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1.
Rev. argent. microbiol ; 53(2): 21-30, June 2021. graf
Article in English | LILACS | ID: biblio-1376404

ABSTRACT

Abstract The National Quality Control Program in Mycology (PNCCM) of Argentina was establishedin 1996 to improve the quality of the mycological diagnosis, to help establish and to setup standardized procedures and continuous training of laboratory staff. The aim of this studywas to assess the effectiveness of the PNCCM in the 1996---2018 period. Data from the NationalMycology Laboratory Network (NMLN) and PNCCM database was used to estimate the increasein the number of controlled laboratories and jurisdictions, the percentage of participation, theimprovement in the quality of results and the adherence to the program. Satisfaction surveyswere performed to assess user satisfaction. The number of controlled laboratories increasedfrom 29 to 146; participation increased from 49% to 93% and general adherence was 72% inthe evaluated period (1996---2018). Improvement in the quality of the results was 15% for lowcomplexity samples; 7% for intermediate complexity samples and 14% for the identification ofhigh complexity strains. Up to 84% of the users consider the PNCCM to be ''very good'' and 16%''satisfactory''. These results show the importance of the PNCCM, which is widely accepted bymycological diagnostic laboratories from Argentina.


Resumen En 1996 se creó el Programa Nacional de Control de Calidad en Micología (PNCCM)de Argentina con el objetivo de mejorar la calidad del diagnóstico micológico, colaborar enel establecimiento de procedimientos estandarizados en aquellos laboratorios que carecen deellos y contribuir a la capacitación continua del personal.El objetivo de este estudio fue evaluar la efectividad del PNCCM en el período 1996-2018.Se utilizaron los datos de la base de la Red Nacional de Laboratorios de Micología (RNLM) ydel PNCCM para estimar el aumento en el número de laboratorios controlados y el porcentajede participación, la mejora de la calidad de los resultados y la adhesión al programa. Paraevaluar el grado de satisfacción de los usuarios, se analizaron las encuestas de satisfacción delos participantes. En el período evaluado, el número de laboratorios controlados aumentó de 29a 146, la participación aumentó de 49% a 93% y la adherencia general de los participantes fue del72%. La mejora de la calidad de los resultados de los laboratorios fue del 15% para muestras debaja complejidad, 7% para muestras de complejidad intermedia y 14% para la identificación decepas de alta complejidad. El 84% de los usuarios considera que el PNCCM es muy bueno y el 16%que es satisfactorio. Estos resultados evidencian la importancia del PNCCM, que es ampliamenteaceptado por los laboratorios que realizan diagnóstico micológico en nuestro país.


Subject(s)
Humans , Laboratories , Mycology , Argentina , Quality Control , Diagnostic Tests, Routine
2.
J Fungi (Basel) ; 7(3)2021 Feb 24.
Article in English | MEDLINE | ID: mdl-33668188

ABSTRACT

Species of the genus Scedosporium (family Microascaceae, phylum Ascomycota) are responsible for a wide range of opportunistic human infections, and have a low susceptibility to most antifungal drugs. It is well known that the pattern of Scedosporium species distribution varies according to geographic region. To assess the diversity of Scedosporium species in Argentina involved in human infections, we carried out a retrospective study reviewing 49 strains from clinical samples sent for diagnosis to the National Clinical Mycology Reference Laboratory between 1985 and 2019. Then, a phenotypic characterization, a phylogenetic study and and in vitro susceptibility test to antifungals were carried out. An analysis of combined nucleotide sequences dataset of the internal transcribed spacer of the ribosomal DNA (ITS) and of a fragment of the ß-tubulin gene (BT2) demonstrated that 92 % of the strains belonged to the species S. boydii, S. apiospermum and S. angustum, all them pertaining to S. apiospermum species complex. However, two strains (4%) were identified as S. aurantiacum, a species never reported in clinical settings in the Americas'. Surprisingly, one of them displayed a polycytella-like conidiogenesis, up to date only reported for S. apiospermum. In addition, the strain DMic 165285 was phylogenetically located far away from the rest of the species, so is proposed as the novel species Scedosporium americanum. On the other hand, from all seven antifungals tested, voriconazole and posaconazole were the most active drugs against Scedosporium spp.

