Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 22
Filtrar
1.
Biochim Biophys Acta Gen Subj ; 1866(4): 130083, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35033574

RESUMEN

The rapidity of the diagnosis of invasive candidiasis (IC) is crucial to allow the early introduction of antifungal therapy that dramatically increases the survival rate of patients. Early diagnosis is unfortunately often delayed because Candida blood culture, the gold standard diagnostic test, is positive in only 50% of cases of IC and takes several days to obtain this result. Complementary non-culture-based methods relying on the detection of Candida cell wall polysaccharides in the serum, ß-glucans and mannans, by enzymatic and immunological reagents have been successfully developed to allow a more efficient patients care. We have previously demonstrated that detection of circulating glycans by mass spectrometry could provide a reliable and cost-effective early diagnosis method called MS-DS for Mass Spectrometry of Di-Saccharide. Here, by comparing patient's sera and Candida albicans strains deficient in carbohydrates synthesis, we demonstrate that trehalose derived from fungal metabolism can be specifically targeted by MS-DS to allow early diagnosis. In particular, the use of C. albicans strains deficient in the synthesis of trehalose synthesizing enzymes Tps1 and Tps2 show that MS-DS results were correlated to the metabolism of trehalose. Finally, we demonstrate that the performance of the IC diagnosis can be significantly improved by using high resolution mass spectrometry, which opens new perspectives in the management of the disease.


Asunto(s)
Candidiasis Invasiva , Trehalosa , Candida albicans , Candidiasis , Candidiasis Invasiva/diagnóstico , Candidiasis Invasiva/tratamiento farmacológico , Humanos , Espectrometría de Masas
2.
J Fungi (Basel) ; 7(5)2021 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-33922391

RESUMEN

BACKGROUND AND AIMS: This study prompted by growing evidence of the relationship between the yeast Candida albicans and Crohn's disease (CD) was intended to assess the effect of a 6-month course of the antifungal fluconazole (FCZ) on post-operative recurrence of CD. METHODS: Mycological samples (mouth swabs and stools) and serum samples were collected from 28 CD patients randomized to receive either FCZ (n = 14) or placebo (n = 14) before surgical resection. Serological analysis focused on levels of calprotectin, anti-glycan antibodies, and antibody markers of C. albicans pathogenic transition. Levels of galectin-3 and mannose binding lectin (MBL) involved in C. albicans sensing and inflammation were also measured. RESULTS: 1, 2, 3, and 6 months after surgery, endoscopy revealed recurrence in 5/12 (41.7%) patients in the FCZ group and 5/9 (55.6%) in the placebo group, the small cohort preventing any clinical conclusions. In both groups, surgery was followed by a marked decrease in C. albicans colonization and biomarkers of C. albicans pathogenic transition decreased to non-significant levels. Anti-glycan antibodies also decreased but remained significant for CD. Galectin-3 and calprotectin also decreased. Conversely, MBL levels, which inversely correlated with anti-C. albicans antibodies before surgery, remained stable. Building biostatistical multivariate models to analyze he changes in antibody and lectin levels revealed a significant relationship between C. albicans and CD. CONCLUSION: Several combinations of biomarkers of adaptive and innate immunity targeting C. albicans were predictive of CD recurrence after surgery, with area under the curves (AUCs) as high as 0.86. FCZ had a positive effect on biomarkers evolution. ClinicalTrials.gov ID: NCT02997059, 19 December 2016. University Hospital Lille, Ministry of Health, France. Effect of Fluconazole on the Levels of Anti-Saccharomyces cerevisiae Antibodies (ASCA) After Surgical Resection for Crohn's Disease. Multicenter, Randomized, and Controlled in Two Parallel Groups Versus Placebo.

