[Topical treatment with eberconazole of the experimental guinea pig cutaneous candidosis.]. / Tratamiento tópico de la candidosis cutánea experimental del cobayo con eberconazol.

Eberconazole is a new azole antifungal drug for topical treatment of superficial mycoses. The usefulness of this drug was evaluated in an experimental model of cutaneous candidosis in guinea pigs comparing with the classical clotrimazole in a single blind trial. Twenty-five animals were inoculated in two symmetrical areas of the back with Candida albicans developing skin infection. One group of 10 animals were treated once per day with clotrimazole 1% cream in one side and with excipient in the other. Other group of 10 guinea pigs received eberconazole 1% cream and excipient. Five animals did not receive any treatment and were used as controls. After five days of treatment most lesions cured or improved and cultures were negative when clotrimazole or eberconazole were applied. Seventy per cent of lesions treated with excipient were clinically improved and 10% cured, but 85% of cultures remained positive for C. albicans. The therapeutic efficacy of eberconazole 1% cream was similar to clotrimazole 1% cream in the guinea ping model of cutaneous candidosis. Tolerance of both drugs was excellent. These results suggest the usefulness of eberconazole in human cutaneous infections due to C. albicans.

Aspergillus versicolor as cause of onychomycosis: report of 12 cases and susceptibility testing to antifungal drugs.

BACKGROUND: Onychomycoses caused by opportunistic moulds are not well understood, and many are due to Scopulariopsis brevicaulis and other species. Aspergillus versicolor is not documented as an etiological agent in most studies. We have found an increasing prevalence of this species which is involved in 5.8% of all fungal infections of toe nails. OBJECTIVE: To study the clinical and mycological characteristics of the onychomycosis caused by A. versicolor and the in vitro susceptibility of this mould to antifungal agents. RESULTS: Onychomycosis due to A. versicolor is mainly seen in people over 60 and presents with chronic involvement of the big toe nails. Predisposing factors are not always present and the infection does not respond to conventional topical antifungals. In vitro, A. versicolor has been shown to be resistant to griseofulvin and fluconazole as well as to amphotericin B, whereas MICs for itraconazole and ketoconazole are variable but within a range of 0.50-4.0 microg/ml; on the contrary, MICs for terbinafine are very low (<0.125 microg/ml). DISCUSSION: Aspergillus versicolor could be considered as an emergent pathogen causing toenail onychomycosis. Local treatment seems not to be effective. Of the various systemic antifungal agents studied terbinafine appears to be the most effective in treating onychomycosis.

Immunochemical characterization of somatic and metabolic antigens of 4 species of Aphanoascus: preliminary results.

Aphanoascus spp. are keratinophylic fungi occasionally described as etiological agents of tinea-like dermatomycoses. The goal of this work was to immunochemically characterize somatic and metabolic soluble antigens prepared from 4 species of Aphanoascus. Electrophoresis in SDS-PAGE gel and immunoblotting with sera from rabbits experimentally immunized with both somatic and metabolic antigens have shown a similar pattern among the species analyzed. However, some differences were noted between the species of Aphanoascus. These results suggest the existence of species-specific antigens.

[Oral terbinafine for the tinea unguium of the toenails. Efficacy between 12 and 24 weeks of treament.]. / Terbinafina por vía oral en el tratamiento de la tinea unguium de los pies. Eficacia entre 12 y 24 semanas de tratamiento.

Terbinafine 250 mg po daily was administered to 21 patients affected by tinea unguium of the toenails. In 14 cases Trichophyton rubrum was the aetiological agent while Trichophyton mentagrophytes var. interdigitale affected the rest. The treatment was administered randomized during 12 or 24 weeks in two groups of 11 (group A) and 10 (group B) patients. The clinical and mycological response was evaluated at week 12, 24 and 48. Adverse events were registered during the therapeutic period. At week 24, 55.5% of patients from group A were cured, only one patient did not improve and cultures were positive. In group B 66.6% were cured and three were clinically improved but cultures were positive. In the last control after 48 weeks the results were similar except one patient of the group B who worsened of his nails lesions. Only one case of acute urticaria was noted, the symptoms disappeared after the withdrawal of terbinafine. Terbinafine per os is a safe and effective antifungal for the treatment of the tinea unguium of the toenails. A period of 12 weeks of administration is enough in most of cases but when T. rubrum is the aetiology relapse could be possible.

Candiduria in non-neutropenic critically-ill surgical patients. Detection of IgA, IgG and IgM antibodies to Candida albicans by germ tube immunofluorescence.

