ABSTRACT
Resumen La hipofisitis es una afección con baja incidencia y prevalencia. Asimismo, las infecciones profundas por hongos en pacientes inmunocompetentes también re presentan un fenómeno infrecuente. Más raro aún es el caso que se describe a continuación, en donde se conjugan estos dos elementos mencionados, a saber: cryptococcoma hipofisario o hipofisitis granulomatosa causado por dicho patógeno en un huésped sin altera ción de la respuesta inmune. Luego de una búsqueda realizada en PubMed, existen limitados casos en la literatura médica de hipofisitis granulomatosa por Cryptococcus spp., que simuló por manifestaciones clínicas e imagenológicas un macro adenoma hipofisario. No encontramos informes en los que no haya evidencia de afectación del tejido meníngeo. La etiología micótica está escasamente descrita en las guías de referencia para hipofisitis y creemos que Cryp tococcus spp. debe ser tenido en cuenta en el diagnóstico diferencial de las hipofisitis granulomatosas secundarias dado que es un patógeno ubicuo y el tratamiento es sustancialmente diferente a otras entidades. Cobra mayor relevancia ante la tendencia actual al uso de glucocorticoides sistémicos a altas dosis para el tratamiento de la hipofisitis, que podría haber gene rado mayor daño de no haberse hecho el diagnóstico correcto.
Abstract Hypophysitis is a pathology with low incidence and prevalence. Likewise, deep fungal infections in immuno competent patients also represent a rare phenomenon. Even rarer is the case described below, where these two mentioned elements are combined, namely: pituitary cryptococcoma or granulomatous hypophysitis caused by said pathogen in a host without altered immune response. After research in PubMed, there are limited cases in the medical literature of granulomatous hypophysitis caused by Cryptococcus spp., which simulated a pituitary macroadenoma by clinical and imaging manifestations. We did not find reports in which there is no evidence of involvement of the meningeal tissue. The fungal etiology is scarcely described in the reference guidelines for hypophysitis and we believe that Cryptococcus spp. it should be taken into account in the differential diagnosis of secondary granuloma tous hypophysitis since it is a ubiquitous pathogen and the treatment is substantially different from other entities. It becomes more relevant given the current trend towards the use of high-dose systemic glucocorticoids for the treatment of hypophysitis, which could have generated greater damage if the correct diagnosis had not been made.
ABSTRACT
Among the major causative agents of invasive fungal infections stands out the opportunistic yeasts of Candida and Cryptococcus. Regarding the problem of the high incidence of infections by these agents and the difculty of treating the low stockpile of antifungal drugs and the high toxicity of most therapies, the search for new antifungal compounds has been highlighted in recent decades. Hedychium coronarium, popularly known as "lírio-do-brejo" or "gengibre-branco" features several previously reported biological activities, including antimicrobial activity. Compound 1.8-cineole is the major compound in essential oil extracted from roots of H. coronarium, while caryophyllene oxide presents itself as the major in essential oil extracted from leaves of this plant. Our data show strong antifungal activity of compounds, against species of Candida albicans, Candida parapsilosis, Candida krusei, Cryptococcus neoformans and Cryptococcus gattii, with minimal inhibitory concentration and minimal fungicidal concentration equal to 0.2 % (v/v) for essential oil extracted from roots, while the essential oil extracted from leaves showed no activity against yeasts. The caryophyllene oxide showed higher antifungal activity for Cryptococcus spp. Thus, our results showed that the essential oil of rhizome is a promising antifungal agent against pathogenic yeasts.(AU)