4.
J Clin Microbiol ; 57(5)2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30787140

RESUMEN

A mass spectrometry (MS) method that detects a serum disaccharide (DS) (MS-DS) was recently described for the diagnosis of invasive fungal infections (IFI). We carried out a European collaborative study to evaluate this assay. Patients with the following IFI were selected according to the availability of sera obtained at about the time that IFI was documented: invasive candidiasis (IC; n = 26 patients), invasive aspergillosis (IA; n = 19), and mucormycosis (MM; n = 23). Control sera originated from 20 neutropenic patients and 20 patients with bacteremia. MS-DS was carried out in blind manner for the diagnosis of IFI. A diagnosis of IC or IA was confirmed by detection of mannan (Man) or galactomannan (GM), respectively, associated with detection of (1,3)-ß-d-glucan (BDG) in both infections. MM was detected by quantitative real-time PCR (qPCR). All tests discriminated sera from patients with IC from sera from control subjects with bacteremia (P ≤ 0.0009). For IC, the MS-DS sensitivity and specificity were 51% and 87%, respectively. MS-DS complemented the high specificity of Man monitoring. All tests discriminated sera from IA patients from sera from neutropenic controls (P ≤ 0.0009). For IA, MS-DS sensitivity and specificity were 64% and 95%, respectively. Only 13/36 serum samples from patients with MM were concordant by MS-DS and qPCR (6 were positive, and 7 were negative); 14 were positive by MS-DS alone. qPCR and MS-DS made a similar contribution to the diagnosis of MM. In patients undergoing long-term monitoring, the persistent circulation of serum disaccharide was observed, whereas DNA was detected only for a short period after initiation of treatment. MS-DS has an important role to play in the early diagnosis of IFI. Its panfungal nature and complementarity with other tests may justify its use in the management of IFI.


Asunto(s)
Antígenos Fúngicos/sangre , Disacáridos/sangre , Infecciones Fúngicas Invasoras/sangre , Infecciones Fúngicas Invasoras/diagnóstico , Espectrometría de Masas , Adulto , Anciano , Anciano de 80 o más Años , Aspergilosis/diagnóstico , Candidiasis/diagnóstico , Europa (Continente) , Femenino , Galactosa/análogos & derivados , Humanos , Colaboración Intersectorial , Masculino , Mananos/sangre , Persona de Mediana Edad , Mucormicosis/diagnóstico , Sensibilidad y Especificidad , Adulto Joven
5.
BMC Pharmacol Toxicol ; 19(1): 81, 2018 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-30522521

RESUMEN

BACKGROUND: The use of isavuconazole is approved for the management of invasive aspergillosis and mucormycosis, only in adults, as no paediatric pharmacology studies have been reported to date. Very few paediatric cases have been published concerning the use of isavuconazole. Amphotericin B is the only antifungal agent recommended in paediatric mucormycosis, but adverse effects and especially nephrotoxicity, even with the liposomal formulation, could be problematic. In this context, the use of other antifungal molecules active on Mucorales becomes needful. CASE PRESENTATION: We describe a case of mucormycosis with rapid onset dissemination in a 3-year-old girl recently diagnosed with acute lymphocytic leukaemia. She was successfully treated with isavuconazole alone and then in combination with liposomal amphotericin B. Isavuconazole therapy was guided by therapeutic drug monitoring. CONCLUSIONS: This case offers new perspectives on the potential use of isavuconazole in children with mucormycosis, as an alternative or adjunct to liposomal amphotericin B.


Asunto(s)
Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Leucemia de Células B/tratamiento farmacológico , Mucormicosis/tratamiento farmacológico , Nitrilos/uso terapéutico , Piridinas/uso terapéutico , Triazoles/uso terapéutico , Enfermedad Aguda , Preescolar , Quimioterapia Combinada , Femenino , Humanos , Resultado del Tratamiento
6.
J Clin Microbiol ; 54(11): 2786-2797, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27605710

