RESUMEN
The results obtained with 307 specimens from putatively immunocompetent patients between May 1991 and May 1992 were reviewed, to determine the frequency of isolation of fungal species causing onychomycoses. Sixty eight percent of the specimen were positive for microscopic examination and/or cultures. Onychomycoses occurred with double frequency in women than in men (Table 1), and 77
of cases were diagnosed in patients aged between 30 and 70 years (Figure 1). Out of 182 patients with positive cultures, 60
were affected by dermatophytes and 39
by yeasts; molds (Aspergillus spp.) were isolated in only two cases (Table 3). Neither Corynebacterium spp., nor Malasezzia furfur were detected. In toe nails Trichophyton rubrum predominated over yeasts being isolated in 72.9
of the cases; yeasts other than Candida albicans were isolated in 12.3
, Trichophyton mentagrophytes in 10
, while Aspergillus spp., C. albicans and Epidermophyton floccosum in only 1.6
. On the other hand, in finger nails yeasts predominated: C. albicans was isolated in 46.7
of cases, other yeasts in 43.3
; and T. rubrum in the remaining 10
. Out of 41 isolations of yeasts other than C. albicans, 42
Trichosporum cutaneum and 6
RESUMEN
The results obtained with 307 specimens from putatively immunocompetent patients between May 1991 and May 1992 were reviewed, to determine the frequency of isolation of fungal species causing onychomycoses. Sixty eight percent of the specimen were positive for microscopic examination and/or cultures. Onychomycoses occurred with double frequency in women than in men (Table 1), and 77
of cases were diagnosed in patients aged between 30 and 70 years (Figure 1). Out of 182 patients with positive cultures, 60
were affected by dermatophytes and 39
by yeasts; molds (Aspergillus spp.) were isolated in only two cases (Table 3). Neither Corynebacterium spp., nor Malasezzia furfur were detected. In toe nails Trichophyton rubrum predominated over yeasts being isolated in 72.9
of the cases; yeasts other than Candida albicans were isolated in 12.3
, Trichophyton mentagrophytes in 10
, while Aspergillus spp., C. albicans and Epidermophyton floccosum in only 1.6
. On the other hand, in finger nails yeasts predominated: C. albicans was isolated in 46.7
of cases, other yeasts in 43.3
; and T. rubrum in the remaining 10
. Out of 41 isolations of yeasts other than C. albicans, 42
were C. parapsilosis, 16
Debaryomyces hansenii, 6
C. pulcherrima, 6
Trichosporum cutaneum and 6
C. famata (Figure 2).
RESUMEN
In a retrospective review of laboratory records at the Department of Mycology, National Institute of Microbiology [quot ]Dr. Carlos G. Malbrán[quot ], during the period June 1989-July 1991, 1225 putatively immunocompetent cases of superficial mycoses were identified. Ninety five percent of these patients were adults and 5
children. Among the total cases, dermatomycoses were caused, 67.6
by Malassezia furfur. and 0.5
by other fungi, as proven by the isolation of the etiological agents. (Figure 1, Table 2). Among the dermatophytes Trichophyton rubrum and Trichophyton mentagrophytes greatly predominated accounting for 66.6
of the isolates, respectively, whereas Microsporum canis (8.0
) and Microsporum gypseum (0.3
) were found with less frequency (Figure 2). Nails (47
) were the most common source of isolates in adults, followed by feet (28
) and hands (2
) (Table 1). Regarding the relative efficiency of the diagnostic methods, the analyses of laboratory results evidenced that, 98
of the cases with clinical findings compatible with mycoses and 76
of the cases with positive cultures (Table 1) were identified by microscopic observation.
