[Non-pathogenic intestinal amoebae: a clinical-analytical overview]. / Amebas intestinales no patógenas: una visión clinicoanalítica.

Human beings can be parasitized by various species of intestinal amoebae. Entamoeba histolytica is the only intestinal amoeba recognized to be pathogenic, while other amoeba species, E. dispar, E. moshkovskii, E. hartmanni, E. coli, E. polecki, Endolimax nana and Iodamoeba buetschlii are considered to be non-pathogenic. The aim of this review is to synthesize the main morphological characteristics of the trophozoite and cyst stages of each amoeba as the basis for precise microscopical diagnosis. The difficulty of morphological differentiation among species included in the so-called "Entamoeba complex" entails the use of immunological and molecular diagnoses. In addition, a summary of basic epidemiological, therapeutic and prophylactic aspects of these non-pathogenic amoebae is provided. All of these aspects are crucial since these amoebae are usually found to be present in human coproparasitological analyses and must be differentiated from the pathogenic species E. histolytica. Furthermore, they can be used as suitable biological tags of the hygienic state of the environment and the health and hygiene measures of the population.

[Changes in the epidemiology of fungaemia and fluconazole susceptibility of blood isolates during the last 10 years in Spain: results from the FUNGEMYCA study]. / Variación de la epidemiología de las fungemias y de la sensibilidad al fluconazol de los aislamientos de hemocultivos en los últimos 10 años en España: resultados del estudio FUNGEMYCA.

BACKGROUND: Recent epidemiological surveillance studies have reported an increase in fungaemia caused by non-Candida albicans species, as well as a decrease in fluconazole susceptibility. OBJECTIVES: To evaluate changes in the epidemiology of fungaemia in Spain comparing data from a new surveillance epidemiological study conducted in 2009 with a previous study carried out from 1997 to 1999 (Pemán J, et al. Eur J Clin Microbiol Infect Dis. 2005). METHODS: From January 2009 to February 2010, 44 Spanish hospitals participated in a prospective multicentre fungaemia surveillance study to ascertain whether there have been changes in the epidemiology and fluconazole susceptibility. Susceptibility was determined by the colorimetric method Sensititre Yeast One. Demographic and clinical data and the first isolate of each episode were gathered. RESULTS: A total of 1,377 isolates from 1,357 fungaemia episodes were collected, 46.7% from patients older than 64years and 8.6% from children less than 1 year old. C. albicans (44.7%), Candida parapsilosis (29.1%), Candida glabrata (11.5%), Candida tropicalis (8.2%), and Candida krusei (1.9%) were the most frequent species isolated. Distribution varied with the geographical area. C. albicans incidence has increased significantly in the last 10years in Cataluña (39.1 vs. 54.7%, P=0.03) and decreased in the Valencian Community (49.1 vs. 34.6%, P=0.002) and Extremadura (58.3 vs. 20%, P=0.01). Susceptibility to fluconazole was similar for all geographical areas, although resistance in C. albicans was ten times greater for patients aged more than 64years. The overall rate of fluconazole resistance (MIC > 32 mg/L) has decreased with respect to that obtained 10years ago (3.7 vs. 2.5%) mainly in C. albicans (3 vs. 1.6%). CONCLUSIONS: In the last ten years, species distribution and fluconazole susceptibility have not significantly changed, although a lower rate of fluconazole resistance has been observed. Species distribution varies with hospital, hospitalization Unit and geographical area.

Amebas intestinales no patógenas: una visión clinicoanalítica / Non-pathogenic intestinal amoebae: a clinical-analytical overview

El ser humano puede ser parasitado por diferentes especies de amebas intestinales. Entamoeba histolytica es la única de reconocido poder patógeno, mientras que las restantes, E. dispar, E. moshkovskii, E. hartmanni, E. coli, E. polecki, Endolimax nana y Iodamoeba buetschlii, se consideran no patógenas. El objetivo de esta revisión es sintetizar las características morfológicas fundamentales de los estadios de trofozoíto y de quiste de cada una de ellas como base primordial para llevar a cabo un diagnóstico microscópico preciso. La dificultad que conlleva la diferenciación morfológica entre las especies englobadas en el denominado “complejo Entamoeba” obliga al uso de métodos diagnósticos inmunológicos y moleculares. También se lleva a cabo una síntesis de los aspectos epidemiológicos e incluso terapéuticos y profilácticos básicos de este grupo de amebas no patógenas. Todo ello resulta relevante porque estas amebas se encuentran presentes habitualmente en las analíticas coproparasitológicas humanas y deben ser diferenciadas de la especie patógena, E. histolytica. Además, se pueden utilizar como adecuados marcadores biológicos del grado de saneamiento ambiental y de las medidas higienicosanitarias de la población (AU)

Human beings can be parasitized by various species of intestinal amoebae. Entamoeba histolytica is the onlyintestinal amoeba recognized to be pathogenic, while other amoeba species, E. dispar, E. moshkovskii, E.hartmanni, E. coli, E. polecki, Endolimax nana and Iodamoeba buetschlii are considered to be non-pathogenic.The aim of this review is to synthesize the main morphological characteristics of the trophozoite and cyststages of each amoeba as the basis for precise microscopical diagnosis. The difficulty of morphological differentiation among species included in the so-called “Entamoeba complex” entails the use of immunological and molecular diagnoses. In addition, a summary of basic epidemiological, therapeutic and prophylactic aspects of these non-pathogenic amoebae is provided. All of these aspects are crucial since these amoebae are usually found to be present in human coproparasitological analyses and must be differentiated from the pathogenic species E. histolytica. Furthermore, they can be used as suitable biological tags of the hygienic state of the environment and the health and hygiene measures of the population (AU)