RESUMO
In the present work, we studied the distribution of Candida parapsilosis complex species and the antifungal susceptibility of clinical isolates collected during an Italian surveillance study of yeast invasive fungal infections (IFIs) in intensive care units (ICUs). Minimum inhibitory concentrations (MICs) were determined using the Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution method. BanI digestion patterns of the secondary alcohol dehydrogenase polymerase chain reaction (PCR) products were used to identify C. parapsilosis sensu stricto, C. orthopsilosis, and C. metapsilosis. A total of 138 C. parapsilosis isolates were stored (January 2007-December 2008). The overall frequency of C. parapsilosis complex in IFIs was 22%. Of the 138 tested isolates, 95% were C. parapsilosis sensu stricto, 3.6% were C. orthopsilosis, and 1.4% were C. metapsilosis. The MIC(50) values (expressed as µg/ml) for anidulafungin, caspofungin, and micafungin for C. parapsilosis complex were 2, 1, and 2, respectively, and the MIC(90) values were 4, 2, and 4, respectively. The MIC(50) and MIC(90) values for itraconazole and posaconazole were 0.12 and 0.25, respectively, and for fluconazole, they were 1 and 4, respectively. This study, the most comprehensive study conducted to date to evaluate the frequency and antifungal susceptibility profiles of C. parapsilosis complex isolates from critically ill patients in Italy, highlights the low prevalence of C. orthopsilosis and C. metapsilosis in IFIs.
Assuntos
Álcool Desidrogenase/genética , Antifúngicos/farmacologia , Candida/classificação , Candidíase Invasiva/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anfotericina B/farmacologia , Candida/efeitos dos fármacos , Candida/genética , Candida/isolamento & purificação , Candidíase Invasiva/microbiologia , Criança , Pré-Escolar , Estado Terminal , Equinocandinas/farmacologia , Proteínas Fúngicas/genética , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva , Itália/epidemiologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Técnicas de Tipagem Micológica , Reação em Cadeia da Polimerase , Triazóis/farmacologia , Adulto JovemAssuntos
Biofilmes/crescimento & desenvolvimento , Candida/isolamento & purificação , Candida/fisiologia , Candida/patogenicidade , Candida albicans/isolamento & purificação , Candida albicans/patogenicidade , Candida albicans/fisiologia , Candida glabrata/isolamento & purificação , Candida glabrata/patogenicidade , Candida glabrata/fisiologia , Candida tropicalis/isolamento & purificação , Candida tropicalis/patogenicidade , Candida tropicalis/fisiologia , Membrana Celular/fisiologia , Humanos , Interações Hidrofóbicas e Hidrofílicas , Modelos Biológicos , Análise de Regressão , Especificidade da EspécieRESUMO
We report the establishment in vitro of three-dimensional (3D) cultures of human osteoblasts (hOB) derived from normal adults and supported uniquely by the extracellular matrix (ECM) they deposit. Osteoblasts were cultured in 3D cultures in vitro for up to 120 days. The 3D cultures, examined at 25, 31, and 48 days, expressed protein markers of osteoblastic cells, namely osteonectin, collagen type I, fibronectin, osteopontin, bone sialoprotein, biglycan, and decorin. Sequentially, alkaline phosphatase (AP) and then Ca incorporation, mineralization of matrix (monitored by histochemistry and transmission electron microscopy), and finally osteocalcin expression, were detected in the 3D cultures. Ultrastructurally, morphology progressed from early to mature osteoblast and to osteocyte-like. Cells were embedded in a matrix with organized collagen type I fibers containing, increasingly with time of culture, needle-shaped crystals, often associated with matrix vesicles, characteristic of those in bone. During the culture (up to 120 days) there was an outgrowth of proliferating osteogenic cells from the 3D structure. Subcutaneous implantation in nude mice for 20 days of osteoblasts cultured in 3D culture for different lengths of time in vitro, showed progression of mineralization from the inner region of the implant outward, with peripheral cells being embedded in nonmineralized, collagen-rich matrix. The 3D implants were invaded by vessels derived from the host.