RESUMEN
In a retrospective review of laboratory records at the Department of Mycology, National Institute of Microbiology [quot ]Dr. Carlos G. Malbrán[quot ], during the period June 1989-July 1991, 1225 putatively immunocompetent cases of superficial mycoses were identified. Ninety five percent of these patients were adults and 5
children. Among the total cases, dermatomycoses were caused, 67.6
by dermatophytes, 25.9
by yeasts, 5.9
by Malassezia furfur. and 0.5
by other fungi, as proven by the isolation of the etiological agents. (Figure 1, Table 2). Among the dermatophytes Trichophyton rubrum and Trichophyton mentagrophytes greatly predominated accounting for 66.6
and 20.0
of the isolates, respectively, whereas Microsporum canis (8.0
). Epidermophyton floccosum (5.1
) and Microsporum gypseum (0.3
) were found with less frequency (Figure 2). Nails (47
) were the most common source of isolates in adults, followed by feet (28
), smooth skin (15
), groin (5
) and hands (2
) (Table 1). Regarding the relative efficiency of the diagnostic methods, the analyses of laboratory results evidenced that, 98
of the cases with clinical findings compatible with mycoses and 76
of the cases with positive cultures (Table 1) were identified by microscopic observation.
RESUMEN
Candida vaginitis is one of the most frequent infection of the female genital tract with a high incidence. Approximately 75
of sexually active women suffer at least one episode of Candida vaginitis and 10
of them have recurrent episodes. Pregnancy, diabetes mellitus and antibiotic treatment are the most common predisposing factors, C. albicans is the etiologic agent most frequently found. The widespread reports of fluconazole resistance in Candida species and the selection of non Candida albicans prompted the study of species distribution of vulvovaginal candidiasis and their in vitro susceptibility against current antifungal agents. A total of 314 women with vaginal infection were studied. Yeasts were isolated from 104 patients with vulvovaginal candidiasis. The following species were identified: C. albicans 87.5
included C. krusei, C. famata, C. tropicalis and S. cerevisiae. The minimal inhibitory concentration (MIC) was determined for nystatin, isoconazole, fluconazole and ketoconazole, using a broth microdilution method based on NCCLS procedure. Although most of the isolates were C. albicans, the high percentage of C. glabrata recovered suggests the need to identify the yeasts isolated. Fluconazole resistant C. albicans were isolated in 13.46
of the cases. Thus, further studies are required to correlate the possible role of these strains in recurrent vulvovaginal candidiasis.
RESUMEN
Candida vaginitis is one of the most frequent infection of the female genital tract with a high incidence. Approximately 75
of sexually active women suffer at least one episode of Candida vaginitis and 10
of them have recurrent episodes. Pregnancy, diabetes mellitus and antibiotic treatment are the most common predisposing factors, C. albicans is the etiologic agent most frequently found. The widespread reports of fluconazole resistance in Candida species and the selection of non Candida albicans prompted the study of species distribution of vulvovaginal candidiasis and their in vitro susceptibility against current antifungal agents. A total of 314 women with vaginal infection were studied. Yeasts were isolated from 104 patients with vulvovaginal candidiasis. The following species were identified: C. albicans 87.5
, C. glabrata 8.6
and 3.9
included C. krusei, C. famata, C. tropicalis and S. cerevisiae. The minimal inhibitory concentration (MIC) was determined for nystatin, isoconazole, fluconazole and ketoconazole, using a broth microdilution method based on NCCLS procedure. Although most of the isolates were C. albicans, the high percentage of C. glabrata recovered suggests the need to identify the yeasts isolated. Fluconazole resistant C. albicans were isolated in 13.46
of the cases. Thus, further studies are required to correlate the possible role of these strains in recurrent vulvovaginal candidiasis.
RESUMEN
The incidence of candidemia has increased approximately 500
in high-complexity hospitals. A change in the spectrum of Candida infections due to species other than Candida albicans has also been detected. Between April 1999 and April 2000 a multicenter study was performed in order to determine the species distribution associated to candidemias in Argentina and the susceptibility profile of the isolates to the current antifungal drugs. Thirty six institutions have participated. All the 265 yeast strains isolated from blood cultures were identified by morphological, physiological, and biochemical tests. The antifungal susceptibility testing of isolates was performed based on the reference NCCLS procedure. The distribution of species was: Candida albicans (40.75
), Candida parapsilosis (28.67
), Candida tropicalis (15.84
), Candida famata (3.77
), Cryptococcus neoformans (3.77
), Candida glabrata (2.64
), and others (4.53
). Most of the isolates were susceptible to amphotericin B, fluconazole and itraconazole. Mortality associated to the fungemia by yeasts episodes (n=265) was 30
, lower than results previously determined (33-54
). The mortality percentage in patients who received antifungal therapy versus patients without treatment was 26.3
and 47
, respectively.
