RESUMEN
Candida spp. colonization in neonates occurs due to vertical or horizontal transmission. Preliminary studies determined that Candida albicans is the principal agent of these infections. In order to establish nosocomial transmission, 26 Candida albicans strains isolated from patients with candidosis hospitalized during a 18-month period in 2 neonatal intensive care units (NICU) from a pediatric hospital were studied. Fourteen isolates from patients and health care workers, involved in possible outbreaks of an intensive care unit (UCI) and a NICU from another pediatric hospital were also studied. All Candida albicans strains were genotyped by Southern blot hybridization with 27A. Isolates for outbreak confirmation were also hybridized with another specific Candida albicans probe, Ca3. Hybridization patterns demonstrated horizontal transmission in all the units studied. In a NICU, transmission among 4 patients during a 10-month period could be established and in the other NICU, 3 cases of transmission among 2 patients each were demonstrated in periods of 2 to 20 days. The outbreak studies showed the same strain isolated from 2 nurses and from one patient at the NICU and at the ICU identical strains were found in 3 patients. In this study, hybridization with Ca3 in addition to 27A probe did not increase discrimination power among isolates. Genotypic analysis allows, not only, determination of transmission and persistence of strains during prolonged periods or in sporadic outbreaks, but also facilitates necessary epidemiological decisions for optimizing nosocomial fungal infection control measures.(AU)
Asunto(s)
Humanos , Recién Nacido , RESEARCH SUPPORT, NON-U.S. GOVT , Candidiasis/transmisión , Infección Hospitalaria/transmisión , Transmisión de Enfermedad Infecciosa , Candida albicans/aislamiento & purificación , Candidiasis/microbiología , Infección Hospitalaria/microbiología , Unidades de Cuidado Intensivo NeonatalRESUMEN
Candida spp. colonization in neonates occurs due to vertical or horizontal transmission. Preliminary studies determined that Candida albicans is the principal agent of these infections. In order to establish nosocomial transmission, 26 Candida albicans strains isolated from patients with candidosis hospitalized during a 18-month period in 2 neonatal intensive care units (NICU) from a pediatric hospital were studied. Fourteen isolates from patients and health care workers, involved in possible outbreaks of an intensive care unit (UCI) and a NICU from another pediatric hospital were also studied. All Candida albicans strains were genotyped by Southern blot hybridization with 27A. Isolates for outbreak confirmation were also hybridized with another specific Candida albicans probe, Ca3. Hybridization patterns demonstrated horizontal transmission in all the units studied. In a NICU, transmission among 4 patients during a 10-month period could be established and in the other NICU, 3 cases of transmission among 2 patients each were demonstrated in periods of 2 to 20 days. The outbreak studies showed the same strain isolated from 2 nurses and from one patient at the NICU and at the ICU identical strains were found in 3 patients. In this study, hybridization with Ca3 in addition to 27A probe did not increase discrimination power among isolates. Genotypic analysis allows, not only, determination of transmission and persistence of strains during prolonged periods or in sporadic outbreaks, but also facilitates necessary epidemiological decisions for optimizing nosocomial fungal infection control measures.
Asunto(s)
Humanos , Recién Nacido , Candidiasis/transmisión , Infección Hospitalaria/transmisión , Transmisión de Enfermedad Infecciosa , Candida albicans , Candidiasis/microbiología , Infección Hospitalaria/microbiología , Unidades de Cuidado Intensivo NeonatalAsunto(s)
Antifúngicos/síntesis química , Candida/efectos de los fármacos , Carbazoles/síntesis química , Triazoles/farmacología , Antifúngicos/farmacología , Antifúngicos/toxicidad , Carbazoles/farmacología , Carbazoles/toxicidad , Fluconazol/farmacología , Pruebas de Sensibilidad Microbiana , Mutágenos/toxicidad , Salmonella typhimurium/efectos de los fármacos , Salmonella typhimurium/genéticaRESUMEN
The in vitro activities of three antifungal drugs alone and in combination were evaluated against five isolates of Cryptococcus neoformans using time-kill curves (TKC). The isolates were from AIDS patients who had either died or had failed to show a clinical response during amphotericin B (AMB) treatment. AMB, fluconazole (FCZ) and flucytosine (5FC), and combinations of the drugs (AMB plus 5FC, AMB plus rifampicin (RIF) and FCZ plus 5FC), were evaluated. With all five isolates AMB did not show fungicidal activity; instead, a persistent or tolerant effect was observed. Combinations of AMB plus 5FC and AMB plus RIF showed a clear synergic effect, except for one isolate tested with AMB plus RIF. In contrast, the FCZ plus 5FC combination did not inhibit growth of any isolate.
