[Paracoccidioidomycosis in Formosa province (Argentina)]. / Paracoccidioidomicosis en la Provincia de Formosa, Argentina.

Patients with paracoccidioidomycosis (PCM) compatible symptoms who attended Hospital Central de Formosa, were studied during 2 years. Three hundred and thirty five patients were selected, 264 male and 71 female, ages were between 25 and 79 years old. Twenty four patients were diagnosed, the prevalence observed was 7.16%. There was only one female positive case. Most patients (83%) had smoked for more than 10 years, 96% came from a rural area and 63% was alcoholic. Also a case of neuroparacoccidioidomycosis and a juvenile-type PCM case were detected. Specimens of mucocutaneous lesions were 100% positives. Immunodiffusion (IDGA) allowed the diagnostic in 22/249 patients. PCM and others infectious diseases with similar clinical manifestations coexist in Formosa province, for this reason differential diagnostic must be done.

Paracoccidioidomicosis en la Provincia de Formosa, Argentina / Paracoccidioidomycosis in Formosa province (Argentina)

Durante 2 años, en un estudio de corte trasversal, se estudiaron los pacientes con síntomas compatibles con paracoccidioidomicosis (PCM) que concurrieron al Hospital Central de Formosa. Se seleccionaron 335 enfermos, de los cuales 264 eran varones y 71 mujeres, con edades comprendidas entre los 25 y los 79 años. Se hizo diagnóstico de PCM en 24 pacientes, obteniéndose una prevalencia de 7,16%. Hubo un solo caso femenino. La mayoría (83%) de los pacientes había consumido tabaco por un tiempo mayor a 10 años, el 96% pertenecía al área rural y el 63% de ellos refería una ingesta elevada de alcohol. Se detectaron también un caso de PCM infanto-juvenil y uno de neuroparacoccidioidomicosis. El 100% de las muestras de lesiones muco-cutáneas de pacientes con PCM estudiadas fue positivo. El estudio serológico por inmunodifusión en gel de agar (IDGA) permitió el diagnóstico en 22/249 pacientes estudiados. La PCM es endémica en la provincia de Formosa donde coexiste con otras afecciones con manifestaciones semejantes, por lo que se debe realizar siempre el diagnóstico diferencial.

Patients with paracoccidioidomycosis (PCM) compatible symptoms who attended Hospital Central de Formosa, were studied during 2 years. Three hundred and thirty five patients were selected, 264 male and 71 female, ages were between 25 and 79 years old. Twenty four patients were diagnosed, the prevalence observed was 7.16%. There was only one female positive case. Most patients (83%) had smoked for more than 10 years, 96% came from a rural area and 63% was alcoholic. Also a case of neuroparacoccidioidomycosis and a juvenile-type PCM case were detected. Specimens of mucocutaneous lesions were 100% positives. Immunodiffusion (IDGA) allowed the diagnostic in 22/249 patients. PCM and others infectious diseases with similar clinical manifestations coexist in Formosa province, for this reason differential diagnostic must be done.

[Association of paracoccidioidomycosis with different pulmonary pathologies in a hospital in Corrientes Province, Argentina]. / Paracoccidioidomicosis asociada a otras patologías respiratorias en un hospital de Corrientes, Argentina.

For 2 years, a systematic research of paracoccidioidomycosis (PCM) had been conducted in a hospital in the city of Corrientes. The inclusion criterium used was: tuberculosis patients (TBC), presumptive or confirmed diagnosis of pulmonary cancer (CA), chronic obstructive pulmonary disease (COPD) and/or X-ray images compatible with pulmonary mycosis (XRC). Eighty four patients were studied: 57 (TBC), 1 (CA), 5 (COPD), 3 (TBC+CA), 4 (TBC+COPD), 4 (COPD+CA) and 10 (XRC). Serology tests by agar gel immunodiffusion (IDGA) were performed on all patients, whereas microbiological studies were performed on those cases in which clinical samples could be obtained. Ten PCM were diagnosed by IDGA; 4 associated to TBC, 1 to TBC+CA, 3 to COPD and only 2 to XRC. PCM was mycologically proven in 9 of these cases. Systematic research of PCM would lead to an early diagnosis and therefore, to better chances for a successful treatment.

