Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.314
Filtrar
1.
J Med Microbiol ; 70(3)2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33599604

RESUMO

Over a decade ago, a multidrug-resistant nosocomial fungus Candida auris emerged worldwide and has since become a significant challenge for clinicians and microbiologists across the globe. A resilient pathogen, C. auris survives harsh disinfectants, desiccation and high-saline environments. It readily colonizes the inanimate environment, susceptible patients and causes invasive infections that exact a high toll. Prone to misidentification by conventional microbiology techniques, C. auris rapidly acquires multiple genetic determinants that confer multidrug resistance. Whole-genome sequencing has identified four distinct clades of C. auris, and possibly a fifth one, in circulation. Even as our understanding of this formidable pathogen grows, the nearly simultaneous emergence of its distinct clades in different parts of the world, followed by their rapid global spread, remains largely unexplained. We contend that certain host-pathogen-environmental factors have been evolving along adverse trajectories for the last few decades, especially in regions where C. auris originally appeared, until these factors possibly reached a tipping point to compel the evolution, emergence and spread of C. auris. Comparative genomics has helped identify several resistance mechanisms in C. auris that are analogous to those seen in other Candida species, but they fail to fully explain how high-level resistance rapidly develops in this yeast. A better understanding of these unresolved aspects is essential not only for the effective management of C. auris patients, hospital outbreaks and its global spread but also for forecasting and tackling novel resistant pathogens that might emerge in the future. In this review, we discuss the emergence, spread and resistance of C. auris, and propose future investigations to tackle this resilient pathogen.


Assuntos
Candida/fisiologia , Candidíase/microbiologia , Doenças Transmissíveis Emergentes/microbiologia , Farmacorresistência Fúngica Múltipla , Microbiologia Ambiental , Anti-Infecciosos/farmacologia , Anti-Infecciosos/uso terapêutico , Candida/classificação , Candida/isolamento & purificação , Candida/patogenicidade , Candidíase/epidemiologia , Candidíase/transmissão , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/transmissão , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/transmissão , Saúde Global , Humanos , Virulência
2.
MMWR Morb Mortal Wkly Rep ; 70(2): 56-57, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33444298

RESUMO

In July 2020, the Florida Department of Health was alerted to three Candida auris bloodstream infections and one urinary tract infection in four patients with coronavirus disease 2019 (COVID-19) who received care in the same dedicated COVID-19 unit of an acute care hospital (hospital A). C. auris is a multidrug-resistant yeast that can cause invasive infection. Its ability to colonize patients asymptomatically and persist on surfaces has contributed to previous C. auris outbreaks in health care settings (1-7). Since the first C. auris case was identified in Florida in 2017, aggressive measures have been implemented to limit spread, including contact tracing and screening upon detection of a new case. Before the COVID-19 pandemic, hospital A conducted admission screening for C. auris and admitted colonized patients to a separate dedicated ward.


Assuntos
/terapia , Candida/isolamento & purificação , Candidíase/epidemiologia , Surtos de Doenças , Unidades Hospitalares , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Florida/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade
3.
J Infect ; 82(2): 276-281, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33412206

RESUMO

OBJECTIVES: The Infectious Disease Society of America recommends that all patients with candidemia undergo a dilated retinal exam to exclude endogenous Candida endophthalmitis. Our objective was to determine if there are significant risk factors in candidemic patients for developing endogenous Candida endophthalmitis METHODS: We conducted a retrospective study of all candidemic patients at three academic medical centers between 2012 and 2017. We extracted risk factors for Candida endophthalmitis based on prior literature and compared them between patients with and without endophthalmitis. We then built a multivariate logistic regression model to assess which ones were significant. RESULTS: We found 771 patients with candidemia. 120 (15.6%) of these patients were diagnosed with Candida endophthalmitis. In our logistic regression analysis, central venous catheter presence (OR 8.35), intravenous drug use (OR 4.76), immunosuppression (OR 2.40), total parenteral nutrition recipient (OR 2.28), race (OR 1.65), age (OR 1.02), and gender (OR 0.57) were risk factors for developing Candida endophthalmitis. Additionally, Candida albicans was more likely to result in Candida endophthalmitis (OR 1.86). CONCLUSIONS: This cohort represents the largest study of risk factors for candidemic patients who developed endogenous Candida endophthalmitis. Based on our findings, clinicians should develop targeted and cost-effective strategies for endophthalmitis screening.


