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1.
MMWR Morb Mortal Wkly Rep ; 69(1): 6-9, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31917780

RESUMO

Candida auris is a globally emerging yeast that causes outbreaks in health care settings and is often resistant to one or more classes of antifungal medications (1). Cases of C. auris with resistance to all three classes of commonly prescribed antifungal drugs (pan-resistance) have been reported in multiple countries (1). C. auris has been identified in the United States since 2016; the largest number (427 of 911 [47%]) of confirmed clinical cases reported as of October 31, 2019, have been reported in New York, where C. auris was first detected in July 2016 (1,2). As of June 28, 2019, a total of 801 patients with C. auris were identified in New York, based on clinical cultures or swabs of skin or nares obtained to detect asymptomatic colonization (3). Among these patients, three were found to have pan-resistant C. auris that developed after receipt of antifungal medications, including echinocandins, a class of drugs that targets the fungal cell wall. All three patients had multiple comorbidities and no known recent domestic or foreign travel. Although extensive investigations failed to document transmission of pan-resistant isolates from the three patients to other patients or the environment, the emergence of pan-resistance is concerning. The occurrence of these cases underscores the public health importance of surveillance for C. auris, the need for prudent antifungal prescribing, and the importance of conducting susceptibility testing on all clinical isolates, including serial isolates from individual patients, especially those treated with echinocandin medications. This report summarizes investigations related to the three New York patients with pan-resistant infections and the subsequent actions conducted by the New York State Department of Health and hospital and long-term care facility partners.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Farmacorresistência Fúngica , Idoso , Antifúngicos/classificação , Candida/isolamento & purificação , Humanos , Pessoa de Meia-Idade , New York
2.
Pol J Microbiol ; 68(3): 303-308, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31880875

RESUMO

The data on susceptibility to antifungals of new species within Candida glabrata complex are limited. Our study was to enrich a global knowledge of yeast epidemiology and drug resistance. The study was focused on the identification of species within clinical isolates of the C. glabrata complex and on the determination of their resistance to antifungals. Four hundred forty-five clinical C. glabrata sensu lato strains were isolated from different clinical samples at routine mycological exams at the Infant Jesus Teaching Hospital in Warsaw. The identification of the most of tested isolates to species complex level was performed using the ID 32 C system. The identification of C. nivariensis and C. bracarensis species within the C. glabrata complex was performed by DNA sequencing. The MICs of amphotericin B, fluconazole, itraconazole, posaconazole, voriconazole, caspofungin, anidulafungin, and micafungin were determined by E-test. Twenty-four isolates did not have an ITS-1 region, characteristic of C. glabrata sensu stricto and their D1/D2 regions of the 26S rRNA were 99% homologous to C. nivariensis 26S rRNA. No strains of C. bracarensis were recovered. C. nivariensis strains were very susceptible to amphotericin B, anidulafungin, micafungin, and caspofungin. Ninety-two percent of C. nivariensis were resistant to itraconazole. The halves of the strains was resistant to posaconazole. Eighty-three percent of C. nivariensis were susceptible to voriconazole. None of the tested strains were susceptible to fluconazole. In the present study, none of the C. nivariensis strains were simultaneously resistant to azoles and echinocandins. C. nivariensis should be recognized as an emerging pathogen, resistant to azoles.The data on susceptibility to antifungals of new species within Candida glabrata complex are limited. Our study was to enrich a global knowledge of yeast epidemiology and drug resistance. The study was focused on the identification of species within clinical isolates of the C. glabrata complex and on the determination of their resistance to antifungals. Four hundred forty-five clinical C. glabrata sensu lato strains were isolated from different clinical samples at routine mycological exams at the Infant Jesus Teaching Hospital in Warsaw. The identification of the most of tested isolates to species complex level was performed using the ID 32 C system. The identification of C. nivariensis and C. bracarensis species within the C. glabrata complex was performed by DNA sequencing. The MICs of amphotericin B, fluconazole, itraconazole, posaconazole, voriconazole, caspofungin, anidulafungin, and micafungin were determined by E-test. Twenty-four isolates did not have an ITS-1 region, characteristic of C. glabrata sensu stricto and their D1/D2 regions of the 26S rRNA were 99% homologous to C. nivariensis 26S rRNA. No strains of C. bracarensis were recovered. C. nivariensis strains were very susceptible to amphotericin B, anidulafungin, micafungin, and caspofungin. Ninety-two percent of C. nivariensis were resistant to itraconazole. The halves of the strains was resistant to posaconazole. Eighty-three percent of C. nivariensis were susceptible to voriconazole. None of the tested strains were susceptible to fluconazole. In the present study, none of the C. nivariensis strains were simultaneously resistant to azoles and echinocandins. C. nivariensis should be recognized as an emerging pathogen, resistant to azoles.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidíase/microbiologia , Anfotericina B/farmacologia , Candida/classificação , Candida/genética , Candida/isolamento & purificação , Candidíase/epidemiologia , Farmacorresistência Fúngica , Fluconazol/farmacologia , Hospitais de Ensino/estatística & dados numéricos , Humanos , Testes de Sensibilidade Microbiana , Polônia/epidemiologia , Prevalência , Triazóis/farmacologia
3.
Pan Afr Med J ; 33: 198, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692732

