Artritis por Mycobacterium kansasii en una mujer infectada por el virus de la inmunodeficiencia humana / Arthritis due to Mycobacterium kansasii in a woman with human immunodeficiency virus infection

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[In vitro activity of amphotericin B, itraconazole and voriconazole against 20 species of Aspergillus using the Sensititre microdilution method]. / Actividad in vitro de anfotericina B, itraconazol y voriconazol frente a 20 especies de Aspergillus empleando el método de microdilución Sensititre.

BACKGROUND: The in vitro activity of antifungal agents against Aspergillus has been recently investigated. We studied the susceptibility to amphotericin B, itraconazole and voriconazole of 68 strains belonging to 20 different Aspergillus species. METHODS: The minimum inhibitory concentrations (MICs) for 10 strains of A. fumigatus, 9 A. flavus, 8 A. niger, 5 A. tamarii, 5 A. versicolor, 4 A. terreus, 3 A. glaucus, 3 A. ochraceus, 3 A. oryzae, 2 A. candidus, 2 A. chevalieri, 2 A. rubrobrunneus, 2 A. sclerotiorum, 2 A. sydowii, 2 A. unguis, 2 A. ustus, 1 A. clavatus, 1 A. nidulans, 1 A. pseudofischeri y 1 A. reptans, were determined using the Sensititre Yeast One microdilution method. RESULTS: Voriconazole was more active in vitro than amphotericin B and itraconazole, with 95.6% (65/68) of strains exhibiting MICs of < or = 2 mg/l. A. flavus, A. versicolor, A. terreus, A. ochraceus, A. sclerotiorum, A. ustus and A. reptans species presented reduced susceptibility to amphotericin B (MIC > or = 2 mg/l); A. niger, A. versicolor, A. sclerotiorum and A. ustus showed in vitro resistance to itraconazole (MIC > or = 1 mg/l); and A. sclerotiorum and A. ustus displayed poor susceptibility to voriconazole (MIC > or = 2 mg/l). CONCLUSIONS: The susceptibility of Aspergillus species to itraconazole and voriconazole was generally good; nevertheless, susceptibility to amphotericin B was low. These results suggest that Aspergillus susceptibility testing to this antifungal agent would be advisable to guide treatment.

Actividad in vitro de anfotericina B, itraconazol y voriconazol frente a 20 especies de Aspergillus empleando el método de microdilución Sensititre / In vitro activity of amphotericin B, itraconazole and voriconazole against 20 species of Aspergillus using the Sensititre® microdilution method

ANTECEDENTES. La actividad in vitro de los antifúngicos frente a Aspergillus se ha investigado recientemente. Estudiamos la sensibilidad frente a la anfotericina B, itraconazol y voriconazol de 68 cepas pertenecientes a 20 especies diferentes de Aspergillus. MÉTODOS. Se determinaron las concentraciones inhibitorias mínimas (CIM) para: 10, A. fumigatus; 9, A. flavus;8, A. niger; 5, A. tamarii; 5, A. versicolor; 4, A. terreus;3, A. glaucus; 3, A. ochraceus; 3, A. oryzae; 2, A. candidus;2, A. chevalieri; 2, A. rubrobrunneus; 2, A. sclerotiorum;2, A. sydowii; 2, A. unguis; 2, A. ustus; 1, A. clavatus;1, A. nidulans; 1, A. pseudofischeri, y 1, A. reptans,utilizando el método de microdilución Sensititre Yeast One®. RESULTADOS. El voriconazol fue más activo in vitro que la anfotericina B y el itraconazol, exhibiendo el 95,6% (65/68)de las cepas una CIM igual o inferior a 2 mg/l. Las especies A. flavus, A. versicolor, A. terreus, A. ochraceus,A. sclerotiorum, A. ustus y A. reptans presentaron una sensibilidad reducida frente a la anfotericina B(CIM >= 2 mg/l); A. niger, A. versicolor, A. sclerotiorumy A. ustus mostraron cierta resistencia in vitro frente al itraconazol (CIM >= 1 mg/l); A. sclerotiorum y A. ustus fueron poco sensibles frente al voriconazol (CIM >= 2 mg/l).CONCLUSIONES. La sensibilidad de las especies de Aspergillus frente a itraconazol y voriconazol es buena, pero es significativa la sensibilidad reducida frente a la anfotericina B. Estos resultados sugieren que las pruebas de sensibilidad de Aspergillus a los antifúngicos están recomendadas para orientar un tratamiento (AU)

BACKGROUND. The in vitro activity of antifungal agents against Aspergillus has been recently investigated. We studied the susceptibility to amphotericin B, itraconazole and voriconazole of 68 strains belonging to 20 different Aspergillus species. METHODS. The minimum inhibitory concentrations (MICs)for 10 strains of A. fumigatus, 9 A. flavus, 8 A. niger,5 A. tamarii, 5 A. versicolor, 4 A. terreus, 3 A. glaucus,3 A. ochraceus, 3 A. oryzae, 2 A. candidus, 2 A. chevalieri,2 A. rubrobrunneus, 2 A. sclerotiorum, 2 A. sydowii,2 A. unguis, 2 A. ustus, 1 A. clavatus, 1 A. nidulans,1 A. pseudofischeri y 1 A. reptans, were determined using the Sensititre® Yeast One microdilution method. RESULTS. Voriconazole was more active in vitro thanamphotericin B and itraconazole, with 95.6% (65/68) ofstrains exhibiting MICs of = 2 mg/l); A. niger, A. versicolor,A. sclerotiorum and A. ustus showed in vitro resistance to itraconazole (MIC >= 1 mg/l); and A. sclerotiorum and A. ustus displayed poor susceptibility to voriconazole(MIC >= 2 mg/l).CONCLUSIONS. The susceptibility of Aspergillus species to itraconazole and voriconazole was generally good; never the less, susceptibility to amphotericin B was low. These results suggest that Aspergillus susceptibility testing to this antifungal agent would be advisable to guide treatment (AU)

[Candida ciferrii in an immunocompromised patient]. / Aislamiento de Candida ciferrii en un paciente inmunodeficiente.

