Caracterização das infecções que acometem o usuário no momento do diagnóstico para o Hiv/Aids / Characterization of infections that affect the user at the moment of diagnosis for Hiv/Aids / Caracterización de las infecciones que afectan a los usuarios en el momento del diagnóstico del Vih/Sida

: O estado do Pará, de 2009 a 2019, apresentou um aumento de 46,5% na taxa de detecção de aids. O que destaca a importância de estudos para a avaliação e acompanhamento deste público. Objetivo: Analisar as infecções que acometem os usuários de um centro de referência no momento de seu diagnóstico para a infecção pelo HIV. Métodos: Estudo descritivo, realizado em um centro de referência da cidade de Santarém, Pará. A amostra foi de 332 prontuários de pacientes diagnosticados para o HIV nos anos de 2016 e 2017. A coleta de dados buscou informações sociodemográficas, clínicas e imunológicas dos pacientes no momento do diagnóstico para a infecção pelo HIV. Os dados foram organizados e analisados por estatística descritiva e inferencial, adotando- se p<0,05. Resultados: Observou-se prevalência do sexo masculino (67%), faixa etária de 15-24 anos (32,2%), solteiros (59%), com vínculo empregatício (64,5%), contagem de linfócitos T CD4+ ≥200 céls/mm3 (54,8%) e carga viral detectável (75,3%). A Candidíase (25%) e a Tuberculose (25%) predominaram como infecções oportunistas (IO), e a Sífilis (67,5%) como outras infecções. Conclusão: Conforme método proposto e os dados já informados, conclui-se que o diagnóstico para a Sífilis se associou ao sexo masculino, bem como a situação de contagem de linfócitos T CD4+ <200 céls/mm3 se associou com a presença de alguma infecção oportunista, da instalação da Candidíase e da Tuberculose.

Introduction: The state of Pará, from 2009 to 2019, showed a 46.5% increase in the AIDS detection rate. What stands out the importance of studies for the evaluation and monitoring of this public. Objective: Analyze the infections that affect the users of a reference center at the moment of diagnosis for HIV infection. Methods: Descriptive study, carried out in a reference center in the city of Santarém, Pará. The sample consisted of 332 records of patients diagnosed with HIV in the years 2016 and 2017. The data collection sought sociodemographic, clinical and immunological information of the patients at the moment diagnosis for HIV infection. The data were organized and analyzed using descriptive and inferential statistics, adopting p <0.05. Results: There was a prevalence of males (67%), aged 15-24 years (32.2%), single (59%), with employment (64.5%), CD4 + T lymphocyte count ≥200 cells/mm3 (54.8%) and detectable viral load (75.3%). Candidiasis (25%) and Tuberculosis (25%) predominated as opportunistic infections (IO), and Syphilis (67.5%) as other infections. Conclusion: According to the proposed method and the data already reported, it is concluded that the diagnosis for Syphilis was associated with the male gender, as well as the situation of CD4 + T lymphocyte count <200 cells/mm3 was associated with the presence of some opportunistic infection, of the installation of Candidiasis and Tuberculosis.

Introducción: El estado de Pará, de 2009 a 2019, presentó un aumento del 46,5% en la tasa de detección del SIDA. Lo que pone de manifiesto la importancia de los estudios para la evaluación y el seguimiento de este público. Objetivo: Analizar las infecciones que sufren los usuarios de un centro de referencia en el momento de su diagnóstico de infección por VIH. Métodos: Estudo descritivo, realizado em um centro de referência da cidade de Santarém, Pará. La muestra fue de 332 historias clínicas de pacientes diagnosticados de VIH en los años 2016 y 2017. La recogida de datos buscaba información sociodemográfica, clínica e inmunológica de los pacientes en el momento del diagnóstico de la infección por VIH. Los datos se organizaron y analizaron mediante estadísticas descriptivas e inferenciales, adoptando p<0,05. Resultados: Se observó la prevalencia del sexo masculino (67%), el grupo de edad de 15 a 24 años (32,2%), la soltería (59%), el empleo (64,5%), el recuento de linfocitos T CD4+ ≥200 células/mm3 (54,8%) y la carga viral detectable (75,3%). La candidiasis (25%) y la tuberculosis (25%) predominaron como infecciones oportunistas (IO), y la sífilis (67,5%) como otras infecciones. Conclusión: De acuerdo con el método propuesto y los datos ya informados, se concluye que el diagnóstico de Sífilis se asocia al sexo masculino, así como la situación de contagio de linfocitos T CD4+ <200 células/mm3 se asocia a la presencia de alguna infección oportunista, a la instauración de la Candidiasis y a la Tuberculosis.

Fatores associados a candidíase vaginal em gestantes: O que exibem as publicações / Factores asociados a la candidiasis vaginal en mujeres embarazadas: Lo que muestran las publicaciones / Factors associated with vaginal canediasis in pregnant women: What the publications exhibit

Objetivo: analisar os fatores associados a candidíase vaginal em gestantes. Método: Trata-se de uma revisão integrativa de literatura realizado na PubMed. Utilizou-se os descritores: "pregnant women", pregnancy, candidiasis, "candidiasis, vulvovaginal". Foram selecionados ao final 07 estudos e o período de busca aconteceu entre os meses de novembro a dezembro de 2021. Resultados: a candidíase vulvovaginal teve uma média da prevalência geral de candidíase foi de 51,71% dos casos mencionados nos estudos. Dentre as manifestações clínicas da candidíase, destaca-se o corrimento alterado, prurido intenso, disúria, irritação ou queimação e dor pélvica Conclusão: A Candida albicans foi a cepa de levedura mais frequentemente identificada, mas, outras espécies também foram descritas, como a C. krusei, C.glabrata, Candida parapsilosis e C. tropicalis. A candidiasé não é letal, mas os sintomas podem definir o diagnóstico clínico da candidíase, na gestação o diagnóstico precoce norteia o tratamento eficiente e contribui para a melhora do prognóstico da gestante.(AU)

Objective: to analyze the factors associated with vaginal candidiasis in pregnant women. Method: This is an integrative literature review carried out at PubMed. The descriptors were used: "pregnant women", pregnancy, candidiasis, "candidiasis, vulvovaginal". At the end, 07 studies were selected and the search period took place between the months of November and December 2021. Results: vulvovaginal candidiasis had an average general prevalence of candidiasis of 51.71% of the cases mentioned in the studies. Among the clinical manifestations of candidiasis, there is an altered discharge, intense itching, dysuria, irritation or burning and pelvic pain. Conclusion: Candida albicans was the most frequently identified yeast strain, but other species were also described, such as C krusei, C. glabrata, Candida parapsilosis and C. tropicalis. Candidiasis is not lethal, but the symptoms can define the clinical diagnosis of candidiasis, in pregnancy, early diagnosis guides efficient treatment and contributes to improving the prognosis of the pregnant woman.(AU)

Objetivo: analizar los factores asociados a la candidiasis vaginal en gestantes. Métodos: Esta es una revisión integradora de la literatura realizada en PubMed. Fueron utilizados los descriptores: "embarazadas", embarazo, candidiasis, "candidiasis, vulvovaginal", al final fueron seleccionados 07 estudios. Resultados: la candidiasis vulvovaginal tuvo una prevalencia general promedio de candidiasis del 51,71% de los casos mencionados en los estudios. Entre las manifestaciones clínicas de la candidiasis se encuentran secreción alterada, prurito intenso, disuria, irritación o ardor y dolor pélvico. Conclusión: Candida albicans fue la cepa de levadura más frecuentemente identificada, pero también se han descrito otras especies, como C. krusei, C. glabrata, Candida parapsilosis y C. tropicalis. Se infiere que la VVC no es letal, pero los síntomas pueden definir el diagnóstico clínico de candidiasis, en el embarazo, el diagnóstico precoz orienta un tratamiento eficaz y contribuye a mejorar el pronósticode la gestante.(AU)

Análise físico-química e atividades antifúngica e antioxidante do óleo essencial da flor de Curatella americana L / Physichochemical analysis, and antifungal and antioxidant activities of the essential oil of Curatella americana L. flower

Introdução: a espécie vegetal Curatella americana produz anualmente inflorescências com aroma adocicado rica em óleo essencial. Objetivo: avaliar as características físico-químicas, e atividades antifúngica e antioxidante do óleo essencial da flor de Curatella americana. Metodologia: as flores foram coletadas em quatro áreas de Cerrado no estado de Goiás; o rendimento de óleo essencial foi obtido através de hidrodestilação; as características físicas foram determinadas para densidade e solubilidade, a atividade antioxidante foi determinada pela redução do radical livre DPPH; a atividade antifúngica foi determinada por inibição das cepas de Candida, Sclerotinia sclerotiorum, Colletotrichum gloeosporioides e Aspergillus flavus. Resultados: o rendimento de óleo foi de 0,18%, densidade de 0,907 g mL-1, solubilidade positiva para EtOH 70%, atividade antioxidante de CI50 µL mL-1 1,95. Atividade de inibição fúngica apenas para Candida tropicalis na concentração de 8% com halo de antibiose de 10 mm. Sensibilidade discreta nas maiores concentrações de 25, 50 e 100 µL-1 para Aspergillus flavus e Sclerotinia sclerotiorum e baixa atividade de inibição para Colletotrichum gloeosporioides. Conclusão: o óleo essencial da flor de Curatella americana apresentou baixo rendimento, entretanto, alta eficiência na redução do radical livre DPPH. As atividades antifúngicas apresentaram bons resultados de inibição, entretanto, torna-se necessário a adição de outros óleos essenciais para aumento das taxas de inibição micelial.

Introduction: the plant species Curatella americana produces annual inflorescences with a sweet flavour rich in essential oil. Objective: to evaluate the physicochemical characteristics, antifungal and antioxidant activities of the essential oil of the Curatella americana flower. Methodology: the flowers were collected in four areas of Cerrado in the state of Goiás; the essential oil yield was obtained through hydrodistillation; the physical characteristics were determined for density and solubility, the antioxidant activity was determined by the reduction of the free radical DPPH; antifungal activity was determined by inhibiting the strains of Candida, Sclerotinia sclerotiorum, Colletotrichum gloeosporioides and Aspergillus flavus. Results: the oil yield was 0.18%, density 0.907 g mL-1, positive solubility for EtOH 70%, antioxidant activity of IC50 µL mL-1 1.95. Fungal inhibition activity only for Candida tropicalis at a concentration of 8% with a 10 mm antibiosis halo. Discrete sensitivity in the highest concentrations of 25, 50 and 100 µL-1 for Aspergillus flavus and Sclerotinia sclerotiorum and low inhibition activity for Colletotrichum gloeosporioides. Conclusion: The essential oil of the Curatella americana flower showed low yield, however, high efficiency in reducing DPPH free radical. Antifungal activities showed good inhibition results, however, it is necessary to add other essential oils to increase mycelial inhibition rates.

Candida Infection-caused Lumbar Vertebral Osteomyelitis:Report of One Case / 中国医学科学院学报

Candida vertebral osteomyelitis,a rare but challenging clinical disease without specific clinical manifestations,is prone to delay in diagnosis,with potential risks of serious complications.Therefore,early diagnosis is the key to improving the cure rate of this disease.A case of invasive candida lumbar osteomyelitis after gastrointestinal surgery is reported in this paper.We analyzed the clinical characteristics of the patient and reviewed the relevant literature,aiming to improve the early diagnosis and treatment of this disease.

Desenvolvimento de formulações probióticas de isolados clínicos de Lactobacillus spp. para controle de Candida albicans / Development of probiotic formulations of clinical isolates of Lactobacillus spp. for the control of Candida albicans

O uso de probióticos tem sido considerado uma alternativa para o controle das candidoses bucais, como a estomatite protética. Recentemente, nosso grupo de pesquisa isolou cepas clínicas bucais de Lactobacillus rhamnosus (5.2) e Lactobacillus fermentum (20.4) com atividade antifúngica contra Candida albicans. Entretanto, é necessário o desenvolvimento de formulações para uso clínico dessas cepas probióticas na cavidade bucal. Assim, o objetivo desse projeto foi desenvolver formulações probióticas em hidrogel gellan gum com atividade antifúngica que possam ser usadas no controle da estomatite protética. Para o preparo das formulações probióticas, as cepas L. rhamnosus 5.2 ou L. fermentum 20.4 foram incorporadas em formulações com diferentes concentrações de gellan gum (0,6 a 1%). A viabilidade das células de Lactobacillus nas formulações e o sistema de liberação foram testados em diferentes condições de armazenamento, incluindo tempo e temperaturas de estocagem. A seguir, os efeitos das formulações probióticas foram avaliados sobre C. albicans pelo método de difusão em ágar e sobre biofilmes microcosmos por contagem de células viáveis e análise de microscopia eletrônica de varredura. Os resultados demonstraram que todas as concentrações do gellan foram capazes de manter a viabilidade das células de L. rhamnosus e L. fermentum em torno de 5 a 7 log, durante 14 semanas, independentemente da temperatura de armazenamento (4°C ou temperatura ambiente). No teste de difusão em ágar, verificou-se que as formulações probióticas levaram à inibição de cepas padrão e clínicas de C. albicans, demonstrando que as cepas de Lactobacillus incorporadas no gellan mantiveram sua atividade antifúngica. As formulações probióticas também conseguiram inibir os biofilmes microcosmos provenientes de pacientes com estomatite protética, reduzindo o número de células viáveis de Candida e desestruturando a arquitetura dos biofilmes. Concluiu-se que o gellan gum mostrou ser um biomaterial promissor como carreador das cepas probióticas de L. rhamnosus 5.2 e L. fermentum 20.4. Além disso, as formulações probióticas desenvolvidas apresentaram ação antifúngica sobre células de C. albicans e biofilmes de estomatite protética, podendo desta forma atuar na prevenção da candidose bucal. (AU)

The use of probiotics has been considered an alternative for the control of oral candidiasis such as denture stomatitis. Recently, our research group isolated oral clinical strains of Lactobacillus rhamnosus (5.2) and Lactobacillus fermentum (20.4) with antifungal activity against Candida albicans. However, it is necessary to develop formulations for clinical use of these probiotic strains in the oral cavity. Thus, the purpose of this project was to develop probiotic formulations in gellan gum hydrogel with antifungal activity that could be used in the control of denture stomatitis. For the preparation of probiotic formulations, the strains L. rhamnosus 5.2 or L. fermentum 20.4 were incorporated into formulations with different concentrations of gellan gum (0.6 to 1%). The viability of Lactobacillus cells in the formulations and the delivery system were tested under different storage conditions, including storage time and temperatures. Next, the effects of the probiotic formulations were evaluated on C. albicans by the agar diffusion method and on microcosm biofilms by viable cell count and scanning electron microscopy analysis. The results showed that all concentrations of gellan were able to maintain the viability of L. rhamnosus and L. fermentum cells around 5 to 7 log for 14 weeks, regardless of storage temperature (4°C or room temperature). In the agar diffusion test, it was found that the probiotic formulations led to the inhibition of standard and clinical strains of C. albicans, demonstrating that the Lactobacillus strains incorporated into gellan maintained their antifungal activity. Probiotic formulations were also able to inhibit microcosm biofilms from patients with denture stomatitis, reducing the number of viable Candida cells and disrupting the architecture of biofilms. As a conclusion, the gellan gum proved to be a promising biomaterial as a carrier of the probiotic strains of L. rhamnosus 5.2 and L. fermentum 20.4. In addition, the probiotic formulations developed showed antifungal action on C. albicans cells and denture stomatitis biofilms, thus being able to act in the prevention of oral candidiasis. (AU)

Candida Tropicalis Spondylodiscits in an Immunocompetent Host: A Case Report and Literature Review

Background Fungal spondylodiscitis is not common but should be suspected in some cases. Candida tropicalis infections are being more frequently diagnosed due to some factors related to the microorganism. Case Description A C. tropicalis spondylodiscitis is described in a 72-year-old man who was treated with a combination of echinocandin (micafungin) and surgery. Conclusion The presence of some risk factors should promptly raise the suspicion of fungal spondylodiscitis. Treatment should be instituted as early as possible for the best outcome for the patient.

El misterio del muguet en la Francia de Luis Felipe de Orleáns (1830-1848) / The muguet's mystery in the France of Louis Philipe d'Orleans (1830-1848)

Resumen Durante el severo reinado de Luis Felipe de Orleáns (1830-1848) existió un breve intervalo de paz en Francia, permitiendo el desarrollo de las ciencias médicas, entre ellas la pediatría. El Dr. Vanier, viendo que los estudiantes de medicina tenían difícil acceso a los hospitales de niños, quiso ayudarles creando para ellos una revista con temas y casos pediátricos, entre éstos comunicaciones sobre el muguet, la candidiasis oral de los recién nacidos y también de lactantes mayores, por parte del célebre Trousseau, de Valleix y de los investigadores Gruby y Berg, quienes llegarían a descubrir que no se debía a la lactancia ni a las nodrizas, sino a un "parásito vegetal", un hongo similar a los champiñones.

Abstract Under the severe rule of Louis Philippe of Orleans (1830-1848) a brief interval of peace in France was favorable for the development of some medical arts, like pediatrics. The Dr. Vanier, considering how difficult was for the students the access to a children's hospital, wanted to help their learning with a journal with clinical cases and conferences on children pathology, including several papers on muguet (the oral infection by Candida albicans in newborns), written by the famous Trousseau and the clinical investigators Valleix, Gruby and Berg, who became to the description of the etiological agent as "a vegetal parasite, a fungus similar to the mush-rooms".

Candidiasis y Candida albicans / Candidiasis and Candida albicans

La candidiasis es una enfermedad micótica debida a levaduras pertenecientes al género Candida. Dentro del gran conjunto de microorganismos que colonizan al ser humano, Candida albicans es el agente etiológico más comúnmente detectado ya que habita como comensal en las superficies mucosas y la piel. C. albicans participa en procesos de fermentación de azúcares y asimilación de nutrientes, pero, en algunas ocasiones se relaciona con procesos patológicos. En los últimos años los avances tecnológicos y médicos; así como el aumento en la incidencia de infecciones por el virus de la inmunodeficiencia humana, el auge creciente de la terapia inmunomoduladora y el uso de antibióticos de amplio espectro durante largos períodos de tiempo se han convertido en los factores de riesgo más importantes para la creciente incidencia de infecciones por microorganismos del género Candida. Debido a esto, resulta imperativo el conocimiento de esta enfermedad y sus formas clínicas más importantes, así como el abordaje diagnóstico y el tratamiento actual; información que recolectamos en este documento para brindar una visión general sobre esta patología(AU)

Candidiasis is a fungal disease caused by yeasts belonging to the genus Candida. Within the large group of microorganisms that colonize humans, candida albicans is the most commonly detected etiological agent since it inhabits mucosal surfaces and skin as a commensal. C. albicans participates in sugar fermentation processes and assimilation of nutrients but, on some occasions, it is related to pathological processes. In recent years, technological and medical advances; As well as the increase in the incidence of human immunodeficiency virus infections, the growing boom in immunomodulatory therapy and the use of broad-spectrum antibiotics for long periods of time have become the most important risk factors for the increasing incidence of infections by microorganisms of the genus Candida. Due to this, knowledge of this disease and its most important clinical forms, as well as the current diagnostic approach and treatment, is imperative; information that we collect in this document to provide an overview of this condition(AU)

Recent progress on anti-Candida natural products / 中国天然药物

Candida is an intractable life-threatening pathogen. Candida infection is extremely difficult to eradicate, and thus is the major cause of morbidity and mortality in immunocompromised individuals. Morevover, the rapid spread of drug-resistant fungi has led to significant decreases in the therapeutic effects of clinical drugs. New anti-Candida agents are urgently needed to solve the complicated medical problem. Natural products with intricate structures have attracted great attention of researchers who make every endeavor to discover leading compounds for antifungal agents. Their novel mechanisms and diverse modes of action expand the variety of fungistatic agents and reduce the emergence of drug resistance. In recent decades, considerable effort has been devoted to finding unique antifungal agents from nature and revealing their unusual mechanisms, which results in important progress on the development of new antifungals, such as the novel cell wall inhibitors YW3548 and SCY-078 which are being tested in clinical trials. This review will present a brief summary on the landscape of anti-Candida natural products within the last decade. We will also discuss in-depth the research progress on diverse natural fungistatic agents along with their novel mechanisms.

Infecciones cervicovaginales en exudados vaginales / Cervicovaginal infections in vaginal exudates

Introducción: Se desconocen las características de las infecciones cervicovaginales, diagnosticadas mediante el exudado vaginal, sobre todo en mujeres cubanas de mediana edad. En otras etapas del ciclo vital femenino, sí se han realizado estos estudios. Esta información es importante, fundamentalmente para realizar acciones de promoción de salud. Objetivo: Determinar las características de las infecciones cervicovaginales más frecuentes diagnosticadas mediante el exudado vaginal. Método: Se realizó un estudio transversal en 1118 mujeres. Se recogió la edad (agrupada en 20 - 44 años y 45 y más años), los resultados del exudado vaginal, la percepción de secreción vaginal o la ausencia de esta (asintomáticas) y los microorganismos identificados en el exudado. Resultados: El 49,9 por ciento de exudados vaginales fueron positivos a vaginosis bacteriana, Cándidas albicans, Trichomonas vaginalis y desequilibro en la ecología vaginal. El 45 por ciento de las pacientes no tenían secreción vaginal, es decir, estaban asintomáticas. Conclusión: Las infecciones cervicovaginales se caracterizaron por ser de elevada frecuencia, usualmente asintomáticas, con predominio de vaginosis bacteriana, candidiasis y trichomoniasis(AU)

ABSTRACT Introduction: The characteristics of cervicovaginal infections diagnosed by vaginal exudate are unknown, especially in middle-aged Cuban women. At other stages of the female life cycle, these studies have been done. Due to the importance of this information, to carry out health promotion actions, this research was carried out. Objective: To determine the characteristics of the most frequent cervicovaginal infections diagnosed by vaginal exudate. Method: A cross-sectional study was conducted in 1118 women. Age (grouped into 20-44 years and 45 and over), the results of positive vaginal discharge, the perception of presence or not of vaginal discharge (asymptomatic) and the microorganisms identified in the discharge were collected. Results: 49.9 percent of vaginal exudates were positive for bacterial vaginosis, Candidas albicans, Trichomonas vaginalis and imbalance in vaginal ecology. 45 percent of the patients had no vaginal discharge, that is, they were asymptomatic. Conclusion: Cervicovaginal infections were characterized by being of high frequency, usually asymptomatic, with prevalence of bacterial vaginosis, candidiasis and trichomoniasis(AU)

Características de las fungemias en un centro de referencia del Perú: retrospectiva de cinco años / Characteristics of fungemia in a peruvian referral center: 5-year retrospective analysis

RESUMEN Con el objetivo de conocer las características de las fungemias en 285 pacientes oncológicos hospitalizados del 2012 al 2016 en el Instituto Nacional de Enfermedades Neoplásicas se realizó un estudio descriptivo retrospectivo. Se evaluó información demográfica, clínica y microbiológica. Las fungemias por C. albicans predominaron en pacientes con tumores sólidos y sin neutropenia, mientras las causadas por C. tropicalis predominaron en pacientes con neoplasias hematológicas y neutropenia. C. tropicalis fue el agente más aislado (47,0%). Las fungemias aumentaron con el tiempo en los pacientes sin neutropenia. Las fungemias causadas por C. albicans aumentan con la edad en pacientes con tumores sólidos sin neutropenia. Se concluye que las fungemias son mayormente causadas por C. tropicalis en pacientes con neoplasias hematológicas con neutropenia y por C. albicans en pacientes con tumores sólidos sin neutropenia. Además, las fungemias en pacientes sin neutropenia aumentan en el tiempo y las causadas por C. albicans, en tumores sólidos sin neutropenia, aumentan con la edad.

ABSTRACT Retrospective descriptive study carried out to determine the characteristics of fungemia in 285 cancer patients hospitalized from 2012 to 2016 at the Instituto Nacional de Enfermedades Neoplásicas (INEN). Demographic, clinical and microbiological information was evaluated. Fungemia by C. albicans predominated in patients with solid tumors and without neutropenia, while those caused by C. tropicalis predominated in patients with hematological neoplasia and neutropenia. C. tropicalis was the agent isolated in most cases (47.0%). Fungemia increased over time in patients without neutropenia. Fungemia caused by C. albicans increases with age in patients with solid tumors without neutropenia. It is concluded that fungemia are mainly caused by C. tropicalis in patients with hematological neoplasia with neutropenia and by C. albicans in patients with solid tumors without neutropenia. In addition, fungemia in patients without neutropenia increases over time; and those caused by C. albicans increase with age in patients with solid tumors without neutropenia.

