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Braz. j. biol ; 78(4): 644-652, Nov. 2018. tab
Article in English | LILACS | ID: biblio-951608


Abstract The aim of this study was to evaluate the frequency of Candida species between a non-hospitalized and a hospitalized population. For this purpose, samples of saliva were sampled through sterile swabs, moistened in peptone water and rubbed in the oral cavity of 140 individuals, from which, 70 were hospitalized patients from the Medical Clinic of a Teaching Hospital and the other 70 were non-hospitalized subjects. All saliva samples were plated in Sabouraud Dextrose agar added with Chloramphenicol and incubated at 36 °C for 48 hours. The morphology identification was performed through macroscopic and microscopic characterization, the CHROMagar Candida medium and the VITEK® system Yeast Biochemical Card (bio Mérieux SA, France). The results showed a colonization of Candida spp. in 85.7% the hospitalized individuals, where the species found were C. albicans (60%), C. tropicalis (23.4%), C. krusei (3.3%) and Candida spp. (13.3%). In the non-hospitalized individuals the colonization by Candida spp was 47.1%, and the species found were: C. albicans (45.5%), C.krusei (9.1%), C. guilliermondii (9.1% %), C. tropicalis (3.0%), C. famata (3.0%) and Candida spp. (30.3%). In spite of their presence in oral cavity in both groups, Candida spp. was more frequently isolated in hospitalized individuals, who were 6.73 times more likely to have this fungus in the oral cavity and were 3.88 times more likely to have Candida albicans.

Resumo O objetivo deste estudo foi avaliar a frequência de espécies de Candida entre uma população de indivíduos não-hospitalizados e hospitalizados. Para isto, amostras de saliva foram coletadas através de swabs estéreis, umedecidas em água de peptona e friccionadas na cavidade bucal de 140 indivíduos, dos quais 70 eram pacientes internados em uma Clínica Médica de um Hospital Escola e os outros 70 eram indivíduos não hospitalizados sem contato com ambiente hospitalar. Todas as amostras de saliva foram plaqueadas em ágar Sabouraud dextrose adicionadas de cloranfenicol e incubadas a 36 °C durante 48 horas. A identificação morfológica foi realizada através da caracterização macroscópica e microscópica, com o meio CHROMagar Candida e do sistema VITEK® Biochemical Card (bio Mérieux SA, França). Os resultados mostraram uma colonização de Candida spp. em 85,7% dos indivíduos hospitalizados, onde as espécies encontradas foram: C.albicans (60%), C. tropicalis (23,4%), C. krusei (3,3%) e Candida spp. (13,3%). Nos indivíduos não-hospitalizados a colonização por Candida spp foi de 47,1%, e as espécies encontradas foram: C. albicans (45,5%), C. krusei (9,1%), C. guilliermondii (9,1%), C. tropicalis (3,0%), C. famata (3,0%) e Candida spp. (30,3%). Apesar de sua presença na cavidade oral em ambos os grupos, Candida spp. foi mais freqüentemente isolada em indivíduos hospitalizados, que foram 6,73 vezes mais propensos a ter este fungo na cavidade oral e foram 3,88 vezes mais propensos a ter Candida albicans.

Humans , Male , Female , Middle Aged , Outpatients/statistics & numerical data , Candida/isolation & purification , Candidiasis/diagnosis , Candidiasis/microbiology , Inpatients/statistics & numerical data , Saliva/microbiology , Candida/classification , Candida/growth & development , Colony Count, Microbial , Culture Media , Mouth/microbiology
Braz. j. microbiol ; 49(supl.1): 193-198, 2018. tab, graf
Article in English | LILACS | ID: biblio-974340


Abstract In this study, phenotypic methods presented >80% agreement with the molecular identification of 59 Candida parapsilosis complex. Growth at 15% NaCl or pH 7.0 significantly reduced cfu-counts of Candida orthopsilosis, suggesting these conditions may support the development of phenotypic methods for the differentiation of the cryptic species of C. parapsilosis complex.

