RESUMO
This paper reports the emergence of Candida auris infections in an intensive care unit at a hospital in Moscow. Forty-nine cases were diagnosed in 2016-2017, and the risk factors and antifungal susceptibilities are described. The 30-day all-cause mortality for 19 bloodstream infections in patients who did not receive appropriate antifungal therapy was 42.1%. Phylogenetic analysis of the internal transcribed spacer and D1-D2 regions and K143R substitution in the ERG11 gene indicated that the studied C. auris strains were of South Asian origin. This first reported series of C. auris infections in Russia demonstrates the rapid dissemination of this species, and the need for international surveillance and control measures.
Assuntos
Candida/isolamento & purificação , Candidemia/epidemiologia , Infecção Hospitalar/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/uso terapêutico , Candidemia/tratamento farmacológico , Candidemia/microbiologia , Candidemia/mortalidade , Análise por Conglomerados , Infecção Hospitalar/microbiologia , Infecção Hospitalar/mortalidade , DNA Fúngico/química , DNA Fúngico/genética , DNA Ribossômico/química , DNA Ribossômico/genética , DNA Espaçador Ribossômico/química , DNA Espaçador Ribossômico/genética , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Moscou , Filogenia , RNA Ribossômico/genética , Fatores de Risco , Análise de Sequência de DNA , Análise de Sobrevida , Adulto JovemRESUMO
The composition and the structure of microbial communities in areas of Arctic settlements were studied. The main attention has been given to microscopic fungi. As result of observation of 5 Arctic regions 117 species of microscopic fungi are revealed in soils and anthropogenic substrates. The identification was carried out with the use ofmycological and molecular genetic methods. Most ofspecies belong to the Ascomycotina. Genus Penicillium is characterized by the most species diversity (24 species). Most offungi are destructors of various materials and potential human pathogens. Dominant species are revealed. The distribution of microorganisms in the living and working areas of polar stations, as well as the adjacent areas are described. Black-colored fungi adapted to unfavorable environment are often the dominated group of microorganisms on soils and anthropogenic substrates. The shaping of soil microbiota was shown to be related to the anthropogenic impact. Considerable similarity of microbial communities composition in the soil and man-made substrates is fixed. As result of mycological analysis of contaminated soils 76 species of microscopic fungi were observed, but 41 species of them (53.9%) were identified in the areas of Arctic polar stations on the man-made materials. These species include the representatives of the genera Alternaria, Aspergillus, Aureobasidium, Chaetomium, Cladosporium, Exophiala, Geomyces, Humicola, Penicillium, Mucor, Phoma, Rhodotorula, Trichoderma and Ulocladium. The obtained data show a significant similarity in species composition of contaminated soils and anthropogenic substrates. Human activity contributes to the distribution of cosmopolitan species, including opportunistic fungi, in the Arctic region. The high numbers of organotrophic bacteria were revealed in soil samples. Some species of microorganisms produce the organic acids in an external environment that promotes the erosion of materials.
Assuntos
Fungos Mitospóricos , Microbiologia do Solo , Solo/normas , Regiões Árticas/epidemiologia , Biota , Monitoramento Ambiental/métodos , Monitoramento Ambiental/estatística & dados numéricos , Humanos , Microbiota , Fungos Mitospóricos/classificação , Fungos Mitospóricos/isolamento & purificação , Fungos Mitospóricos/fisiologia , Filogeografia , Federação Russa/epidemiologiaAssuntos
Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/enzimologia , Infecções Urinárias/microbiologia , beta-Lactamases/metabolismo , Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Eletroforese em Gel de Campo Pulsado , Humanos , Cálculos Renais/complicações , Cálculos Renais/diagnóstico , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Tipagem Molecular , Federação Russa , Infecções Urinárias/diagnósticoRESUMO
The content of intermediate and small circulating immune complexes (iCIC and sCIC), the classical path of compliment activation (CCA), the concentration of C4 and C3 compliment components as well as the levels of IgM, IgG1, IgG2 and IgG3 in blood serum were examined in patients with atopic rhinitis and rhinoconjunctivitis concomitant with hypersensitivity to the Candida albicans allergen of the immediate and mixed (immediate and delayed) types. A significantly reduced concentration of sCIC, sCIC/iCIC(sCIC/iCIC), CCA and of the C4 content as well as a pronouncedly increased IgM concentration was typical of the patients with the mixed allergic reaction, which made them markedly different from the virtually healthy subjects and from patients with the immediate type of hypersensitivity. The most pronounced differences (p < 0.001) between the group of patients with the mixed type of allergic reaction and two other groups were those related with the sCIC/iCIC ratio index. Considering the study results, it can be assumed that the determination of the sCIC/iCIC could be used as an extra criterion in the laboratory diagnosis of the 3d (immunocomplex) types of allergic reaction as made in patients with atopic rhinitis and rhinoconjunctivitis with hypersensitivity to the C. albicans allergen.
Assuntos
Complexo Antígeno-Anticorpo/imunologia , Doenças do Complexo Imune/diagnóstico , Adolescente , Adulto , Alérgenos/imunologia , Complexo Antígeno-Anticorpo/sangue , Candida albicans/imunologia , Ativação do Complemento/imunologia , Feminino , Humanos , Doenças do Complexo Imune/imunologia , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Masculino , Pessoa de Meia-IdadeRESUMO
The authors report their experience gained in intensive care of patients with a grave complication of the underlying diseases: disseminated mycotic infection. Factors of risk of the complication are enumerated, diagnosis and treatment of mycotic involvement in patients of intensive care wards are described.
Assuntos
Cuidados Críticos , Micoses/terapia , Adulto , Antifúngicos/uso terapêutico , Aspergilose/diagnóstico , Aspergilose/terapia , Candidíase/diagnóstico , Candidíase/terapia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/diagnóstico , Micoses/mortalidade , Fatores de RiscoRESUMO
A new antifungal drug of systemic action diflucan (Pfizer, USA) has been tried in 10 patients (mean age 35.9 + (-)3.7 years) with various disseminated mycoses. The drug was used in a daily dose 200 mg intravenously or orally for 23.6 + (-)3.3 days. The response was achieved in all the patients with disseminated mycoses caused by yeast fulgi. Side effects were not registered.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Antifúngicos/uso terapêutico , Fluconazol/uso terapêutico , Meningite Criptocócica/tratamento farmacológico , Micoses/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Adulto , Evolução Fatal , Feminino , Humanos , Meningite Criptocócica/microbiologia , Micoses/microbiologiaRESUMO
Diflucan was used in 18 patients with chronic and recurrent candidiasis involving esophagus. The drug proved effective and safe. Recurrences were also responsive to diflucan.
Assuntos
Antifúngicos/uso terapêutico , Candidíase/tratamento farmacológico , Doenças do Esôfago/tratamento farmacológico , Fluconazol/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Among 180 patients with varying leukemias bronchopulmonary aspergillosis was diagnosed in 4 (2.2%). Further development of the methods for the treatment of the main disease in this category of patients permits prognosing a significant rise in the incidence of bronchopulmonary aspergillosis. The character of the clinical course of this infection and the ways for further improvements of its diagnosis in lifetime of leukemia patients have been considered.
Assuntos
Aspergilose Broncopulmonar Alérgica/complicações , Leucemia/complicações , Aspergilose Broncopulmonar Alérgica/epidemiologia , Feminino , Humanos , Incidência , Pessoa de Meia-IdadeAssuntos
Candidíase/etiologia , Doenças do Esôfago/etiologia , Leucemia Mieloide Aguda/complicações , Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Diagnóstico Diferencial , Doenças do Esôfago/diagnóstico , Doenças do Esôfago/tratamento farmacológico , Feminino , Humanos , Cetoconazol/uso terapêutico , Pessoa de Meia-IdadeRESUMO
A 30-year-old female with HIV-infection (AIDS-stage) died with generalized, including meningoencephalitis, infection. Fungi found in the brain were identified as Cryptococcus neoformans. Fungal cells were also found in the lungs and in the necrotic phlegmon of soft tissue i. e. there was a generalized Cryptococcus infection.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Criptococose/etiologia , Meningoencefalite/etiologia , Adulto , Cryptococcus neoformans/isolamento & purificação , Feminino , Humanos , Meningoencefalite/microbiologiaRESUMO
A total of 84 blood sera taken from patients with tumors of the hematopoietic system, among them 63 blood sera from patients with candidiasis and 21 blood sera from patients without symptoms of Candida infection have been tested in the enzyme immunoassay (EIA). This assay has been found suitable for the diagnosis of the visceral forms of candidiasis in patients with acute leukemia and hematosarcoma. EIA has proved to be an inadequate method for the detection of Candida infection in chronic lympholeukemia patients, as well as in patients with acute leukemia and hematosarcoma, suffering from such local forms of candidiasis as candidiasis of the oral cavity.