3.
Rev Argent Microbiol ; 53(2): 104-109, 2021.
Article in English | MEDLINE | ID: mdl-33010958

ABSTRACT

The National Quality Control Program in Mycology (PNCCM) of Argentina was established in 1996 to improve the quality of the mycological diagnosis, to help establish and to set up standardized procedures and continuous training of laboratory staff. The aim of this study was to assess the effectiveness of the PNCCM in the 1996-2018 period. Data from the National Mycology Laboratory Network (NMLN) and PNCCM database was used to estimate the increase in the number of controlled laboratories and jurisdictions, the percentage of participation, the improvement in the quality of results and the adherence to the program. Satisfaction surveys were performed to assess user satisfaction. The number of controlled laboratories increased from 29 to 146; participation increased from 49% to 93% and general adherence was 72% in the evaluated period (1996-2018). Improvement in the quality of the results was 15% for low complexity samples; 7% for intermediate complexity samples and 14% for the identification of high complexity strains. Up to 84% of the users consider the PNCCM to be "very good" and 16% "satisfactory". These results show the importance of the PNCCM, which is widely accepted by mycological diagnostic laboratories from Argentina.


Subject(s)
Laboratories , Mycology , Argentina , Diagnostic Tests, Routine , Humans , Quality Control
4.
Rev Soc Bras Med Trop ; 52: e20180419, 2019 Mar 28.
Article in English | MEDLINE | ID: mdl-30942260

ABSTRACT

We report the first case of cryptococcosis due to Cryptococcus decagattii in an immunocompetent pediatric patient from an indigenous community in Argentina with a successful outcome. Two isolates (blood, cerebrospinal fluid) were genotyped by restriction fragment length polymorphism of the orotidine monophosphate pyrophosphorylase (URA5) gene as VGIV and identified by multi-locus sequence typing as C. decagattii. Matrix-assisted laser desorption/ionization time of flight mass spectrometry identification indicated genotype VGIII. The minimum inhibitory concentration of amphotericin B, fluconazole, itraconazole, and voriconazole was determined (cerebrospinal fluid: 0.25, 16, 0.12, and 0.12, blood: 0.25, 4, 0.12, and 0.06, respectively, all in mg/L).


Subject(s)
Cryptococcosis/microbiology , Cryptococcus/genetics , Argentina , Child , Cryptococcosis/diagnosis , Cryptococcus/classification , Cryptococcus/isolation & purification , Female , Genotype , Humans , Multilocus Sequence Typing
5.
Rev. Soc. Bras. Med. Trop ; 52: e20180419, 2019. graf
Article in English | LILACS | ID: biblio-990432

ABSTRACT

Abstract We report the first case of cryptococcosis due to Cryptococcus decagattii in an immunocompetent pediatric patient from an indigenous community in Argentina with a successful outcome. Two isolates (blood, cerebrospinal fluid) were genotyped by restriction fragment length polymorphism of the orotidine monophosphate pyrophosphorylase (URA5) gene as VGIV and identified by multi-locus sequence typing as C. decagattii. Matrix-assisted laser desorption/ionization time of flight mass spectrometry identification indicated genotype VGIII. The minimum inhibitory concentration of amphotericin B, fluconazole, itraconazole, and voriconazole was determined (cerebrospinal fluid: 0.25, 16, 0.12, and 0.12, blood: 0.25, 4, 0.12, and 0.06, respectively, all in mg/L).


Subject(s)
Humans , Female , Child , Cryptococcosis/microbiology , Cryptococcus/genetics , Argentina , Cryptococcosis/diagnosis , Cryptococcus/isolation & purification , Cryptococcus/classification , Multilocus Sequence Typing , Genotype
6.
Article in English | MEDLINE | ID: mdl-30082288

ABSTRACT

One of the most recently described Aspergillus fumigatusCYP51A-mediated azole resistance mechanisms is TR46 Y121F T289A. Clinical A. fumigatus strains harboring these substitutions have been reported worldwide, with the exception of South America. We describe the first clinical A. fumigatus strain with this resistance mechanism isolated from an Argentinian patient. The strain was isolated in 2009 (1 year after the first-described mutant in United States), demonstrating that these alleles were scattered worldwide earlier than previously thought.