Humans , Candidiasis/microbiology , Mycological Typing Techniques/methods , Candida parapsilosis/isolation & purification , Phenotype , Polymerase Chain Reaction , Culture Media/metabolism , Candida parapsilosis/classification , Candida parapsilosis/growth & development , Candida parapsilosis/genetics
Rev. chil. infectol ; 35(5): 553-559, 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-978069


Resumen Introducción: El tratamiento y evolución de endocarditis infecciosa por Candida spp en niños debe basarse en guías de manejo; sin embargo, aún existen controversias al respecto. Objetivo: Describir nuestra experiencia en el tratamiento de EI por Candida spp en pacientes pediátricos. Métodos: Estudio prospectivo, analítico, realizado entre enero de 2006 y diciembre 2017. Análisis paramétrico de variables cuantitativas; razones, proporciones, comparación por medio de χ2 y prueba exacta de Fisher con IC al 95% para variables no paramétricas. Tasa de mortalidad. Resultados: Veinticinco episodios de endocarditis por Candida spp recibieron tratamiento anti fúngico estándar. La mortalidad fue superior en pacientes sometidos a resección de la vegetación endocárdica (66,7%) RR 3,16, χ2 p = 0,029, en niños con síndrome linfo-hemofagocítico SLHF (50%), RR= 1,18 (χ2 NS), en co infección con bacterias multi-resistentes (57,1 %) RR= 2, (χ2 NS) y en EI trombótica (88,9%) RR = 4,74 (χ2 p = 0,004). Conclusiones: Co-infección de EI por Candida sp con bacterias multi-resistentes, SLHF y/o manejo quirúrgico de la vegetación endocárdica, pueden considerarse factores de mal pronóstico.

Background: Treatment and outcome of Candida spp infectious endocarditis in children it most be based on treatment guidelines, however there are some controversies. Aim: To describe our experience on treatment of pediatric candidal infective endocarditis. Methods: Analytic prospective study, from January 2006 to December 2017. Parametric analysis for quantitative variable. Proportions were compared by χ2 and exact Fisher Test CI 95%. Mortality rate. Results: 25 episodes of Candida spp infective endocarditis were treated with standard antifungal drugs. Mortality rate was higher on patients submited to endocardic vegetation resection (66.7%) RR= 3.16, (χ2 p = 0.029), children with lymphohemophagocytic syndrome (LHFS) (50 %) RR= 1.18 (χ2 = N.S.), in multidrug resistant bacterial co infection (57.14%), RR = 2, (χ2 = NS) also thrombotic endocarditis (88.9%) RR= 4.74 (χ2 p = 0.004). Conclusion: Multidrug resistant bacteria co infection with Candida sp IE, LHFS, and/or surgical treatment of endocardic vegetation, might be considered as bad prognostic factors.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Candida/classification , Candidiasis/microbiology , Endocarditis, Bacterial/microbiology , Candidiasis/mortality , Candidiasis/therapy , Prospective Studies , Risk Factors , Endocarditis, Bacterial/mortality , Endocarditis, Bacterial/therapy
Rev. Soc. Bras. Med. Trop ; 50(6): 843-847, Nov.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-1041438


Abstract INTRODUCTION Incidence and antifungal susceptibility of Candida spp. from two teaching public hospitals are described. METHODS The minimum inhibitory concentrations of fluconazole, voriconazole, itraconazole, and amphotericin B were determined using Clinical Laboratory Standard Institute broth microdilution and genomic differentiation using PCR. RESULTS Of 221 Candida isolates, 50.2% were obtained from intensive care unit patients; 71.5% were recovered from urine and 9.1% from bloodstream samples. Candida parapsilosis sensu stricto was the most common candidemia agent. CONCLUSIONS We observed variations in Candida species distribution in hospitals in the same geographic region and documented the emergence of non-C. albicans species resistant to azoles.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Adolescent , Adult , Young Adult , Candida/drug effects , Candidiasis/microbiology , Antifungal Agents/pharmacology , Brazil , Candida/classification , Candida/genetics , Microbial Sensitivity Tests , Fluconazole/pharmacology , Amphotericin B/pharmacology , Itraconazole/pharmacology , Drug Resistance, Fungal , Voriconazole/pharmacology , Hospitals, Public , Middle Aged
J. appl. oral sci ; 25(3): 265-273, May-June 2017. tab, graf
Article in English | LILACS, BBO | ID: biblio-893620