RESUMEN

We recently developed a mass spectrometry (MS) procedure based on the detection of a serum disaccharide (MS-DS) in patients with invasive candidiasis (IC). Here, we compare the performance of MS-DS for the diagnosis of IC, invasive aspergillosis (IA), and mucormycosis (MM) with those of commercially available antigen detection tests. This retrospective study included 48 patients (23 IC patients [74 serum samples], 15 IA patients [40 serum samples], and 10 MM patients [15 serum samples]) and 49 appropriate controls (102 serum samples). MS-DS, mannan (Mnn), galactomannan (GM), and (1,3)-ß-d-glucan (BDG) were detected by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) MS, Platelia, and Fungitell assays, respectively. For IC, the sensitivity and specificity of the MS-DS index, BDG detection, and Mnn detection were 62% and 84%, 82% and 60%, and 33% and 94% per serum sample and 83% and 69%, 96% and 31%, and 39% and 86% per patient, respectively. For IA, the corresponding values in comparison to BDG and GM detection were 83% and 81%, 62% and 95%, and 62% and 100% per serum sample and 93% and 76%, 87% and 90%, and 93% and 100% per patient, respectively. Nine of the 10 MM patients had a positive MS-DS result. MS-DS gave an early diagnosis in IC (73% positivity before blood culture), IA (positive before GM detection in six patients), and MM (positivity mainly preceded the date of diagnosis) patients. For IC, persisting MS-DS was associated with a poor prognosis. The different biomarkers were rarely detected simultaneously, suggesting different kinetics of release and clearance. For IA, MS-DS provided better complementation to GM monitoring than BDG monitoring. MS-DS detects panfungal molecules circulating during invasive fungal infections. The performance of MS-DS compared favorably with those of biological tests currently recommended for monitoring at-risk patients. Further validation of this test in multicenter studies is required.


Asunto(s)
Diagnóstico Precoz , Infecciones Fúngicas Invasoras/diagnóstico , Técnicas Microbiológicas/métodos , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Sensibilidad y Especificidad , Adulto Joven
7.
Am J Physiol Heart Circ Physiol ; 311(3): H725-34, 2016 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-27288438

RESUMEN

Platelets are capable of binding, aggregating, and internalizing microorganisms, which enhances the elimination of pathogens from the blood. The yeast Candida albicans is a pathobiont causing life-threatening invasive infections. Its cell wall contains ß-1,3 glucans that are known to trigger a wide range of host cell activities and to circulate during infection. We studied the effect of ß-1,3 glucan fractions (BGFs) consisting of diglucosides (Glc2), tetraglucosides (Glc4), and pentaglucosides (Glc5) on human platelets, their mechanisms of action, and their possible impact on host defenses. The effect of BGFs on the coagulation process was determined by measuring thrombin generation. Platelets pretreated with BGFs were analyzed in terms of activation, receptor expression, aggregation, and adhesion to neutrophils and to C. albicans The results show that BGFs affected the endogenous thrombin potential in a concentration-dependent manner. For platelet activation, BGFs at a low concentration (2 µmol/l) reduced ATP release and prevented the phosphorylation of protein kinase C. BGFs diminished the expression of P-selectin and the activation of αIIbß3 BGFs decreased platelet aggregation and the interaction between thrombin-stimulated platelets and neutrophils, fibrinogen, and C. albicans GLc5 decreased ATP release and TGF-ß1 production in response to TLR4 upregulation in thrombin-stimulated platelets, but TLR4 blockage abolished the effect of BGFs on platelets. This study provides evidence that fungal pentaglucosides modulate platelet activity mediated via TLR4 stimulation and reduce platelet-neutrophil interaction.


Asunto(s)
Plaquetas/efectos de los fármacos , Glucósidos/farmacología , Activación Plaquetaria/efectos de los fármacos , Adhesividad Plaquetaria/efectos de los fármacos , Agregación Plaquetaria/efectos de los fármacos , Receptor Toll-Like 4/metabolismo , beta-Glucanos/farmacología , Adenosina Trifosfato/metabolismo , Plaquetas/metabolismo , Candida albicans , Fibrinógeno/efectos de los fármacos , Fibrinógeno/metabolismo , Hongos/química , Humanos , Neutrófilos , Selectina-P/efectos de los fármacos , Selectina-P/metabolismo , Fosforilación , Complejo GPIIb-IIIa de Glicoproteína Plaquetaria/efectos de los fármacos , Complejo GPIIb-IIIa de Glicoproteína Plaquetaria/metabolismo , Proteína Quinasa C/efectos de los fármacos , Proteína Quinasa C/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , Trombina/efectos de los fármacos , Trombina/metabolismo , Receptor Toll-Like 4/antagonistas & inhibidores , Factor de Crecimiento Transformador beta1/efectos de los fármacos , Factor de Crecimiento Transformador beta1/metabolismo , Regulación hacia Arriba
8.
Mycopathologia ; 178(3-4): 285-90, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25151365

