was performed against 8 antifungals using the M27-A3 protocol of the Clinical and Laboratory Standards Institute (CLSI). RESULTS Voriconazole, lanoconazole, and caspofungin showed the highest in vitro activity against all the isolates of C. albicans. Resistance against the tested antifungals was only observed in the C. albicans isolates. CONCLUSIONS Our finding revealed that resistance against amphotericin B, itraconazole, ketoconazole, posaconazole, and fluconazole can be observed in C. albicans.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Candida/drug effects , Diabetes Mellitus/microbiology , Antifungal Agents/pharmacology , Candida/isolation & purification , Candida/classification , Microbial Sensitivity Tests/methods , Middle Aged
12.
Rev. Soc. Bras. Med. Trop ; 51(3): 352-356, Apr.-June 2018. tab
Article in English | LILACS | ID: biblio-1041467

ABSTRACT

Abstract INTRODUCTION We describe the clinical and laboratorial features of oral candidiasis in 66 HIV-positive patients. METHODS: Polymerase chain reaction-based techniques were performed for differentiation of Candida spp. isolated from patients at a public teaching hospital in Midwest Brazil. RESULTS: Oral lesions, mainly pseudomembranous, were significantly related to higher levels of immunosuppression. Of 45 Candida isolates, 66.7% were C. albicans. Most of the isolates were susceptible to the antifungal drugs tested. CONCLUSIONS: Oral lesions were associated with higher immunosuppression levels. Lower susceptibility to antifungals by non-albicans isolates supports the importance of surveillance studies using susceptibility tests to aid in the treatment.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Candida/drug effects , Candidiasis, Oral/diagnosis , AIDS-Related Opportunistic Infections/diagnosis , Antifungal Agents/pharmacology , Brazil , Candida/isolation & purification , Candida/classification , Candidiasis, Oral/microbiology , Drug Resistance, Microbial , Microbial Sensitivity Tests , Fluconazole/pharmacology , Amphotericin B/pharmacology , Mycological Typing Techniques , AIDS-Related Opportunistic Infections/microbiology , Itraconazole/pharmacology , Middle Aged
13.
Article | IMSEAR | ID: sea-200798

ABSTRACT

Introduction:Vulvovaginal candidiasis (VVC) is the most common fungal infection of lower genital tract of females. It is an important cause of morbidity in young women due to its increasing incidence and is considered as an important public health problem worldwide. In recent years there has been a change in the trend of infections caused by non-albicans Candida species and anti-fungal susceptibility patterns. This study was carried out to assess the prevalence, potential risk factors and detect the antifungal susceptibilities of the isolates. Methods:A prospective study was con-ducted in a tertiary health centre of southern Odisha from January 2016 to December 2017and included 240 clinical-ly diagnosed cases of VVC in the reproductive age group presenting with curdy white discharge with or without pruri-tus, burning, or dysuria. After getting an informed consent and brief history, vaginal swabs were collected and micro-scopic examination, culture and antifungal susceptibility were done. Results: Most common age group affected by VVC belonged to 26-35 years and majority of the cases were from rural areas. A total of 87 Candida species (36.3%) and, 4 Trichosporon asahiiwere isolated. Candida albicans was the most common isolate (52), followed by Candida glabrata. Most of the isolates were sensitive to clotrimazole (90.1%) followed by fluconazole (83.5%). Conclusion:The prevalence of VVC in our study was found to be 36.3%. Low socioeconomic status, low education, oral contra-ceptive pill users and Diabetes were the common predisposing factors. The most common agent causing VVC was Candidia albicans followed by Candida glabrata. Most of the yeasts isolated were sensitive to Clotrimazole followed by fluconazole.