Asunto(s)
Anfotericina B/farmacología , Anfotericina B/uso terapéutico , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Criptococosis/microbiología , Cryptococcus neoformans/efectos de los fármacos , Síndrome de Inmunodeficiencia Adquirida/microbiología , Interacciones Farmacológicas , Farmacorresistencia Microbiana , Fluconazol/farmacología , Flucitosina/farmacología , Humanos , Leprostáticos/farmacología , Rifampin/farmacología , Factores de TiempoRESUMEN
Candida spp. colonization in neonates occurs due to vertical or horizontal transmission. Preliminary studies determined that Candida albicans is the principal agent of these infections. In order to establish nosocomial transmission, 26 Candida albicans strains isolated from patients with candidosis hospitalized during a 18-month period in 2 neonatal intensive care units (NICU) from a pediatric hospital were studied. Fourteen isolates from patients and health care workers, involved in possible outbreaks of an intensive care unit (UCI) and a NICU from another pediatric hospital were also studied. All Candida albicans strains were genotyped by Southern blot hybridization with 27A. Isolates for outbreak confirmation were also hybridized with another specific Candida albicans probe, Ca3. Hybridization patterns demonstrated horizontal transmission in all the units studied. In a NICU, transmission among 4 patients during a 10-month period could be established and in the other NICU, 3 cases of transmission among 2 patients each were demonstrated in periods of 2 to 20 days. The outbreak studies showed the same strain isolated from 2 nurses and from one patient at the NICU and at the ICU identical strains were found in 3 patients. In this study, hybridization with Ca3 in addition to 27A probe did not increase discrimination power among isolates. Genotypic analysis allows, not only, determination of transmission and persistence of strains during prolonged periods or in sporadic outbreaks, but also facilitates necessary epidemiological decisions for optimizing nosocomial fungal infection control measures.
Asunto(s)
Candidiasis/transmisión , Infección Hospitalaria/transmisión , Transmisión de Enfermedad Infecciosa , Candida albicans/aislamiento & purificación , Candidiasis/microbiología , Infección Hospitalaria/microbiología , Humanos , Recién Nacido , Unidades de Cuidado Intensivo NeonatalRESUMEN
Candida spp. colonization in neonates occurs due to vertical or horizontal transmission. Preliminary studies determined that Candida albicans is the principal agent of these infections. In order to establish nosocomial transmission, 26 Candida albicans strains isolated from patients with candidosis hospitalized during a 18-month period in 2 neonatal intensive care units (NICU) from a pediatric hospital were studied. Fourteen isolates from patients and health care workers, involved in possible outbreaks of an intensive care unit (UCI) and a NICU from another pediatric hospital were also studied. All Candida albicans strains were genotyped by Southern blot hybridization with 27A. Isolates for outbreak confirmation were also hybridized with another specific Candida albicans probe, Ca3. Hybridization patterns demonstrated horizontal transmission in all the units studied. In a NICU, transmission among 4 patients during a 10-month period could be established and in the other NICU, 3 cases of transmission among 2 patients each were demonstrated in periods of 2 to 20 days. The outbreak studies showed the same strain isolated from 2 nurses and from one patient at the NICU and at the ICU identical strains were found in 3 patients. In this study, hybridization with Ca3 in addition to 27A probe did not increase discrimination power among isolates. Genotypic analysis allows, not only, determination of transmission and persistence of strains during prolonged periods or in sporadic outbreaks, but also facilitates necessary epidemiological decisions for optimizing nosocomial fungal infection control measures.
