A prospective observational study of vulvovagintis in pregnant women in Argentina, with special reference to candidiasis.

To evaluate the frequency of yeast, bacteria or protozoa in pregnant women and to correlate the possible associations of these microorganisms and their relationships with vulvovaginitis (VV) and cervicitis. Vaginal specimens were collected and prepared for smears in microscope slides for the evaluation of yeast, Trichomonas vaginalis and bacteria. Samples were cultured in specific culture medium. Cervical specimens were used to investigate the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis. We enrolled 210 pregnant women, aged 10-42 years old. Of them, 38.1% were symptomatic. Symptoms were most prevalent in the second and third trimesters of pregnancy coincident with a major prevalence of microorganisms. In this study, 39.5% of pregnant women had normal microbial biota and symptoms of VV due to non-infectious causes were observed (6.2%). The occurrence of vulvovaginal candidiasis was 25% and Candida albicans with a prevalence of 80.7% was the dominant species (P = 0.005) while non-albicans Candida species and other yeast were more common in asymptomatic ones (P = 0.0038). The frequency of bacterial vaginosis, T. vaginalis, C. trachomatis and N. gonorrhoeae were 18.1%, 1.4, 1.4% and 0.5% respectively.

[Evaluation of mass spectrometry: MALDI-TOF MS for fast and reliable yeast identification]. / Evaluación de la espectrometría de masas: MALDI-TOF MS para la identificación rápida y confiable de levaduras.

The matrix-assisted laser desorption/ionization time-of-flight mass spectrometry technique known as MALDI-TOF MS is a tool used for the identification of clinical pathogens by generating a protein spectrum that is unique for a given species. In this study we assessed the identification of clinical yeast isolates by MALDI-TOF MS in a university hospital from Argentina and compared two procedures for protein extraction: a rapid method and a procedure based on the manufacturer's recommendations. A short protein extraction procedure was applied in 100 isolates and the rate of correct identification at genus and species level was 98.0%. In addition, we analyzed 201 isolates, previously identified by conventional methods, using the methodology recommended by the manufacturer and there was 95.38% coincidence in the identification at species level. MALDI TOF MS showed to be a fast, simple and reliable tool for yeast identification.

[Disseminated infection due to Penicillium marneffei related to HIV infection: first observation in Argentina]. / Infección diseminada por Penicillium marneffei en un paciente HIV-positivo: Primera observación en la República Argentina.

The first case observed in Argentina of AIDS-related human penicillosis is herein presented. The patient was a six- teen year-old young man coming from a rural area of southern China. He was admitted at the F. J. Muñiz Hospital of Buenos Aires city with severe pneumonia and adult respiratory distress. Penicillium marneffei was isolated from bronchoalveolar lavage fuid and was microscopically observed in a skin cytodiagnosis. P. marneffei identification was confirmed by rRNA amplification and its phenotypic characteristics. The patient suffered an advanced HIV infection and also presented several AIDS-related diseases due to CMV, nosocomial bacterial infections and Pneumocystis jirovecii which led to a fatal outcome.

Antibiotic susceptibility of Staphylococcus aureus isolates in oral mucosa and pockets of patients with gingivitis-periodontitis.

Both oral cavity and subgingival pocket are ecological niches conducive to hosting microorganisms that may act as opportunistic pathogens, such as Staphylococcus aureus and especially methicillin-resistant Staphylococcus aureus (MRSA). Early detection of MRSA is a matter of concern to Public Health. The aim of our study was to determine phenotypic and genotypic detection of methicillin resistance of S. aureus in oral mucosa and subgingival pocket in 102 patients with gingivitis-periodontitis. The prevalence of S. aureus was 10.8% (n = 11) in subgingival pocket and 19.6% (n = 20) in oral mucosa. We obtained 31 isolates of S. aureus of which 13 were mecA positive and 18 were mecA negative. Detection of mecA gene by PCR was used as the reference method to compare the results of phenotypic methods to determine methicillin resistance. Early, accurate detection of S. aureus through phenotyping and genotyping methods is crucial for assessing the colonization and preventing the spread of MRSA.

Phenotypic and genotypic characterization of Aspergillus lentulus and Aspergillus fumigatus isolates in a patient with probable invasive aspergillosis.

