[Urinary tract infection by Candida species]. / Infección de vías urinarias por especies de Candida.

OBJECTIVES: To determine the frequency and characteristics of urinary tract infection (UTI) by Candida in diabetic patients (with and without symptoms) and to compare them with non-diabetic patients (with and without symptoms). DESIGN: Longitudinal, descriptive, and observational study. SETTING: Study conducted at the "Dr Ignacio Chavez" Clinic of family medicine, ISSSTE: Mexico. PARTICIPANTS: There were 2 kinds of patients; 1 with diabetes mellitus diagnosis (DM) with and without clinical picture of probable urinary tract infection (UTI), and 1 without DM and with and without clinical picture of probable UTI. MAIN MEASUREMENTS: A urine culture and a confidential questionnaire were administered to find the presence of urinary symptoms and likely risk factors associated with the infection. To associate these risks, the chi2 statistical method was used, with significance at 95% and Fisher's Exact Test for small frequencies, using the EpiInfo V.6.0 program. RESULTS: Two hundred thirty seven patients between 28 and 82 years old were included. The prevalence of urinary infection by Candida was 5.1%, but only 33% of these had C albicans. There was no association between candidiasis and factors like age, sex, or presence of DM, but it was related to previous treatments, previous UTI and the evolution time of DM. CONCLUSIONS: The conscious search by both doctor and laboratory for Candida micro-organisms as factors causing UTI is important. This is especially so in those patients with factors of risk that may condition Candida's presence.

Infección de vías urinarias por especies de Candida / Urinary tract infection by Candida species

Objetivo. Determinar la frecuencia y las características de la candidiasis urinaria en pacientes diabéticos (con y sin sintomatología urinaria) y compararla con un grupo de pacientes sin dicha afección (con y sin sintomatología). Diseño. Estudio longitudinal, descriptivo y observacional. Emplazamiento. Trabajo realizado en la Clínica de Medicina Familiar Dr. Ignacio Chávez ISSSTE. Participantes. Se incluyó a 2 tipos de pacientes: a) pacientes con diagnóstico de diabetes mellitus (DM) con y sin cuadros clínicos de probable infección de vías urinarias (IVU), y b) un segundo tipo sin DM y con o sin cuadro clínico de probable IVU. Mediciones principales. Se realizaron un urocultivo y un cuestionario confidencial para reconocer la sintomatología urinaria y los probables factores de riesgo del paciente asociados con el proceso infeccioso. Para asociar estos últimos se utilizó el método estadístico de la *2, con significanción del 95%, y la prueba exacta de Fisher para frecuencias pequeñas; se utilizó el programa EpiInfo versión 6.0. Resultados. Se incluyó a 237 pacientes de 28-82 años; la prevalencia de candidiasis urinaria fue del 5,1%, pero sólo el 33% fue C. albicans. No se encontró ninguna asociación entre la candidiasis y factores como la edad, el sexo o la presencia de DM, pero sí con tratamientos previos, IVU previas y el tiempo de evolución de la DM. Conclusiones. Se considera importante la búsqueda intencionada, tanto por el médico como por el laboratorio, de estos microorganismos como causales de IVU, principalmente en los pacientes con factores de riesgo que parecen condicionar su presencia

Objectives. To determine the frequency and characteristics of urinary tract infection (UTI) by Candida in diabetic patients (with and without symptoms) and to compare them with non-diabetic patients (with and without symptoms). Design. Longitudinal, descriptive, and observational study. Setting. Study conducted at the "Dr Ignacio Chavez" Clinic of family medicine, ISSSTE. Mexico. Participants. There were 2 kinds of patients; 1 with diabetes mellitus diagnosis (DM) with and without clinical picture of probable urinary tract infection (UTI), and 1 without DM and with and without clinical picture of probable UTI. Main measurements. A urine culture and a confidential questionnaire were administered to find the presence of urinary symptoms and likely risk factors associated with the infection. To associate these risks, the *2 statistical method was used, with significance at 95% and Fisher's Exact Test for small frequencies, using the EpiInfo V.6.0 program. Results. Two hundred thirty seven patients between 28 and 82 years old were included. The prevalence of urinary infection by Candida was 5.1%, but only 33% of these had C albicans. There was no association between candidiasis and factors like age, sex, or presence of DM, but it was related to previous treatments, previous UTI and the evolution time of DM. Conclusions. The conscious search by both doctor and laboratory for Candida micro-organisms as factors causing UTI is important. This is especially so in those patients with factors of risk that may condition Candida's presence