RESUMEN
A microdilution antifungal susceptibility test for yeasts was evaluated, based on the macro broth dilution method standardized by the National Committee for Clinical Laboratory Standards (NCCLS) Subcommittee on Antifungal Susceptibility Testing. Both methods were compared using six reference strains with different patterns of susceptibility to the following antifungal drugs: amphotericin B (AMB), flucytosine (5FC), fluconazole (FCZ), itraconazole (ITZ), ketoconazole (KTZ) and miconazole (MCZ). Minimal inhibitory concentration (MIC) results obtained by both methods differed only in 1 or 2 dilutions. Microdilution MICs determined as visual endpoints and as quantitative measurement of 80
inhibition of relative growth showed a significant correlation (p < 0.001) for AMB, 5FC, FCZ, MCZ and ITZ, conversely no correlation (p = 1.00) for KTZ was observed as determined with 47 local isolates of Candida albicans.
RESUMEN
Se probó un método de inoculación en conejos, por vía intradérmica para la producción de antisueros fúngicos contra Aspergillus fumigatus (AF), Histoplasma capsulatum (HC), Paracoccidioides brasiliensis (PB) y Coccidioides immitis (CI), con el fin de ser utilizados como sueros control positivos para pruebas de inmunodifusión en gel de agar (ID). En este trabajo se utilizó como inmunógeno el antígeno en la dilución de uso (DU) para las pruebas de rutina de ID, lo que facilitó su estandarización. Los antígenos de AF, HC, CI se prepararon por los métodos descriptos por el Center for Disease Control (CDC), y el de PB según la técnica descripta por Camargo y col. Todos los conejos produjeron anticuerpos contra los diferentes antígenos específicos (bandas por ID) en el momento en que se alcanzaron los picos de respuesta primaria y luego de cada refuerzo. La respuesta secundaria fue igual o menor que la primaria, aunque se mantuvo la calidad y cantidad de bandas de precipitación específicas detectadas por ID. La inmunización primaria con concentraciones de antígeno mayores o menores a la DU, sólo analizadas en el caso de A. fumigatus, produjo bandas de precipitación menos definidas o en menor número respectivamente, aunque los títulos de anticuerpos fueron similares (AU)
Asunto(s)
Animales , Conejos , Sueros Inmunes/biosíntesis , Inmunodifusión , Micosis/diagnóstico , Aspergillus fumigatus/inmunología , Histoplasma/inmunología , Coccidioides/inmunología , Antígenos Fúngicos , ArgentinaRESUMEN
Se realizó un estudio retrospectivo de las candidiasis en pacientes pediátricos hospitalizados y en adultos HIV positivos provenientes de 5 instituciones de la ciudad de Bunnos Aires, ciudad de La Plata y partidos del conurbano bonaerense, durante el período 1993-1995. Se determinó la frecuencia de aparición de las especies de levaduras y su perfil de sensibilidad a los antifúngicos de uso sistémico con el objeto de obtener datos actualizados de esta patología. Candida albicans fue el agente etiológico en el 87 o/o de los 214 pacientes adultos HIV positivos con candidiasis orofaríngeas estudiados y en el 50 o/o de los 209 pacientes pediátricos hospitalizados. En este último grupo el 28 o/o de estas infecciones se debió a Candida parapsilosis y el 18 o/o a Candida tropicalis, mientras que sólo el 2 y el 4 o/o de las candidiasis orales fueron causadas por estos microorganismos. La recuperación de Candida krusei y Candida glabrata, especies intrínsecamente resistentes a los azoles, se vio incrementada en la población expuesta al tratamiento con fluconazol. En ambos grupos se observó un bajo número de levaduras resistentes a la anfotericina B, en cambio para las drogas azólicas se detectó un mayor porcentaje de aislamientos resistentes, en especial al fluconazol: 13 o/o en los pacientes pediátricos y 34 o/o en los pacientes HIV positivos (AU)