RESUMO

Introduction: Epidemiology of these disorders, mainly caused by mycosis, is little known in the Ivory Coast. The aim of this study was to determine the different clinical aspects of intertrigos caused by fungal infections. Methods: We conducted a cross-sectional study in the Department of Clinical Dermatology at the University Hospital in Yopougon (Abidjan, Ivory Coast) from April to October 2012. The study involved the patients come to consultation with lesions in the folds suggesting a mycosis. Samples of serous fluid by swabbing or of scales by scrape cutting with the scalpel blade were performed at the level of the lesions. The fungal agents responsible for these lesions were identified after biological culture. Results: A total of 200 patients had lesions suggesting intertrigo caused by fungal infection. The average age of patients was 29.8 years (with a standard deviation of 11.1 years). Mycosis-related intertrigos accounted for 6.7% of reasons for consultation. A female predominance was observed (76.7%). Lesions mainly occurred in the groin area (40.8%) and in the intergluteal clefts (36.9%). The most observed symptoms were maceration (52.4%) followed by burning (18.4%). In 89.3% of cases, intertrigos were caused by yeasts, including Candida albicans (33%), and Candida parapsilosis(19.4%) which were predominant. Conclusion: Mycosis-related intertrigos mainly affect the young adults of female sex. Lesions mainly occur at the level of the inguinal folds and intergluteal clefts. The main etiological agents are yeasts (Candida).


Assuntos
Candidíase/epidemiologia , Intertrigo/epidemiologia , Micoses/epidemiologia , Adolescente , Adulto , Candida/isolamento & purificação , Candidíase/microbiologia , Criança , Pré-Escolar , Costa do Marfim , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Lactente , Intertrigo/microbiologia , Masculino , Pessoa de Meia-Idade , Micoses/microbiologia , Fatores Sexuais , Adulto Jovem
4.
J Assoc Physicians India ; 67(9): 42-45, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31561688