RESUMEN
A multicenter study was performed between April and September 1998 with the participation of 12 medical centers located in 8 different provinces and in the capital city of Argentina. The aim of this study was to determine the species distribution and the antifungal susceptibility profile of isolates causing nosocomial fungal infections. All the fungal isolates obtained were sent to the Mycology Department for reference identification and antifungal susceptibility testing. Eighty-nine isolates were received from different clinical specimens. The distribution of species obtained was C. albicans (50.6%), C. tropicalis (22.5%), C. parapsilosis (20.2%), C. krusei (3.4%), C. glabrata (2.2%) and Debaryomyces hansenii (1.1%). Most of the isolates (85/88) had MICs for amphotericin B < or = 1 microgram/ml, C. krusei showed resistance to fluconazole but was dose dependent susceptible to itraconazole, C. glabrata (2/2) were resistant against both drugs, most of the isolates of C. albicans, C. tropicalis and C. parapsilosis were susceptible to these triazole drugs. These data showed a different distribution of Candida species compared with results obtained in other countries. The low frequency of appearance of C. krusei and C. glabrata in our country suggests a reduced selective pressure by triazoles.
Asunto(s)
Candidiasis/epidemiología , Infección Hospitalaria/epidemiología , Antifúngicos/farmacología , Argentina/epidemiología , Candidiasis/microbiología , Infección Hospitalaria/microbiología , Fluconazol/farmacología , Humanos , Incidencia , Itraconazol/farmacología , Pruebas de Sensibilidad MicrobianaRESUMEN
A multicenter study was performed between April and September 1998 with the participation of 12 medical centers located in 8 different provinces and in the capital city of Argentina. The aim of this study was to determine the species distribution and the antifungal susceptibility profile of isolates causing nosocomial fungal infections. All the fungal isolates obtained were sent to the Mycology Department for reference identification and antifungal susceptibility testing. Eighty-nine isolates were received from different clinical specimens. The distribution of species obtained was C. albicans (50.6), C. tropicalis (22.5), C. parapsilosis (20.2), C. krusei (3.4), C. glabrata (2.2) and Debaryomyces hansenii (1.1). Most of the isolates (85/88) had MICs for amphotericin B < or = 1 microgram/ml, C. krusei showed resistance to fluconazole but was dose dependent susceptible to itraconazole, C. glabrata (2/2) were resistant against both drugs, most of the isolates of C. albicans, C. tropicalis and C. parapsilosis were susceptible to these triazole drugs. These data showed a different distribution of Candida species compared with results obtained in other countries. The low frequency of appearance of C. krusei and C. glabrata in our country suggests a reduced selective pressure by triazoles.(AU)
Asunto(s)
Humanos , Candidiasis/epidemiología , Infección Hospitalaria/epidemiología , Antifúngicos/farmacología , Argentina/epidemiología , Candidiasis/microbiología , Infección Hospitalaria/microbiología , Fluconazol/farmacología , Incidencia , Itraconazol/farmacología , Pruebas de Sensibilidad MicrobianaRESUMEN
A multicenter study was performed between April and September 1998 with the participation of 12 medical centers located in 8 different provinces and in the capital city of Argentina. The aim of this study was to determine the species distribution and the antifungal susceptibility profile of isolates causing nosocomial fungal infections. All the fungal isolates obtained were sent to the Mycology Department for reference identification and antifungal susceptibility testing. Eighty-nine isolates were received from different clinical specimens. The distribution of species obtained was C. albicans (50.6), C. tropicalis (22.5), C. parapsilosis (20.2), C. krusei (3.4), C. glabrata (2.2) and Debaryomyces hansenii (1.1). Most of the isolates (85/88) had MICs for amphotericin B < or = 1 microgram/ml, C. krusei showed resistance to fluconazole but was dose dependent susceptible to itraconazole, C. glabrata (2/2) were resistant against both drugs, most of the isolates of C. albicans, C. tropicalis and C. parapsilosis were susceptible to these triazole drugs. These data showed a different distribution of Candida species compared with results obtained in other countries. The low frequency of appearance of C. krusei and C. glabrata in our country suggests a reduced selective pressure by triazoles.
