Relationship between Candidas and melanin / 医学研究生学报

Objective Candidas rank as the second factor of deep fungal infection .This study aimed to investigate the rela-tionship between Candidas and melanin by screening clinically isolated melanin -producing Candidas . Methods We incubated 360 strains of clinically isolated Candidas with caffeic acid , DOPA agar , and minimal medium at a temperature of 35℃, with Cryptococcus neoformans as the positive control .We observed the changes in the culture media using transmission electron microscopy (TEM) and electron spin resonance ( ESR) spectroscopy . Results Cryptococcus neoforman produced pigmentation in all the three types of medi -um.At 5 days, a standard strain of Candida albicans SC 5314 turned dark brown in the DOPA agar and minimal medium and , at 10 days, 12 and 15 of the 360 Candida strains turned dark brown in the DOPA agar and minimal medium , respectively, which were not shown to be melanin by TEM and ESR spectroscopy . Conclusion Culture media are not reliable enough for the identification of mel-anin-producing Candidas , and the observations need to be further verified by TEM and ESR spectroscopy .

Infección sistémica por candida en unidades de cuidados intensivos neonatales / Systemic infection by candida in neonatal intensive care units

En las unidades de cuidados intensivos neonatales, los recién nacidos pretérmino pueden contraer infecciones micóticas invasivas, predominantemente por Candidas sp, causantes de una mayor morbilidad y mortalidad, así como también de frecuentes alteraciones del neurodesarrollo en los sobrevivientes. La candidiasis neonatal es de difícil diagnóstico, dado el carácter transitorio de la candidemia y la dificultad para eliminarla por su rápida invasión de los órganos y sistemas anatómicos. La mejor opción para disminuir la incidencia de la enfermedad, es prevenirla. En este artículo se actualiza lo concerniente a los principales elementos relacionados no solo con el diagnóstico, sino con el tratamiento profiláctico y específico de estos pacientes, referidos hasta el 2010 por grupos de expertos internacionales en esta materia de salud.

In neonatal intensive care units the preterm infants may develop invasive fungal infections, mainly by Candida sp, causative of increased morbidity and mortality, as well as of frequent neurodevelopmental disorders in survivors. Neonatal candidiasis is difficult to diagnose because of the transitory nature of candidemia and the difficulty to eliminate its rapid invasion from organs and anatomical systems. The best option to reduce the incidence of the disease is to prevent it. In this article the main elements related not only to the diagnosis, but also to the specific and prophylactic treatment of these patients are updated, which were referred to 2010 by groups of international experts in this field of health.

Balance del contenido vaginal en el diagnóstico diferencial de vaginosis-vaginitis: Reacción inflamatoria vaginal en embarazadas sintomáticas / Balance of vaginal content in vaginosis-vaginitis differential diagnosis: Vaginal inflammatory reaction in symptomatic pregnant women

El objetivo del trabajo fue validar el alto valor predictivo de BACOVA (Balance del contenido vaginal, disponible en www.fba.org.ar/proeco) en el diagnóstico microscópico diferencial de vaginosis bacteriana (VB) y vaginitis microbiana inespecífica (VMI). Fueron estudiadas 299 embarazadas sintomáticas. Se determinó por microscopía el Valor Numérico (Nugent) (VN), células guía (CG), morfotipos extraños (Mex), leucocitos por campo (Lpc), tricomonas (TV) y levaduras (LE) con lectura a 400X. Los resultados globales fueron: VN de 7 a 10, 16,4% del total de casos. BACOVA permitió diferenciar 11,7% de los casos con VN de 7 a 10, con reacción inflamatoria vaginal (RIV) menor de 10 Lpc, como casos típicos de BV. Con igual VN se detectó 4,7% de casos con RIV con más de 10 Lpc, compatibles con VMI. En sólo 7,3% de los casos de LE detectadas por microscopía (20,4% en total), se confirmó una RIV significativa. Hubo 2,7% del total de casos con RIV significativa, pH<4,5 y resultado negativo para el resto de los criterios estudiados. La determinación de la RIV, fue imprescindible, junto al VN, en el diagnóstico diferencial de VB y VMI. La RIV también es necesaria para establecer la significación clínica de la presencia de levaduras. BACOVA detecta casos con RIV significativa (2,7%), como único marcador, con pH inferior a 4,5, compatibles con infección del tracto genital superior.

This study was undertaken to demonstrate the high diagnostic predictive value of BACOVA (Balance of Vaginal Content, www.fba.org.ar/proeco) for bacterial vaginosis and microbial non specific vaginitis, in pregnant women primary health care. BACOVA including Nugent score (Gram 1000X) and leucocyte count (Wet mount and Giemsa, using 400X) was evaluated in 299 symptomatic pregnant women. Nugent score 7 to 10 was detected in 16.4%. Crossing Nugent value 7 to 10 with leucocytes counts shows that only 11.7% were below 10 leucocytes per field and 4.7% had a significant vaginal inflammatory response. Yeasts were detected in 20.4% but only in 7.2% of cases they show a significant association with vaginal inflammatory response. In 2.7% of the cases there was a significant vaginal inflammatory response, with pH below 4.5, VN from 0 to 3 and negative for TV, fishy odor, and exogenous microbial morphotypes. Simultaneous study of vaginal inflammatory response and Nugent score is mandatory in order to detect true cases of bacterial vaginosis (11.7%) from those of potential microbial non specific vaginitis (4.7%) (Donders' "aerobic vaginitis") Besides, vaginal inflammatory response became a strong criterion to define yeast vulvovaginitis (7.2%). Cases (2.7%) with score 0 to 3, negative for other criteria, with a high vaginal inflammatory response, are predictors of upper genital infections.