RESUMEN

We report a case of congenital candidiasis in triplets, in the context of premature labor at 25 weeks gestation, without symptomatic vaginitis or chorioamnionitis. All three infants died as a result of prematurity, aggravated by systemic candidiasis. Multi-locus sequence typing confirmed vertical transmission of Candida albicans from the mother to the triplets and revealed a slight diversity among the strains isolated from the neonates.


Asunto(s)
Candida albicans/clasificación , Candidemia/congénito , Candidemia/transmisión , Variación Genética , Transmisión Vertical de Enfermedad Infecciosa , Nacimiento Prematuro , Trillizos , Adulto , Candida albicans/genética , Candida albicans/aislamiento & purificación , Candidemia/microbiología , ADN de Hongos/química , ADN de Hongos/genética , Resultado Fatal , Femenino , Genotipo , Humanos , Tipificación de Secuencias Multilocus , Técnicas de Tipificación Micológica
9.
Crit Care ; 18(3): R135, 2014 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-24975380

RESUMEN

INTRODUCTION: Prompt diagnosis of candidaemia and invasive candidosis is crucial to the early initiation of antifungal therapy. The poor sensitivity of blood cultures (BCs) has led to the development of fungal glycan tests as a diagnostic adjunct. We analysed the performance of tests for the detection of circulating ß-D-1,3-glucan (BDG) and mannan in the intensive care unit (ICU) setting. METHODS: This retrospective, case-control study included 43 ICU patients with candidaemia and 67 controls, hospitalised on the same ward and assessed weekly for yeast colonisation with simultaneous serum sampling; 340 sera taken before and after positive BCs were available for the cases group and 203 for the controls. BDG and mannan levels were determined using the Fungitell® and Platelia™ Candida Ag tests, respectively. RESULTS: BDG was detected early in sera from cases patients but was also present in several sera from controls. Increasing the cut-off from 80 pg/mL to 350 pg/mL and 800 pg/mL resulted in sensitivity/specificity ratios of 0.97/0.31, 0.65/0.74, 0.30/0.86, respectively. Detection of mannan was more specific but lacked sensitivity. No obvious correlation was found between BDG and colonisation, but a trend existed between high colonisation and high BDG. Candidaemia relapses were associated with a rise in BDG and mannan but, in contrast to the transient nature of mannan, BDG persisted up to 7 weeks after positive BCs. CONCLUSION: A combination of mannan and BDG tests could be used to guide pre-emptive therapeutic decisions in ICU patients.


Asunto(s)
Candidemia/diagnóstico , Polisacáridos Fúngicos/sangre , Mananos/sangre , beta-Glucanos/sangre , Anciano , Anticuerpos/sangre , Biomarcadores/sangre , Candidemia/microbiología , Estudios de Casos y Controles , Pared Celular , Diagnóstico Precoz , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Mananos/inmunología , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Sensibilidad y Especificidad
11.
APMIS ; 121(11): 1109-17, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23758570