Abstract Elderly denture wearers are commonly affected by Candida-associated denture stomatitis (DS), an inflammatory process of the oral mucosa strongly associated with Candida spp and other microorganisms, as well as local and systemic factors. The impaired immune response against pathogens is among the inherent host factors that have been also associated with the pathogenesis of DS. Mononuclear phagocytes respond to the pathogens through phagocytosis followed by the production of several substances inside the phagosomes, among them are the reactive nitrogen species (RNS). A failure in these mechanisms may contribute to the DS development. Objective The aim of this study was to investigate the influence of aging on the internalization and the production of nitric oxide (NO) by peritoneal adherent cells (PAC), in response to Candida albicans (C. albicans). Material and methods PAC obtained from young and aged mice were challenged with dead or viable C. albicans by using predetermined proportions (cells:yeast) for 30 and 120 minutes. Phagocytosis was analyzed by acridine orange dye, and NO production by the Griess reaction. Results C. albicans phagocytosis by PAC from aged mice was similar to that of young mice, although the cells from older mice cells present more internalized fungi compared with matched control. In addition, a tendency towards impaired NO production by peritoneal mononuclear phagocytes from aged mice was observed. Conclusions PAC from aged mice may capture and store many fungi, which in turn may mean that these cells are effectively unable to eliminate fungi, probably due to impaired NO production. Therefore, considering the important role of C. albicans overgrowth in the pathogenesis of DS and the aspects observed in this study, aging may favor the onset and severity of local candidosis such as DS and its systemic forms.

Animals , Male , Phagocytosis/physiology , Stomatitis, Denture/metabolism , Stomatitis, Denture/microbiology , Candida albicans/pathogenicity , Aging/physiology , Cell Adhesion/physiology , Nitric Oxide/biosynthesis , Peritoneum/cytology , Reference Values , Time Factors , Candida albicans/isolation & purification , Candidiasis/microbiology , Age Factors , Mice, Inbred C57BL , Nitric Oxide/analysis
Rev. chil. infectol ; 34(2): 186-189, abr. 2017. ilus
Article in Spanish | LILACS | ID: biblio-844462


Vesical fungus ball is a mobile, oval and echogenic mass as a result of accumulation of long and wide numerous hyphae. Fungal urinary tract infection incidence has increased notoriously and there are isolated yeast in 7 to 8% of urine cultures. Different species of Candida are cause of urinary tract infection. Epidemiologically, the first isolated pathogen is Candida albicans, followed by Candida tropicalis. Bladder poll has been documented as the most important risk factor for candiduria in critical patients into intensive care.

Un fungoma vesical es una masa móvil, oval y ecogénica en la vejiga resultante del acúmulo de hifas largas y anchas. La incidencia de la infección urinaria de etiología fúngica se ha incrementado notablemente. Se aíslan levaduras en 7 a 8% de los urocultivos. Diferentes especies de Candida son causantes de infección urinaria, siendo Candida albicans la más frecuente, seguida de Candida tropicalis. Presentamos el caso de un niño varón de cuatro años, con un síndrome de Guillain Barré, catéter urinario permanente, estadía prolongada en UCI y expuesto a tratamiento antibacteriano de amplio espectro que desarrolló un fungoma vesical, diagnosticado por ecotomografía, con aislamiento de C. tropicalis en orina. Se trató con anfotericina B deoxicolato y extracción del fungoma por cistoscopia, con buena respuesta clínica. El cateterismo vesical se ha documentado como el factor de riesgo más importante para candiduria en pacientes de terapia intensiva.

Humans , Male , Child, Preschool , Urinary Bladder Diseases/microbiology , Candidiasis/microbiology , Cross Infection/microbiology , Candida tropicalis/isolation & purification
Clin. biomed. res ; 37(3): 247-254, 2017. tab
Article in English | LILACS | ID: biblio-859840


Candida auris is a multidrug-resistant emerging yeast, which was responsible for healthcare-associated infection outbreaks, and was cataloged as a new species in 2009, after being isolated from a patient's ear canal secretion in Japan. Since the notification of this first occurrence, numerous cases have been reported throughout the world, including Brazil. C. auris affects mainly inpatients, patients in intensive care units, exposed to broad-spectrum antifungal medications and who make use of vascular catheters. Currently, this yeast is one of the main responsible for invasive infections in hospitals and has been cause of concern by authorities and organs due to its rapid dissemination and difficult treatment caused by its low susceptibility to antifungal agents traditionally used in clinical practice. As a contributor to the severity of infections associated with C. auris, the transmission mechanism is still unknown, which implies in a lack of control of the microorganism and high mortality rates. Thus, this literature review presents relevant information in order to alert the importance of C. auris as an etiological agent of systemic infections, as well as its epidemiology and the real challenges of the treatment (AU)