RESUMO

Introduction: The incidence of the urinary tract infections caused by Candida species, are becoming more common. Recently, an increase in the incidence of infection caused by fungi especially non albicans candida species (NAC) has been reported. Several virulence factors like biofilm formation, toxin production and presence of adhesins contribute to its pathogenesis. Objectives: This study was undertaken to determine species distribution, biofilm formation and in-vitro antifungal susceptibility of candida isolated in our tertiary care hospital. Method: Eighty seven clinical isolates obtained from urine specimens were subjected to wet mount, Gram's stain and cultured on Sabouraud's Dextrose agar (SDA) medium. Conventional method for yeast identification was done. Biofilm forming ability of each isolate was detected using microtitre plate method. Antifungal susceptibility against posaconazole, amphotericin-B, fluconazole, itraconazole, ketoconazole, 5-flucytosine, voriconazole, and caspofungin was tested using Sensititre® Yeastone® (Trek diagnostic systems). Results and Discussion: Out of 87 candida isolates, 31.03% (n=27) were C. albicans and 68.97% (n=60) were non albicans candida species (NAC). Among 60 NAC, C. kruseii 29.89% (n=26), C. glabrata 24.14% (n=21), C. tropicalis 14.94% (n=13). Among all isolates, 36.78% (n=32) were biofilm producers and biofilm positivity more among C. albicans 55.56% (n=15) as compared to NAC 28.33% (n=17) (Pvalue<0.002). The maximum positivity was observed with isolates from plastic devices (61.8%). The minimum inhibitory concentrations of all antifungal drugs against all isolates were within susceptible range except for fluconazole which was resistant to C. kruseii. Conclusion: C. albicans remains the major isolate from urine samples and also biofilm formation as a virulence factor might have a higher significance for C. albicans than for NAC and its ability to form biofilm is intricately linked with ability of organisms to adhere, colonize and subsequently cause infection.


Assuntos
Antifúngicos/uso terapêutico , Biofilmes/crescimento & desenvolvimento , Candida/efeitos dos fármacos , Infecções Urinárias/tratamento farmacológico , Antifúngicos/farmacologia , Candida/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana , Centros de Atenção Terciária , Infecções Urinárias/microbiologia
5.
BMC Infect Dis ; 19(1): 798, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31510929

RESUMO

BACKGROUND: The present meta-analysis examined the diagnostic accuracy of T2 Candida for candidiasis. METHODS: The literature databases, such as PubMed, Embase, DVIO, Cochrane library, Web of Science, and CNKI, were searched on T2 Candida detection. RESULTS: A total of 8 articles, comprising of 2717 research subjects, were included in the study. The pooled sensitivity and specificity were 0.91 (95% confidence interval (CI): 0.88-0.94) and 0.94 95% CI: 0.93-0.95), respectively. The pooled positive likelihood ratio and negative likelihood ratio was 10.16 (95% CI: 2.75-37.50) and 0.08 (95% CI: 0.02-0.35), respectively. The combined diagnostic odds ratio is 133.65 95% CI: 17.21-1037.73), and the AUC of SROC is 0.9702 [(SE = 0.0235), Q* = 0.9201(SE = 0.0381)]. CONCLUSIONS: The current evidence supported that T2 Candida has high accuracy and sensitivity and is of major clinical significance in the diagnosis of Candida infection.


Assuntos
Candida/isolamento & purificação , Candidíase/diagnóstico , Área Sob a Curva , Bases de Dados Factuais , Humanos , Razão de Chances , Curva ROC , Sensibilidade e Especificidade
6.
BMC Infect Dis ; 19(1): 759, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31470800

RESUMO

BACKGROUND: Surveillance of current changes in the epidemiology of Invasive Fungal Diseases (IFDs) as an important component of the antifungal stewardship programs (ASP), requires careful regular monitoring, especially in high-risk settings such as oncology centers. This study aimed to examine Candida colonization status and corresponding current changes in children with malignancy during repeated admissions and also investigate the possible epidemiological shifts after the implementation of ASP. METHODS: In this prospective observational study, all eligible patients younger than 18 years were recruited during 2016-2017 at Amir Medical Oncology Center (AMOC) in Shiraz, Iran. Totally, 136 patients were enrolled and 482 samples were collected from different sites (oral/nasal discharges, urine and stool). Weekly regular sampling was carried out during hospitalization. Candida colonization status and epidemiological changes were monitored during repeated admissions. Samples were cultivated on Sabouraud Dextrose agar medium and identified by Polymerase Chain Reaction -Restriction Fragment Length Polymorphism (PCR-RFLP). RESULTS: Estimated Candida colonization incidence was 59.9% (82/136) in our patients. Candida colonization was found to be higher in oral cavity and rectum than that in nasal cavity. Among those long-term follow ups and repetitive hospitalizations, a significant number of patients exhibited changes in their colonization patterns (37.7%). Candida colonization did not reveal any significant relationship with age, sex, oncologic diseases and degree of neutropenia. C. albicans (72.0%) was found as the most common Candida species in colonized patients, followed by C. krusei, C. kefyr, C. glabrata and C. parapsilosis. CONCLUSION: Given the high incidence of Candida infections in children with cancers, close monitoring of epidemiologic changes is essential for judicious management, based on local surveillance data and improvement of overall quality of care in high risk patients.