Paracoccidioidomicosis asociada a otras patologías respiratorias en un hospital de Corrientes, Argentina / Association of paracoccidioidomycosis with different pulmonary pathologies in a hospital in Corrientes province, Argentina

Se realizó la búsqueda sistemática de paracoccidioidomicosis (PCM) en un conjunto de pacientes que fueron atendidos en un hospital de la ciudad de Corrientes dentro de un período de dos años. El criterio de inclusión fue: pacientes con tuberculosis (TBC), pacientes con diagnóstico presuntivo o confirmado de cáncer de pulmón (CA), pacientes con enfermedad pulmonar obstructiva crónica (EPOC) y pacientes con imagen radiológica compatible con micosis pulmonar (IRXC). Se estudiaron 84 pacientes: 57 con TBC, 1 con CA, 5 con EPOC, 3 con TBC+CA, 4 con TBC+EPOC, 4 con EPOC+CA y 10 con IRXC. A todos se les realizó serología por inmunodifusión en gel de agar (IDGA) y, en los casos en que se pudo obtener una muestra clínica, también se efectuaron estudios microbiológicos. Por IDGA se diagnosticaron 10 casos de PCM: 4 asociados a TBC, 1 a TBC+CA, 3 a EPOC y 2 a IRXC; 9 de ellos se corroboraron por el hallazgo del hongo. La búsqueda sistemática de PCM en habitantes del área endémica que presentan patología pulmonar favorecería el diagnóstico precoz y, por lo tanto, las posibilidades de un tratamiento eficaz.

For 2 years, a systematic research of paracoccidioidomycosis (PCM) had been conducted in a hospital in the city of Corrientes. The inclusion criterium used was: tuberculosis patients (TBC), presumptive or confirmed diagnosis of pulmonary cancer (CA), chronic obstructive pulmonary disease (COPD) and/or X-ray images compatible with pulmonary mycosis (XRC). Eighty four patients were studied: 57 (TBC), 1 (CA), 5 (COPD), 3 (TBC+CA), 4 (TBC+COPD), 4 (COPD+CA) and 10 (XRC). Serology tests by agar gel immunodiffusion (IDGA) were performed on all patients, whereas microbiological studies were performed on those cases in which clinical samples could be obtained. Ten PCM were diagnosed by IDGA; 4 associated to TBC, 1 to TBC+CA, 3 to COPD and only 2 to XRC. PCM was mycologically proven in 9 of these cases. Systematic research of PCM would lead to an early diagnosis and therefore, to better chances for a successful treatment.

Azole resistance in neonatal intensive care units in Argentina.

The aim of this study was to determine the antifungal susceptibility profile and to detect resistant strains of yeast species isolated from neonates in Intensive Care Units. 92 strains isolated from 25 bloodstream cultures, 20 venous catheters, 23 suprapubic aspirations and 24 rectal swabs were studied. A Candida glabrata strain resistant to fluconazole was detected. Candida krusei appeared with its inherent resistance to fluconazole and showed cross-resistance to itraconazole. Two Candida albicans strains were resistant to azoles, one to itraconazole and the other to fluconazole with a high minimum inhibitory concentration (MIC) for itraconazole. All Candida tropicalis strains were susceptible to fluconazole but two of them showed resistance to itraconazole. The detection of resistant strains in neonates whom had not received previous antifungal therapy is noteworthy. The variations in the epidemiology of fungal infections observed and the antifungal resistance detected emphasize the importance of performing a regular surveillance to observe and to assess them.

Yeasts species distribution in Neonatal Intensive Care Units in northeast Argentina.

The aim of this study was to determine the distribution and antifungal susceptibility profile of yeast species isolated from neonates in Neonatal Intensive Care Units (NICU) in northeast of Argentina. With this purpose 92 strains isolated from 25 blood stream cultures, 20 venous catheters, 23 suprapubic aspirations and 24 rectal swabs were studied. Candida albicans and C. parapsilosis appeared with similar frequencies (36%) in blood stream isolates. Candida parapsilosis (50%) was the most frequent catheters colonizer and C. tropicalis (54.2%) was the most frequent yeast associated with gastrointestinal tract colonization. Candida krusei, C. glabrata and Trichosporon cutaneum appeared with a very low frequency. A high rate of susceptibility to amphotericin B, fluconazole, and itraconazole was observed.