Candida spp e Cryptococcus spp estão classifcadas entre os maiores causadores de infecções fúngicas invasivas em pacientes imunocomprometidos. Diante a alta incidência destas infecções por estes agentes e a difculdade do sucesso no tratamento, decorrente do baixo arsenal de fármacos antifúngicos e da alta toxicidade presente na maioria dos esquemas terapêuticos, a busca por novos compostos antifúngicos tem sido alvo de diversos estudos nas últimas décadas. Hedychium coronarium, popularmente conhecido como "lírio-do-brejo" ou "gengibre-branco", apresenta diversas atividades biológicas já descritas, entre elas a atividade antimicrobiana. O composto 1.8-Cineol é o composto majoritário presente no óleo essencial extraído de raízes de H. coronarium e o composto óxido de cariofleno é o composto majoritário extraído das folhas desta planta. Nossos resultados mostram que os compostos extraídos de H. coronarium apresentam forte atividade contra Candida albicans, Candida parapsilosis, Candida krusei, Cryptococcus neoformans e Cryptococcus gattii, com valores de concentração inibitória minima e concentração fungicida minima igual a 0,2 % (v/v) para o óleo essencial extraído das raízes, enquanto que o óleo essencial extraído das folhas, não mostrou atividade contras as leveduras. O composto óxido de cariofleno mostrou maior atividade antifúngica para Crytopcoccus spp. Assim, nossos dados mostraram que o óleo essencial extraído das raízes de H. coronarium, é um agente antifúngico promissor contra leveduras patogênicas.(AU)
Subject(s)
Candida/drug effects , Oils, Volatile/pharmacology , Cryptococcus/drug effects , Zingiberaceae/microbiology , Oxides , Candidiasis/microbiology , Cryptococcosis/microbiology , Antifungal Agents/therapeutic useABSTRACT
Introdução: Os fungos do gênero Cryptococcus, principalmente as espécies C. neoformans e C. gattii, são patógenos que causam a meningoencefalite, principalmente em indivíduos imunocomprometidos. O fungo é inalado, sendo as excretas de aves o nicho mais evidente do C. neoformans e as árvores do C. gattii. O presente estudo visa pesquisar o fungo Cryptococcus spp. nos arredores de grandes hospitais de Porto Alegre e verificar a susceptibilidade destes isolados ambientais aos antifúngicos. Métodos: Foram coletadas 87 amostras de excretas de pombos no entorno de seis hospitais de Porto Alegre e semeadas. As colônias leveduriformes foram analisadas macro e microscopicamente e submetidas a provas bioquímicas e moleculares. Posteriormente, estes isolados foram submetidos aos testes de susceptibilidade aos antifúngicos Etest® (Biomérieux) e MIC Strip Test® (Leofilchem). Resultados: Os fungos do gênero Cryptococcus foram isolados em seis amostras, sendo que cinco foram identificados, pelas provas convencionais, como o C. neoformans e uma o C. gattii, porém estas espécies não foram confirmadas pelas provas moleculares. No antifungigrama se encontraram entre os isolados de C. neoformans faixas de valores de concentração inibitória mínima (CIM) de 0,25-8 μg/ml para anfotericina B, 0,125->32 μg/ml para cetoconazol, 0,75->256 μg/ml para fluconazol, 0,125->32 μg/ml para voriconazol, e todas apresentaram CIM >32 μg/ml para itraconazol. Conclusões: A presença deste fungo em áreas hospitalares pode configurar um risco biológico, já que nestas áreas circulam muitos indivíduos imunocomprometidos, e a presença de cepas resistentes aos antifúngicos pode levar a uma diferente forma de conduzir o tratamento das patologias provocadas por esta levedura.
Introduction: Fungi of the Cryptococcus genus, mainly the species C. neoformans and C. gattii, are pathogens that cause meningoencephalitis, especially in immunocompromised individuals. The fungus is inhaled, with the excreta of birds being the most obvious niche of C. neoformans and trees of C. gattii. This study aims to fi nd the Cryptococcus spp. fungus on the outskirts of large hospitals in Porto Alegre and check the susceptibility of these environmental isolates to antifungal agents. Methods: We collected 87 samples of pigeon feces in the surroundings of six hospitals in Porto Alegre and cultured them. The yeast colonies were analyzed macroscopically and microscopically and subjected to biochemical and molecular tests. Subsequently these isolates were submitted to susceptibility tests to antifungals Etest® (Biomerieux) and MIC Strip Test® (Leofi lchem). Results: Fungi of the Cryptococcus genus were isolated in 6 samples, of which 5 were identifi ed by conventional tests, such as C. neoformans and C. gattii, but these species were not confi rmed by molecular tests. On antifungal susceptibility tests in C. neoformans isolates showed minimum inhibitory concentration values (MIC) ranging from 0.25 to 8 g/ml for amphotericin B, 0.125-> 32 ug/ml for ketoconazole, 0,75-> 256/ml for fl uconazole, and 0.125->32 ug/ml for voriconazole, and all showed MIC>32 mg/ml for itraconazole. Conclusion: The presence of this fungus in hospital areas may pose a biohazard, as many immunocompromised individuals circulate in these areas, and the presence of antifungal resistant strains can lead to a different way of conducting the treatment of disorders caused by this yeast.