Characteristic morphological and phylogenetic analyses demonstrated the presence of Aspergillus fumigatus and Aspergillus lentulus as the aetiological agents in a case of probable invasive aspergillosis (IA). This is believed to be the first report of an A. lentulus strain isolated from a patient with probable IA in Argentina.

Subgingival distribution of yeast and their antifungal susceptibility in immunocompetent subjects with and without dental devices.

Yeasts colonize the subgingival biofilm, which becomes a reservoir that favors their reproduction. The purpose of the present work was to determine the prevalence of yeasts of the Candida genus in the subgingival biofilm of gingivoperiodontal disease patients, including users and non-users of dental devices, and their susceptibility to fluconazole and voriconazole. Samples of subgingival pockets of immunocompetent nonsmokers showing gingivitis and periodontitis were inoculated in a differential chromogenic medium. Sixty three percent of subjects used dental devices. Yeasts were identified and susceptibility to fluconazole and voriconazole was tested following CLSI M44-A standards. The prevalence of yeasts in the subgingival biofilm was 40% CI 95% (30.5-50.3); 10% were patients who did not use dental appliances. The most frequently observed yeasts were C. albicans, and C. parapsilosis, C. dubliniensis, C. tropicalis and C. guilliermondii. Only C. dubliniensis and C. guilliermondii showed resistance to azoles. The use of dental devices significantly increased the prevalence of yeasts in periodontal pockets inpatients presenting gingivitis. It is noteworthy that non albicans Candida species, such as C. dubliniensis and C. guilliermondii, considered emerging species, which have a diminished susceptibility to antifungal agents were found in the crevicular fluid of immunocompetent patients.

Evaluación de la espectrometría de masas: MALDI-TOF MS para la identificación rápida y confiable de levaduras / Evaluation of mass spectrometry: MALDI-TOF MS for fast and reliable yeast identification

La espectrometría de masas, conocida como matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), es una técnica utilizada en la identificación de microorganismos mediante la creación de un espectro basado en el perfil de proteínas, que es único para una especie dada. El objetivo del presente trabajo fue evaluar la identificación de aislamientos clínicos de levaduras por MALDI-TOF MS en un hospital universitario de Argentina y analizar 2 procedimientos para la extracción de proteínas: el recomendado por el fabricante del equipo y una técnica abreviada rápida. Utilizando el primero de estos procedimientos se analizaron 201 aislamientos identificados previamente por métodos convencionales y se obtuvo coincidencia en la identificación a nivel de especie en el 95,38% de los aislamientos analizados. Con 100 de estos aislamientos se utilizó, además, el procedimiento abreviado para la extracción de proteínas; se obtuvo una identificación correcta a nivel de género y especie en el 98,0% de ellos. La espectrometría de masas MALDI-TOF MS demostró ser una técnica rápida, sencilla y precisa para la identificación de levaduras

The matrix-assisted laser desorption/ionization time-of-flight mass spectrometry technique known as MALDI-TOF MS is a tool used for the identification of clinical pathogens by generating a protein spectrum that is unique for a given species. In this study we assessed the identification of clinical yeast isolates by MALDI-TOF MS in a university hospital from Argentina and compared two procedures for protein extraction: a rapid method and a procedure based on the manufacturer's recommendations. A short protein extraction procedure was applied in 100 isolates and the rate of correct identification at genus and species level was 98.0%. In addition, we analyzed 201 isolates, previously identified by conventional methods, using the methodology recommended by the manufacturer and there was 95.38% coincidence in the identification at species level. MALDI TOF MS showed to be a fast, simple and reliable tool for yeast identification

Infección diseminada por Penicillium marneffei en un paciente HIV-positivo: Primera observación en la República Argentina / Disseminated infection due to Penicillium marneffei related to HIV infection: First observation in Argentina

Se presenta el primer caso humano de peniciliosis por Penicillium marneffei observado en la República Argentina. El paciente era un joven de 16 años, HIV-positivo, procedente de un área rural del sur de China. El paciente fue internado en el Hospital "F. J. Muñiz" por padecer una neumonía grave con insufciencia respiratoria aguda. El agente causal fue aislado de un lavado broncoalveolar y se lo observó en un citodiagnóstico de piel. La identifcación de P. marneffei fue confrmada por las características fenotípicas del aislamiento y la amplifcación del ADNr. El enfermo padecía una infección muy avanzada por HIV que condujo a la aparición simultánea de infecciones por citomegalovirus, Pneumocystis jirovecii y procesos bacterianos nosocomiales. Este complejo cuadro derivó en una evolución fatal.