Assuntos
Candidíase , Endoftalmite , Infecções Oculares Fúngicas , Candida , Candidíase/diagnóstico , Candidíase/epidemiologia , Endoftalmite/epidemiologia , Infecções Oculares Fúngicas/diagnóstico , Infecções Oculares Fúngicas/epidemiologia , Humanos , Estudos Retrospectivos , Fatores de Risco
4.
BMC Infect Dis ; 20(1): 827, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33176724

RESUMO

BACKGROUND: Candida auris is a new pathogen called "superbug fungus" which caused panic worldwide. There are no large-scale epidemiology studies by now, therefore a systematic review and meta-analysis was undertaken to determine the epidemic situation, drug resistance patterns and mortality of C. auris. METHODS: We systematically searched studies on the clinical report of Candida auris in Pubmed, Embase and Cochrane databases until October 6, 2019. A standardized form was used for data collection, and then statics was performed with STATA11.0. RESULTS: It showed that more than 4733 cases of C. auris were reported in over 33 countries, with more cases in South Africa, United States of America, India, Spain, United Kingdom, South Korea, Colombia and Pakistan. C. auirs exhibited a decrease in case count after 2016. Clade I and III were the most prevalent clades with more cases reported and wider geographical distribution. Blood stream infection was observed in 32% of the cases, which varied depending on the clades. Resistance to fluconazole, amphotericin B, caspofungin, micafungin and anidulafungin in C. auris were 91, 12, 12.1, 0.8 and 1.1%. The overall mortality of C. auris infection was 39%. Furthermore, subgroup analyses showed that mortality was higher in bloodstream infections (45%), and lower in Europe (20%). CONCLUSIONS: Over 4000 cases of C. auris were reported in at least 33 countries, which showed high resistance to fluconazole, moderate resistance to amphotericin B and caspofungin, high sensitivity to micafungin and anidulafungin. The crude mortality for BSI of C. auris was 45% which was similar to some drug-resistant bacteria previously reported. In conclusion, C. auris displayed similar characteristics to some drug resistance organisms. This study depicts several issues of C. auris that are most concerned, and is of great significance for the clinical management.


Assuntos
Candida/efeitos dos fármacos , Candidíase/epidemiologia , Candidíase/mortalidade , Anfotericina B/uso terapêutico , Anidulafungina/uso terapêutico , Antifúngicos/uso terapêutico , Candida/classificação , Candida/genética , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Caspofungina/uso terapêutico , Farmacorresistência Fúngica Múltipla/efeitos dos fármacos , Fluconazol/uso terapêutico , Humanos , Micafungina/uso terapêutico , Prevalência
5.
Adv Genet ; 106: 75-100, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33081928

RESUMO

The origins and global spread of two recent, yet quite different, pandemic diseases is discussed and reviewed in depth: Candida auris, a eukaryotic fungal disease, and COVID-19 (SARS-CoV-2), a positive strand RNA viral respiratory disease. Both these diseases display highly distinctive patterns of sudden emergence and global spread, which are not easy to understand by conventional epidemiological analysis based on simple infection-driven human- to-human spread of an infectious disease (assumed to jump suddenly and thus genetically, from an animal reservoir). Both these enigmatic diseases make sense however under a Panspermia in-fall model and the evidence consistent with such a model is critically reviewed.