Identificación de especies de Malassezia por PCR-REA / Malassezia species identification with PCR-REA

Las especies del género Malassezia han adquirido importancia por su asociación a diversos procesos patológicos. Desde 1996 fueron clasificadas en M. pachydermatis, M. furfur, M. sympodialis, M. slooffae, M. obtusa, M. globosa y restricta. El esquema de identificación basado en las características morfológicas, fisiológicas y bioquímicas no siempre permite distinguir entre algunas de ellas. El objetivo de este trabajo fue poner a punto una metodología rapida, específica y eficaz para la identificación de las especies de este género. Con este fin, basados en la técnica de PCR-REA de Guillot y col., se introdujeron modificaciones en la metodología de extracción y purificación del ADN y en la electroforesis. Las variaciones propuestas en este trabajo confieren mayor practicidad a la técnica y disminuyen los costos. La obtención de resultados definidos permitiría a través de investigaciones taxonómicas y epidemiológicas avanzar en el estudio de la ecología, definir el rol patogénico y aumentar la información epidemiológica del género Malassezia

Identificación de especies de Malassezia por PCR-REA / Malassezia species identification with PCR-REA

Las especies del género Malassezia han adquirido importancia por su asociación a diversos procesos patológicos. Desde 1996 fueron clasificadas en M. pachydermatis, M. furfur, M. sympodialis, M. slooffae, M. obtusa, M. globosa y restricta. El esquema de identificación basado en las características morfológicas, fisiológicas y bioquímicas no siempre permite distinguir entre algunas de ellas. El objetivo de este trabajo fue poner a punto una metodología rapida, específica y eficaz para la identificación de las especies de este género. Con este fin, basados en la técnica de PCR-REA de Guillot y col., se introdujeron modificaciones en la metodología de extracción y purificación del ADN y en la electroforesis. Las variaciones propuestas en este trabajo confieren mayor practicidad a la técnica y disminuyen los costos. La obtención de resultados definidos permitiría a través de investigaciones taxonómicas y epidemiológicas avanzar en el estudio de la ecología, definir el rol patogénico y aumentar la información epidemiológica del género Malassezia (AU)

[Identification of Malassezia species by PCR-REA]. / Identificación de especies de Malassezia por PCR-REA.

The genus Malassezia has acquired relevance in the last years for its pathological associations. Since 1996, the genus comprises M. pachydermatis, M. furfur, M. sympodialis, M. slooffiae, M. obtusa, M. globosa and M. restricta. The identification scheme based on morphological, physiological and biochemical characteristics does not resolve ambiguity between some species. The aim of this study was to find out a fast, specific and efficient methodology to distinguish between Malassezia species. Based on a previous technique for polymerase chain reaction-restriction enzyme analysis (PCR-REA), modifications were applied on DNA extraction and purification and the electrophoresis. These changes produced a cheaper, reliable and rapid method as identification procedure with easily defined results. The proposed modifications would allow a better knowledge on ecological and pathogenic roles of Malassezia, studies that have not yet been established.

Identificación de especies de Malassezia por PCR-REA / [Identification of Malassezia species by PCR-REA]

The genus Malassezia has acquired relevance in the last years for its pathological associations. Since 1996, the genus comprises M. pachydermatis, M. furfur, M. sympodialis, M. slooffiae, M. obtusa, M. globosa and M. restricta. The identification scheme based on morphological, physiological and biochemical characteristics does not resolve ambiguity between some species. The aim of this study was to find out a fast, specific and efficient methodology to distinguish between Malassezia species. Based on a previous technique for polymerase chain reaction-restriction enzyme analysis (PCR-REA), modifications were applied on DNA extraction and purification and the electrophoresis. These changes produced a cheaper, reliable and rapid method as identification procedure with easily defined results. The proposed modifications would allow a better knowledge on ecological and pathogenic roles of Malassezia, studies that have not yet been established.

Identificación de especies de Malassezia por PCR-REA. / [Identification of Malassezia species by PCR-REA]

The genus Malassezia has acquired relevance in the last years for its pathological associations. Since 1996, the genus comprises M. pachydermatis, M. furfur, M. sympodialis, M. slooffiae, M. obtusa, M. globosa and M. restricta. The identification scheme based on morphological, physiological and biochemical characteristics does not resolve ambiguity between some species. The aim of this study was to find out a fast, specific and efficient methodology to distinguish between Malassezia species. Based on a previous technique for polymerase chain reaction-restriction enzyme analysis (PCR-REA), modifications were applied on DNA extraction and purification and the electrophoresis. These changes produced a cheaper, reliable and rapid method as identification procedure with easily defined results. The proposed modifications would allow a better knowledge on ecological and pathogenic roles of Malassezia, studies that have not yet been established.

Keratomycosis caused by Cylindrocarpon lichenicola.

We present a case of keratomycosis caused by Cylindrocarpon lichenicola in a 30-year-old immunocompetent male patient living in a rural area of Formosa Province (north-eastern Argentina). No ocular trauma is reported in his case history. There are no previous reports of infections caused by this fungus in Argentina.