Humans , Candida/pathogenicity , Candidiasis/epidemiology , Anti-Infective Agents/therapeutic use , Antifungal Agents/therapeutic use , Candida/drug effects , Candida/isolation & purification , Candidiasis/diagnosis , Candidiasis/drug therapy , Candidiasis/microbiology , Drug Resistance, Multiple, Fungal
Rev. Assoc. Med. Bras. (1992) ; 62(4): 315-319, tab, graf
Article in English | LILACS | ID: lil-787767


Summary Introduction: The prevalence of nosocomial fungemia has increased worldwide, and mortality caused by this disease is high. Objective: To assess progress in the last decade, and the prevalence and profile of fungal agents isolated in blood cultures performed in a tertiary university hospital. Method: All the results of blood cultures processed at Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), in the time intervals 2001-2003 and 2011-2013 were analyzed retrospectively. For each three-year period, the number of collected blood cultures, the overall positivity rate and the percentage of fungemia were recorded. In addition, all identified fungal species were cataloged. All blood samples were incubated in the BacT/ALERT® (bioMérieux) automation system. Results: In 2001-2003, 34,822 samples were evaluated, with 5,510 (15.8%) positive results. In 2011-2013, the number of blood cultures processed increased to 55,052 samples, with 4,873 (8.9%) positive results. There was an increase in the number of positive cultures for fungi in the analyzed period (2001-2003: 4.16%; 2011-2013: 5.95%; p<0.001). Among the agents, candidemias were predominant, especially those caused by non-albicans Candida species (2001-2003: 57.64%; 2011-2013: 65.17%; p<0.05). There was also an increase in fungemia caused by other genera (2001-2003: 2.62%; 2011-2013: 4.48%; p<0.01). Conclusion: There was an increase in the prevalence of fungemia in the last decade at HC-UFMG. Although candidemias have been responsible for most of the cases, there has been an increase in fungemias caused by other species.

Resumo Introdução: a prevalência de fungemia hospitalar tem aumentado em todo o mundo e a mortalidade por essa afecção é elevada. Objetivo: avaliar a evolução, na última década, da prevalência e do perfil dos agentes fúngicos isolados em hemoculturas realizadas em um hospital universitário terciário. Método: foram analisados retrospectivamente todos os resultados de hemocultura processados no Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG), entre os períodos de 2001-2003 e de 2011-2013. Para cada triênio foram registrados o número de hemoculturas coletadas, o percentual de positividade geral e o percentual de fungemia. Também foram catalogadas todas as espécies fúngicas identificadas. Todas as amostras sanguíneas foram incubadas no sistema de automação BacT/ALERT® (bioMérieux). Resultados: entre 2001-2003, foram avaliadas 34.822 amostras, sendo 5.510 (15,8%) positivas. Entre 2011-2013, o número de hemoculturas processadas aumentou para 55.052 amostras, sendo 4.873 (8,9%) positivas. Observou-se um aumento do número de culturas positivas para fungos no período analisado (2001-2003: 4,16%; 2011-2013: 5,95%; p<0,001). Dentre os agentes, as candidemias foram predominantes, principalmente por espécies de Candida não albicans (2001-2003: 57,64%; 2011-2013: 65,17%; p<0,05). Houve também aumento da fungemia por outros gêneros (2001-2003: 2,62%; 2011-2013: 4,48%; p<0,01). Conclusão: houve aumento da prevalência de fungemia na última década no HC-UFMG. Embora as candidemias tenham sido responsáveis pela maioria dos casos, houve aumento de fungemias causadas por outras espécies.

Humans , Cross Infection/epidemiology , Fungemia/epidemiology , Candida/isolation & purification , Candida/classification , Candidiasis/microbiology , Candidiasis/epidemiology , Cross Infection/microbiology , Prevalence , Retrospective Studies , Risk Factors , Fungemia/microbiology , Tertiary Care Centers , Hospitals, University
Braz. j. microbiol ; 47(2): 367-372, Apr.-June 2016. tab
Article in English | LILACS | ID: lil-780823


