ABSTRACT
Introdução: O gênero Candida spp é responsável por cerca de 80% das infecções fúngicas no ambiente hospitalar e constitui causa relevante de infecções sistêmicas em pacientes hospitalizados, especialmente em doentes graves e em imunocomprometidos, com predominância da Candida albicans. A adesão das leveduras às células epiteliais do hospedeiro é um potente estimulador para a formação de hifas, forma invasiva do fungo [1]. Os bioterápicos são medicamentos preparados a partir de produtos biológicos, elaborados conforme a Farmacopeia Homeopática Brasileira (FHB)[2], indicados para tratamento de infecções de etiologia conhecida, empregados com grande sucesso no tratamento clínico destas infecções. Os bioterápicos RC, desenvolvidos pelo médico brasileiro Roberto Costa (RC) são preparados a partir do agente etiológico íntegro e, segundo suas pesquisas, possuem maior capacidade de estimular o sistema imunológico do hospedeiro.
Subject(s)
Biotherapics , Biotherapics/isolation & purification , Cell Respiration , Candida albicans/isolation & purificationABSTRACT
The performance of the BacT/Alert PF (Organon-Teknika Corp., Durham, N.C.), a new nonvented pediatric FAN blood culture bottle, was compared to that of the original pediatric bottle, the Pedi-BacT, with matched aerobic cultures obtained from two separate facilities. A total of 244 clinically significant isolates were recovered from 4,015 compliant pairs. Among the positive cultures, 170 (70%) isolates were detected in both the BacT/Alert PF and the Pedi-BacT bottles, while 47 (19%) isolates were recovered in the BacT/Alert PF bottle only and 27 (11%) isolates were recovered in the Pedi-BacT bottle only. Although isolation of specific microorganisms was comparable for the two bottles, the total number of organisms recovered by the BacT/Alert PF was greater than that by the Pedi-BacT (P = 0.0272). In addition, more organisms were recovered by the BacT/Alert PF bottle from the blood of patients receiving antimicrobial therapy (P = 0.0180). Overall time to detection was similar for the two bottles; however, a significantly decreased mean time to detection was recorded for yeast from the BacT/Alert PF bottle (22.9 h; P = 0.0001) and staphylococci from the Pedi-BacT bottle (22.5 h; P = 0.0056). One false-negative culture and five false-positive cultures occurred with the Pedi-BacT bottle, compared to one false-positive culture with the BacT/Alert PF bottle. The BacT/Alert PF bottle is a reliable blood culture bottle for pediatric blood culture specimens and may offer improved recovery of microbes from patients on antimicrobial therapy. The use of the nonvented bottle will both facilitate bottle processing and decrease expenditures for materials due to the elimination of the venting needles required for the original vented bottles.
Subject(s)
Bacteremia/diagnosis , Bacteremia/microbiology , Blood/microbiology , Fungemia/diagnosis , Fungemia/microbiology , Adolescent , Bacterial Infections/microbiology , Bacteriological Techniques , Candida albicans/isolation & purification , Candidiasis/microbiology , Child , Child, Preschool , Culture Media , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Humans , Infant , Infant, Newborn , Reagent Kits, DiagnosticABSTRACT
OBJECTIVE: To determine the minimum volume of blood and the absolute number of organisms required for detection of bacteremia and fungemia by an automated colorimetric blood culture system (BacT/Alert, Organon Teknika). DESIGN: Common neonatal pathogens, Escherichia coli, Streptococcus agalactiae (group B streptococcus (GBS): one American Type Culture Collection (ATCC) strain and one clinical isolate), Staphylococcus epidermidis, and Candida albicans, were seeded into blood to produce bacteremia or fungemia with low colony counts (1 to 3 colony-forming units (CFU) per milliliter) and ultra-low colony counts (<1 CFU/ml). For each organism, 96 culture bottles were inoculated with either 0.25, 0.5, 1.0, or 4.0 ml of the two seeded blood concentrations. Blood culture bottles were incubated in the BacT/Alert device for 5 days, and time to positivity was noted when applicable. All bottles were subcultured on plated media. DATA ANALYSIS: The Poisson statistic was used to calculate the probability of finding at least one viable CFU per inoculated culture bottle. The fraction of culture bottles with positive findings per group was divided by the probability of one or more organisms present to give the positivity index. RESULTS: Plated subculture identified no growth of organisms not detected by the colorimetric detection system. The false-positive rate for the automated device was less than 1%. The positivity index for the GBS clinical isolate was 1.13, for the GBS ATCC isolate 0.96, for S. epidermidis 0.94, for C. albicans 0.97, and for E. coli 0.95. There was a statistically significant difference with time to positivity and inocula volume (p <0.01), but the difference was not clinically important. CONCLUSIONS: If one or two viable colony-forming units are in the blood inoculated into culture media, the BacT/Alert system will detect growth rapidly. Because there appears to be a sizable subset of neonates who are at risk of sepsis with a colony count less than 4 CFU/ml, then a 0.5 ml inoculum of blood into the culture media is inadequate for sensitive and timely detection of bacteremia. One to two milliliters of blood should increase microorganism recovery in the face of low-colony-count sepsis.
Subject(s)
Bacteremia/blood , Fungemia/blood , Infant, Newborn/blood , Bacteremia/microbiology , Candida albicans/isolation & purification , Candidiasis/blood , Colony Count, Microbial , Colorimetry , Culture Media , Escherichia coli/isolation & purification , Escherichia coli Infections/blood , False Positive Reactions , Fungemia/microbiology , Humans , Poisson Distribution , Probability , Risk Factors , Sepsis/microbiology , Staphylococcal Infections/blood , Staphylococcus epidermidis/isolation & purification , Streptococcal Infections/blood , Streptococcus agalactiae/isolation & purificationABSTRACT
En este estudio se evaluó la frecuencia y biotipos de Cándida sp. en la saliva de portadores sanos, tomando en consideración la actividad cariogénica de dichos individuos a través de informaciones epidemiológicas. La muestra consistió en 239 niños tomados al azar, divididos en cinco estratos sociales. La saliva de cada uno de estos pacientes fue, cultivadas en medios específicos para el crecimiento del hongo. Posterior al crecimiento de las levaduras, las mismas fueron identificadas bioquímicamente mediante pruebas de fermentación. Los resultados obtenidos demostraron que Cándida albicans fue la especia de mayor prevalencia en todas las categorías socioeconómicas evaluadas. En 5 por ciento de las muestras se evidenció la presencia de más de una especie de Cándida coexistiendo en la cavidad bucal, incluyendo asociación de C. albicans con C. tropicalis, C. parapsilosis y C. krusei. En ninguno de los casos las especies fueron detectadas individualmente