Assuntos
Evolução Biológica , Candidíase/etiologia , Doenças Transmissíveis Emergentes/etiologia , Infecções por Coronavirus/etiologia , Origem da Vida , Pneumonia Viral/etiologia , Animais , Betacoronavirus/isolamento & purificação , Betacoronavirus/fisiologia , Candida/isolamento & purificação , Candida/fisiologia , Candidíase/epidemiologia , Doenças Transmissíveis Emergentes/epidemiologia , Coronavirus/isolamento & purificação , Coronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Planeta Terra , Exobiologia , Meio Ambiente Extraterreno , Interações Hospedeiro-Patógeno/fisiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia
7.
J Laryngol Otol ; 134(7): 592-596, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32713390

RESUMO

BACKGROUND: Fungal otitis externa is prevalent in tropical and sub-tropical climates; however, over the past two decades, there has been a reported increase in the prevalence of otomycosis in paediatric patients from more temperate climates. This study aimed to review the children diagnosed with otomycosis at the University Hospital Limerick with reference to frequency, causative organism, predisposing factors and management. METHODS: A retrospective review was conducted of paediatric patients from 2001 to 2015. Patients with positive fungal ear swabs and a diagnosis of otomycosis were identified. RESULTS: Ninety-three patients were positive for candida (mean age, 5.8 years), 10 patients were positive for aspergillus (mean age, 9.1 years) and 1 patient had mixed fungal infection containing both fungi. There was a positive correlation between a diagnosis of otomycosis and prior treatment with topical fluoroquinolones (r = 0.8; p < 0.01). CONCLUSION: The incidence of otomycosis has been increasing since 2001, which correlates with an increase in the use of topical fluoroquinolones. Previous studies identify aspergillus as the commonest causative fungi; however, this study found that candida was the commonest isolated fungi in the paediatric population.


Assuntos
Otomicose/epidemiologia , Antifúngicos/uso terapêutico , Aspergilose/diagnóstico , Aspergilose/tratamento farmacológico , Aspergilose/epidemiologia , Aspergilose/microbiologia , Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Candidíase/epidemiologia , Candidíase/microbiologia , Criança , Pré-Escolar , Coinfecção/diagnóstico , Coinfecção/tratamento farmacológico , Coinfecção/epidemiologia , Coinfecção/microbiologia , Feminino , Humanos , Incidência , Irlanda/epidemiologia , Masculino , Otomicose/diagnóstico , Otomicose/tratamento farmacológico , Otomicose/microbiologia , Estudos Retrospectivos
9.
J Mycol Med ; 30(3): 101011, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32693980

RESUMO

INTRODUCTION: Otomycosis, a superficial fungal infection of the external auditory canal (EAC), is a disease with exceptionally high prevalence. AIM: The aim of this study was to determine the prevalence of otomycosis, the distribution of causative species and to evaluate epidemiological characteristics of these infections. METHODOLOGY: The patients' data were collected from record book and database of mycological examinations conducted at Public Health Institute Nis, Serbia. In the period from 2014 to 2018 samples of 1287 patients with symptoms and signs of EAC infection were investigated. Standard mycological methods were used for isolation and determination of fungi. RESULTS: High prevalence of otomycosis was determined in examined patients (22.7%). However, the prevalence rates did not differ significantly in the studied period (p=0.931). The majority of patients were diagnosed with only unilateral EAC infection (82.9%). Considering all patients with otomycosis, mold infections caused by the genus Aspergillus (143/48.9%) were more frequent than Candida spp. ear infections (133/45.6%), with Aspergillus niger and Candida аlbicans being predominant causative agents. Mixed Aspergillus and Candida otomycosis was established in 16 (5.5%) patients. Otomycosis was more common in male subjects (26.8%, p=0.003) who also suffered from Aspergillus otomycosis more frequently (17.5%, p<0.001). The prevalence of these infections increases with age (p=0.005), while they do not show seasonal pattern (p>0.05). CONCLUSION: Noted high prevalence of otomycosis, with both yeasts and non-dermatophyte molds acting as infectious agents which require different treatment, implies the necessity for further epidemiological monitoring of this form of superficial mycoses.


