[Refractory colitis by Clostridium difficile treated with fecal microbiota transplant]. / Colitis refractaria por Clostridium difficile tratada con trasplante de microbiota fecal.

Clostridium difficile infection is an increasingly recognized cause of diarrhea in inpatients, frequently associated to high mortality. Vancomycin is the treatment of choice for all Clostridium difficile- associated diarrheas, with different degrees of severity. However, some patients develop refractory forms to that treatment and there are no alternative antibiotic schemes recommended for these cases. Fecal microbiota transplantation has been shown to be successful in a series of cases of severe diarrhea associated with this organism. We present a case of refractory C. difficile infection successfully treated with fecal microbiota transplantation.

La diarrea por Clostridium difficile es reconocida de manera creciente en pacientes hospitalizados y se asocia con alta mortalidad. La vancomicina por vía enteral es el tratamiento antibiótico recomendado para las diferentes formas, incluso las más graves. Sin embargo, un grupo pequeño de pacientes desarrolla formas refractarias a ese tratamiento y no existen esquemas antibióticos alternativos recomendados para estos casos. El trasplante de microbiota fecal ha demostrado ser exitoso en una serie de casos de diarrea grave asociada a este microorganismo. Presentamos un caso de diarrea refractaria por C. difficile que fue tratada con éxito con una infusión de microbiota fecal.

[Examination of the genetic variability among biofilm-forming Candida albicans clinical isolates]. / Estudio de la variabilidad genética entre aislamientos clínicos de Candida albicans formadores de biopelículas.

Biofilms are microbial communities encased in a self-produced polymeric matrix and represent a common mode of microbial growth. Candida albicans is able to colonize the surface of catheters, prostheses, and epithelia, forming biofilms that are highly resistant to antimicrobial drugs. The objective of this study was the genotypic characterization of biofilm-forming C. albicans clinical isolates using RAPD (Random Amplified Polymorphic DNA). We have studied 25 clinical isolates of C. albicans from oral cavities, blood, skin, nail, stool, oesophagus biopsy and vaginal fluids from patients suffering from candidiasis. For each strain biofilm formation was analysed by measuring the ability to adhere to and grow on polystyrene plastic surfaces using XTT [2,3-bis(2-methoxi-4nitro-5sulfophenil)-2H tetrazolium-5carboxanilide] reduction assay. The similarity coefficients generated by RAPD using four different primers varied from 49 to 91%, indicating a high degree of genetic variability between the clinical isolates. The dendrogram clustered the isolates in four related groups, all groups included strains with very different abilities to form biofilms. The isolates with similar genotypes often showed very different biofilm formation abilities. Strains were grouped into clusters independently of their clinical sources. Our results suggested that a direct correlation does not exist between the biofilm-forming ability of natural populations of C. albicans and the genotype as determined by RAPD.

Colitis refractaria por Clostridium difficile tratada con trasplante de microbiota fecal / Refractory colitis by Clostridium difficile treated with fecal microbiota transplant

La diarrea por Clostridium difficile es reconocida de manera creciente en pacientes hospitalizados y se asocia con alta mortalidad. La vancomicina por vía enteral es el tratamiento antibiótico recomendado para las diferentes formas, incluso las más graves. Sin embargo, un grupo pequeño de pacientes desarrolla formas refractarias a ese tratamiento y no existen esquemas antibióticos alternativos recomendados para estos casos. El trasplante de microbiota fecal ha demostrado ser exitoso en una serie de casos de diarrea grave asociada a este microorganismo. Presentamos un caso de diarrea refractaria por C. difficile que fue tratada con éxito con una infusión de microbiota fecal.

Clostridium difficile infection is an increasingly recognized cause of diarrhea in inpatients, frequently associated to high mortality. Vancomycin is the treatment of choice for all Clostridium difficile- associated diarrheas, with different degrees of severity. However, some patients develop refractory forms to that treatment and there are no alternative antibiotic schemes recommended for these cases. Fecal microbiota transplantation has been shown to be successful in a series of cases of severe diarrhea associated with this organism. We present a case of refractory C. difficile infection successfully treated with fecal microbiota transplantation.

Estudio de la variabilidad genética entre aislamientos clínicos de Candida albicans formadores de biopelículas / Examination of the genetic variability among biofilm-forming Candida albicans clinical isolates

Las biopelículas están constituidas por microcolonias incluidas dentro de unamatriz polimérica y representan una forma de crecimiento microbiano.Candida albicans puede colonizar las superficies de catéteres, prótesis yepitelios formando biopelículas que son resistentes a las drogas antifúngicas.El objetivo de este trabajo fue la caracterización genotípica de aislamientosclínicos de C. albicans formadores de biopelículas usando la técnica RAPD(Random Amplified Polymorphic DNA).Fueron estudiados 25 aislamientos clínicos de C. albicans de fauces, sangre,piel, uñas, materia fecal, biopsia de esófago, y flujo vaginal de pacientescon candidiasis. Cada cepa fue previamente analizada en su capacidad decrecer y adherirse a la superficie de poliestireno, y la cuantificación de labiopelícula formada fue realizada mediante el ensayo de reducción de XTT[2,3-bis (2-metoxi-4 nitro-5 sulfofenil) -2 H tetrazolio-5 carboxanilida].Los coeficientes de similitud generados por RAPD variaron entre el 49 y el 91%con los cuatro iniciadores usados, revelando un alto nivel de variabilidadgenética. El dendrograma agrupó los aislamientos en cuatro grupos, incluyendotodos ellos cepas con muy diferente capacidad para formar biopelículas.Aislamientos con genotipos similares mostraron diferente capacidad deformación de biopelículas. Las cepas fueron agrupadas independientemente delorigen de la muestra. Nuestros resultados sugieren que en poblacionesnaturales de C. albicans no existe correlación entre la capacidad de formarbiopelículas y el genotipo determinado por PCR-RAPD(AU)

Biofilms are microbial communities encased in a self-produced polymeric matrixand represent a common mode of microbial growth. Candida albicans is able tocolonize the surface of catheters, prostheses, and epithelia, forming biofilms thatare highly resistant to antimicrobial drugs. The objective of this study was thegenotypic characterization of biofilm-forming C. albicans clinical isolates usingRAPD (Random Amplified Polymorphic DNA).We have studied 25 clinical isolates of C. albicans from oral cavities, blood, skin,nail, stool, oesophagus biopsy and vaginal fluids from patients suffering fromcandidiasis. For each strain biofilm formation was analysed by measuring theability to adhere to and grow on polystyrene plastic surfaces using XTT [2,3-bis(2-methoxi-4nitro-5sulfophenil) -2H tetrazolium-5carboxanilide] reduction assay.The similarity coefficients generated by RAPD using four different primers variedfrom 49 to 91%, indicating a high degree of genetic variability between theclinical isolates. The dendrogram clustered the isolates in four related groups, allgroups included strains with very different abilities to form biofilms. The isolateswith similar genotypes often showed very different biofilm formation abilities.Strains were grouped into clusters independently of their clinical sources.Our results suggested that a direct correlation does not exist between thebiofilm-forming ability of natural populations of C. albicans and the genotype asdetermined by RAPD(AU)