The frst case observed in Argentina of AIDS-related human penicillosis is herein presented. The patient was a six- teen year-old young man coming from a rural area of southern China. He was admitted at the F. J. Muñiz Hospital of Buenos Aires city with severe pneumonia and adult respiratory distress. Penicillium marneffei was isolated from bronchoalveolar lavage fuid and was microscopically observed in a skin cytodiagnosis. P. marneffei identifcation was confrmed by rRNA amplifcation and its phenotypic characteristics. The patient suffered an advanced HIV infection and also presented several AIDS-related diseases due to CMV, nosocomial bacterial infections and Pneumocystis jirovecii which led to a fatal outcome.

Subgingival distribution of yeast and their antifungal susceptibility in immunocompetent subjects with and without dental devices

Las levaduras del genero Candida colonizan el biofilm subgingival.Su hallazgo constituye un reservorio favorable para su multiplicación. El propósito de éste trabajo fue investigar la presencia de levaduras del género Candida en el biofilm subgingivalde individuos con enfermedad gingivoperiodontal a fin de establecer la prevalencia de especies y los perfiles desusceptibilidad a fluconazol y voriconazol de las mismas. Se obtuvieron muestras del biofilm subgingival en cien pacientes inmunocompetentes, no fumadores, con salud gingivoperiodontal, gingivitis y periodontitis, con y sin aparatologíabucal. Las muestras se sembraron en medio cromogénico diferencial y las levaduras aisladas se identificaronmediante micromorfología y pruebas bioquímicas. Los estudios de sensibilidad a fluconazol y voriconazol se realizaron según las normas CLSI M44-A. La prevalencia de levadurasen el biofilm subgingival fue del 40 por ciento IC95 por ciento (30.5-50.3) siendo el 10 por ciento y 30 por ciento la frecuencia de las mismas para los pacientes sin y con aparatología bucal respectivamente.C. albicans fue la levadura más frecuente. Encontramos otras especies como C. parapsilosis, C. dubliniensis, C. tropicalis, C. guilliermondii y C. sake. Solo se observó resistencia a los azoles en C. dubliniensis y C. guilliermondii. El tratamiento con aparatología bucal incrementó la prevalencia de levadurasen bolsa periodontal en forma significativa. Es importante destacar la presencia en el fluido subgingival de especies de Candida no albicans consideradas emergentes y con sensibilidad disminuida a los antifúngicos como C. dubliniensisy C. guilliermondii

Yeasts colonize the subgingival biofilm, which becomes a reservoir that favors their reproduction. The purpose of the present work was to determine the prevalence of yeasts of the Candida genus in the subgingival biofilm of gingivoperiodontal disease patients, including users and non-users of dental devices, and their susceptibility to fluconazole and voriconazole. Samples of subgingival pockets of immunocompetent nonsmokers showing gingivitis and periodontitis were inoculated in a differential chromogenic medium. Sixty three percent of subjects used dental devices. Yeasts were identified and susceptibility to fluconazole and voriconazole was tested following CLSI M44-A standards. The prevalence of yeasts in the subgingival biofilm was 40% CI 95% (30.5-50.3); 10% were patients who did not use dental appliances. The most frequently observed yeasts were C. albicans, and C. parapsilosis, C. dubliniensis, C. tropicalis and C. guilliermondii. Only C. dubliniensis and C. guilliermondii showed resistance to azoles. The use of dental devices significantly increased the prevalence of yeasts in periodontal pockets inpatients presenting gingivitis. It is noteworthy that non albicans Candida species, such as C. dubliniensis and C. guilliermondii, considered emerging species, which have a diminished susceptibility to antifungal agents were found in the crevicular fluid of immunocompetent patients.