ABSTRACT
BACKGROUND: Prolonged hospitalization due to the COVID-19 pandemic gathered risk factors for developing invasive candidiasis. AIM: To describe Candida spp. isolated from patients with clinical suspicion of COVID treated in a public hospital specialized in COVID-19 during the pandemic, considering the susceptibility profiles and the risk factors related to the species detected in a positive yeast culture. METHODS: From different samples of 33 patients with comorbidities, 42 clinical isolates were identified by VITEKâ MS Plus. Antifungal susceptibility testing was performed using VITEKâ 2 Compact with the AST-YS08 card. RESULTS: The most frequently identified species were C. albicans and C. glabrata, which were also the most common co-infections, Saprochaete capitata, an uncommon yeast was isolated in one patient. 85% of the co-infections were COVID positive and 100% of patients with a co-infection required mechanical ventilation (MV) which has been described as one of the major predisposing factors to candidiasis. Candida species vary in their response to treatment. In this study, 44% of isolates identified as C. glabrata were fluconazole-resistant, which were also immediately susceptible to caspofungin; this profile limits therapeutic options and emphasizes the importance of evaluating the susceptibility profile. CONCLUSIONS: This work highlights the increase in isolation of different Candida species during COVID-19 and the importance of establishing criteria to declare Candida colonization or infection and the correct etiological identification to establish an agent-based antifungal treatment, to reduce the spreading risk of Candida spp. in the hospital environment, mortality, time, and cost of hospitalization.
ABSTRACT
Introduction: Brucellosis is one of the most frequent zoonosis in most parts of the world. This zoonosis remains a great problem to public health in developing countries, although developed countries have successfully controlled it. Mexico still shows a high annual brucellosis incidence in humans; thus, the country is considered around the world as an endemic brucellosis country. Aim: To describe the connection/association between this zoonosis and the current epidemiological situation in the Mexican population. Methods: Perusal of research reports, epidemiological studies and veterinarian reviews performed in Mexico, using data bases such as PubMed, Thompson Reuters, Mesh research. Conclusion: The risk of infection by Brucella in Mexico is associated with the consumption of unpasteurized dairy products, mainly fresh cheeses.
Introducción: La brucelosis es una de las enfermedades zoonóticas más frecuentes en la mayor parte del mundo. Mientras que en los países desarrollados han logrado con éxito su control, en los países en vías de desarrollo continúa siendo un gran problema de salud pública. México continúa presentando alta incidencia anual de brucelosis en humanos, por lo que es considerado un país endémico de brucelosis. Objetivo: Describir la relación de esta zoonosis con la situación epidemiológica actual en la población de México. Material y Métodos: Consulta de reportes de investigación, estudios epidemiológicos y revisiones veterinarias, realizadas en México, a través de bases de datos como PubMed, Thompson Reuters y Meshresearch. Conclusión: El riesgo del contagio de Brucella spp. en México está asociado al consumo de productos lácteos sin pasteurizar, principalmente quesos frescos.
Subject(s)
Humans , Animals , Brucellosis/epidemiology , Zoonoses , Goat Diseases/epidemiology , Brucellosis/transmission , Brucellosis/veterinary , Goats , Incidence , Mexico/epidemiologyABSTRACT
Introduction: Human brucellosis diagnosis is based on isolation of Brucella spp. from blood or tissue cultures with a positivity rate of 40-70% and serology techniques are used as complementary tools; recently molecular biology diagnostic techniques have been developed intending to optimize the etiological confirmation. Aim: The main objective of this work was to compare the polymerase chain reaction (PCR), against serological diagnostic tests during the clinical follow-up of a family presenting brucellosis. Methods: Seven family members who lived in the urban area of Mexico City, were monitored using the Rose Bengal test, the agglutination test as well as agglutination with 2 mecapto ethanol, blood cultures and serum PCR for a period of 27 months. The suspected source of infection was fresh goat cheese from a known endemic zone. Results: Brucella melitensis was isolated from the blood cultures of two patients. All of the patients were positive in serological and PCR tests at the beginning of this follow-up. At the end of the study, three patients responded well to the treatment and showed negative results in the serological and PCR tests. While two patients with diabetes mellitus type 2, showed positive results in the serological and PCR tests as well as persistent symptoms. Conclusion: Clinical follow-up of patients with brucellosis is of great importance, to properly evaluate the given treatment. In this sense the PCR is a great supporting tool in diagnostic testing.
Introducción: El diagnóstico de brucelosis humana es difícil pues los cultivos de sangre y tejidos tienen un rendimiento limitado (40-70%) y usualmente se recurre a la serología como recurso complementario; últimamente se han desarrollado técnicas de biología molecular que intentan optimizar la confirmación etiológica. Objetivo: Comparar la reacción de la polimerasa en cadena (RPC) con las pruebas de diagnóstico serológicas en el seguimiento clínico de una familia con brucelosis. Métodos: Siete integrantes de una familia con brucelosis que habitaban la zona urbana de Ciudad de México fueron monitoreados mediante aglutinación con antígeno Rosa de Bengala, prueba de aglutinación, aglutinación en presencia de 2 mercapto-etanol, hemocultivos y RPC en suero durante 27 meses. La probable fuente de infección de los pacientes fue el consumo de queso fresco de cabra originario de una zona endémica. Resultados: Brucella melitensis se obtuvo del hemocultivo de dos pacientes. Todos los pacientes fueron positivos a las pruebas serológicas y al RPC al inicio del seguimiento. Tres pacientes respondieron bien al tratamiento y mostraron resultados negativos en serología y RPC al final del estudio. Mientras que en dos pacientes con diabetes mellitus tipo 2 la sintomatología fue persistente, serología positiva y RPC positivos al finalizar el estudio. Conclusión: El seguimiento clínico de pacientes con brucelosis es muy importante para valorar el tratamiento, en este sentido la RPC es una herramienta que puede apoyar a otras pruebas de diagnóstico.