RESUMEN

With the increasing incidence and diverse etiologies of fungal infections, chromogenic yeast culture media are increasingly used for routine diagnosis. Rhodotorula species, which are characterized by the production of carotenoid pigments, are considered as emerging opportunistic pathogens. We recently diagnosed two fungemia due to Rhodotorula spp. and noticed that in both cases, the yeast failed to grow in subculture on the chromogenic yeast culture medium. This study was thus undertaken to investigate more thoroughly the ability (or inability) of Rhodotorula species to grow on different commercially available chromogenic media for yeast. Eighteen Rhodotorula spp. were checked for their ability to grow on four chromogenic yeast culture media: CHROMagar Candida (BD), Candi 4 Select (Biorad), Brilliance Candida (Oxoid), and Candida ID 2 (BioMerieux). All the Rhodotorula spp. strains grew on Brilliance and Candida ID 2, while only six isolates grew on Candi 4, and seven on CHROMagar. Two chromogenic yeast culture media showed a significant inhibitory effect on the growth of Rhodotorula species. As all Rhodotorula species are resistant to echinocandins and fluconazole, it is essential to isolate and identify these yeast quickly to initiate appropriate amphotericin B antifungal treatment as early as possible. The choice of media for routine use should take into account the ability of different media to allow all emerging fungal pathogens to grow.


Asunto(s)
Compuestos Cromogénicos/farmacología , Medios de Cultivo , Micosis/diagnóstico , Rhodotorula/crecimiento & desarrollo , Humanos , Rhodotorula/efectos de los fármacos , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción
12.
Phytother Res ; 27(11): 1640-5, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23280633

RESUMEN

Screening of the antifungal activities of ten Guadeloupean plants was undertaken to find new extracts and formulations against superficial mycoses such as onychomycosis, athlete's foot, Pityriasis versicolor, as well as the deep fungal infection Pneumocystis pneumonia. For the first time, the CMI of these plant extracts [cyclohexane, ethanol and ethanol/water (1:1, v/v)] was determined against five dermatophytes, five Candida species, Scytalidium dimidiatum, a Malassezia sp. strain and Pneumocystis carinii. Cytotoxicity tests of the most active extracts were also performed on an HaCat keratinocyte cell line. Results suggest that the extracts of Bursera simaruba, Cedrela odorata, Enterolobium cyclocarpum and Pluchea carolinensis have interesting activities and could be good candidates for developing antifungal formulations.


Asunto(s)
Antifúngicos/farmacología , Arthrodermataceae/efectos de los fármacos , Extractos Vegetales/farmacología , Plantas Medicinales/química , Asteraceae/química , Bursera/química , Candida/efectos de los fármacos , Cedrela/química , Línea Celular , Fabaceae/química , Guadalupe , Humanos , Malassezia/efectos de los fármacos , Pruebas de Sensibilidad Microbiana , Pneumocystis carinii/efectos de los fármacos
14.
Med Mycol ; 51(1): 25-32, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22703164

RESUMEN

Conventional identification (CI) of yeasts is based on morphological, biochemical and/or immunological methods. Matrix-assisted laser desorption/ionization - time of flight (MALDI-TOF or MT-MS) mass spectrometry has been proposed as a new method for the identification of microorganisms. This prospective study compared the performance of MT-MS and CI for the identification of yeasts isolated from clinical samples. Sequencing of the internal transcribed spacer (ITS) regions of ribosomal DNA was used as the reference method in the analysis of a total of 1207 yeast isolates. Concordance between MT-MS and CI was observed for 1105 isolates (91.5%), while 74 isolates (6.1%) were misidentified. Molecular identification revealed that 73 of these 74 isolates were identified correctly by MT-MS and CI correctly identified the last one. Concordance between the two techniques was excellent for the medically-important species (98-100%), including the identification of closely-related species (Candida albicans/C. dubliniensis; C. inconspicua/C. norvegensis; C. parapsilosis/C. metapsilosis/C. orthopsilosis). Only 2.3% of isolates belonging to C. famata, C. lambica and C. magnoliae or to Geotrichum spp. and Trichosporon spp. were not identified by MT-MS. This investigation highlights the potential of MT-MS-based yeast identification as a reliable, time and cost-efficient alternative to CI.