Subject(s)
Humans , Cryptococcosis , Fungicides, IndustrialABSTRACT
INTRODUÇÃO: A criptococose é uma importante infecção fúngica, que causa um número estimado de 1 milhão de casos e 625 mil mortes por ano, principalmente sob a forma de meningoencefalite em pessoas com imunodeficiência no mundo. O diagnóstico da meningite criptocócica é realizado através de achados das estruturas do fungo em fluidos biológicos em pesquisa direta com tinta da china, cultivo, anatomopatológico, exames de imagem e pesquisa de antígeno criptocócico. Tem sido empregado um testei munocromatográfico conhecido como CrAg-LFA para detecção do antígeno dopolissacarídeo capsular de Cryptococcus spp., em amostras de soro, urina e no líquor, este método tem se tornado um dos testes sorológicos a ser realizado na rotina de investigação micológica para criptococose. OBJETIVO: estimar a frequência de detecção de antígeno criptocócico obtido por CrAg-LFA em amostras de líquido cefalorraquidiano de pacientes com suspeita de meningite em um hospital de referência do estado do Piauí. METODOLOGIA: os pacientes internados com suspeita de meningite realizaram coleta do líquor para exames de tinta da China e CrAg-LFA. Dados como sexo, idade, procedência e resultados laboratoriais foram inseridos em um banco estruturado, essas informações foram obtidas a partir do livro de registro do laboratório, prontuários dos pacientes e fichas de investigação do Sistema de Informação de Agravos de Notificação (SINAN) RESULTADOS: Foram analisados os resultados de 140 pacientes atendidos no hospital de referência e que realizaram os exames detinta da China e CrAg-LFA...
INTRODUCTION: Cryptococcosis is an important fungal infection causing anestimated 1 million cases and 625 thousand deaths per year, primarily in the formof encephalitis in immunodeficient individuals. Diagnosis of cryptococcalmeningitis is performed by detection of fungal structures in biological fluids indetection with India ink staining, culture, pathology, imaging and cryptococcalantigen testing. An immunoassay known as Crag-LFA for the detection ofcapsular polysaccharide antigens of Cryptococcus spp. in has been employed,serum samples, urine and spinal fluid, this method is becoming one of theserological tests to be carried out in routine mycological research forcryptococcosis. OBJECTIVE: To estimate the frequency of cryptococcal antigendetection obtained by Crag-LFA in cerebrospinal fluid samples from patients withsuspected meningitis in a reference hospital of the state of Piauí. METHODS:Patients hospitalized with suspected meningitis held collection of CSF for Indiaink staining and Crag-LFA testing...
Subject(s)
Humans , Chromatography, Affinity , Meningitis, Cryptococcal , CryptococcusABSTRACT
A criptococose é uma micose primariamente pulmonar, sendo adquirida por meio de inalação de propágulos fúngicos infectantes encontrados no ambiente. Um dos principais agentes etiológicos da criptococose é a espécie Cryptococcus neoformans , que apresenta distribuição mundial. O objetivo desse trabalho foi pesquisar a ocorrência de Cryptococcus spp. em excretas de Columba livia (pombos domésticos) encontradas na área externa do prédio do Hospital Universitário Dr. Miguel Riet Correa Junior, centro de referência para o tratamento da Síndrome da Imunodeficiência Adquirida na região sul do estado do Rio Grande do Sul, Brasil. Durante um período de dez meses, foi coletado um total de 40 amostras de excretas secas da área acadêmica e da área hospitalar do Hospital Universitário. As excretas foram adicionadas de solução salina com cloranfenicol, homogeneizados em vórtex, semeados em ágar Níger e incubados a 25ºC com observações diárias até sete dias. A identificação do micro-organismo foi realizada por provas fenotípicas e bioquímicas. Das 40 amostras processadas e analisadas, 13 (32,5%) foram positivas para o isolamento de Cryptococcus spp., variando de 20.000 a 3.000.000 UFC/g de fezes. O isolamento desse fungo em um ambiente hospitalar é relevante em saúde pública, pois evidencia a exposição dos indivíduos que frequentam esse local a propágulos infectantes.(AU)