Abstract The incidence of the species Candida albicans and non-albicans Candida was evaluated in a Brazilian Tertiary Hospital from the environment and health practitioners. In a 12-month period we had a total positivity of 19.65% of Candida spp. The most recurring non-albicans Candida species was C. glabrata (37.62%), generally considered a species of low virulence, but with a higher mortality rate than C. albicans. Subsequently, C. parapsilosis (25.74%) and C. tropicalis (16.86%) were the second and third most commonly isolated species. Considering the total samples collected from the emergency room and from the inpatient and the pediatric sector, 19.10% were positive for Candida spp., with the predominance of non-albicans Candida species (89.42%). The high percentage of positivity occurred in the hands (24.32%) and the lab coats (21.88%) of the health care assistants. No sample of C. albicans presented a profile of resistance to the drugs. All the non-albicans Candida species presented a decreased susceptibility to miconazole and itraconazole, but they were susceptible to nystatin. Most of the isolates were susceptible to fluconazole and amphotericin B. As expected, a high resistance rate was observed in C. glabrata and C. krusei, which are intrinsically less susceptible to this antifungal agent. The contamination of environmental surfaces by Candida spp. through hand touching may facilitate the occurrence of Candida infections predominantly in immunocompromised patients. In addition to that, the antifungal agents used should be carefully evaluated considering local epidemiologic trends in Candida spp. infections, so that therapeutic choices may be better guided.

Humans , Male , Female , Candida/isolation & purification , Candidiasis/microbiology , Microbial Sensitivity Tests , Cross Infection/microbiology , Health Personnel/statistics & numerical data , Candida glabrata/isolation & purification , Equipment and Supplies, Hospital/microbiology , Tertiary Healthcare/statistics & numerical data , Brazil/epidemiology , Candida/classification , Candida/drug effects , Candida/genetics , Candidiasis/epidemiology , Cross Infection/epidemiology , Drug Resistance, Fungal , Candida glabrata/classification , Candida glabrata/drug effects , Candida glabrata/genetics , Hospitals , Hospitals/statistics & numerical data , Antifungal Agents/pharmacology
Mem. Inst. Oswaldo Cruz ; 111(1): 51-58, Jan. 2016. tab, graf
Article in English | LILACS | ID: lil-771081


This study evaluated the antifungal susceptibility profile and the production of potential virulence attributes in a clinical strain of Candida nivariensis for the first time in Brazil, as identified by sequencing the internal transcribed spacer (ITS)1-5.8S-ITS2 region and D1/D2 domains of the 28S of the rDNA. For comparative purposes, tests were also performed with reference strains. All strains presented low planktonic minimal inhibitory concentrations (PMICs) to amphotericin B (AMB), caspofungin (CAS), and voriconazole. However, our strain showed elevated planktonic MICs to posaconazole (POS) and itraconazole, in addition to fluconazole resistance. Adherence to inert surfaces was conducted onto glass and polystyrene. The biofilm formation and antifungal susceptibility on biofilm-growing cells were evaluated by crystal violet staining and a XTT reduction assay. All fungal strains were able to bind both tested surfaces and form biofilm, with a binding preference to polystyrene (p < 0.001). AMB promoted significant reductions (≈50%) in biofilm production by our C. nivariensis strain using both methodologies. This reduction was also observed for CAS and POS, but only in the XTT assay. All strains were excellent protease producers and moderate phytase producers, but lipases were not detected. This study reinforces the pathogenic potential of C. nivariensis and its possible resistance profile to the azolic drugs generally used for candidiasis management.

Humans , Antifungal Agents/pharmacology , Candida/drug effects , Candidiasis/microbiology , Brazil , Biofilms/drug effects , Candida/classification , Candida/isolation & purification , Candida/pathogenicity , Microbial Sensitivity Tests , Phenotype , Virulence
Rev. ciênc. farm. básica apl ; 37(1)2016. tab, graf
Article in English | LILACS | ID: biblio-964167


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)

Candida/drug effects , Oils, Volatile/pharmacology , Cryptococcus/drug effects , Zingiberaceae/microbiology , Oxides , Candidiasis/microbiology , Cryptococcosis/microbiology , Antifungal Agents/therapeutic use
Braz. j. microbiol ; 46(2): 477-484, Apr-Jun/2015. tab
Article in English | LILACS | ID: lil-749709