Subject(s)
Antifungal Agents/pharmacology , Aspergillus fumigatus/genetics , Azoles/pharmacology , Aspergillus fumigatus/drug effects , Drug Resistance, Fungal/genetics , Fungal Proteins/genetics , Mutation/genetics , South America
7.
Mycoses ; 61(7): 441-448, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29500853

ABSTRACT

We studied 23 clinical and environmental strains of Sporothrix schenckii sensu lato collected from 1984 to 2017 in Argentina. The molecular identification (partial sequencing of a fragment of the calmodulin gene) of the strains was performed. For the yeast and mycelial phases, the in vitro susceptibility testing by a microdilution reference method was determined against eight antifungal drugs. Strains studied were identified as S. schenckii sensu stricto 13 (56.5%), S. brasiliensis 8 (34.7%) and S. globosa 2 (8.7%). The most active antifungal drugs tested for the yeast and mycelial phases expressed as geometric mean (GM) value of the minimal inhibitory concentration (MIC) (µg mL-1 ) were terbinafine (0.07 and 0.24), posaconazole (0.13 and 0.58), itraconazole (0.38 and 1.10) and ketoconazole (0.22 and 0.89), while fluconazole (110.10 and 131.92) and flucytosine (2.96 and 79.03) were the less active. For voriconazole and amphotericin B the GM-MIC values were acceptably low for the yeast phase (0.39 and 0.72 µg mL-1 ), while the mycelial phase showed values ≥2-fold higher (8.76 and 1.88 µg mL-1 ), P < .05. Here, we described S. schenckii sensu stricto, S. brasiliensis and S. globosa, these species were isolated from humans, animals and soil and are circulating in Argentina since at least 1984.


Subject(s)
Antifungal Agents/pharmacology , Sporothrix/drug effects , Sporothrix/genetics , Sporotrichosis/microbiology , Animals , Argentina/epidemiology , Calmodulin/genetics , Flucytosine/pharmacology , Humans , Itraconazole/pharmacology , Microbial Sensitivity Tests , Phylogeny , Sequence Analysis, DNA , Soil Microbiology , Sporothrix/isolation & purification , Sporotrichosis/epidemiology , Triazoles/pharmacology
8.
Mycopathologia ; 179(5-6): 359-71, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25700663

ABSTRACT

Infections due to Cryptococcus neoformans cause severe disease, mostly in AIDS patients. The antifungal drug recommended for the initial treatment of these infections is amphotericin B with or without flucytosine, but treatment failure occurs, associated with high mortality. Thus, antifungal susceptibility testing is needed. However, the in vitro susceptibility tests available for C. neoformans are not useful to detect isolates that are not susceptible to antifungal agents such as amphotericin B. The aims of the present study were: (1) to determine and compare the in vitro activity of amphotericin B against C. neoformans clinical isolates by using different dilution and diffusion methods; (2) to evaluate the concordance among the methods used and the reference method; (3) to evaluate which method could be the best to correlate with the clinical outcome. The reference method EDef 7.2 from the European Committee on Antimicrobial Susceptibility Testing and commercial Etest strips were used to determine the minimal inhibitory concentration against amphotericin B. curves, minimal fungicidal concentration, and a disk diffusion method were also developed to evaluate the cidal activity of amphotericin B. The time-kill curve assay showed correlation (p < 0.05) with clinical outcome, whereas EDef 7.2, minimal fungicidal concentration, Etest, and disk diffusion showed no correlation (p > 0.05). Thus, the time-kill curve assay could be a potential tool to guide a more efficient treatment when amphotericin B is used.


Subject(s)
Amphotericin B/metabolism , Antifungal Agents/pharmacology , Cryptococcus neoformans/drug effects , Drug Resistance, Fungal , Microbial Sensitivity Tests/methods , Adult , Cryptococcosis/drug therapy , Cryptococcosis/microbiology , Cryptococcus neoformans/isolation & purification , Female , Humans , Male , Microbial Viability/drug effects , Middle Aged , Retrospective Studies , Treatment Outcome , Young Adult
9.
J Clin Microbiol ; 50(6): 2165-9, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22461681

ABSTRACT

Candida pseudorugosa is a novel species closely related to Candida rugosa for which only one case has been reported. We report the first case of a bloodstream infection in humans caused by a Candida sp. closely related to C. pseudorugosa. We contribute evidence to show this organism as a potential human pathogen that may be misidentified by conventional methods, also pointing out its lower sensitivity to azoles and other antifungal agents.