Assuntos
Candida/classificação , Candida/isolamento & purificação , Infecção Hospitalar/microbiologia , Neoplasias Hematológicas/microbiologia , Readmissão do Paciente , Adolescente , Candida/genética , Candidíase/epidemiologia , Candidíase/microbiologia , Criança , Pré-Escolar , Infecção Hospitalar/epidemiologia , Feminino , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/epidemiologia , Neoplasias Hematológicas/terapia , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Boca/microbiologia , Nariz/microbiologia , Readmissão do Paciente/estatística & dados numéricos , Readmissão do Paciente/tendências , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Estudos Prospectivos , Reto/microbiologia , Recidiva
8.
Med. infant ; 26(3): 272-275, sept. 2019. Tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1026763

RESUMO

Introducción: En pacientes pediátricos quemados la osteomielitis fúngica es una complicación infrecuente que conduce a una significativa morbilidad. La información en la literatura está limitada a unos escasos reportes de casos. Objetivo: Describir las características clínicas, epidemiológicas y de evolución de niños quemados con osteomielitis fúngica. Métodos: Se llevo a cabo un estudio retrospectivo y descriptivo de pacientes mayores de 1 mes y menores de 18 años quemados con osteomielitis fúngica internados en el hospital Juan P. Garrahan, un hospital terciario en Buenos Aires, Argentina. Resultados: entre enero del 2007 y enero del 2017, de 600 niños quemados, 9 pacientes presentaron diagnóstico confirmado de osteomielitis fúngica. La mediana de edad fue de 42.5 meses (RIC, 27-118 meses) y la mediana de superficie quemada fue de 33.5% (RIC, 18.5-58%). La osteomielitis fue diagnosticada con una mediana de 30 días luego de la quemadura. Las localizaciones más frecuentes de osteomielitis fueron los miembros superiores y a nivel de calota. Los microorganismos aislados a partir del cultivo de hueso fueron: Fusarium spp. en tres pacientes, Mucor spp. en un paciente; Trichosporon asahii en un paciente; Cándida albicans en dos pacientes y Candida parapsilosis en dos pacientes. En dos casos la infección fúngica fue asociada con aislamientos bacteriano concomitante. Todos los pacientes presentaron hallazgos histopatológicos compatibles con osteomielitis. La mediana de tiempo de tratamiento fue de 44.5 días (RIC, 34.5- 65.5 días). Seis pacientes (67%) presentaron secuela motora. Conclusión: La osteomielitis fúngica fue infrecuente Candida spp. y Fusarium spp. fueron los hongos más comúnmente identificados. La secuela funcional fue frecuente (AU)


Introduction: In pediatric burn patients fungal osteomyelitis is a rare complication that leads to significant morbidity. Data in the literature are limited to sporadic case reports. Objective: To describe the clinical and epidemiological features and outcome in burned children with fungal osteomyelitis. Methods: A retrospective descriptive study was conducted in burn patients older than 1 month and younger than 18 years admitted to Hospital Juan P. Garrahan, a tertiary hospital in Buenos Aires, Argentina. Results: Between January 2007 and January 2017, of 600 burned children, nine had a confirmed diagnosis of fungal osteomyelitis. Median age was 42.5 months (IQR, 27-118 months) and median burn surface was 33.5% (IQR, 18.5-58%). Osteomyelitis was diagnosed at a median of 30 days after the burn. The most common location of osteomyelitis were the upper limbs and skull. The microorganisms isolated form bone cultures were Fusarium spp. in three patients, Mucor spp. in one patient; Trichosporon asahii in one patient; Candida albicans in two patients; and Candida parapsilosis in two patients. In two cases the funal infection was associated with concomitant bacterial isolation. In all patients, the histopathological findings were compatible with osteomyelitis. Median duration of treatment was 44.5 days (IQR, 34.5-65.5 days). Six patients (67%) had motor sequelae. Conclusion: Fungal osteomyelitis is a rare disease. Candida spp. and Fusarium spp. were most frequently identified fungi. Functional sequelae were common (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Osteomielite/diagnóstico , Osteomielite/etiologia , Osteomielite/epidemiologia , Queimaduras/complicações , Micoses/microbiologia , Candida/isolamento & purificação , Miose/tratamento farmacológico , Estudos Retrospectivos , Fusarium/isolamento & purificação , Antifúngicos/uso terapêutico
9.
MMWR Morb Mortal Wkly Rep ; 68(30): 664-666, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31369523

RESUMO

Candida auris is an emerging drug-resistant yeast that causes outbreaks in health care facilities; cases have been reported from approximately 30 countries. U.S. cases of C. auris are likely the result of importation from abroad followed by extensive local transmission in health care settings (1). Early detection of Candida auris is key to preventing its spread. C. auris frequently co-occurs with carbapenemase-producing organisms (CPOs), like carbapenem-resistant Enterobacteriaceae (CRE), organisms for which testing and public health response capacity substantially increased beginning in 2017. In September 2018, the Maryland Department of Health (MDH) was notified of a hospitalized resident with CPO infection and colonization and recent hospitalization in Kenya. In light of this history, the patient was screened for C. auris and found to be colonized. Public health responses to CPOs can aid in the early identification of C. auris. As part of CPO investigations, health departments should assess whether the patient has risk factors for C. auris and ensure that patients at risk are tested promptly.


Assuntos
Proteínas de Bactérias/biossíntese , Candida/isolamento & purificação , Candidíase/diagnóstico , Hospitalização/estatística & dados numéricos , beta-Lactamases/biossíntese , Humanos , Quênia , Estados Unidos
10.
Internist (Berl) ; 60(10): 1106-1110, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31435719

RESUMO

We describe a patient with ANCA (antineutrophil cytoplasmic antibodies) associated vasculitis and acute-on-chronic renal failure. He had initially presented with severe pulmonary hemorrhage and anuric renal failure and improved rapidly with immunosuppressive therapy. Repeat renal biopsy revealed candida interstitial nephritis. Candida was also detected in bronchoalveolar lavage. Kidney function improved with long-term antifungal therapy. This report adds induction therapy for ANCA vasculitis to the conditions where invasive candidal infections including nephritis need to be considered.


Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/tratamento farmacológico , Antifúngicos/uso terapêutico , Candida/isolamento & purificação , Falência Renal Crônica/diagnóstico , Doença Aguda , Lesão Renal Aguda , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/complicações , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/microbiologia , Anticorpos Anticitoplasma de Neutrófilos/imunologia , Biópsia , Candida/classificação , Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Ciclofosfamida/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Falência Renal Crônica/microbiologia , Masculino , Pessoa de Meia-Idade , Nefrite Intersticial/tratamento farmacológico , Nefrite Intersticial/patologia , Resultado do Tratamento
11.
Int J Food Microbiol ; 306: 108263, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31306941