Cryptococcosis is primarily a pulmonary mycosis, being acquired by inhalation of infective fungal propagules found in the environment. One of the main etiological agents of cryptococcosis is the yeast Cryptococcus neoformans , which has worldwide distribution and whose natural habitat is the feces of birds. The aim of this study was to investigate the occurrence of Cryptococcus spp. in excreta of Columba livia (domestic pigeon) found in the outer area of the building of Hospital Universitário Dr. Miguel Riet Correa Junior, a reference center for the treatment of Acquired Immunodeficiency Syndrome in southern state of Rio Grande do Sul, Brazil. During a period of ten months, a total of 40 samples of dried excreta was collected from the site's academic area and hospital. To the excreta, were added saline solution with chloramphenicol, homogenized in a vortex, cultivated in Niger seed agar and incubated at 25°C with daily observations up to seven days. The identification of the microorganism was performed by phenotypical and biochemical tests. From the 40 samples processed and analyzed, 13 (32.5%) were positive for the isolation of Cryptococcus spp., with the quantity of yeasts ranging from 20.000 to 3.000.000 CFU/g of feces. Isolation of the opportunistic fungus Cryptococcus spp. at a university hospital is relevant in public health for demonstrating the exposure of individuals who frequent this site to infectant propagules.(AU)
Subject(s)
Animals , Columbidae , Virulence , Public Health , Cryptococcosis , Cryptococcus , BrazilABSTRACT
Seven cases of cryptococosis (six cats and one dog) were studied to establish the determining histomorphological and histochemical characteristics in the histopathological diagnosis of this condition. Additional data related to the epidemiology, clinical aspects, sites of the lesions, and gross findings were obtained from the necropsy and biopsy protocols. Histologically, yeasts were observed inside macrophages or free in the parenchyma, associated with scarse to severe lymphohistioplasmacytic inflammatory reaction. In the hematoxylin-eosin (HE) sections, the yeasts were round, with a central cell containing a nucleus, surrounded by a clear halo (usually non-stained capsule). The techniques of periodic Schiff acid (PAS), Groccot (GMS), and Fontana-Masson (FM) were utilized and demonstrated the wall of the yeast cells. The FM stain showed the melanin present in these cells. The Alcian blue and Mayer's mucicarmin stains showed mainly the yeast polysaccharide capsule. The diameter of the cells ranged from 1.67 to 10.00µm and the full diameter of the encapsulated yeasts varied between 4.17 e 34.16µm. Yeast buddings were better observed through the PAS stain and were narrow based, simple or multiple, mainly in the opposite poles of the cells or forming chains. The definitive diagnosis of cryptococosis was established through the histopathological exam, based on the specific morphology of the agent (encapsulated yeast) and on histochemical proprieties, mostly in the cases without fungal culture.
Sete casos de criptococose (seis gatos e um cão) foram estudados para estabelecer as características histomorfológicas e histoquímicas determinantes no diagnóstico histopatológico dessa condição. Os dados complementares relacionados à epidemiologia, aos aspectos clínicos, à localização das lesões e às alterações macroscópicas foram obtidos dos protocolos de necropsias e biópsias. Na histologia, as leveduras foram observadas no interior de macrófagos ou livres no parênquima, associadas à reação inflamatória linfo-histioplasmocítica que variou de escassa a acentuada. Pela técnica de hematoxilina-eosina (HE) as leveduras eram arredondadas, com célula central contendo um núcleo, circundada por um halo claro (cápsula geralmente não corada). As técnicas histoquímicas do ácido periódico de Schiff (PAS), Grocott e Fontana-Masson (FM) foram utilizadas e evidenciaram a parede das células das leveduras. Pelo FM observou-se a melanina presente nessas células. As técnicas do azul Alciano e da mucicarmina de Mayer evidenciaram principalmente a cápsula polissacarídica das leveduras. O diâmetro das células das leveduras variou de 1,67 a 10,00µm e o diâmetro total das leveduras encapsuladas variou entre 4,17 e 34,16µm. Os brotamentos foram melhor visualizados através do PAS e ocorreram em base estreita, de forma única ou múltipla, principalmente em polos opostos das células das leveduras ou formando uma cadeia. O diagnóstico definitivo de criptococose foi estabelecido através do exame histopatológico, baseando-se na morfologia característica do agente (levedura encapsulada) e em suas propriedades tintoriais (histoquímicas), principalmente nos casos em que a cultura micológica não foi realizada.