One hundred and forty-one Candida species isolated from clinical specimens of hospitalized patients in Rio de Janeiro, Brazil, during 2002 to 2007, were analized in order to evaluate the distribution and susceptibility of these species to fluconazole. Candida albicans was the most frequent species (45.4%), followed by C. parapsilosis sensu lato (28.4%), C. tropicalis (14.2%), C. guilliermondii (6.4%), C. famata (2.8%), C. glabrata (1.4%), C. krusei (0.7%) and C. lambica (0.7%). The sources of fungal isolates were blood (47.5%), respiratory tract (17.7%), urinary tract (16.3%), skin and mucous membrane (7.1%), catheter (5.6%), feces (2.1%) and mitral valve tissue (0.7%). The susceptibility test was performed using the methodology of disk-diffusion in agar as recommended in the M44-A2 Document of the Clinical and Laboratory Standards Institute (CLSI). The majority of the clinical isolates (97.2%) was susceptible (S) to fluconazole, although three isolates (2.1%) were susceptible-dose dependent (S-DD) and one of them (0.7%) was resistant (R). The S-DD isolates were C. albicans, C. parapsilosis sensu lato and C. tropicalis. One isolate of C. krusei was resistant to fluconazole. This work documents the high susceptibility to fluconazole by Candida species isolated in Rio de Janeiro, Brazil.

Humans , Antifungal Agents/pharmacology , Candida/drug effects , Candida/isolation & purification , Candidiasis/epidemiology , Cross Infection/epidemiology , Fluconazole/pharmacology , Brazil/epidemiology , Candida/classification , Candidiasis/microbiology , Cross Infection/microbiology , Disk Diffusion Antimicrobial Tests , Drug Resistance, Fungal
Braz. j. microbiol ; 46(1): 125-129, 05/2015. tab
Article in English | LILACS | ID: lil-748244


In vitro interaction between tacrolimus (FK506) and four azoles (fluconazole, ketoconazole, itraconazole and voriconazole) against thirty clinical isolates of both fluconazole susceptible and -resistant Candida glabrata were evaluated by the checkerboard microdilution method. Synergistic, indifferent or antagonism interactions were found for combinations of the antifungal agents and FK506. A larger synergistic effect was observed for the combinations of FK506 with itraconazole and voriconazole (43%), followed by that of the combination with ketoconazole (37%), against fluconazole-susceptible isolates. For fluconazole-resistant C. glabrata, a higher synergistic effect was obtained from FK506 combined with ketoconazole (77%), itraconazole (73%), voriconazole (63%) and fluconazole (60%). The synergisms that we observed in vitro, notably against fluconazole-resistant C. glabrata isolates, are promising and warrant further analysis of their applications in experimental in vivo studies.

Humans , Antifungal Agents/pharmacology , Azoles/pharmacology , Candida glabrata/drug effects , Drug Synergism , Tacrolimus/pharmacology , Candida glabrata/isolation & purification , Candidiasis/microbiology , Drug Resistance, Bacterial , Microbial Sensitivity Tests
Braz. j. microbiol ; 45(4): 1371-1377, Oct.-Dec. 2014. graf, tab
Article in English | LILACS | ID: lil-741289


Over the last decades, there have been important changes in the epidemiology of Candida infections. In recent years, Candida species have emerged as important causes of invasive infections mainly among immunocompromised patients. This study analyzed Candida spp. isolates and compared the frequency and biofilm production of different species among the different sources of isolation: blood, urine, vulvovaginal secretions and peritoneal dialysis fluid. Biofilm production was quantified in 327 Candida isolates obtained from patients attended at a Brazilian tertiary public hospital (Botucatu, Sao Paulo). C. albicans ALS3 gene polymorphism was also evaluated by determining the number of repeated motifs in the central domain. Of the 198 total biofilm-positive isolates, 72 and 126 were considered as low and high biofilm producers, respectively. Biofilm production by C. albicans was significantly lower than that by non-albicans isolates and was most frequently observed in C. tropicalis. Biofilm production was more frequent among bloodstream isolates than other clinical sources,in urine, the isolates displayed a peculiar distribution by presenting two distinct peaks, one containing biofilm-negative isolates and the other containing isolates with intense biofilm production. The numbers of tandem-repeat copies per allele were not associated with biofilm production, suggesting the evolvement of other genetic determinants.

Humans , Biofilms/growth & development , Candida/genetics , Candida/physiology , Candidiasis/microbiology , Fungal Proteins/genetics , Polymorphism, Genetic , Brazil , Candida/classification , Candida/isolation & purification , Hospitals, Public , Tertiary Care Centers
Mem. Inst. Oswaldo Cruz ; 109(4): 436-441, 03/07/2014. tab, graf
Article in English | LILACS | ID: lil-716301