Candidemia en Colombia / Candidemia in Colombia

En Colombia, especialmente en las unidades de cuidados intensivos, la candidemia es una causa frecuente de infección del torrente sanguíneo y representa el 88 % de las infecciones fúngicas en pacientes hospitalizados, con una mortalidad entre 36 y 78 %. Su incidencia en Colombia es mayor a la reportada en los países desarrollados e, incluso, en otros países de Latinoamérica. Para su manejo deben considerarse los factores de riesgo del paciente, luego valorar las características clínicas y, finalmente, hacer los estudios microbiológicos y, si es necesario, pruebas moleculares. En general, las guías estadounidenses, latinoamericanas y europeas recomiendan las equinocandinas como el tratamiento de primera línea de la candidemia y difieren en el uso de fluconazol dependiendo de la 'evidencia', la gravedad de la enfermedad, la exposición previa a los azoles y la prevalencia de Candida no albicans. Dada su gran incidencia en nuestro país, asociada con una elevada mortalidad, esta infección debe buscarse sistemáticamente en pacientes con factores de riesgo, con el fin de iniciar oportunamente el tratamiento antifúngico.

In Colombia, especially in intensive care units, candidemia is a frequent cause of infection, accounting for 88% of fungal infections in hospitalized patients, with mortality ranging from 36% to 78%. Its incidence in Colombia is higher than that reported in developed countries and even higher than in other Latin American countries. First, the patient's risk factors should be considered, and then clinical characteristics should be assessed. Finally, microbiological studies are recommended and if the evidence supports its use, molecular testing. In general, American, Latin American, and European guides place the echinocandins as the first-line treatment for candidemia and differ in the use of fluconazole based on evidence, disease severity, previous exposure to azoles, and prevalence of Candida non-albicans. Taking into account the high incidence of this disease in our setting, it should be looked for in patients with risk factors to start a prompt empirical anti-fungal treatment.

Elimination of an intraradicular biofilm composed of enterococcus faecalis and candida albicans using a negative apical pressure irrigation system / Eliminación de una biopelícula intraradicular compuesta por enterococcus faecalis y candida albicans utilizando un sistema de irrigación de presión apical negativa

Endodontic treatment consists of the cleaning and disinfecting the root canal system, which is achieved using adequate mechanical instru-mentation and chemical irrigation. Endodontic microorganisms are present in root canals in the form of a biofilm, and their elimination ensures the success of endodontic treatment. Irrigation is a key factor contributing to the elimination of this intraconduct biofilm, and different irrigator agents and irrigation techniques, such as irrigation with negative apical pressure, a novel automated irrigation mechanism based on suction intraconduct, have been used. In this study, we evaluated the ability of a negative apical pressure system with different concentrations of sodium hypochlorite and durations to reduce the microbial load. Materials and Methods: An intraradicular biofilm composed of Enterococcus faecalis and Candida albicans was generated during twenty-one days of static culture on one hundred mesio-vestibular roots of upper molars with complex curvatures greater than 30°C, and the roots were classified in six groups with different concentrations and contact times of sodium hypochlorite. Subsequently, the reduction in the microbial load was measured with McFarland scale and the enumeration of colony forming units and was evaluated with scanning electronic microscopy. Results: We observed a significant difference in the reduction of the microbial load prior to instrumentation compared with postinstrumentation between the groups treated with 2.25% and 5.25% NaOCl for 30, 60 and 90 seconds of contact time (p<0.05), but we did not observe differences in the reduction of microbial load between different contact times and concentrations of sodium hypochlorite employed (p>0.05). Conclusion: Negative apical pressure is a good option for irrigation in endodontics, as it allows the passage of the irrigation fluid along the total length of the root canal and produces a better antimicrobial effect.

El tratamiento de endodoncia consiste en la limpieza y desinfección del sistema de conducto radicular, lo que se logra utilizando instrumentación mecánica adecuada y riego químico. Los microorganismos endodónticos están presentes en los conductos radiculares en forma de una biopelícula, y su eliminación asegura el éxito del tratamiento endodóntico. La irrigación es un factor clave que contribuye a la eliminación de esta biopelícula intraconductora, y se han utilizado diferentes agentes irrigadores y técnicas de irrigación, como la irrigación con presión apical negativa, un nuevo mecanismo automatizado de irrigación basado en la intraconducción de succión. En este estudio, evaluamos la capacidad de un sistema de presión apical negativa con diferentes concentraciones de hipoclorito de sodio y duraciones para reducir la carga microbiana. Material y Métodos: Se generó una biopelícula intraradicular compuesta por Enterococcus faecalisy Candida albicans durante veintiún días de cultivo estático en cien raíces mesio-vestibulares de molares superiores con curvaturas complejas superiores a 30°C, y las raíces se clasificaron en seis grupos con diferentes concentraciones y tiempos de contacto de hipoclorito de sodio. Posteriormente, la reducción en la carga microbiana se midió con la escala de McFarland y la enumeración de las unidades formadoras de colonias y se evaluó con microscopía electrónica de barrido. Resultado: Observamos una diferencia significativa en la reducción de la carga microbiana antes de la instrumentación en comparación con la postinstrumentación entre los grupos tratados con NaOCl 2.25% y 5.25% durante 30, 60 y 90 segundos de tiempo de contacto (p<0.05), pero lo hicimos No se observan diferencias en la reducción de la carga microbiana entre los diferentes tiempos de contacto y las concentraciones de hipoclorito de sodio empleado (p>0.05). Conclusión:La presión apical negativa es una buena opción para el riego en endodoncia, ya que permite el paso del líquido de riego a lo largo de todo el conducto radicular y produce un mejor efecto antimicrobiano.