Asunto(s)
Micosis/microbiología , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/métodos , Levaduras/aislamiento & purificación , Costos y Análisis de Costo , ADN Espaciador Ribosómico/química , ADN Espaciador Ribosómico/genética , Francia , Humanos , Laboratorios de Hospital , Tipificación Molecular/economía , Tipificación Molecular/métodos , Técnicas de Tipificación Micológica/economía , Técnicas de Tipificación Micológica/métodos , Micosis/diagnóstico , Estudios Prospectivos , Reproducibilidad de los Resultados , Especificidad de la Especie , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/economía , Factores de Tiempo , Levaduras/clasificación
15.
J Clin Immunol ; 32(6): 1317-23, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22833166

RESUMEN

The high morbi-mortality associated with invasive candidiasis (IC) is a persistent problem in hospitals. Mannose-binding lectin (MBL) plays a role in innate immunity through its interaction with mannosylated molecules of Candida albicans. A correlation between MBL deficiency and vulvovaginal candidiasis or peritonitis has been reported. We investigated circulating MBL levels and their evolution during the course of IC. Sixty-eight patients with proven IC, 82 hospitalized patients (HP) without evidence of infection, and 70 healthy subjects (HS) were studied in order to examine the relationship between serum MBL and IC. Serum MBL levels were measured by enzyme-linked immunosorbent assay (ELISA). MBL levels were significantly higher in IC patients than in HP and HS (p < 0.0001, p < 0.0055, respectively). A change in MBL concentrations was observed during the course of IC, with a dramatic decrease during the 2 days before positive blood culture sampling. This decrease was concomitant with the presence of high levels of circulating mannan (Mn). Like MBL levels, anti-mannan antibodies (AMn) increased after the mannanemia/blood culture period. These findings suggest a possible role of MBL during the early stage of IC. The mechanisms that regulate these observations in terms of effect and consequences on innate and adaptive immunity and the prognosis of IC require further investigation.


Asunto(s)
Candida albicans/inmunología , Candidiasis Invasiva/sangre , Lectina de Unión a Manosa/sangre , Adulto , Anciano , Anticuerpos/sangre , Anticuerpos/inmunología , Candidiasis Invasiva/inmunología , Candidiasis Invasiva/microbiología , Candidiasis Invasiva/patología , Estudios de Casos y Controles , Ensayo de Inmunoadsorción Enzimática , Femenino , Polisacáridos Fúngicos/sangre , Polisacáridos Fúngicos/inmunología , Expresión Génica , Variación Genética/inmunología , Humanos , Inmunidad Innata , Masculino , Mananos/sangre , Mananos/inmunología , Lectina de Unión a Manosa/genética , Lectina de Unión a Manosa/inmunología , Persona de Mediana Edad
16.
Glycobiology ; 22(10): 1332-42, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22745283

RESUMEN

A family of nine genes encoding proteins involved in the synthesis of ß-1,2 mannose adhesins of Candida albicans has been identified. Four of these genes, BMT1-4, encode enzymes acting stepwise to add ß-mannoses on to cell-wall phosphopeptidomannan (PPM). None of these acts on phospholipomannan (PLM), a glycosphingolipid member of the mannose-inositol-phosphoceramide family, which contributes with PPM to ß-mannose surface expression. We show that deletion of BMT5 and BMT6 led to a dramatic reduction of PLM glycosylation and accumulation of PLM with a truncated ß-oligomannoside chain, respectively. Disruptions had no effect on sphingolipid biosynthesis and on PPM ß-mannosylation. ß-Mannose surface expression was not affected, confirming that ß-mannosylation is a process based on specificity of acceptor molecules, but liable to global regulation.