Subject(s)
Candida/isolation & purification , Candidemia/diagnosis , Antifungal Agents/pharmacology , Azoles/pharmacology , Candida/classification , Candida/drug effects , Candida/genetics , Candidemia/microbiology , Cluster Analysis , DNA, Fungal/chemistry , DNA, Fungal/genetics , DNA, Ribosomal Spacer/chemistry , DNA, Ribosomal Spacer/genetics , Female , Humans , Microbial Sensitivity Tests , Middle Aged , Molecular Sequence Data , Phylogeny , Sequence Analysis, DNA
10.
Rev. argent. microbiol ; 43(3): 176-185, jun.-set. 2011. tab
Article in English | LILACS | ID: lil-634688

ABSTRACT

The Mycology Department of the Instituto Nacional de Enfermedades Infecciosas "Dr. C. Malbrán", conducted the Second National Multicenter Survey on Fungemia due to Yeasts in Argentina. The aim was to obtain updated data of the frequency of the causative species encountered and their in vitro susceptibility to seven antifungal agents. Yeast species were identified by micromorphological and biochemical studies. Antifungal susceptibility testing was performed by the reference microdilution method E.Def 7.1 of the European Committee on Antibiotic Susceptibility Testing (EUCAST). A total of 461 viable yeasts were identified. The most frequent species were: Candida albicans (38.4 %), Candida parapsilosis (26 %), Candida tropicalis (15.4 %) and Candida glabrata (4.3 %). Other uncommon species, such as Candida viswanathii (0.6 %), Candida haemulonii (0.4 %), Candida inconspicua (0.2 %) and Candida fermentati (0.2 %) were also isolated. Among the Candida spp., 5.4 % and 1.6 % were resistant to fluconazole and voriconazole, respectively. Itraconazole and caspofungin were the most efficient agents against all Candida spp. tested (MIC < 1 mg/l). For anidulafungin, 21.6 % of C. parapsilosis showed a MIC value of 4 mg/l. Fluconazole was less active against 53.1 % of Cryptococcus neoformans (MIC > 8 mg/l), 75 % of Trichosporon spp., and 100 % of Rhodotorula spp., Geotrichum candidum, Saccharomyces cerevisiae. The global percentage of mortality was 20 %. The presence of uncommon species reinforces the need for performing continuous laboratory surveillance in order to monitor possible changes, not only in the epidemiological distribution of species, but also in the resistance to antifungal drugs.


Distribución de especies y perfil de sensibilidad de levaduras aisladas de hemocultivos: resultados de un estudio multicéntrico de vigilancia de laboratorio en Argentina. El Departamento Micología del Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán" condujo el segundo estudio multicéntrico nacional sobre funge- mias debidas a levaduras. El objetivo fue obtener datos actualizados sobre la distribución de especies y la sensibilidad in vitro frente a siete antifúngicos. Las levaduras fueron identificadas mediante el estudio de la micromorfología y la realización de pruebas bioquímicas. La determinación de la sensibilidad se realizó según el método de referencia E.Def 7.1 del European Committee on Antibiotic Susceptibility Testing (EUCAST). Se identificaron 461 levaduras. Las especies más frecuentes fueron Candida albicans (38,4 %), Candida parapsilosis (26 %), Candida tropicalis (15,4 %) y Candida glabrata (4,3 %). Se aislaron otras especies menos comunes, como Candida viswanathii (0,6 %), Candida haemulonii (0,4 %), Candida inconspicua (0,2 %) y Candida fermentati (0,2 %). Entre las especies del género Candida, el 5,4 % y el 1,6 % fueron resistentes al fluconazol y al voriconazol, respectivamente. El itraconazol y la caspofungina fueron los antifúngicos más eficaces in vitro frente a las especies de Candida evaluadas (CIM < 1 mg/l). Para la anidulafungina, el 21,6 % de los aislamientos de C. parapsilosis mostraron una CIM de 4 mg/l. El fluconazol fue menos activo para el 53,1 % de los aislamientos de Cryptococcus neoformans (CIM > 8 mg/l), el 75 % de los aislamientos de Trichosporon spp. y el 100 % de los aislamientos de Rhodotorula spp., Geotrichum candidum y Saccharomyces cerevisiae. El porcentaje de mortalidad fue del 20 %. La presencia de especies infrecuentes refuerza la necesidad de realizar la continua vigilancia de laboratorio con el fin de monitorear posibles cambios, no solo en la epidemiología de las especies causantes de fungemia, sino también en la resistencia a los antifúngicos.