RESUMO

Ishizuchi-kurocha is a Japanese traditional fermented tea that is produced by primary aerobic and secondary fermentation steps. The secondary fermentation step of Ishizuchi-kurocha is mainly mediated through lactic acid bacteria. Here, we performed quantitative analyses of the culturable fungal communities at each step and identified several morphologically representative fungal isolates. While filamentous fungi (median, 3.2 × 107 CFU/g sample) and yeasts (median, 3.7 × 107 CFU/g) were both detected after the primary fermentation step, only yeasts (median, 1.6 × 107 CFU/g) were detected in the end of the secondary fermentation step, suggesting that the fungal community in tea leaves are dramatically changed between the two steps. Pichia kudriavzevii and Pichia manshurica, the prevalent fungal species at the end of the secondary fermentation step, grew well in exudate from the secondary fermentation step. P. kudriavzevii also grew well in media containing d- or l-lactate as the sole carbon source. The growth of the disruptant of cyb2A encoding a cytochrome b2 lactate dehydrogenase in P. kudriavzevii was severely impaired on medium supplemented with l-lactate, but not d-lactate, suggesting that Cyb2Ap plays a crucial role in the use of l-lactate, and P. kudriavzevii efficiently uses both l- and d-lactate as carbon sources. Thus, lactate assimilation seems to be a key phenotype to become a prevalent species in the secondary fermentation step, and Cyb2Ap has a pivotal role in l-lactate metabolism in P. kudriavzevii. Further understanding and engineering of P. kudriavzevii and P. manshurica will contribute to the control of lactic acid bacteria fermentation during the fermented tea production and also to other industrial uses.


Assuntos
/microbiologia , L-Lactato Desidrogenase (Citocromo)/genética , Ácido Láctico/metabolismo , Pichia/genética , Pichia/metabolismo , Reatores Biológicos , Candida/isolamento & purificação , Fermentação , Pichia/isolamento & purificação , Leveduras/isolamento & purificação
12.
Vet Microbiol ; 235: 43-52, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31282378

RESUMO

Even though it is widely known that Cryptococcus spp. may transmit cryptococcosis trough aerosol formed when dried birds (mainly pigeons) droppings are dispersed and become airborne, little is known about the role of these birds in harboring other pathogenic yeasts in their gastrointestinal tract, feathers and beaks, specifically because these animals often stay and reproduce close or even above air conditioner units. Here we evaluated the prevalence of pathogenic yeasts isolated from pigeon droppings collected in the outside area of a University Hospital in Brazil. We also aimed to investigate the pathogenic potential and antifungal susceptibility of Candida species of medical interest isolated from these samples. Therefore, we performed the evaluation of virulence factors attributes expression in vitro, including the ability to adhere to human buccal epithelial cells and biofilm formation and to produce lytic enzymes, such as phospholipases, proteinases and hemolysins. Antifungal susceptibility testing against fluconazole, itraconazole, amphotericin and micafungin was also performed. The Candida genus was the most prevalent in our study, with several medically important species being isolated. Of note, these strains were able to express several virulence factors in vitro, clearly showing their pathogenic potential. Our study was able to demonstrate that Candida spp. isolated from pigeon droppings may express virulence factors in the same manner of clinical isolates, suggesting a pathogenic potential for these yeasts. The fact these strains were collected from the outside area of a tertiary hospital may be of interest, because they may be a source of infection, specifically to immunocompromised hosts.


Assuntos
Antifúngicos/farmacologia , Azóis/farmacologia , Candida/efeitos dos fármacos , Columbidae/microbiologia , Farmacorresistência Fúngica , Fatores de Virulência/genética , Anfotericina B/farmacologia , Animais , Brasil , Candida/genética , Candida/isolamento & purificação , Criptococose/veterinária , Fezes/microbiologia , Fluconazol/farmacologia , Itraconazol/farmacologia , Testes de Sensibilidade Microbiana
13.
J Med Microbiol ; 68(9): 1353-1358, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31271350

