ABSTRACT
Neither breakpoints (BPs) nor epidemiological cutoff values (ECVs) have been established for Candida spp. with anidulafungin, caspofungin, and micafungin when using the Sensititre YeastOne (SYO) broth dilution colorimetric method. In addition, reference caspofungin MICs have so far proven to be unreliable. Candida species wild-type (WT) MIC distributions (for microorganisms in a species/drug combination with no detectable phenotypic resistance) were established for 6,007 Candida albicans, 186 C. dubliniensis, 3,188 C. glabrata complex, 119 C. guilliermondii, 493 C. krusei, 205 C. lusitaniae, 3,136 C. parapsilosis complex, and 1,016 C. tropicalis isolates. SYO MIC data gathered from 38 laboratories in Australia, Canada, Europe, Mexico, New Zealand, South Africa, and the United States were pooled to statistically define SYO ECVs. ECVs for anidulafungin, caspofungin, and micafungin encompassing ≥97.5% of the statistically modeled population were, respectively, 0.12, 0.25, and 0.06 µg/ml for C. albicans, 0.12, 0.25, and 0.03 µg/ml for C. glabrata complex, 4, 2, and 4 µg/ml for C. parapsilosis complex, 0.5, 0.25, and 0.06 µg/ml for C. tropicalis, 0.25, 1, and 0.25 µg/ml for C. krusei, 0.25, 1, and 0.12 µg/ml for C. lusitaniae, 4, 2, and 2 µg/ml for C. guilliermondii, and 0.25, 0.25, and 0.12 µg/ml for C. dubliniensis. Species-specific SYO ECVs for anidulafungin, caspofungin, and micafungin correctly classified 72 (88.9%), 74 (91.4%), 76 (93.8%), respectively, of 81 Candida isolates with identified fks mutations. SYO ECVs may aid in detecting non-WT isolates with reduced susceptibility to anidulafungin, micafungin, and especially caspofungin, since testing the susceptibilities of Candida spp. to caspofungin by reference methodologies is not recommended.
Subject(s)
Antifungal Agents/pharmacology , Candida/drug effects , Echinocandins/pharmacology , Lipopeptides/pharmacology , Anidulafungin , Candida/genetics , Caspofungin , Micafungin , Microbial Sensitivity Tests , Mutation/geneticsABSTRACT
We report the cases of two patients, 5 and 4 months of age, without clinically important antecedents, that were hospitalized with a bronchiolitis syndrome. In the respiratory samples (nasopharynx aspirates) of both patients we isolated Ureaplasma urealyticum in pure culture and with a quantitative count > 10(3) cfu/ml. Vaginal cultures of mothers were negative. The patients were treated with fluid therapy and salbutamol, and after the respiratory cultures were reported positive, with erythromycin for 7 days. Because of the age of the patients (not in the neonatal period) and the type of respiratory syndrome (bronchiolitis), it is very difficult to evaluate the real clinical significance of these isolations. We review the respiratory pathology caused by U. urealyticum during the neonatal period and we recommend the need for a multicenter study about the clinical significance of this microorganism in children under one year of age.
Subject(s)
Bronchiolitis/microbiology , Ureaplasma urealyticum/isolation & purification , Child, Preschool , Female , Humans , Male , Sputum/microbiologyABSTRACT
Streptococcus pneumoniae is an unusual pathogen during the neonatal period. Two cases of neonatal early-onset sepsis, one of them associated with meningitis, are reported. Positive cultures for Strep. pneumoniae were obtained from both newborns and their mothers. Both newborns were full term with birth weights in the normal range. In one of them, amniorrexis occurred 18 hours before the delivery and the amniotic fluid was meconium stained. Significant clinical findings consisted in fever and respiratory distress. There was leucopenia and in one case the chest radiography was abnormal. Both neonates had an uneventful recovery after starting antibiotic treatment and no long term sequellae were detected. The incidence of neonatal sepsis caused by Strep. pneumoniae and its pathogenesis are reviewed.