The significance of indirect immunofluorescence using Candida albicans germ tube as well as blastospore antigens in the diagnosis of isolated candiduria in non-neutropenic, critically-ill surgical patients was assessed. Ten patients with isolated candiduria, 12 with systemic candidosis and 10 with multifocal muco-cutaneous candidosis were included in the study. The sera of another 10 critically-ill patients with no signs of candidosis served as controls. The patients' sera were tested for IgG, IgA and IgM antibodies. The results obtained confirmed that indirect germ tube immunofluorescence is a useful procedure for differentiating systemic candidosis from colonisation of the urinary tract. Indirect immunofluorescence with blastospores, although more sensitive than germ tube immunofluorescence, cannot distinguish muco-cutaneous candidosis from systemic candidosis. Therefore, indirect germ tube immunofluorescence is regarded a useful complementary test to evaluate candiduria in non-neutropenic, HIV-negative, critically ill patients.

Aspergillus fumigatus somatic antigens: comparison between two methods of preparation and immunochemical characterization.

Aspergillus fumigatus and other species of the same genus can cause different pathological processes amongst which can be found pulmonary hypersensitivity, intracavitary colonization and invasive and disseminated aspergillosis. The diagnosis of these processes is helped in a great way by the immunological response of the patient to Aspergillus antigens or by the detection of these as a metabolic product in blood and other fluids such as urine. To date, no firm agreement exists regarding the best preparation and standardization technique of aspergillar antigens, which is however the most important step towards the development of immunological diagnostic tests. In this study, two methods for the obtention of A. fumigatus somatic antigens have been compared, using 3 strains of different origins. The main differences between both antigenic extraction methods were the liquid media used for cultures (Czapek and Glucose peptone), the incubation times (4 weeks and 3 days respectively), the type of agitation during the incubation period (intermittent or continuous) and the dialysis and concentration method. The antigens obtained were standardized by the determination of the proteic and hydrocarbonate content, vertical electrophoresis in SDS PAGE, immunoprecipitation and immunoblotting against experimental antisera. From the comparison between both extraction methods, it was found that the highest proteic content was obtained with the somatic antigens of mycelium developed in Czapek for 4 weeks, whereas fungi cultivated in Glucose peptone had a higher glucide content. Vertical electrophoresis revealed the presence of 6 common fractions in all the antigens, whilst some fractions were in majority, only found in one antigen such as the MW 109 kDa, present in the GP 69 antigen.(ABSTRACT TRUNCATED AT 250 WORDS)

[Identification of yeasts of the Candida genus with a growth inhibition system: Microring YT]. / Identificación de levaduras del género Candida por un sistema de inhibición del crecimiento: Microring YT.

BACKGROUND: It has been observed an spectacular increasing of opportunistic Candida yeast infections. Many of them are fatal, and rapid and effective identification of the infecting species contributes to start the correct treatment. Several new methods for yeast identification have become available; Microring YT is one of these methods based on the growth inhibition by 6 different chemical products. The aim of this work is to study the performance of the test using representative clinical yeast isolates. METHODS: A total of 146 strains belonging to the 5 most common Candida species isolated in the clinical laboratory were identified using conventional methods (germ tube and chlamydospores production, and the standard API 20C AUX and 16 sugars auxonography; Institute Pasteur) and the Microring YT System. This test uses the differing susceptibilities of yeast to 6 discs mounted on a filter paper ring. The chemical products and dyes are: janus green, ethidium bromide, triphenyl tetrazolium chloride, brilliant green, cycloheximide and rhodamine 6G. The inhibition pattern of a 6 digit code is compared with a list of profiles. RESULTS: Using the Microring YT system 112 of the 146 studied strains were correctly identified with an overall concordance of 77% between this method and the standard one. The morphological study (germ tube production) increased 6% the identification of Candida albicans. Better results were obtained with C. krusei and C. parapsilosis (85% of concordance). With C. glabrata only 59% of concordance was found. CONCLUSIONS: In spite Microring YT is a simple method, easy to perform and read, it was considered inadequate for the identification of Candida species as a routine microbiological procedure.

Extensive dermatophytoses caused by Trichophyton mentagrophytes and Microsporum canis in a patient with AIDS.

Retrospective studies have shown the occurrence of episodes of deep or superficial fungal infections in 58 to 81% of HIV/AIDS patients as a result of impairment of cell immunity. We describe a case of disseminated cutaneous dermatophytoses caused by Trichophyton mentagrophytes and Microsporum canis in a patients with AIDS. Diagnostic and therapeutic problems in relation to this unusual presentation are emphasized as well as the importance of an early mycologic diagnosis to prescribe antifungal therapy.