14.
Article | IMSEAR | ID: sea-200826

ABSTRACT

Background: Infective keratitis is the second major cause of blindness next to cataract. Mycotic keratitis is an im-portant ophthalmologic problem especially in developing countries including India. Fungal infection involving cornea is a fatal condition which needs early diagnosis and treatment to save the patient’s eye. Though studies on mycotic keratitis have been reported from different part of India, to the best of our knowledge this study showing antifungal susceptibility is the first to be reported from Southern Odisha. Objective: The purpose of this study was to study epi-demiological characteristics, predisposing factors, fungal etiology and antifungal susceptibility of common fungal isolates in infective keratitis cases. Materials and Methods: A prospective study was conducted from November 2015 to October 2017 in the Department of Microbiology and Ophthalmology M.K.C.G Medical College and Hospi-tal .Relevant information was recorded using standard proforma of keratitis cases. Corneal scrapings were collected under strict aseptic conditions and subjected to10% KOH mount, Gram stain and culture. Identification of fungala-gents were done as per standard microbiological procedures. An antifungal sensitivity test was done by microbroth dilutions as per CLSI reference method. Results: Over a period of two years 149 patients of infective keratitis were evaluated. Microbiological diagnosis of mycotic keratitis was established in 39 (26.17%) cases. Filamentous fungi were isolated more often than yeasts. The most frequently encountered filamentous fungi and yeasts were Aspergil-lusspp. 14 (35.89%) and Candida albicans 7 (17.94%) respectively. Males were more commonly affected and were mostly in the age group of 46-60 years. Ocular trauma due to vegetative matter was the most common predisposing factor. Natamycin was the most effective antifungal against filamentous fungi and amphotericin B was most effective for Candida albicans. Conclusion: Because of serious consequences of mycotic keratitis, it is very important to know the exact etiological agents and effective antifungals to save the eye of the patients. So laboratory confirmation should be undertaken and fungal infection should be ruled out before prescribing antimicrobial agents.

15.
Rev. argent. microbiol ; 49(4): 320-322, Dec. 2017. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1041795

ABSTRACT

Las infecciones graves causadas por levaduras del género Candida son frecuentes en la población hospitalaria. Debido a las diferencias en la distribución de especies y la sensibilidad a los antifúngicos según el área geográfica y el tipo de paciente, resulta importante estudiar la epidemiología de cada institución. Con este propósito, hemos realizado un estudio retrospectivo y descriptivo sobre las candidemias ocurridas en el Hospital de Ninos «Superiora Sor María Ludovica¼ de la ciudad de La Plata. En un período de 6 años (2010-2015) se registraron 177 episodios de candidemia. Las especies predominantes fueron Candida albicans (45%) y Candida parapsilosis (28%). Las salas de internación con mayor cantidad de episodios fueron las unidades de terapia intensiva de pediatría, la neonatal y la cardiovascular (58%). En los casos donde se realizaron pruebas de sensibilidad a los antifúngicos, no se observó resistencia a la anfotericina B en todo el período y la resistencia a azoles se limitó a 4 aislamientos de especies menos frecuentes.


Serious infections caused by Candida yeasts are frequent in the hospital population. Due to differences in species distribution and antifungal susceptibility testing depending on the geographic area and the type of patient, it is important to study the epidemiology of each institution. For this purpose, we conducted a retrospective, descriptive study on the occurrence of candidemia in the Children's Hospital "Superiora Sor María Ludovica" of the city of La Plata. In a 6-year period (2010-2015), 177 candidemia episodes were recorded. The predominant species were Candida albicans (45%) and Candida parapsilosis (28%). The hospital wards with the highest number of candidemia episodes were the pediatric, neonatal and cardiovascular intensive care units (58%). No resistance to amphotericin B was observed throughout the period whereas resistance to azoles was limited to 4 strains of less frequent species.

16.
Mem. Inst. Oswaldo Cruz ; 112(10): 719-722, Oct. 2017. graf
Article in English | LILACS | ID: biblio-1040562

ABSTRACT

We report the first two cases of Trichosporon mycotoxinivorans infections in Latin America. We also conducted a literature review and a microbiological investigation, including that of clinical and environmental isolates. A 30-year-old man with chronic renal failure had disseminated infection after dialysis and a 15-year-old boy with cystic fibrosis (CF) had pulmonary exacerbations with positive respiratory samples. A review of the relevant literature revealed that deep-seated infections were related to immunosuppression or invasive devices, while most of the CF patients showed a decline in lung function after positive cultures. Phylogenetic analyses revealed three distinct circulating genotypes. MALDI-TOF mass spectrometry analysis showed similar spectral profiles and correctly identified all strains/isolates. Biofilm production was documented in a bloodstream isolate and biofilm-producing cells showed high minimum inhibitory concentrations against antifungals.


