RESUMO
Candidiasis is the most common opportunistic fungal infection in HIV patients. The aims of this study were to identify the prevalence of carriers of Candida, Candida species diversity, and in vitro susceptibility to antifungal drugs. In 297 HIV/AIDS patients in Baja California, Mexico, Candida strains were identified by molecular methods (PCR-RFLP) from isolates of oral rinses of patients in Tijuana, Mexicali, and Ensenada. 56.3% of patients were colonized or infected with Candida. In Tijuana, there was a significantly higher percentage of carriers (75.5%). Out of the 181 strains that were isolated, 71.8% were Candida albicans and 28.2% were non-albicans species. The most common non-albicans species was Candida tropicalis (12.2%), followed by Candida glabrata (8.3%), Candida parapsilosis (2.2%), Candida krusei (1.7%), and Candida guilliermondii (1.1%). Candida dubliniensis was not isolated. Two associated species were found in 11 patients. In Mexicali and Ensenada, there was a lower proportion of Candida carriers compared to other regions in Mexico and worldwide, however, in Tijuana, a border town with many peculiarities, a higher carrier rate was found. In this population, only a high viral load was associated with oral Candida carriers. Other factors such as gender, use of antiretroviral therapy, CD4+ T-lymphocyte levels, time since diagnosis, and alcohol/ tobacco consumption, were not associated with Candida carriers.
Assuntos
Antifúngicos/farmacologia , Candida/classificação , Candida/efeitos dos fármacos , Candidíase Bucal/epidemiologia , Portador Sadio/epidemiologia , Infecções por HIV/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Candida/genética , Candida/isolamento & purificação , Candidíase Bucal/microbiologia , Portador Sadio/microbiologia , DNA Fúngico/genética , Feminino , Humanos , Masculino , México/epidemiologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Prevalência , Adulto JovemRESUMO
BACKGROUND: In 3 to 8% of pregnancies there are preeclampsia, and it is considered an irreversible disease that affects several organs, and causes injuries in fetus and mother alike. OBJECTIVE: To identify maternal risk factors related to low birth weight in preterm newborns born at Hospital de Ginecología-Pediatría con Medicina Familiar no. 31 from IMSS, at Mexicali, BC, Mexico. PATIENTS AND METHOD: Case-control study (1:2 ratio) made in 114 prematures (38 cases and 76 controls) who were evaluated for socioeconomic and biological maternal risk factors influencing low birth weight in preterm newborns. Odds ratio and confidence intervals of 95% were used to calculate epidemiologic correlation, and logistic regression to specific importance of risks. RESULTS: Preeclampsia persists as a risk factor for low birth weight: OR 3.16 (95% CI 3.15-8.40, p = 0.00). In logistic regression meaningful variables were: preeclampsia 5.27 (95% CI 1.45-19.14, p = 0.01), and in premature newborn: thrombocytopenia 6.0 (95% CI 1.2-11.2, p = 0.00), and neonatal sepsis 4.31 (95% CI 1.73-10.70, p = 0.00). CONCLUSIONS: Preeclampsia was the major risk factor related to low birth weight and was associated with thrombocytopenia in preterm newborn. Neonatal sepsis is secondary to low birth weight. We need to observe and obey prenatal care of pregnant women in our hospital to reduce negative impact of low birth weight in preterm newborns.