Subject(s)
Adult , Child , Female , Humans , Male , Antifungal Agents/pharmacology , Cross Infection/microbiology , Drug Resistance, Fungal , Fungemia/microbiology , Population Surveillance , Yeasts/isolation & purification , Argentina/epidemiology , Cross Infection/drug therapy , Cross Infection/mortality , Databases, Factual , Drug Resistance, Multiple, Fungal , Fungemia/drug therapy , Fungemia/mortality , Laboratories, Hospital , Microbial Sensitivity Tests , Prospective Studies , Species Specificity , Yeasts/classification , Yeasts/drug effects
11.
Rev Argent Microbiol ; 43(3): 176-85, 2011.
Article in English | MEDLINE | ID: mdl-22430989

ABSTRACT

The Mycology Department of the Instituto Nacional de Enfermedades Infecciosas "Dr. C. Malbrán", conducted the Second National Multicenter Survey on Fungemia due to Yeasts in Argentina. The aim was to obtain updated data of the frequency of the causative species encountered and their in vitro susceptibility to seven antifungal agents. Yeast species were identified by micromorphological and biochemical studies. Antifungal susceptibility testing was performed by the reference microdilution method E.Def 7.1 of the European Committee on Antibiotic Susceptibility Testing (EUCAST). A total of 461 viable yeasts were identified. The most frequent species were: Candida albicans (38.4 %), Candida parapsilosis (26 %), Candida tropicalis (15.4 %) and Candida glabrata (4.3 %). Other uncommon species, such as Candida viswanathii (0.6 %), Candida haemulonii (0.4 %), Candida inconspicua (0.2 %) and Candida fermentati (0.2 %) were also isolated. Among the Candida spp., 5.4 % and 1.6 % were resistant to fluconazole and voriconazole, respectively. Itraconazole and caspofungin were the most efficient agents against all Candida spp. tested (MIC < 1 mg/l). For anidulafungin, 21.6 % of C. parapsilosis showed a MIC value of 4 mg/l. Fluconazole was less active against 53.1 % of Cryptococcus neoformans (MIC > 8 mg/l), 75 % of Trichosporon spp., and 100 % of Rhodotorula spp., Geotrichum candidum, Saccharomyces cerevisiae. The global percentage of mortality was 20 %. The presence of uncommon species reinforces the need for performing continuous laboratory surveillance in order to monitor possible changes, not only in the epidemiological distribution of species, but also in the resistance to antifungal drugs.


Subject(s)
Antifungal Agents/pharmacology , Cross Infection/microbiology , Drug Resistance, Fungal , Fungemia/microbiology , Population Surveillance , Yeasts/isolation & purification , Adult , Argentina/epidemiology , Child , Cross Infection/drug therapy , Cross Infection/mortality , Databases, Factual , Drug Resistance, Multiple, Fungal , Female , Fungemia/drug therapy , Fungemia/mortality , Humans , Laboratories, Hospital , Male , Microbial Sensitivity Tests , Prospective Studies , Species Specificity , Yeasts/classification , Yeasts/drug effects
12.
J Infect Dev Ctries ; 2(5): 403-5, 2008 Oct 01.
Article in English | MEDLINE | ID: mdl-19745513

ABSTRACT

The microscopic recognition of typical rounded capsulated yeasts in centrifuged cerebrospinal fluid (CSF), stained with India ink, is a common, rapid and effective method for the diagnosis of cryptococcal meningitis among AIDS patients. The presence of atypical forms of Cryptococcus neoformans var. neoformans in samples of CSF of an AIDS patient with cryptococcosis treated at the University Hospital of Infectious Disease is presented. The India ink microscopy of three consecutive CSF samples revealed capsulated yeast with India ink particles in the deteriorated capsules and capsulated pseudohyophae. Clinically, the patient showed a subacute meningoencephalitis, with a clinical picture not particularly different from those commonly observed in patients with AIDS-associated cryptococcosis treated in our hospital. In all cases, the culture of the CSF showed colonies of C. neoformans with typical macro and micromorphology, and the in vitro susceptibility tests to amphotericin B, fluocitosine, itraconazole and fluconazole showed MIC values into the limits of sensitivity. The presence of atypical forms of C. neoformans, considered as an atypical finding, could be the consequence of an adaptive phenomenon of this fungal species to an impaired immunological status present in the host.


Subject(s)
Acquired Immunodeficiency Syndrome/complications , Cryptococcus neoformans/cytology , Meningitis, Cryptococcal , Acquired Immunodeficiency Syndrome/cerebrospinal fluid , Adaptation, Physiological , Adult , Carbon , Cryptococcus neoformans/isolation & purification , Cryptococcus neoformans/physiology , Humans , Male , Meningitis, Cryptococcal/cerebrospinal fluid , Meningitis, Cryptococcal/microbiology , Meningoencephalitis/cerebrospinal fluid , Meningoencephalitis/etiology , Microbial Sensitivity Tests , Microscopy
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