[Paracoccidioides brasiliensis infection in a subtropical region with important environmental changes]. / Infection par Paracoccidioides brasiliensis dans une région subtropicale avec changements importants de l'environnement.

Paracoccidioidomycosis is a systemic mycoses caused by Paracoccidioides brasiliensis, a dimorphic fungus that infects man through respiratory ducts. It has been accepted that its ecological niche is located in the soil and plants of subtropical forests of Latin America. The Province of Corrientes is located at the northeastern border of Argentina, in a subtropical area where important environmental modifications have been introduced in the last decade as consequence of damming the Paranà river at Yacyretà, one of the biggest hydroelectric dams in the world. Since there are no data on human infection provoqued by this fungal agent in Corrientes, the purpose of this study was to obtain information at present time about infection indexes and to assess if environmental changes introduced in the area could impact on the epidemiology of the disease. Skin tests with paracoccidioidin and histoplasmin were performed on 455 persons of both sexes, from 1 to 73 years of age, who live permanently in the area and voluntarily accepted to be included in the study. Both antigens were employed at the same time in order to evaluate crossed type reactions. Of the 455 persons, 52 (39 males-13 females) were reactive to paracoccidioidin (11.4%), with an increasing prevalence with age. According to previous data, these results would indicate an increase in the index of human infection by P. brasiliensis, and this may be related to the important changes in climatic and environmental conditions introduced in the area in the last years.

Diferenciación e identificación presuntiva rápida de levaduras con el medio chrom-agar candida / Fast differentation and presumptive identification of yeast with chrom-agar candida culture medium

Con el objetivo de evaluar métodos rápidos y de bajos costos para aislamiento e identificación de levaduras de interés clínico, se utilizó el medio cromogénico CHROM-agar Candida (CAC) para diferenciación e identificación presuntiva. Se estudió un total de 546 cepas de diferentes especies de levaduras. Las cepas fueron identificadas previamente por métodos convencionales. Se comprobó que los colores y texturas de las colonias de Candida albicans (C. albicans), C. tropicalis, C. krusei, y Trichosporon beigelli fueron constantes lo que permitió su diferenciación de otros hongos levaduriformes. Otras especies presentaron pigmentaciones persistentes, como por ejemplo C. glabrata (rosa oscuro), Saccharomyces cerevisiae (púrpura), C. parapsilopsis (rosa pálido), que acompañadas del estudio paralelo de la micromorfología característica posibilitaron su identificación presuntiva, ofreciendo así, también una orientación hacia la identificación de otras levaduras aisladas comunmente en el laboratorio. Comprobamos la aptitud de CAC para el cultivo primario de levaduras, ya que por su contenido en Cloranfenicol, admitió el aislamiento y la detección de distintas especies de éste tipo de hongos a partir de muestra clínica. Consideramos a éste medio de gran utilidad para la diferenciación e identificación presuntiva rápida de hongos levaduriformes, tanto a partir de cepas aisladas como de muestras clínicas, lo que resulta de gran interés especialmente para el caso de pacientes inmunocomprometidos en quienes la celeridad del diagnóstico resulta de vital importancia

Dermatofitosis en el área del Gran Resistencia (Provincia del Chaco-Argentina) / Dermatophytoses in the metropolitan area of Resistencia city (Chaco-Argentina)

Se estudiaron las características epidemiológicas de la dermatofitosis humana en el Gran Resistencia (Chaco-Argentina). Las muestras fueron analizadas en el laboratorio de Micología del Instituto de Medicina Regional de la Universidad Nacional del Nordeste y en dos laboratorios privados. El número total de muestras fue de 3.507, de las cuales 1.391 (39,66 por ciento) resultaron positivas en el exámen microscópico directo y 1.279 (36,47 por ciento) desarrollaron en los cultivos. Entre éstas últimas, se obtuvieron dermatofitos en el 40,66 por ciento de los casos y otros hongos en el 59,34 por ciento. Microsporum canis fue la especie con mayor prevalencia, presente en el 41,73 por ciento de los cultivos positivos, Trichophyton rubrum se recuperó en el 38,46 por ciento, Epidermophyton floccosum el 6,35 por ciento, Microsporum gypseum desarrolló en el 5,58 por ciento y Trichophyton mentagrophytes sólo en el 4,81 por ciento. Los géneros Microsporum y Trichophyton tuvieron un franco predominio sobre Epidermophyton. Las diferencias entre los hallazgos de Resistencia con los de otros lugares, permiten inferir la existencia de situaciones epidemiológicas particulares según las regiones consideradas, determinadas por factores bióticos y abióticos que inciden en la presentación de éstas patologías