Subject(s)
Animals , Cats , Dogs , Dogs/microbiology , Cryptococcosis/veterinary , Cryptococcus/isolation & purification , Cats/microbiology , Mycoses , Cryptococcosis/diagnosis , Cryptococcus/pathogenicityABSTRACT
Cryptococcosis is an infection that affects humans and animals, the etiology is attributed to Cryptococcus neoformans variety neoformans, C. neoformans var. grubii and Cryptococcus gattii. The infection is common in dogs and cats, causing respiratory, neurological, cutaneous and ocular infections. Aiming to better understand the epidemiology of cryptococcosis in animals in the region, this paper describe the occurrence and characterization of the Cryptococcus species involved in this illness in pet animals at Mato Grosso State, Brazil. Clinical samples of four cases, two in cats and two dogs, were submitted for pathological, microbiological and molecular analysis. Microscopically, in three cases, tissue sections stained with hematoxylin and eosin had absence to severe granulomatous reaction composed by histiocytes, multinucleated cells and lymphocytes infiltration. In one case, citological imprint analysis showed similar inflammatory mainly mononuclear and lymphocyte cells infiltration. All cases had variable amounts of intracellular and extracellular fungal structures compatible with Cryptococcus sp. on Periodic Acid-Schiff (PAS) stain. All clinical samples were positive for culture on Sabouraud Dextrose Agar (SDA) and morphologically classified as Cryptococcus sp. The isolates were PCR positive for C. gatti, being confirmed by sequencing technique. The findings characterize the molecular species involved in animal infections in the region, and may contribute to future studies of the epidemiology of C. gattii.
A criptococose é uma infecção que afeta humanos e animais sendo a etiologia atribuída às espécies Cryptococcus neoformans variedade neoformans, C. neoformans var. grubii e C. gattii. A doença é comum em cães e gatos, causando infecções respiratórias, neurológicas, cutâneas e oculares. Com o objetivo de entender melhor a epidemiologia da criptococose em animais, este trabalho descreve a ocorrência e a caracterização de espécies de Cryptococcus em pequenos animais doentes no Estado de Mato Grosso, Brasil. Amostras clínicas de quatro casos, dois em felinos e dois em caninos, foram submetidas à análise patológica, microbiológica e molecular. Microscopicamente, em três casos, nos cortes de tecidos corados pela hematoxilina notou-se desde ausência até acentuada inflamação granulomatosa composta por histiócitos, células multinucleadas e infiltração linfocitária. Em um caso, na análise citológica de "imprint" observou-se infiltrado inflamatório similar composto principalmente por células mononucleares e linfócitos. Em todos os casos havia variável quantidade de estruturas fúngicas intra e extracelulares compatíveis com Cryptococcus spp pela coloração do ácido períodico de Schiff (PAS). Todas as amostras foram positivas para a cultura em Sabouraud Dextrose Agar (SDA), e morfologicamente classificadas como Cryptococcus sp. Os isolados foram positivos no PCR para C. gattii, sendo confirmados pelo seqüenciamento. Os resultados caracterizaram a espécie envolvida na região, e contribuem para futuros estudos sobre a epidemiologia de C. gattii.
Subject(s)
Animals , Cats , Dogs , Cats , Cryptococcosis/veterinary , Cryptococcus gattii/isolation & purification , Cryptococcus neoformans/isolation & purification , Dogs , Epidemiologic StudiesABSTRACT
Introduction The incidence of opportunistic fungal infections has increased in recent years and is considered an important public health problem. Among systemic and opportunistic mycoses, cryptococcosis is distinguished by its clinical importance due to the increased risk of infection in individuals infected by human immunodeficiency virus. Methods To determine the occurrence of pathogenic Cryptococcus in pigeon excrement in the City of Araraquara, samples were collected from nine environments, including state and municipal schools, abandoned buildings, parks, and a hospital. The isolates were identified using classical tests, and susceptibility testing for the antifungal drugs (fluconazole, itraconazole, voriconazole, and amphotericin B) independently was also performed. After collection, the excrement samples were plated on Niger agar and incubated at room temperature. Results A total of 87 bird dropping samples were collected, and 66.6% were positive for the genus Cryptococcus. The following species were identified: Cryptococcus neoformans (17.2%), Cryptococcus gattii (5.2%), Cryptococcus ater (3.5%), Cryptococcus laurentti (1.7%), and Cryptococcus luteolus (1.7%). A total of 70.7% of the isolates were not identified to the species level and are referred to as Cryptococcus spp. throughout the manuscript. Conclusions Although none of the isolates demonstrated resistance to antifungal drugs, the identification of infested areas, the proper control of birds, and the disinfection of these environments are essential for the epidemiological control of cryptococcosis. .