Asunto(s)
Candida albicans/enzimología , Pared Celular/química , Glucolípidos/metabolismo , Mananos/metabolismo , Fosfopéptidos/metabolismo , Acetiltransferasas , Proteínas Bacterianas , Activación Enzimática , Glicosilación , Especificidad de la Especie
17.
Ann Biol Clin (Paris) ; 70(1): 89-92, 2012.
Artículo en Francés | MEDLINE | ID: mdl-22294141

RESUMEN

The prevalence of invasive mycoses is increasing, especially among patients who are immunocompromised or hospitalized with serious underlying diseases. Such infections are associated with a high morbidity and significant mortality, requiring early diagnosis and appropriate treatment but also an optimal prophylaxis in patients with high risk factors. We report a case of triple fungal infection including an invasive pulmonary aspergillosis by Aspergillus fumigatus, a candidemia by Candida albicans and a Pneumocystis pneumonia. The overall clinical picture of this patient was liver cirrhosis with medical history of immunosuppressive treatment for Crohn disease and a non-hodgkin lymphoma. There was no antifungal prophylaxis for this patient. Under treatment, the issue was unfavourable with multivisceral failure.


Asunto(s)
Cirrosis Hepática/complicaciones , Micosis/complicaciones , Aspergilosis/inducido químicamente , Aspergilosis/complicaciones , Aspergilosis/diagnóstico , Candidiasis/inducido químicamente , Candidiasis/complicaciones , Candidiasis/diagnóstico , Resultado Fatal , Humanos , Huésped Inmunocomprometido , Inmunosupresores/efectos adversos , Cirrosis Hepática/inducido químicamente , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica , Micosis/inducido químicamente , Micosis/diagnóstico , Neumonía por Pneumocystis/inducido químicamente , Neumonía por Pneumocystis/complicaciones , Neumonía por Pneumocystis/diagnóstico
18.
Inflamm Bowel Dis ; 18(3): 430-8, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21739538

RESUMEN

BACKGROUND: NOD2 is involved in Crohn's disease (CD), but the role of NOD1 remains unclear. Anti-Saccharomyces cerevisiae antibodies (ASCA) are higher in CD patients and some of their relatives. Using family-based analyses we investigated the relationships between NOD2 mutations, NOD1 +32656 variant, and both the risk of CD and ASCA levels. We compared allelic frequencies between families with multiple CD cases (multiplex), those with one case of CD (simplex), and control families, searching for a gradient of at risk alleles according to the prevalence of the disease among families. METHODS: In all, 93 CD patients, 160 healthy relatives from 22 multiplex families, 22 CD patients and 81 healthy relatives from 22 simplex families, and 169 subjects from 27 control families were included in the study. ASCA levels were determined by enzyme-linked immunosorbent assay. NOD1 +32656, NOD2 R702W, G908R, and 1007fs were genotyped by polymerase chain reaction / restriction fragment length polymorphism. RESULTS: In family-based analyses NOD2 mutations and the NOD1 wildtype allele were associated with CD in multiplex families, with a synergetic effect when risk alleles of both genes were transmitted. Lower ASCA levels were strongly associated with the NOD1 variant allele. Simplex families had a lower frequency of the "at risk" +32656 allele than multiplex families. CONCLUSIONS: The +32656 variant was associated with low ASCA level and low risk of CD in multiplex families. NOD2 and NOD1 variants displayed antagonist effects on the risk of CD and ASCA level. A gradient of NOD1, NOD2 at-risk alleles was associated with the variable prevalence of CD in families.


Asunto(s)
Anticuerpos Antifúngicos/sangre , Enfermedad de Crohn/genética , Proteína Adaptadora de Señalización NOD1/genética , Proteína Adaptadora de Señalización NOD2/genética , Distribución de Chi-Cuadrado , Frecuencia de los Genes , Genotipo , Humanos , Método de Montecarlo , Mutación , Polimorfismo Genético , Saccharomyces cerevisiae/inmunología
19.
Am J Gastroenterol ; 104(7): 1745-53, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19471251