A case of possible infection due to Candida ciferrii in an immunocompromised patient is presented. This fungal species has been rarely reported as cause of human infection. The isolate showed in vitro resistance to fluconazole.

[Carbohydrate assimilation by clinical and environmental Rhodotorula glutinis strains]. / Asimilación de carbohidratos por cepas de Rhodotorula glutinis de origen clínico y ambiental.

This study was carried to determine the carbohydrate assimilation patterns of Rhodotorula strains isolated from clinical and environmental specimens. We have tested the commercial system ID 32C (bioMerieux, France) on 80 different strains of Rhodotorula glutinis: 47 strains from clinical samples and 33 strains from environmental samples. The assimilation percentages obtained in our study for galactose, cellobiose, gluconate and sorbose were lower than those showed in the identification table of the method. However, the assimilation percentages for mannitol and esculin were higher. According to our results, we conclude that the numerical profiles and the identification software of the commercial system present limitations for the characterization of some R. glutinis strains.

[Characteristics of tuberculosis in patients older than 65 years in the sanitary area of Cadiz (Spain)]. / Características de la tuberculosis en pacientes mayores de 65 años en el área sanitaria de Cádiz (España).

BACKGROUND: Tuberculosis in the elderly is an increasing public health problem. AIM: To describe the epidemiological, clinical and microbiological characteristics of tuberculosis in patients over 65 years old, as compared to younger patients. MATERIAL AND METHODS: We reviewed the case histories of tuberculosis, microbiologically diagnosed by Ziehl-Neelsen/auramine smear and Löwenstein-Jensen culture, in patients over 65 years old, in the sanitary area of Cadiz (Spain). RESULTS: We detected 49 new cases (37 males) of tuberculosis in elderly subjects. The infection rate in this age group (16.3/100,000 inhabitants) is lower than in people younger than 65 years old (21.1/100,000 inhabitants). The most common symptoms were cough (44.9%), fever (40.8%) and dyspnea (44.9%). Neither of them were infected by the human immunodeficiency virus nor were parenteral drug abusers. Thirty seven percent of cases had a history of previous tuberculosis, and in 75.5% the disease location was pulmonary. The Ziehl-Neelsen/auramine smear was negative in 53.1% of the samples. CONCLUSIONS: The number of patients older than 65 years old with tuberculosis has increased in the sanitary area of Cadiz (Spain). This group of patients shows different epidemiological and clinical characteristics than younger patients.

Características de la tuberculosis en pacientes mayores de 65 años en el área sanitaria de Cádiz (España) / Characteristics of tuberculosis in patients older than 65 years in the sanitary area of Cadiz (Spain)

Background : Tuberculosis in the elderly is an increasing public health problem. Aim: To describe the epidemiological, clinical and microbiological characteristics of tuberculosis in patients over 65 years old, as compared to younger patients. Material and methods: We reviewed the case histories of tuberculosis, microbiologically diagnosed by Ziehl-Neelsen/auramine smear and L÷wenstein-Jensen culture, in patients over 65 years old, in the sanitary area of Cadiz (Spain). Results: We detected 49 new cases (37 males) of tuberculosis in elderly subjects. The infection rate in this age group (16.3/100.000 inhabitants) is lower than in people younger than 65 years old (21.1/100.000 inhabitants). The most common symptoms were cough (44.9 percent), fever (40.8 percent) and dyspnea (44.9 percent). Neither of them were infected by the human immunodeficiency virus nor were parenteral drug abusers. Thirty seven percent of cases had a history of previous tuberculosis, and in 75.5 percent the disease location was pulmonary. The Ziehl-Neelsen/auramine smear was negative in 53.1 percent of the samples. Conclusions: The number of patients older than 65 years old with tuberculosis has increased in the sanitary area of Cadiz (Spain). This group of patients shows different epidemiological and clinical characteristics than younger patients (Rev MÚd Chile 2004; 132: 325-30).

Evaluación de un nuevo medio CHROMagar Candida para la identificación presuntiva de levaduras / Evaluation of a new CHROMagar Candida medium for presumptive identification of yeasts

Se evaluó la utilidad de un nuevo medio cromogénico diferencial CHROMagar Candida frente a dos medios de eficacia probada. Ensayamos 34 levaduras de diferentes especies, pertenecientes a ocho géneros: Candida, Cryptococcus, Trichosporon, Blastoschizomyces, Rhodotorula, Kloeckera, Pichia y Saccharomyces. Tras su correcta identificación se cultivaron en los tres medios a estudiar, apreciando la morfología colonial, color y capacidad de crecimiento. En el nuevo medio las colonias presentaron un tamaño menor y más intensidad de color. Muchas especies ofrecieron el mismo morfotipo. El nuevo medio CHROMagar Candida no muestra la misma eficacia que los otros medios para la identificación de especies de levaduras, al presentar menor sensibilidad, requerir un mayor tiempo de incubación para que las colonias se desarrollen y dificultar la diferenciación de algunas especies de interés clínico como C. tropicalis, C. dubliniensis y C. parapsilosis (AU)