Assuntos
Otomicose/epidemiologia , Otomicose/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/classificação , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergilose/epidemiologia , Aspergilose/microbiologia , Aspergillus niger/efeitos dos fármacos , Aspergillus niger/isolamento & purificação , Candida/classificação , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candida albicans/efeitos dos fármacos , Candida albicans/isolamento & purificação , Candidíase/tratamento farmacológico , Candidíase/epidemiologia , Candidíase/microbiologia , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Técnicas de Tipagem Micológica , Otomicose/tratamento farmacológico , Prevalência , Sérvia/epidemiologia , Adulto Jovem
10.
PLoS One ; 15(7): e0236368, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32706836

RESUMO

INTRODUCTION: In the past decade, new diagnostic methods and strategies have appeared, HIV testing efforts and the generalization of antiretroviral therapy may have influenced the number of opportunistic diagnoses and mortality of HIV-infected patients. To test this hypothesis we compiled data on the top opportunistic infections and causes of early death in the HIV cohort of French Guiana. METHODS: HIV-infected persons followed in Cayenne, Kourou, and Saint Laurent du Maroni hospitals from 2010 to 2019 were studied. Annual incidence of different opportunistic infections and annual deaths are compiled. For patients with opportunistic infections we calculated the proportion of early deaths. RESULTS: At the time of analysis, among 2 459 patients, (treated and untreated) 90% had a viral load <400 copies, 91% of the patients in the cohort were on antiretroviral treatment, and 94.2% of patients on treatment for over 6 months had undetectable viral loads. Only 9% of patients had CD4 counts under 200 per mm3. Histoplasmosis clearly remained the most frequent (128 cases) opportunistic infection among HIV-infected persons followed by cerebral toxoplasmosis (63 cases) and esophageal candidiasis (41 cases). Cryptococcal meningitis was ranked 5th most frequent opportunistic infection as was tuberculosis (31 cases). The trend for a sharp decline in early deaths continued (3.9% of patients). CONCLUSIONS: Despite the successes of antiretrovirals, patients presenting with advanced HIV are still common and they are still at risk of dying. Improved diagnosis, and notably systematic screening with appropriate tools are still important areas of potential progress.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/mortalidade , Histoplasmose/epidemiologia , Carga Viral/estatística & dados numéricos , Adolescente , Adulto , Candidíase/epidemiologia , Estudos de Coortes , Feminino , Guiana Francesa , HIV-1 , Humanos , Masculino , Meningite Criptocócica/epidemiologia , Pessoa de Meia-Idade , Toxoplasmose Cerebral/epidemiologia , Tuberculose/epidemiologia , Adulto Jovem
11.
BMC Public Health ; 20(1): 832, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32487232

RESUMO

BACKGROUND: Candida auris is a novel Candida species, and has emerged globally as a multidrug-resistant health care-associated fungal pathogen. YouTube™ (http://www.youtube.com) as the largest free video-sharing website is increasingly used to search health information. Thus, the aim of this study was to evaluate the content, reliability and quality of YouTube™ videos regarding Candida auris infection, and to identify whether it is a useful resource for people. METHODS: The YouTube™ was used to search systematically for videos using the keywords: "Candida auris infection" and "Candida auris". Strict inclusion and exclusion criteria were used to select the videos. The videos were reviewed and scored by two independent reviewers and recorded the "title", "length", "views", "comments", "dislike", "like", "posted days" and "category of videos". The videos were categorized as "poor", "good" and "excellent" by the score. The DISCERN tool was used to assess the reliability of the YouTube™ videos. RESULTS: Seventy-six videos were included in final analysis in our study. Most videos (59.2%, 55/76) had better quality. There were no statistically significant differences between groups in respect of the number of likes, dislikes, views, comments, percentage positivity, likebility, view rate and viewers' interaction. Length and posted days were significantly associated with the classification. The videos were categorized as "educational video", "new report", "personal experience and blog entertainment" and "interview". Significant differences were found in the source of videos and the characteristics of the individuals appearing in a video between the groups. CONCLUSION: YouTube™ has striking potential to be an effective user-friendly learning interface for people to obtain information of Candida auris infection.