RESUMO

Introduction. Candida auris is a pathogenic yeast that mainly affects immunosuppressed patients and those with implanted medical devices. This pathogen also displays elevated resistance to common antifungals and high survival and spreading capacities. Since no antifungal breakpoints have yet been defined for this pathogen, the data obtained here can be useful for further research concerning treatment or implementation of a prevention and disinfection protocol. Our aim was to study the antifungal resistance of C. auris to current antifungals in planktonic and sessile states. Using confocal laser scanning microscopy and viable biomass production, we demonstrated the ability of C. auris to develop a mature biofilm. We compared the minimal inhibitory concentration (MIC) and the minimal biofilm eradication concentration (MBEC) for the C. auris DSM 21092 strain plus two clinical isolates, and the results were compared with those obtained for Candida albicans and Candida parapsilosis, two species strongly linked to bloodstream infections and infections associated with biomaterials. We found that the clinical isolates of C. auris were resistant to fluconazole and sensitive to echinocandins and polyenes. The C. auris biofilms did not show susceptibility to any antifungal agent, showing MBECs that were up to 512-fold higher than the MICs. These findings highlight the importance of biofilm formation as a key factor underlying the resistance of this species to antifungals and suggest that the presence of implantable medical devices is one of the major risk factors in immunocompromised patients.


Assuntos
Antifúngicos/farmacologia , Biofilmes/efeitos dos fármacos , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candida albicans/efeitos dos fármacos , Candida parapsilosis/efeitos dos fármacos , Candidíase/microbiologia , Contagem de Colônia Microbiana , Farmacorresistência Fúngica , Equinocandinas/farmacologia , Fluconazol/farmacologia , Humanos , Testes de Sensibilidade Microbiana , Microscopia Confocal , Polienos/farmacologia
14.
J Appl Oral Sci ; 27: e20180635, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31215600

RESUMO

OBJECTIVE: Acetaldehyde, associated with consumption of alcoholic beverages, is known to be a carcinogen and to be related to the tongue dorsum. The aim of this study was to investigate the relationship between acetaldehyde concentration in mouth air and bacterial characteristics on the tongue dorsum. METHODOLOGY: Thirty-nine healthy volunteers participated in the study. Acetaldehyde concentrations in mouth air were evaluated by a high-sensitivity semiconductor gas sensor. A 16S rRNA gene sequencing technique was used to compare microbiomes between two groups, focusing on the six samples with the highest acetaldehyde concentrations (HG) and the six samples with lowest acetaldehyde concentrations (LG). RESULTS: Acetaldehyde concentration increased in correlation with the increase in bacterial count (p=0.048). The number of species observed in the oral microbiome of the HG was higher than that in the oral microbiome of the LG (p=0.011). The relative abundances of Gemella sanguinis, Veillonella parvula and Neisseria flavescens in the oral microbiome of the HG were higher than those in the oral microbiome of the LG (p<0.05). CONCLUSION: Acetaldehyde concentration in mouth air was associated with bacterial count, diversity of microbiome, and relative abundance of G. sanguinis, V. parvula, and N. flavescens.


Assuntos
Acetaldeído/análise , Microbiota , Boca/química , Língua/microbiologia , Acetaldeído/metabolismo , Adulto , Consumo de Bebidas Alcoólicas/metabolismo , Bactérias/genética , Bactérias/isolamento & purificação , Carga Bacteriana , Candida/isolamento & purificação , Estudos Transversais , Feminino , Humanos , Japão , Masculino , Boca/metabolismo , Boca/microbiologia , RNA Ribossômico 16S/análise , RNA Ribossômico 16S/metabolismo , Valores de Referência , Fumar/metabolismo , Estatísticas não Paramétricas , Inquéritos e Questionários , Língua/metabolismo , Adulto Jovem
18.
Int J Syst Evol Microbiol ; 69(9): 2674-2680, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31166159