Over the last decades, Candida spp have been responsible for an increasing number of infections, especially in patients requiring intensive care. Knowledge of local epidemiology and analysis of the spread of these pathogens is important in understanding and controlling their transmission. The aim of this study was to evaluate the genetic diversity of 31 Candida albicans and 17 Candida glabrata isolates recovered from intensive care unit patients from the tertiary hospital in Krakow between 2011-2012. The strains were typed by random amplified polymorphic DNA (RAPD) polymerase chain reaction using five primers (CD16AS, HP1247, ERIC-2, OPE-3 and OPE-18). The results of the present investigation revealed a high degree of genetic diversity among the isolates. No clonal relationship was found among the C. albicans strains, whereas two C. glabrata isolates were identical. The source of Candida infection appeared to be mostly endogenous; however, the presence of two clonal C. glabrata strains suggested the possibility of cross-transmission of these pathogens. Our study confirmed the high discriminatory power of the RAPD technique in the molecular typing of Candida clinical isolates. This method may be applied to the evaluation of transmission routes of pathogenic fungi on a local level.

Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Candida albicans/genetics , Candida glabrata/genetics , Candidiasis/epidemiology , Antifungal Agents/pharmacology , Candida albicans/drug effects , Candida glabrata/drug effects , Candidiasis/microbiology , DNA Primers/genetics , DNA, Fungal/genetics , Intensive Care Units , Microbial Sensitivity Tests , Molecular Typing , Poland/epidemiology , Random Amplified Polymorphic DNA Technique
Braz. j. microbiol ; 45(2): 515-522, Apr.-June 2014. ilus, tab
Article in English | LILACS | ID: lil-723109


Microbial culture collections underpin biotechnology applications and are important resources for clinical microbiology by supplying reference strains and/or performing microbial identifications as a service. Proteomic profiles by MALDI-TOF MS have been used for Candida spp. identification in clinical laboratories and demonstrated to be a fast and reliable technique for the routine identification of pathogenic yeasts. The main aim of this study was to apply MALDI-TOF MS combined with classical phenotypic and molecular approaches to identify Candida clinical isolates preserved from 1 up to 52 years in a Brazilian culture collection and assess its value for the identification of yeasts preserved in this type of collections. Forty Candida spp. clinical isolates were identified by morphological and biochemical analyses. Identifications were also performed by the new proteomic approach based on MALDI-TOF MS. Results demonstrated 15% discordance when compared with morphological and biochemical analyses. Discordant isolates were analysed by ITS sequencing, which confirmed the MALDI-TOF MS identifications and these strains were renamed in the culture collection catalogue. In conclusion, proteomic profiles by MALDI-TOF MS represents a rapid and reliable method for identifying clinical Candida species preserved in culture collections and may present clear benefits when compared with the performance of existing daily routine methods applied at health centres and hospitals.

Humans , Candida/chemistry , Candida/classification , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Brazil , Cluster Analysis , Candida/genetics , Candida/isolation & purification , Candidiasis/microbiology , DNA, Fungal/chemistry , DNA, Fungal/genetics , DNA, Ribosomal Spacer/chemistry , DNA, Ribosomal Spacer/genetics , Molecular Sequence Data , Mycological Typing Techniques , Phylogeny , Sequence Analysis, DNA
Rev. Inst. Med. Trop. Säo Paulo ; 55(6): 385-391, Nov-Dec/2013. tab, graf
Article in English | LILACS | ID: lil-690341


SUMMARY Introduction: The majority of nosocomial fungal infections are caused by Candida spp. where C. albicans is the species most commonly identified. Molecular methods are important tools for assessing the origin of the yeasts isolated in hospitals. Methods: This is a study on the genetic profifiles of 39 nosocomial clinical isolates of C. albicans using two typing methods: random amplifified polymorphic DNA (RAPD) and microsatellite, two different primers for each technique were used. Results: RAPD provided 10 and 11 different profiles with values for SAB of 0.84 ± 0.126 and 0.88 ± 0.08 for primers M2 and P4, respectively. Microsatellite using two markers, CDC3 and HIS3, allowed the observation of six and seven different alleles, respectively, with combined discriminatory power of 0.91. Conclusions: Although genetic variability is clear, it was possible to identify high similarity, suggesting a common origin for at least a part of isolates. It is important to emphasize that common origin was proven from yeasts isolated from colonization (urine, catheter or endotracheal secretions) and blood culture from the same patient, indicating that the candidemia must have started from a site of colonization. The combination of RAPD and microsatellite provides a quick and efficient analysis for investigation of similarity among nosocomial isolates of C. albicans. .