Assuntos
Candidíase/epidemiologia , Candidíase/fisiopatologia , Confiabilidade dos Dados , Promoção da Saúde/métodos , Internet/normas , Mídias Sociais/normas , Gravação em Vídeo/normas , Humanos , Reprodutibilidade dos Testes
12.
J Mycol Med ; 30(3): 100968, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32386800

RESUMO

OBJECTIVE: Candida parapsilosis species complex, an important set of non-albicans Candida species, is known to cause candidaemia particularly in neonates and infants. However, the incidence has increased in recent years, owing to higher numbers of at individuals at risk for these infections. Our objective was to evaluate the in vitro susceptibility of clinical isolates of C. parapsilosis complex isolates from Iran to seven antifungal drugs. MATERIAL AND METHODS: One hundred-one clinical isolates of C. parapsilosis species complex cultured from humans were included. Species identification had been previously confirmed by combined phenotypic characteristics, matrix-assisted laser desorption ionization-time of flight mass spectrometry-based assay and reconfirmed by DNA sequence analysis of the ITS rDNA region and D1/D2 gene. Minimum inhibitory concentrations (MICs) for amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, micafungin and anidulafungin were determined against well-characterized isolates by broth microdilution susceptibility testing according to the CLSI M27-A3 guideline. RESULTS: Species identifications were performed on 101 isolates, of which 88 (87.2%) C. parapsilosis sensu stricto and 13 (12.8%) C. orthopsilosis. Amphotericin B and posaconazole were the most active drugs with 100% of isolates being wild-type (WT). Voriconazole and micafungin, 99% of isolates were WT. The low activity was recorded for fluconazole and itraconazole with 93.1% and 89.1% of isolates being WT, respectively. At the species level, all Candida parapsilosis sensu stricto isolates were WT to amphotericin B and posaconazole and all Candida orthopsilosis isolates were WT to amphotericin B, voriconazole, posaconazole, anidulafungin and micafungin. In contrast, the highest rate of non-WT was observed in C. orthopsilosis to itraconazole (4 of 13, 30.8%). CONCLUSIONS: Although almost all of the tested drugs demonstrated potent activity against C. parapsilosis species complex, it seems that more especially C. orthopsilosis isolates had decreased susceptibility to itraconazole. Further studies are needed to determine how these findings may switch into in vivo efficacy.


Assuntos
Antifúngicos/farmacologia , Candida parapsilosis/efeitos dos fármacos , Candidíase/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Candida parapsilosis/crescimento & desenvolvimento , Candida parapsilosis/isolamento & purificação , Candidíase/tratamento farmacológico , Candidíase/epidemiologia , Criança , Pré-Escolar , Farmacorresistência Fúngica/efeitos dos fármacos , Feminino , Humanos , Lactente , Recém-Nascido , Irã (Geográfico)/epidemiologia , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Adulto Jovem
14.
Euro Surveill ; 25(12)2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32234118

RESUMO

Between January 2018 and May 2019, 349 cases of Candida auris were reported in the European Union/European Economic Area*, 257 (73.6%) colonisations, 84 (24.1%) bloodstream infections, seven (2.0%) other infections and one case of unknown infection/colonisation status (0.3%). Most cases (97.1%, n = 339) were reported from Spain or the United Kingdom, but also for the first time in Greece, the Netherlands and Poland. Laboratory capacity and preparedness has improved since January 2018.