RESUMEN

OBJECTIVES: Anti-Saccharomyces cerevisiae antibodies (ASCAs) are present in 50-60% of patients with Crohn's disease (CD) and in 20-25% of their healthy relatives (HRs). The yeast, Candida albicans, has been shown to generate ASCAs, but the presence of C. albicans in the digestive tract of CD patients and their HRs has never been investigated. Therefore, we studied C. albicans carriage in familial CD and its correlation with ASCAs. METHODS: Study groups consisted of 41 CD families composed of 129 patients and 113 HRs, and 14 control families composed of 76 individuals. Mouth swabs and stool specimens were collected for isolation, identification, and quantification of yeasts. Serum samples were collected for detection of ASCAs and anti-C. albicans mannan antibodies (ACMAs). RESULTS: C. albicans was isolated significantly more frequently from stool samples from CD patients (44%) and their HRs (38%) than from controls (22%) (P<0.05). The prevalence of ACMAs was similar between CD patients, their HRs, and controls (22, 19, and 21%, respectively, P=0.845), whereas the prevalence of ASCAs was significantly increased in CD families (72 and 34% in CD and HRs, respectively, in contrast to 4% in controls, P<0.0001). AMCA levels correlated with C. albicans colonization in all populations. ASCA levels correlated with C. albicans colonization in HRs but not in CD patients. CONCLUSIONS: CD patients and their first-degree HRs are more frequently and more heavily colonized by C. albicans than are controls. ASCAs correlate with C. albicans colonization in HRs but not in CD. In HRs, ASCAs could result from an altered immune response to C. albicans. In CD, a subsequent alteration in sensing C. albicans colonization could occur with disease onset.


Asunto(s)
Candida albicans/genética , Candidiasis/genética , Enfermedad de Crohn/genética , Enfermedad de Crohn/microbiología , Saccharomyces cerevisiae/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Anticuerpos Antifúngicos/análisis , Candida albicans/inmunología , Candidiasis/inmunología , Estudios de Casos y Controles , Recuento de Colonia Microbiana , Ensayo de Inmunoadsorción Enzimática , Femenino , Francia , Humanos , Incidencia , Modelos Logísticos , Masculino , Persona de Mediana Edad , Linaje , Probabilidad , Valores de Referencia , Medición de Riesgo , Saccharomyces cerevisiae/inmunología , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Levaduras/genética , Levaduras/inmunología , Adulto Joven
20.
J Med Microbiol ; 56(Pt 4): 495-499, 2007 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-17374890

RESUMEN

The rapid identification of pathogenic yeasts is a crucial step in ensuring that effective antifungal treatment is started as early as possible. CandiSelect 4 (CS4; Bio-Rad) is a new chromogenic medium for the isolation of fungi, the direct identification of Candida albicans and the presumptive identification of the major pathogenic Candida species. The performance of CS4 was compared with that of another chromogenic medium, CHROMagar Candida (CA; Becton Dickinson). For primary cultures, 502 of the 1549 (32 %) samples were culture-positive. A total of 542 yeasts were isolated including 465 monomicrobial and 37 mixed cultures: 392 C. albicans, 60 Candida glabrata, 25 Candida tropicalis, 12 Candida krusei and 53 other Candida species. The percentage of C. albicans isolates that could be identified directly after 24, 48 and 72 h culture was 31.6, 82.9 and 92.1 %, respectively, for CS4, and 32.9, 82.9 and 91.1 % for CA. The presumptive identification of C. glabrata, C. tropicalis and C. krusei was evaluated after 48 h incubation. The percentage of strains with morphologically typical colonies was 80, 68 and 84.6 %, respectively, for CS4 compared with 75, 76 and 76.9 % for CA. For pure subcultures, from 24 h, all isolates of C. albicans (n=21) were directly identifiable on the two chromogenic media CA and CS4. At 48 h, the proportion of typical strains observed on the two chromogenic media was identical for C. glabrata (85 %) and C. krusei (100 %). A slight difference in favour of CS4 was observed for C. tropicalis (100 vs 95 %). CS4 also allowed the growth of several other fungi. CS4 can be recommended as a primary isolation medium for the identification of C. albicans, and for the rapid and effective differentiation of the major pathogenic Candida species.


Asunto(s)
Candida/aislamiento & purificación , Compuestos Cromogénicos/química , Medios de Cultivo/química , Humanos , Micosis/diagnóstico , Micosis/microbiología , Especificidad de la Especie
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA