Multicenter study of epidemiological cutoff values and detection of resistance in Candida spp. to anidulafungin, caspofungin, and micafungin using the Sensititre YeastOne colorimetric method.

Neither breakpoints (BPs) nor epidemiological cutoff values (ECVs) have been established for Candida spp. with anidulafungin, caspofungin, and micafungin when using the Sensititre YeastOne (SYO) broth dilution colorimetric method. In addition, reference caspofungin MICs have so far proven to be unreliable. Candida species wild-type (WT) MIC distributions (for microorganisms in a species/drug combination with no detectable phenotypic resistance) were established for 6,007 Candida albicans, 186 C. dubliniensis, 3,188 C. glabrata complex, 119 C. guilliermondii, 493 C. krusei, 205 C. lusitaniae, 3,136 C. parapsilosis complex, and 1,016 C. tropicalis isolates. SYO MIC data gathered from 38 laboratories in Australia, Canada, Europe, Mexico, New Zealand, South Africa, and the United States were pooled to statistically define SYO ECVs. ECVs for anidulafungin, caspofungin, and micafungin encompassing ≥97.5% of the statistically modeled population were, respectively, 0.12, 0.25, and 0.06 µg/ml for C. albicans, 0.12, 0.25, and 0.03 µg/ml for C. glabrata complex, 4, 2, and 4 µg/ml for C. parapsilosis complex, 0.5, 0.25, and 0.06 µg/ml for C. tropicalis, 0.25, 1, and 0.25 µg/ml for C. krusei, 0.25, 1, and 0.12 µg/ml for C. lusitaniae, 4, 2, and 2 µg/ml for C. guilliermondii, and 0.25, 0.25, and 0.12 µg/ml for C. dubliniensis. Species-specific SYO ECVs for anidulafungin, caspofungin, and micafungin correctly classified 72 (88.9%), 74 (91.4%), 76 (93.8%), respectively, of 81 Candida isolates with identified fks mutations. SYO ECVs may aid in detecting non-WT isolates with reduced susceptibility to anidulafungin, micafungin, and especially caspofungin, since testing the susceptibilities of Candida spp. to caspofungin by reference methodologies is not recommended.

Estudio epidemiológico de parásitos en niños de Sevilla / Epidemiological study of parasites in children in Seville

Introducción. Las parasitosis intestinales son infestaciones de microorganismos, cuyo hábitat habitual es el tracto digestivo del hospedador. La distribución es mundial, con mayor prevalencia en zonas insalubres. En España, constituyen un 10% del total de las causas de. diarreas, con tendencia al aumento. Aunque no representan un problema tan importante como en los países en desarrollo, algunas parasitosis previamente infrecuentes están empezando a aparecer en nuestro medio y es importante conocerlas, sospecharlas y mejorar la terapéutica. Por ello, realizamos este trabajo con el fin de analizar la frecuencia de distintos parásitos intestinales en nuestro entorno, revisar las indicaciones de solicitud de estudio de parásitos en heces y aumentar su rentabilidad. Materiales y métodos. Análisis descriptivo, transversal y retrospectivo de los datos registrados en la base de datos informatizada de estudios de parásitos fecales realizados durante el período 2010—2014. Todos los estudios han sido solicitados en Centros de Atención Primaria y realizados en el Servicio de Microbiología del Hospital Universitario Virgen del Rocío, de Sevilla. Resultados. Encontramos un resultado patológico en un 9,3 % de las muestras. El parásito más frecuente fue Giardia lamblia seguido de Blastocystis spp. En menores de un año fueron patológicas el 3,7% de las muestras y solo se visualizaron dos tipos de parásitos (Cryptosporidinm spp. y Giardia lamblia). En el grupo de edad de 1 4 años fueron positivas un 9,9% del total de muestras remitida si bien se hallaron hasta 12 tipos de parásitos, el más frecuéntemente encontrado ha sido Blastocystis spp. seguido de Giardia lamblia. Conclusiones. El parásito intestinal más frecuente en nuestro entorno es Giardia lamblia, aunque se obsservan variaciones según el grupo de edad estudiado. La recogida de muestras según los protocolos establecidos y la sospecha clinica fundada son imprescindibles para optimizar el diagnóstico de las parasitosis intestinales (AU)

Introduction. intestinal parasitosis are infestations of microorganisms, whose habitat is usually the digestive tract of the host. They have a worldwide distribution, with higher prevalence in unhealthy areas. In Spain, they constitute 10% of the total causes of diarrhea, with a tendency to increase. Although they do not represent a problem as important as in the developing countries, some previously frequent parasitosis are beginning to appear in our environment and it is important to know them, to suspect them and to improve the therapeutics. Therefore, we performed this work in order to analyze the frequency of different intestinal parasites in our environment, to review the indications for the study of feces parasites and to increase their profitability. Materials and methods. Descriptive, crosss-sectional and retrospective analysis of the data recorded in the computerized database for fecal parasite studies conducted during the period 2010-2014. All the studies have been requested in Primary Health Centers and performed at the Microbiology Service of the University Hospital Virgen del Rocío, Sevilla. Results. We found a pathological result in 9.3% of the samples. The most frequent parasite was Giardia lamblia followed by Blastocystis spp. In patients less than one year old, 3.7% of the samples were pathological and only two types of parasites (Cryptosporidium spp. and Giardia lamblia) were visualized. In patients between 10-14 years old, 9.9% of the total samples were pathological and, although up to 12 types of parasites were found, the most frequently found was Blastocystis spp. followed by Giardia lamblia. Conclusions. The most frequent intestinal parasite in our environment is Giardia iamblia, although variations are observed according to the studied age group. The collection of samples according to the established protocols and the established clinical suspicion are essential to optimize the diagnosis of intestinal parasitosis (AU)

Sepsis y meningitis neumocócica 2001-2003: incidencia, clínica e identificación de serotipos / Pneumococcal sepsis and meningitis, 2001-2003: incidence, clinical features and identification of serotypes

Objetivo: Determinar las tasas de incidencia, características clínicas y serotipos causantes de meningitis y sepsis neumocócica en los últimos años. Material y métodos: Estudio prospectivo de los casos de sepsis y meningitis neumocócica que ingresaron en nuestro hospital entre enero de 2001 y febrero de 2003. Se aisló el germen en cultivo de líquido cefalorraquídeo y/o sangre. Se identificó el serotipo de neumococo en los casos que se produjeron en 2002 y 2003. Se analizan los parámetros epidemiológicos, bacteriológicos y clínicos. Resultados: Se han diagnosticado 14 casos, en 12 niños; dos niños presentaron 2 episodios de meningitis y/o sepsis. La incidencia anual fue de 15,38 casos por cada 100.000 niños menores de 2 años y de 9,16 casos por cada 100.000 niños menores de 5 años de edad. El 67% eran menores de 2 años de edad. Todos los mayores de 2 años presentaban algún factor de riesgo de padecer enfermedad neumocócica invasora. Los serotipos identificados fueron: 6B en cinco casos, 14 en dos y 18C en uno. El 69% de las cepas aisladas presentaba sensibilidad intermedia o resistencia a penicilina y el 54% mostraba resistencia a eritromicina. El 57% de los niños sufrieron complicaciones graves: dos (14%) quedaron con secuelas neurológicas graves y 3 fallecieron (21 %).Conclusiones: Las sepsis y meningitis neumocócicas tienen una alta morbimortalidad. En el último año, hemos observado un aumento importante de su incidencia. Todos los serotipos identificados están incluidos en la vacuna conjugada heptavalente. Actualmente, el método más eficaz para prevenir esta grave enfermedad es el uso generalizado de la vacuna heptavalente

Objective. To determine the incidence, clinical features and serotypes implicated in pneumococcal sepsis and meningitis in recent years. Material and methods. We performed a prospective study of cases of pneumococcal sepsis and meningitis that occurred in our hospital between January, 2001 and February, 2003. Streptococcus pneumoniae was isolated from cerebrospinal fluid and/or blood cultures in all the patients. Serotyping was performed in the cases occurring in 2002 and 2003. The epidemiological, bacteriological and clinical characteristics were studied. Results. Fourteen cases were identified in 12 patients. Two children had recurrent meningitis and/or sepsis. From 0 to 2 years of age, the incidence of pneumococcal meningitis was 15.38 cases per 100,000 population per year, and from 0 to 5 years of age, it was 9.16 cases per 100,000 population per year. Eight patients (67%) were aged less than 2 years. All children older than 2 years had a predisposing disease. The most common serotype was 6B (5 cases). Penicillin-resistant strains were detected in 69% of cases and erythromycin-resistant strains in 54%. Fifty-seven percent of the children developed serious complications. Conclusions. Pneumococcal meningitis and sepsis are common causes of morbidity and mortality. Their incidence increased considerably over the past year. All the serotypes isolated were included in the heptavalent conjugate vaccine. The most effective way to combat these severe infections would be through widespread vaccination with the conjugate pneumococcal vaccine