Assuntos
Candida/isolamento & purificação , Candidíase/diagnóstico , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Candida/efeitos dos fármacos , Candidíase/tratamento farmacológico , Candidíase/epidemiologia , Doenças Transmissíveis Emergentes/epidemiologia , Surtos de Doenças , Farmacorresistência Fúngica Múltipla , Europa (Continente)/epidemiologia , União Europeia , Humanos , Controle de Infecções , Testes de Sensibilidade Microbiana
17.
J Postgrad Med ; 66(2): 102-104, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31898594

RESUMO

Idiopathic CD4+ T lymphocytopenia (ICL) is a very rare immunodeficiency syndrome with an unexplained depletion of CD4+ T lymphocytes and no evidence of Human Immunodeficiency Virus (HIV) infection. Here we report a 29-year-old male patient who had severe ulcerative colitis with low level CD4+ count of 254 cells/mm3, and had no evidence of HIV or Human T cell Lymphotrophic virus type I or II infections. He had recurrent Candidiasis infection and his CD4 count was just 53 cells/mm3 after 3 months. The cause for the decline of CD4 T lymphocytes was unknown.


Assuntos
Linfócitos T CD4-Positivos/patologia , Candidíase/epidemiologia , Colite Ulcerativa/complicações , T-Linfocitopenia Idiopática CD4-Positiva/diagnóstico , Adulto , Humanos , Masculino , T-Linfocitopenia Idiopática CD4-Positiva/sangue
18.
Mycoses ; 63(4): 326-333, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31930592

RESUMO

BACKGROUND: Non-albicans Candida spp. are an emerging cause of hospital-acquired bloodstream infections, associated with high mortality due to the challenges in diagnosis and delayed treatment. OBJECTIVES: We aimed to investigate a cluster of healthcare-associated invasive candidiasis caused by C tropicalis and review the literature of healthcare-associated outbreaks or clusters caused by C tropicalis. METHODS: An investigation was performed to determine clinical presentation, treatment outcomes and the factors contributing to C tropicalis candidemia occurrence. We searched the Medline database via PubMed and Ovid using the keywords of "Candida tropicalis" combined with "outbreak" or "clustering" or "clusters," and we limited the search to studies conducted from January 1989 to January 2019. RESULTS: We report two related cases of C tropicalis candidemia among patients with AML following a period of neutropenia, who had erythematous skin rash as a first manifesting sign of candidiasis. C tropicalis was isolated from blood and skin cultures of both patients, which were identical by pulsed-field gel electrophoresis typing. Our systematic review of outbreaks caused by C tropicalis suggests that (a) most reported outbreaks have occurred in neonatal and adult ICUs; (b) patients who receive total parenteral therapy, antibiotics and those who have indwelling catheters and recent surgery are at high risk of infection; and (c) environmental and healthcare personnel surveillance suggest that cross-contamination is a major risk factor. CONCLUSION: Control of nosocomial outbreaks caused by C tropicalis should include better infection control measures, education of healthcare professionals especially working in adult and neonatal intensive care and haematology units.


Assuntos
Candida tropicalis/isolamento & purificação , Candidemia/epidemiologia , Candidíase/epidemiologia , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Hematologia , Hospitais , Humanos , Controle de Infecções , Unidades de Terapia Intensiva , Unidades de Terapia Intensiva Neonatal
19.
Eur Radiol ; 30(4): 2253-2260, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31900707