Subject(s)
Animals , Antifungal Agents/pharmacology , Cryptococcus/drug effects , Feces/microbiology , Brazil , Columbidae , Cryptococcus/classification , Cryptococcus/isolation & purification , Microbial Sensitivity TestsABSTRACT
O artigo apresenta resultados de um projeto de ensino de Metodologia Científica em Curso de Graduação deMedicina Veterinária. Pautou-se por uma reflexão crítica da necessidade de interação entre as dimensões teórica eprática na formação do profissional e realizou-se análise de fontes urbanas de Cryptococcus spp em fezes de pombos(Columbia livia), evidenciando a importância de orientação à população sobre os riscos de contágio, caracterizando a patogenicidade dos agentes identificados em dez ambientes públicos.
This article presents the results of an educational project for the Scientific Methodology degree course for veterinary medicine. The project was guided by the critical reflection on the necessity for the interaction between the theoretical and practical dimensions of professional training. An analysis was performed of urban sources of Cryptococcus spp in excrements of pigeons (Columbia livia), indicating the need for education of the population about the risks factors of transmission and characterizing the pathogenicity of the identified agents in ten public places.
El artículo presenta los resultados de un proyecto de enseñanza de Metodología Científica en el Curso de Graduaciónde Medicina Veterinaria. Se marcó por una reflexión crítica da la necesidad de la interacción entre las dimensionesteóricas y prácticas en la formación del profesional y se realizó un análisis de fuentes urbanas de Cryptococcus sppen excremento de palomas (Columbia livia), mostrando la importancia de la orientación a la población sobre losriesgos del contagio, caracterizando la patogenicidad de los agentes identificados en diez ambientes públicos.
Subject(s)
Humans , Cryptococcosis/prevention & control , Cryptococcosis/transmission , Cryptococcosis/veterinary , Zoonoses/epidemiology , Zoonoses/transmission , Methodology as a Subject , Public Health/educationABSTRACT
Descreve-se presença de lesão pulmonar em cabra (Capra hircus) sugestiva de criptococose. O cultivo bacteriológico realizado a partir de material purulento articular revelou concomitante infecção por Corynebacterium pseudotuberculosis. À microscopia óptica observaram-se estruturas leveduriformes nos espaços alveolares do pulmão, dotadas de espessa cápsula de polissacarídeos PAS positivas, compatíveis com Cryptococcus spp. Casos de criptococose em caprídeos são considerados raros na literatura. Objetiva-se relatar os aspectos epidemiológicos e clínico-patológicos da forma pulmonar de infecção por Cryptococcus spp. em uma cabra no Brasil.
An infection by Cryptococcus spp. in a goat (Capra hircus) is reported. The bacterial culture performed from purulent material collected from joint abscesses revealed concomitant infection by Corynebacterium pseudotuberculosis. Optical microscopy revealed yeast-like structures in the alveolar spaces of the lungs, exhibiting a thick, PAS positive, polysaccharide capsule compatible with Cryptococcus spp. Cases of cryptococcosis in goats are considered rare in the literature. The objective is to describe the epidemiological and clinical-pathological aspects of the pulmonary form of an infection by Cryptococcus spp. in a goat in Brazil.
ABSTRACT
The Cryptococcus genus is composed by 37 different species, however, the C. gattii and C. neoformans are the two most concerning species once they cause deep mycosis in humans. In this way, the present study had as aim to perform an analysis in droppings of pigeon (Columba sp.) from the city of Maringá, PR, in order to verify the presence of suggestive yeast forms of Cryptococcus spp. For this study 70 samples of pigeon excrements were evaluated which were collected in 7 different sites. These samples were submitted to the tests of thermotolerance at 37°C, urease, phenoloxidase activity and direct exam with China ink preparation. The results show that the pigeon droppings of 5,7% of the studied samples presented suggestive yeast forms of Cryptococcus spp. These results are relevant due to the positive samples are from the sites with a higher possibility of immunocompromised individuals flow, who are more up to have the most severe kinds of the disease caused by this fungi.