Subject(s)
Humans , Male , Adolescent , Adult , Trichosporon/genetics , Trichosporonosis/diagnosis , Trichosporon/classification , Trichosporon/drug effects , Brazil/epidemiology , Microbial Sensitivity Tests , Biofilms/growth & development , Trichosporonosis/microbiology , Trichosporonosis/epidemiology , Genotype , Latin America , Antifungal Agents/pharmacology
17.
Rev. argent. microbiol ; 49(3): 224-226, set. 2017. ilus
Article in English | LILACS-Express | LILACS | ID: biblio-1041789

ABSTRACT

Human protothecosis is a rare infection caused by algae of the genus Prototheca. Prototheca wickerhamii has been recognized as the main species that causes infection in immunocompromised hosts with deficits in innate or cellular immunity. We report a case of persisting subcutaneous protothecosis in a patient with T-cell large granular lymphocyte leukemia, who also presented a history of disseminated histoplasmosis.


La prototecosis humana es una infección rara causada por algas del género Prototheca. Prototheca wickerhamii ha sido reconocida como la principal especie causante de infección en huéspedes inmunocomprometidos, con déficit de inmunidad innata o celular. Presentamos un caso de prototecosis subcutánea persistente en un paciente con leucemia linfocítica granular de células T, con antecedentes de histoplasmosis diseminada.

18.
Article | IMSEAR | ID: sea-186616

ABSTRACT

Background: Sepsis is a global problem causing substantial morbidity and mortality to the patients afflicted with it. Moreover sepsis due to fungal infections, especially, the Candida infections has increased in the recent times due to increase in patients with immunocompromised conditions. They are the normal commensal of the oral cavity, GIT and the mucosal surfaces in the body as well as the pathogens leading to colonization and also infection. Though Candida albicans is the most commonly isolated fungal pathogen from clinical samples, gradually non-albicans Candida species are becoming predominant pathogens. The increased use of anti-fungal agents for treatment and also for prophylaxis especially in ICU patients has lead to development of resistance against commonly used anti-fungal agents in the treatment like various azoles. Thus this study was carried out to identify different Candida species from specimens of clinically diagnosed sepsis patients and their antifungal susceptibility pattern which can be utilized for better management of sepsis patients. Objectives: The objectives of this study were to isolate and identify the species of Candida from different samples of clinically diagnosed sepsis patients and to determine the susceptibility pattern of the Candida species isolates against the commonly used anti-fungal agents from the clinical samples of sepsis patients from a rural based tertiary care and teaching hospital. Khara R, Lakhani SJ, Vasava S. Isolation, Identification and Antifungal Susceptibility Testing of Candida species from Sepsis Patients from a rural based tertiary care and teaching hospital in Vadodara district, Gujarat. IAIM, 2017; 4(7): 151- 160. Page 152 Materials and methods: A total of 100 Candida species were isolated from different samples of clinically diagnosed sepsis patients. These were identified on the basis of gram stain of the samples, colony morphology on Saboraud’s Dextrose agar and HiCrome also germ tube and chlamydospore formation. The antifungal susceptibility testing was done according to CLSI M44-A2 for yeasts. Results: A total of 100 (14.26%) Candida species were isolated out of the total 701 isolates from 1136 different samples cultured from clinically diagnosed sepsis patients. Of these, 53% were C. albicans, 37% C. non-albicans, 6% C. glabrata and 4% C. tropicalis. Also 35% were obtained from blood, 20% from catheterized urine, 19% from sputum, 14% from non-catheterized urine, 7% from ET (Endotracheal) tips/secretions and the smaller percentage from other specimens. The antifungal testing showed a higher resistance to most of the antifungal agents tested with 80% towards clotrimazole, 77% to ketoconazole and 63% to fluconazole and 62% towards itraconazole. However, 80% of Candida species were susceptible to amphotericin B followed by 33% to fluconazole and 80% were susceptible-dose-dependent to nystatin. Conclusion: The findings of our study suggest that Candida species are an important pathogen causing various infections in our patients leading to sepsis as well as a higher resistance to most of the antifungal agents tested poses a real challenge in the management of patients with sepsis due to Candida. Thus routine identification using HiCrome Media and antifungal susceptibility testing by disc diffusion method for yeasts will help in better management of sepsis due to Candida infections.