RESUMO

OBJECTIVES: To compare imaging and clinical features of fungal and Staphylococcus aureus discitis-osteomyelitis (DO) for patients presenting for CT-guided biopsies. METHODS: Our study was IRB-approved and HIPAA-compliant. A group of 11 fungal DO (FG) with MRI within 7 days of the biopsy and a control group (CG) of 19 Staphylococcus aureus DO were evaluated. Imaging findings (focal vs diffuse paravertebral soft tissue abnormality, partial vs complete involvement of the disc/endplate), biopsy location, pathology, duration of back pain, immune status, history of intravenous drug, history of prior infection, current antibiotic treatment, and history of invasive intervention. Differences were assessed using the Fisher exact test and Kruskal-Wallis test. Naïve Bayes predictive modeling was performed. RESULTS: The most common fungal organisms were Candida species (9/11, 82%). The FG was more likely to have focal soft tissue abnormality (p = 0.040) and partial disc/endplate involvement (p = 0.053). The clinical predictors for fungal DO, in order of importance, back pain for 10 or more weeks, current antibiotic use for 1 week or more, and current intravenous drug use. History of invasive instrumentation within 1 year was more predictive of Staphylococcus aureus DO. CONCLUSION: MRI features (focal partial soft tissue abnormality and partial involvement of the disc/endplate) in combination with clinical features may help to predict fungal species as a causative organism for DO. KEY POINTS: • MRI features of discitis-osteomyelitis (focal partial soft tissue abnormality and partial involvement of the disc/endplate) in combination with clinical features may help to predict fungal species as a causative organism for DO.


Assuntos
Dor nas Costas/fisiopatologia , Candidíase/diagnóstico por imagem , Discite/diagnóstico por imagem , Osteomielite/diagnóstico por imagem , Doenças da Coluna Vertebral/diagnóstico por imagem , Infecções Estafilocócicas/diagnóstico por imagem , Adulto , Idoso , Antibacterianos/uso terapêutico , Teorema de Bayes , Candidíase/epidemiologia , Candidíase/imunologia , Candidíase/microbiologia , Estudos de Casos e Controles , Discite/epidemiologia , Discite/imunologia , Discite/microbiologia , Feminino , Humanos , Biópsia Guiada por Imagem , Hospedeiro Imunocomprometido/imunologia , Imagem por Ressonância Magnética , Masculino , Staphylococcus aureus Resistente à Meticilina , Pessoa de Meia-Idade , Osteomielite/epidemiologia , Osteomielite/imunologia , Osteomielite/microbiologia , Fatores de Risco , Doenças da Coluna Vertebral/epidemiologia , Doenças da Coluna Vertebral/imunologia , Doenças da Coluna Vertebral/microbiologia , Staphylococcus aureus , Abuso de Substâncias por Via Intravenosa/epidemiologia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Adulto Jovem
20.
Microb Pathog ; 139: 103898, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31794817

RESUMO

Diagnosis of fungal co-infections in patients suffering from pulmonary tuberculosis has critical importance. Therefore, we aimed to determine the prevalence of candida coinfection in patients with pulmonary tuberculosis. The present systematic review of cross-sectional studies was conducted based on the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) Protocol. Studies published online in English from January 2001 to March 2019 were assessed. Literature search was done in Web of Science, MEDLINE/PubMed, and Scopus databases and search engines using keywords combinations of "pulmonary fungi", "pulmonary coinfection", OR "pulmonary mycosis", "pulmonary fungal infections/agents", OR "polymicrobial infection", OR "secondary infection", OR "mixed infections", "pulmonary candidiasis", "fungi coinfection", "fungal co-colonization", AND "pulmonary tuberculosis", OR "pulmonary TB", AND "Asia", AND "Africa". Data was analyzed using Comprehensive Meta-Analysis software (CMA). Heterogeneity between studies was evaluated by Cochran's Q and I2 tests. The pooled prevalence of candida coinfection among patients with pulmonary tuberculosis was 25.7% (95% CI: 23.7-27.9). C. albicans was the most prevalent Candida spp. with a pooled prevalence of 65.8% (95% CI: 54.3-75.7). Risk factors of candida coinfection were smoking, diabetes, advanced age, and low body mass index. The present review showed a high rate of candida coinfection among patients suffering from pulmonary tuberculosis. So, appropriate measures are necessary to early diagnose and treat these infections.


Assuntos
Candidíase/epidemiologia , Candidíase/microbiologia , Pneumopatias Fúngicas/epidemiologia , Pneumopatias Fúngicas/microbiologia , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/microbiologia , África/epidemiologia , Ásia/epidemiologia , Estudos Transversais , Humanos , Prevalência , Medição de Risco , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...