O gênero Cryptococcus é composto de 37 espécies diferentes, contudo o C. gattii e C. neoformans são as mais preocupantes por causarem micose profunda em humanos. Desta forma, o presente trabalho teve como objetivo realizar uma análise em excretas de pombos (Columba sp.) procedentes da cidade de Maringá, PR, para verificar a presença de leveduras sugestivas de Cryptococcus spp. Para este estudo foram analisadas 70 amostras de excretas de pombos, coletadas em sete localidades diferentes. Essas amostras foram submetidas ao teste de termotolerância à 37°C, urease, atividade fenoloxidase e exame direto com tinta da china. Os resultados demonstraram que nos excrementos de pombos de 5,7% das localidades estudadas apresentaram leveduras sugestivas de Cryptococcus spp. Estes resultados mostraram-se relevantes, devido ao fato de as amostras positivas pertencerem aos locais de maior possibilidade de circulação de indivíduos imunocomprometidos, os quais estão mais propícios a contrair as formas mais graves da doença causada por este fungo.
Subject(s)
Animals , Columbidae/microbiology , Cryptococcosis/microbiology , Cryptococcus/pathogenicityABSTRACT
Foram avaliados 37 isolados de 10 pacientes HIV negativos e 26 positivos, em Mato Grosso. Exame direto, cultura e quimiotipagem de espécies foram realizados. Cetoconazol, itraconazol, voriconazol, fluconazol e anfotericina B foram avaliados. Foram identificadas 37 leveduras do gênero Cryptococcus spp sendo 26 de pacientes HIV- positivos (25 Cryptococcus neoformans e um Cryptococcus gattii) e 10 de HIV- negativos (cinco Cryptococcus neoformans e cinco Cryptococcus gattii). Considerando isolados clínicos (Cryptococcus neoformans) de HIV positivos observou-se resistência (8 por cento e 8,7 por cento) e susceptibilidade dose-dependência (20 por cento e 17,4 por cento) para fluconazol e itraconazol respectivamente. Para isolados de Cryptococcus neoformans oriundos de pacientes HIV negativos, observou-se susceptibilidade dose-dependência (40 por cento) ao fluconazol. Os isolados de Cryptococcus gattii provenientes de pacientes HIV- negativos mostraram-se susceptíveis a todos os antifúngicos, exceto um isolado de Cryptococcus gattii que foi susceptível dose-dependente ao fluconazol (20 por cento). O isolado proveniente do paciente HIV- positivo demonstrou resistência ao fluconazol (CIM > 256µg/mL) e itraconazol (CIM=3µg/mL).
Thirty-seven isolates from 10 HIV-negative and 26 HIV-positive patients in Mato Grosso were evaluated. Direct examination, culturing and chemotyping of species were performed. Ketoconazole, itraconazole, voriconazole, fluconazole and amphotericin B were evaluated. Thirty-seven yeasts of Cryptococcus spp were identified, of which 26 were from HIV-positive patients (25 Cryptococcus neoformans and one Cryptococcus gattii) and 10 from HIV-negative patients (five Cryptococcus neoformans and five Cryptococcus gattii). The Cryptococcus neoformans clinical isolates from HIV-positive patients showed resistance (8 percent and 8.7 percent) and dose-dependent susceptibility (20 percent and 17.4 percent) to fluconazole and itraconazole, respectively. Among the Cryptococcus neoformans isolates from HIV-negative patients, there was dose-dependent susceptibility (40 percent) to fluconazole. Cryptococcus gattii isolates from HIV-negative patients were shown to be susceptible to all antifungal agents, except for one isolate of Cryptococcus gattii that showed dose-dependent susceptibility to fluconazole (20 percent). The Cryptococcus gattii isolate from an HIV-positive patient showed resistance to fluconazole (MIC > 256 »g/ml) and itraconazole (MIC = 3 »g/ml).
Subject(s)
Adult , Female , Humans , Male , AIDS-Related Opportunistic Infections/microbiology , Antifungal Agents/pharmacology , Cryptococcus gattii/drug effects , Cryptococcus neoformans/drug effects , Cryptococcus gattii/genetics , Cryptococcus neoformans/genetics , Microbial Sensitivity Tests , Phenotype , Prospective StudiesABSTRACT
El lector del panel microbiológico automatizado autoScan®-4 detecta el crecimiento del hongo en diversos sustratos bioquímicos, presentes en los pozos de los paneles del MicroScan®. El propósito de este estudio fue relacionar el ¨biotipo¨ identificado por el MicroScan® con la especie causante de criptococosis, con el objeto de permitir una identificación en el menor tiempo posible. Se evaluaron 82 cepas de Cryptococcus spp. aisladas a partir de muestras clínicas entre 1995 y 2004. Para garantizar la pureza de las cepas, se realizó la identificación de las mismas por métodos convencionales; para identificar las especies se utilizó el medio L-canavanina-glicina-azul de bromotimol (CGB). Se utilizó también el panel de identificación rápida de levaduras del MicroScan®, con el fin de determinar el ¨biotipo¨. El MicroScan® reveló 27 diferentes ¨biotipos¨. De los 82 aislados tipificados con el uso del medio CGB, el 91,46 % correspondieron a C. neoformans y 8,54 % a C. gattii. No se encontró una diferencia significativa entre los ¨biotipos¨ y las especies (p>0,05). Sin embargo, se encontró significancia estadística entre las especies C. gattii y C. neoformans y la asimilación de p-nitrofenil-N-acetil-ß-D-glucosamina (NAG) (p<0,05). El panel de identificación rápida de levaduras del MicroScan® no fue capaz de diferenciar ambas especies.