RESUMO

Three strains, representing a novel anamorphic and d-xylose-fermenting yeast species, were isolated from moss (ST-302T), seawater (ST-1169) and peat (DMKU-XE12) collected from the southern part of Thailand. The three strains had identical sequences of the D1/D2 regions of the large subunit (LSU) rRNA gene and the internal transcribed spacer (ITS) regions. Candida flosculorum CBS 10566T and Candida sharkiensis CBS 11368T were the most closely related species with 7.9 % nucleotide substitutions in the D1/D2 regions of the LSU rRNA gene, and 10.3 and 12.6% nucleotide substitutions in the ITS regions, respectively. Phylogenetic analysis based on the concatenated sequences of the ITS and the D1/D2 regions confirmed that the three strains represented a distinct anamorphic species in the Clavispora clade. Therefore, the three strains were described as a novel species, for which we propose the name Candida xylosifermentans sp. nov.


Assuntos
Candida/classificação , Filogenia , Xilose/metabolismo , Briófitas/microbiologia , Candida/isolamento & purificação , DNA Fúngico/genética , DNA Espaçador Ribossômico/genética , Fermentação , Técnicas de Tipagem Micológica , Água do Mar/microbiologia , Análise de Sequência de DNA , Solo , Microbiologia do Solo , Tailândia
19.
Int J Infect Dis ; 85: 182-187, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31185293

RESUMO

OBJECTIVES: Candida auris emerged as a human pathogen in 2009 and has subsequently been identified around the world as a cause of invasive candidiasis. We did an analysis from a single institution in order to analyze risk factors and outcomes for C. auris candidemia. METHODS: Patients with candidemia were identified by the electronic medical record and reviewed for risk factors and outcome. Candida isolates were identified by Vitek2 as Candida haemulonii, but species determinations for 21 of the isolates using published molecular and proteomic methods identified all as C. auris. FINDINGS: From September 2010 to December 2016, C. auris accounted for 38% of 201 patients with candidemia, while C. albicans contributed 25%. C. auris patients had been hospitalized longer (mean 32 days vs. 13 days; p<0.001), were more likely to have central lines preceding candidemia than C. albicans patients (84% vs. 54%; p=<0.001) and had more commonly been treated with carbapenems (83% vs 61% for C. albicans [p=0.01]). The crude mortality was 29%, compared to 36% for C. albicans. CONCLUSIONS: These findings suggest an opportunistic pathogen that may be less virulent, but difficult to eradicate and that control efforts should focus on antimicrobial usage.


Assuntos
Candidemia/microbiologia , Adulto , Idoso , Antifúngicos/uso terapêutico , Candida/isolamento & purificação , Candida albicans/isolamento & purificação , Candidemia/tratamento farmacológico , Candidemia/mortalidade , Feminino , Humanos , Quênia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
20.
Arch Microbiol ; 201(8): 1147-1149, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31147748

RESUMO

Non-albicans Candida species have acquired relevance in the last decades as a cause of serious disease. The virulence factors and antifungal susceptibility of these rare pathogens remain largely unrecognized. We examined a total of 50 yeast isolates corresponding to 11 different infrequently isolated yeast species for their in vitro enzymatic profile and susceptibility pattern as first-line antifungals. We found aspartyl protease activity for 100% of the isolates tested as well as variable DNAse, hemolysin, phospholipase and esterase activities. All strains had low MICs for amphotericin B and showed a variable response to fluconazole (0.125-32 µg/mL) and the echinocandins tested (0.25-> 8 µg/mL).


Assuntos
Anfotericina B/farmacologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candida/genética , Equinocandinas/farmacologia , Fluconazol/farmacologia , Ácido Aspártico Proteases/genética , Candida/classificação , Candida/isolamento & purificação , Desoxirribonucleases/genética , Esterases/genética , Proteínas Hemolisinas/genética , Humanos , Testes de Sensibilidade Microbiana , Fosfolipases/genética , Fatores de Virulência , Leveduras/classificação , Leveduras/efeitos dos fármacos , Leveduras/isolamento & purificação
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