19.
Braz. j. med. biol. res ; 50(6): e5797, 2017. tab
Article in English | LILACS | ID: biblio-839307

ABSTRACT

Candida species are the leading cause of invasive fungal infections, and over the past decade there has been an increased isolation of drug resistant Candida species. This study aimed to identify the species distribution of Candida isolates and to determine their unique antifungal susceptibility and resistance patterns. During a cross-sectional study, 209 Candida isolates (recovered from 206 clinical samples) were collected and their species distribution was determined using ChromAgar Candida. The Vitek-2 system (Biomerieux, South Africa) was used to determine minimum inhibitory concentrations (MICs) to azoles (fluconazole, voriconazole), echinocandins (caspofungin, micafungin), polyenes (amphotericin B) and flucytosine. Four species of Candida were isolated, of which C. albicans was the most frequent, isolated in 45.4% (95/209) of the isolates, followed by C. glabrata: 31.1% (65/209). The MICs of the different antifungal drugs varied amongst the species of Candida. From the 130 isolates tested for MICs, 90.77% (112/130) were susceptible to all antifungal drugs and 6.9% (9/130) of the isolates were multi-drug resistant. C. dubliniensis (n=2) isolates were susceptible to all the above mentioned antifungal drugs. There was no significant difference in species distribution amongst clinical specimens and between patients' genders (P>0.05). An increase in MIC values for fluconazole and flucytosine towards the resistance range was observed. To our knowledge, this is the first report on surveillance of Candida species distribution and antifungal susceptibility at a public tertiary teaching hospital in Eastern Cape, South Africa.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Antifungal Agents/pharmacology , Candida/drug effects , Urine/microbiology , Vagina/microbiology , Candida/classification , Candida/isolation & purification , Cross-Sectional Studies , Drug Resistance, Fungal , Hospitals, Teaching/statistics & numerical data , Microbial Sensitivity Tests , South Africa , Tertiary Care Centers/statistics & numerical data
20.
Rev. Inst. Med. Trop. Säo Paulo ; 59: e13, 2017. tab, graf
Article in English | LILACS | ID: biblio-842793

ABSTRACT

ABSTRACT Cryptococcosis, a systemic disease caused by the fungus Cryptococcus neoformans/ Cryptococcus gattii is more severe in immunocompromised individuals. This study aimed to analyze the epidemiology of the disease, the molecular characteristics and the antifungal susceptibility of C. neoformans isolated from patients treated in a Brazilian university hospital. This retrospective study was conducted in the Clinical Hospital, Federal University of Uberlândia, and evaluated cases of cryptococcosis and strains of C. neoformans isolated from 2004 to 2013. We evaluated 41 patients, 85% of whom were diagnosed with AIDS. The fungus was isolated from the cerebrospinal fluid (CSF) of 21 patients (51%); 19.5% had fungemia and in 24% the agent was isolated from the CSF and blood, concurrently. Meningoencephalitis was the most frequent (75%) manifestation of infection. Despite adequate treatment, the mortality of the disease was 58.5%. Most isolates (97.5%) presented the VNI genotype (serotype A, var. grubii) and one isolate was genotyped as C. gattii (VGI); all the isolates were determined as mating type MATa and showed susceptibility to the tested antifungals (fluconazole, voriconazole, amphotericin B and 5-flucytosine). Although AIDS detection rates remain stable, opportunistic infections such as cryptococcosis remain as major causes of morbidity and mortality in these patients.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Cryptococcosis/mortality , Cryptococcus neoformans/isolation & purification , AIDS-Related Opportunistic Infections/microbiology , AIDS-Related Opportunistic Infections/mortality , Antifungal Agents/pharmacology , Brazil/epidemiology , Cryptococcosis/microbiology , Cryptococcus neoformans/drug effects , Cryptococcus neoformans/genetics , DNA, Fungal/analysis , Hospitals, University , Microbial Sensitivity Tests , Retrospective Studies
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