Efficacy of copper sulphate on candida albicans on heat-polymerized acrylic resin / Eficacia del sulfato de cobre sobre candida albicans en resinas acrílicas de termocurado

The ageing of population is increasing, and a great percentage of these patients wear removable prostheses, and can suffer denture stomatitis, a condition that has been associated with candidiasis. Aims: To evaluate in vitro the effectiveness of Copper Sulfate against Candida albicans in samples of heat-polymerized acrylic resin, compared to nystatin, sodium hypochlorite and chlorhexidine. Materials and Methods: Initially, the minimum inhibitory concentration (MIC) of copper sulfate for Candida albicans was determined by microdilution. Then, 54 resin samples were divided into 6 treatment groups corresponding to Nystatin 100.000 UI, Sodium Hypochlorite 0.5%, chlorhexidine 0.12%, Copper Sulfate 4.7µg/ml, Copper Sulfate 9.4µg/ml and physiological saline solution, in which samples were submerged for 6 hours. Resin samples were then washed and cultured on solid media at 37°C for 72 hours. The number of colony-forming units was determined using a Quebec colony counter. The statistical analysis was performed using the Kruskal-Wallis test and the Mann-Whitney U test. Results: Copper sulfate at a concentration of 9.4µg/ml presented a similar effectiveness as the other control products regarding the reduction in the number of colonies of Candida albicans post-treatment. Conclusion: The effectiveness of copper sulfate against Candida albicans on acrylic resin was similar to that of nystatin, sodium hypochlorite and chlorhexidine.

En las últimas décadas se ha observado un aumento de la población de adultos mayores, de los cuales un gran porcentaje es portador de prótesis removible, y dos tercios pueden sufrir estomatitis subprotésica, enfermedad que es asociada a infecciones como candidiasis. Objetivo: Evaluar la efectividad antimicótica in vitro del sulfato de cobre en placas de resinas acrílicas de termocurado inoculadas con Candida albicans, frente a Nistatina, Hipoclorito de Sodio y Clorhexidina. Material y Métodos: Inicialmente, y mediante microdilución del sulfato de cobre, se determinó la concentración mínima inhibitoria (CMI) para Candida albicans. En la fase experimental, 54 muestras de resina se dividieron en 6 grupos correspondientes a Nistatina 100.000 UI, Hipoclorito 0.5%, Clorhexidina 0.12%, Sulfato de Cu 4.7µg/ml, Sufato de Cu 9.4 µg/ml y suero fisiológico. Las muestras fueron sumergidas en estos agentes por 6 horas, para posteriormente ser lavadas y cultivada en medios solidos a 37°C por 72 horas. Luego se realizó el conteo de unidades formadoras de colonias mediante contador tipo Quebec. El análisis estadístico se realizó mediante la prueba de Kruskal-Wallis y la prueba U de Mann-Whitney. Resultado: El sulfato de cobre a una concentración de 9.4µg/ ml presentó una efectividad similar a los otros productos, en la reducción de colonias de Candida albicans. Conclusión: La efectividad del sulfato de cobre contra Candida albicans fue semejante a la de Nistatina, Hipoclorito y Clorhexidina.

The secreted acid trehalase encoded by the CgATH1 gene is involved in Candida glabrata virulence

BACKGROUND Candida glabrata yeast is the second cause of candidiasis worldwide. Differs from other yeasts since assimilates only glucose and trehalose (a characteristic used in rapid identification tests for this pathogen) by secreting into the medium a highly active acid trehalase encoded by the CgATH1 gene. OBJECTIVE This study aimed to characterise the function of the acid trehalase in the physiopathology of C. glabrata. METHODS Gene deletion was performed to obtain a mutant ath1Δ strain, and the ability of the ath1Δ strain to grow in trehalase, or the presence of trehalase activity in the ath1Δ yeast cells, was verified. We also tested the virulence of the ath1Δ strain in a murine model of infection. FINDINGS The ath1Δ mutant strain grows normally in the presence of glucose, but loses its ability to grow in trehalose. Due to the high acid trehalase activity present in wild-type cells, the cytoplasmic neutral trehalase activity is only detected in the ath1Δ strain. We also observed a significantly lower virulence of the ath1Δ strain in a murine model of infection with either normal or immunocompromised mice. MAIN CONCLUSIONS The acid trehalase is involved in the hydrolysis of external trehalose by C. glabrata, and the enzyme also plays a major virulence role during infectivity.