The automated reader of the AutoScan® -4 microbiological panels detects fungi growth in various biological substrates present in the MicroScan® panel wells. The purpose of this study was to relate the biotype identified by the MicroScan® with the species causing the criptococcosis, in order to obtain identification in the shortest possible period. The evaluation included 82 Cryptococcus spp. strains isolated from clinical samples between 1995 and 2004. To guarantee the purity of the strains they were also identified by conventional methods; to identify the species we used L-canavanin-glycine-bromthymol blue medium (CGB). We also used the fast yeast identification MicroScan® panel with the purpose of determining the biotype. The MicroScan® revealed 27 different biotypes. Of the 82 isolates typed with the CGB medium, 91.46% corresponded to C. neoformans and 8.5% to C. gattii. No significant difference was found among the biotypes and the species (p<0,05). Nevertheless, there was a statistically significant difference between the assimilation of p-nitrophenil-N-acetyl-ß-D-glucosamine (NAG) (p<0.05) by the C. gattii and the C. neoformans species. The fast yeast identification MicroScan® panel was not able to differentiate between both species.
ABSTRACT
OBJETIVO: Aislar e identificar hongos en diferentes especímenes de pacientes inmunocomprometidos, atendidos en un hospital de la Ciudad de México, y determinar su asociación con micosis. MATERIAL Y MÉTODOS: Se realizó un estudio de tipo observacional transversal en pacientes del Hospital Regional General Ignacio Zaragoza, de junio de 1999 a mayo de 2000. De 108 pacientes se procesaron 268 especímenes para estudio micológico que incluyó examen directo, frotis, cultivos y microcultivos en medios específicos además de pruebas bioquímicas. La mayoría de pacientes tenía diagnóstico clínico de tuberculosis pulmonar y de síndrome de inmunodeficiencia adquirida. RESULTADOS: Se obtuvieron 183 aislamientos de levaduras y 66 de hongos filamentosos. Se diagnosticaron 45 micosis que en su mayoría correspondieron a candidosis pulmonar (32 casos). Las especies de Candida más frecuentes asociadas a patología fueron Candida albicans y C parapsilosis. Se obtuvieron cinco aislamientos de Cryptococcus neoformans variedad neoformans, uno de C albidus, tres de Histoplasma capsulatum y uno de Geotrichum candidum, asociados a infección micótica. CONCLUSIONES: El 41.6 por ciento de los pacientes estudiados presentaron una micosis asociada principalmente a síndrome de inmunodeficiencia adquirida y a tuberculosis pulmonar.
OBJECTIVE: To isolate and identify the fungi in specimens collected from immunocompromised patients seen in Mexico City hospital, and to assess their association with mycosis. MATERIAL AND METHODS: A total of 268 specimens from 108 patients were processed for mycological study, including direct examination, smears, cultures, and microcultures in specific media, in addition to biochemical tests. Most of the patients had been diagnosed with pulmonary tuberculosis and Acquired Immunodeficiency Syndrome (AIDS). RESULTS: One hundred and eighty-three yeasts and 66 mycelial fungi were isolated. Forty-five mycoses were diagnosed; the most frequent mycosis was pulmonary candidosis (32 cases). Candida albicans and C parapsilosis were the predominant species associated with mycotic infection. Five Cryptococcus neoformans var. neoformans, one C albidus, three Histoplasma capsulatum and one Geotrichum candidum isolats were associated with mycosis. CONCLUSIONS: Of the studied patients, 41.6 percent showed a mycotic infection, principally associated with AIDS and pulmonary tuberculosis.