RESUMO Introdução: A maioria das infecções fúngicas hospitalares são causadas por Candida spp. e C. albicans é a espécie mais comumente identificada. Métodos moleculares são ferramentas importantes para a avaliação da origem das leveduras isoladas em hospitais. Métodos: Este é um estudo sobre o perfil genético de 39 isolados clínicos nosocomiais de C. albicans através das técnicas de RAPD e microssatélite, foram usados dois diferentes iniciadores para cada técnica. Resultados: RAPD forneceu 10 e 11 diferentes perfis com valores de SAB 0,84 ± 0,126 e 0,88 ± 0,08 para os primers M2 e P4, respectivamente. A análise de microssatélites, usando os marcadores CDC3 e HIS3 permitiu a observação de seis e sete diferentes alelos respectivamente, com poder discriminatório combinado de 0,91. Conclusões: Embora seja clara a variabilidade genética, foi possível identificar alta similaridade, sugerindo origem comum para pelo menos parte deles. É importante enfatizar que foi comprovada origem comum de leveduras isoladas de colonização (urina, cateter ou secreção orotraqueal) e hemocultura do mesmo paciente, indicando que a candidemia deve ter iniciado a partir de um sítio de colonização. A combinação das técnicas RAPD e microssatélites fornece uma análise rápida e eficiente para investigação de similaridade entre isolados nosocomiais de C. albicans. .

Humans , Candida albicans/genetics , Candidiasis/microbiology , Cross Infection/microbiology , Candida albicans/classification , Candida albicans/isolation & purification , DNA Primers/genetics , DNA, Fungal/genetics , Electrophoresis, Gel, Pulsed-Field , Genotype , Microsatellite Repeats , Mycological Typing Techniques , Random Amplified Polymorphic DNA Technique
Rev. Soc. Bras. Med. Trop ; 46(6): 795-796, Nov-Dec/2013.
Article in English | LILACS | ID: lil-698051


Lithiasic cholecystitis is classically associated with the presence of enterobacteria, such as Escherichia coli, Enterococcus, Klebsiella, and Enterobacter, in the gallbladder. Cholecystitis associated with fungal infections is a rare event related to underlying conditions such as diabetes mellitus, steroid use, and broad-spectrum antibiotic use for prolonged periods, as well as pancreatitis and surgery of the digestive tract. Here, we present the first reported case of a gallbladder infection caused by Candida famata.

Aged , Female , Humans , Candidiasis/microbiology , Cholecystitis/microbiology , Candida/classification , Candida/isolation & purification , Candidiasis/diagnosis , Fatal Outcome
Braz. j. microbiol ; 44(3): 813-821, July-Sept. 2013. ilus, tab
Article in English | LILACS | ID: lil-699791


Scanning electron microscope (SEM) observations were used to analyze particular morphologies of Candida albicans clinical isolate (strain 82) and mutants defective in hyphae-promoting genes EFG1 (strain HLC52) and/ or CPH1 (strains HLC54 and Can16). Transcription factors Efg1 and Cph1 play role in regulating filamentation and adhesion of C. albicans' morphologies. Comparative analysis of such mutants and clinical isolate showed that Efg1 is required for human serum-induced cell growth and morphological switching. In the study, distinct differences between ultrastructural patterns of clinical strain's and null mutants' morphologies were observed (spherical vs tube-like blastoconidia, or solid and fragile constricted septa vs only the latter observed in strains with EFG1 deleted). In addition, wild type strain displayed smooth colonies of cells in comparison to mutants which exhibited wrinkled phenotype. It was observed that blastoconidia of clinical strain exhibited either polarly or randomly located budding. Contrariwise, morphotypes of mutants showed either multiple polar budding or a centrally located single bud scar (mother-daughter cell junction) distinguishing tube-like yeast/ pseudohyphal growth (the length-to-width ratios larger than 1.5). In their planktonic form of growth, blastoconidia of clinical bloodstream isolate formed constitutively true hyphae under undiluted human serum inducing conditions. It was found that true hyphae are essential elements for developing structural integrity of conglomerate, as mutants displaying defects in their flocculation and conglomerate-forming abilities in serum. While filamentation is an important virulence trait in C. albicans the true hyphae are the morphologies which may be expected to play a role in bloodstream infections.

Humans , Candida albicans/ultrastructure , Candida albicans/genetics , Candida albicans/growth & development , Candida albicans/isolation & purification , Candidiasis/microbiology , Gene Deletion , Hyphae/genetics , Hyphae/growth & development , Hyphae/ultrastructure , Microscopy, Electron, Scanning