Study on growth characteristics of under different conditions and its toxicity / 南方医科大学学报

OBJECTIVE@#To investigate the characteristics of growth and metabolism and the toxicity of under different conditions.@*METHODS@#We observed the growth of and under routine culture conditions and in different pH and salt concentrations, and compared their activities of sugar fermentation using microbiochemical reaction tubes. Four-week-old nude mice were randomized into infection group (=5), infection group (=5) and control group (=5) for intragastric administration of 0.3 mL suspension the two (5×10 cfu/mL) or 0.3 mL normal saline. Samples of the liver, kidney, intestine, feces and blood were taken for analysis of the distribution and toxicity of by fungal culture and histopathological examination.@*RESULTS@# exhibited logarithmic growth at 8-24 h after inoculation and showed stable growth after 24 h. showed optimal growth within the pH value range of 5-7 with a growth pattern identical to that of . grew better than in media containing 5% and 10% NaCl, and could ferment glucose, sucrose, trehalose and sorbitol. could be isolated from the feces, blood, liver and kidney of infected nude mice, and the liver had the highest fungal load (5.7 log cfu/g). could cause pathological changes in the liver and intestine of the mice, but with a lesser severity as compared with .@*CONCLUSIONS@# exhibits optimal growth in mildly acidic or neutral conditions with a high salt tolerance, and can potentially penetrate the intestinal barrier into blood and lead to tissue injuries in hosts with immunosuppression.

Study on growth characteristics of under different conditions and its toxicity / 浙江大学学报·医学版

OBJECTIVE@#To investigate the characteristics of growth and metabolism and the toxicity of under different conditions.@*METHODS@#We observed the growth of and under routine culture conditions and in different pH and salt concentrations, and compared their activities of sugar fermentation using microbiochemical reaction tubes. Four-week-old nude mice were randomized into infection group (=5), infection group (=5) and control group (=5) for intragastric administration of 0.3 mL suspension the two (5×10 cfu/mL) or 0.3 mL normal saline. Samples of the liver, kidney, intestine, feces and blood were taken for analysis of the distribution and toxicity of by fungal culture and histopathological examination.@*RESULTS@# exhibited logarithmic growth at 8-24 h after inoculation and showed stable growth after 24 h. showed optimal growth within the pH value range of 5-7 with a growth pattern identical to that of . grew better than in media containing 5% and 10% NaCl, and could ferment glucose, sucrose, trehalose and sorbitol. could be isolated from the feces, blood, liver and kidney of infected nude mice, and the liver had the highest fungal load (5.7 log cfu/g). could cause pathological changes in the liver and intestine of the mice, but with a lesser severity as compared with .@*CONCLUSIONS@# exhibits optimal growth in mildly acidic or neutral conditions with a high salt tolerance, and can potentially penetrate the intestinal barrier into blood and lead to tissue injuries in hosts with immunosuppression.

Candida auris infection in the central catheter of a patient without sepsis symptoms / Infección por Candida auris en el catéter central de un paciente sin síntomas de sepsis

Abstract Background: Candida auris is an emerging yeast frequently reported as resistant to multiple antifungal drugs commonly used to treat Candida infections. This specie can colonize the patient's skin and has great ability for producing outbreaks in hospitals. C. auris is phylogenetically related to other Candida species, can be misidentified using conventional biochemical or commercial methods and requires specific technology for its identification. Case report: We report the first isolate of C. auris in Cali, Colombia, from a central venous catheter in a 37-year-old patient with rheumatoid arthritis and endocarditis who did not have symptoms of sepsis. The yeast was initially misidentified as C. haemulonii using the Phoenix system and subsequently identified as C. auris by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS). The broth microdilution method was used to determine the minimum inhibitory concentration; the isolate was susceptible to fluconazole, itraconazole, voriconazole and amphotericin B. Conclusions: This report contributes to knowledge of the epidemiology of C. auris infections in individuals with underlying disease and describes an isolate with a behavior different from what is usually reported.

Resumen Antecedentes: Candida auris es una levadura emergente, informada con frecuencia como resistente a diversos antifúngicos usados comúnmente para tratar infecciones por Candida. Esta especie puede colonizar la piel y tiene gran capacidad de producir brotes en ambientes hospitalarios. Está filogenéticamente relacionada con otras especies de Candida, es mal identificada por los métodos bioquímicos o comerciales, y requiere tecnología específica para su identificación. Reporte de caso: Se informa el primer aislamiento de C. auris en Cali, Colombia en un paciente de 37 años con artritis reumatoide y endocarditis, sin síntomas de sepsis, a partir de la punta de catéter venoso central. La levadura inicialmente se identificó como C. haemulonii por el sistema Phoenix® y posteriormente como C. auris por espectrometría de masas desorción/ionización láser asistida por una matriz con detección de masas por tiempo de vuelo (MALDI-TOF MS). Se determinó la concentración inhibitoria mínima por el método de microdilución en caldo que mostró un aislamiento sensible a fluconazol, itraconazol, voriconazol y anfotericina B. Conclusión: Este informe contribuye al conocimiento de la epidemiología de las infecciones por C. auris en individuos con enfermedad subyacente y describe un aislamiento con un comportamiento diferente a lo indicado en otros estudios.