[Antimicrobial sensitivity and characterization of Streptococcus pyogenes strains isoleated from a scarlatina outbreak]. / Sensibilidad antimicrobiana y caracterización de cepas de Streptococcus pyogenes aisladas de un brote de escarlatina.

OBJECTIVE: To evaluate the in vitro activities of 13 antimicrobial agents against 47 group A Streptococcus pyogenes (GAS) strains, and to determine the presence of genes encoding streptococcal pyrogenic exotoxin A (SpeA) and the M-protein serotypes. MATERIALS AND METHODS: A cross-sectional study was conducted at Centro de Salud Dr. José Castro Villagrana, during a scarlet fever outbreak occurring between December 1999 and January 2000, among 137 children at Colegio Espíritu de América. Minimum Inhibitory Concentrations (MICs) were obtained by the semiautomated microdilution method. Automated DNA sequencing was used for analysis of sequence variation in genes encoding the M protein, and SpeA. RESULTS: All strains were sensitive to betalactams and clindamycin. Six (12.7%) were resistant to erythromycin. The M2 type was the most frequently isolated GAS (27); almost all (96%) bacteria with the SpeA gene had the gene encoding the M2 protein. CONCLUSIONS: The recent resurgence of GAS infections calls for molecular epidemiology research and studies on the sensitivity to macrolides and beta-lactams.

Sensibilidad antimicrobiana y caracterización de cepas de Streptococcus pyogenes aisladas de un brote de escarlatina / Antimicrobial sensitivity and characterization of Streptococcus pyogenes strains isoleated from a scarlatina outbreak

OBJECTIVE: To evaluate the in vitro activities of 13 antimicrobial agents against 47 group A Streptococcus pyogenes (GAS) strains, and to determine the presence of genes encoding streptococcal pyrogenic exotoxin A (SpeA) and the M-protein serotypes. MATERIALS AND METHODS: A cross-sectional study was conducted at Centro de Salud Dr. JosÚ Castro Villagrana, during a scarlet fever outbreak occurring between December 1999 and January 2000, among 137 children at Colegio EspÝritu de AmÚrica. Minimum Inhibitory Concentrations (MICs) were obtained by the semiautomated microdilution method. Automated DNA sequencing was used for analysis of sequence variation in genes encoding the M protein, and SpeA. RESULTS: All strains were sensitive to betalactams and clindamycin. Six (12.7) were resistant to erythromycin. The M2 type was the most frequently isolated GAS (27); almost all (96) bacteria with the SpeA gene had the gene encoding the M2 protein. CONCLUSIONS: The recent resurgence of GAS infections calls for molecular epidemiology research and studies on the sensitivity to macrolides and beta-lactams.

Prevalencia del streptococcus pyogenes y su relación con la fiebre reumática / Prevalence of Streptococcus pyogenes and its relation to rheumatic fever

La fiebre reumática es una enfermedad de la infancia y de la adolescencia, alcanza su mayor frecuencia entre los cuatro y los nueve años de edad; su incidencia es muy alta en la segunda década de la vida y declina rápidamente a partir de los 20 años. El objetivo del presente estudio fué determinar la presencia de Streptococcus pyogenes en niños de dos guarderías de diferente nivel socio-económico y establecer un programa de vigilancia en ambas. Para ello, se procesaron 42 cultivos de exudado faríngeo de la guardería del Centro de Estudios de Atención Primaria de la Salud y 39 de la guardería CENDI, Coyoacán. Obteniéndose un 14% de positividad en la primera por un 11% de la segunda. Estos resultados son discutivos en el presente trabajo. Finalmente al implantar este to de programas se le debe dar un énfasis especial a los portadores ya que son la fuente de infección a otras personas.