Asunto(s)
Humanos , Candidiasis/epidemiología , Infección Hospitalaria/epidemiología , Antifúngicos/farmacología , Argentina , Candidiasis/microbiología , Fluconazol , Incidencia , Infección Hospitalaria/microbiología , Itraconazol , Pruebas de Sensibilidad MicrobianaRESUMEN
A multicenter study was performed between April and September 1998 with the participation of 12 medical centers located in 8 different provinces and in the capital city of Argentina. The aim of this study was to determine the species distribution and the antifungal susceptibility profile of isolates causing nosocomial fungal infections. All the fungal isolates obtained were sent to the Mycology Department for reference identification and antifungal susceptibility testing. Eighty-nine isolates were received from different clinical specimens. The distribution of species obtained was C. albicans (50.6
), C. tropicalis (22.5
), C. parapsilosis (20.2
), C. krusei (3.4
), C. glabrata (2.2
) and Debaryomyces hansenii (1.1
). Most of the isolates (85/88) had MICs for amphotericin B < or = 1 microgram/ml, C. krusei showed resistance to fluconazole but was dose dependent susceptible to itraconazole, C. glabrata (2/2) were resistant against both drugs, most of the isolates of C. albicans, C. tropicalis and C. parapsilosis were susceptible to these triazole drugs. These data showed a different distribution of Candida species compared with results obtained in other countries. The low frequency of appearance of C. krusei and C. glabrata in our country suggests a reduced selective pressure by triazoles.
RESUMEN
We report the first isolation of Candida dubliniensis in Argentina. This strain was isolated from an oral lesion of an adult patient with AIDS during one recurrent episode of a previously treated oropharingeal candidosis. Phenotypic and genotypic characteristics coincided with those described by Sullivan et al., who was the first to study this new species.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Candida/aislamiento & purificación , Candidiasis Bucal/microbiología , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Adulto , Antifúngicos/farmacología , Argentina/epidemiología , Candida/clasificación , Candida/efectos de los fármacos , Candida/metabolismo , Candidiasis Bucal/epidemiología , Farmacorresistencia Microbiana , Fermentación , Humanos , Lactatos/metabolismo , Masculino , Metilglucósidos/metabolismo , Recurrencia , Especificidad de la EspecieRESUMEN
Se comunica el primer aislamiento de Candida Dubliniensis en Argentina. La cepa fue aislada a partir de una lesión oral de un paciente de 32 años de edad con SIDA, durante un episodio de una candidiasis orofaríngea recurrente multitratada. Las características fenotípicas y genotípicas fueron coincidentes con las descriptas anteriormente por Sullivan y col. quienes describieron esta nueva especie por primera vez (AU)
Asunto(s)
Humanos , Adulto , Masculino , Candidiasis Bucal/diagnóstico , Candidiasis Bucal/etiología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Candida/aislamiento & purificación , Candida/clasificación , ArgentinaRESUMEN
Se comunica el primer aislamiento de Candida Dubliniensis en Argentina. La cepa fue aislada a partir de una lesión oral de un paciente de 32 años de edad con SIDA, durante un episodio de una candidiasis orofaríngea recurrente multitratada. Las características fenotípicas y genotípicas fueron coincidentes con las descriptas anteriormente por Sullivan y col. quienes describieron esta nueva especie por primera vez
Asunto(s)
Humanos , Adulto , Masculino , Candida/clasificación , Candida/aislamiento & purificación , Candidiasis Bucal/diagnóstico , Candidiasis Bucal/etiología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , ArgentinaRESUMEN
Se realizó un estudio retrospectivo de las candidiasis en pacientes pediátricos hospitalizados y en adultos HIV positivos provenientes de 5 instituciones de la ciudad de Bunnos Aires, ciudad de La Plata y partidos del conurbano bonaerense, durante el período 1993-1995. Se determinó la frecuencia de aparición de las especies de levaduras y su perfil de sensibilidad a los antifúngicos de uso sistémico con el objeto de obtener datos actualizados de esta patología. Candida albicans fue el agente etiológico en el 87 o/o de los 214 pacientes adultos HIV positivos con candidiasis orofaríngeas estudiados y en el 50 o/o de los 209 pacientes pediátricos hospitalizados. En este último grupo el 28 o/o de estas infecciones se debió a Candida parapsilosis y el 18 o/o a Candida tropicalis, mientras que sólo el 2 y el 4 o/o de las candidiasis orales fueron causadas por estos microorganismos. La recuperación de Candida krusei y Candida glabrata, especies intrínsecamente resistentes a los azoles, se vio incrementada en la población expuesta al tratamiento con fluconazol. En ambos grupos se observó un bajo número de levaduras resistentes a la anfotericina B, en cambio para las drogas azólicas se detectó un mayor porcentaje de aislamientos resistentes, en especial al fluconazol: 13 o/o en los pacientes pediátricos y 34 o/o en los pacientes HIV positivos (AU)
Asunto(s)
Humanos , Femenino , Masculino , Adulto , Candidiasis/etiología , Candida albicans/efectos de los fármacos , Candida albicans/patogenicidad , Candida/patogenicidad , Candida/efectos de los fármacos , Resistencia a Medicamentos , Anfotericina B , Azoles , Fluconazol/uso terapéutico , Niño Hospitalizado/estadística & datos numéricos , Seropositividad para VIH/patología , Argentina/epidemiologíaRESUMEN
Se realizó un estudio retrospectivo de las candidiasis en pacientes pediátricos hospitalizados y en adultos HIV positivos provenientes de 5 instituciones de la ciudad de Bunnos Aires, ciudad de La Plata y partidos del conurbano bonaerense, durante el período 1993-1995. Se determinó la frecuencia de aparición de las especies de levaduras y su perfil de sensibilidad a los antifúngicos de uso sistémico con el objeto de obtener datos actualizados de esta patología. Candida albicans fue el agente etiológico en el 87 o/o de los 214 pacientes adultos HIV positivos con candidiasis orofaríngeas estudiados y en el 50 o/o de los 209 pacientes pediátricos hospitalizados. En este último grupo el 28 o/o de estas infecciones se debió a Candida parapsilosis y el 18 o/o a Candida tropicalis, mientras que sólo el 2 y el 4 o/o de las candidiasis orales fueron causadas por estos microorganismos. La recuperación de Candida krusei y Candida glabrata, especies intrínsecamente resistentes a los azoles, se vio incrementada en la población expuesta al tratamiento con fluconazol. En ambos grupos se observó un bajo número de levaduras resistentes a la anfotericina B, en cambio para las drogas azólicas se detectó un mayor porcentaje de aislamientos resistentes, en especial al fluconazol: 13 o/o en los pacientes pediátricos y 34 o/o en los pacientes HIV positivos
Asunto(s)
Humanos , Femenino , Masculino , Adulto , Anfotericina B , Candida albicans/efectos de los fármacos , Candida albicans/patogenicidad , Candida/efectos de los fármacos , Candida/patogenicidad , Candidiasis/etiología , Resistencia a Medicamentos , Argentina/epidemiología , Azoles , Fluconazol/uso terapéutico , Seropositividad para VIH/patología , Niño Hospitalizado/estadística & datos numéricosRESUMEN
Candidiasis has increased its frequency over the last decade, particularly among hospitalized patients where it is accompanied with high rates of mortality, and in patients with AIDS who are predisposed to oropharyngeal or esophageal candidiasis. The aim of this study was to determine the frequency of appearance of different yeast species and the resistance profile to current antifungal drugs in hospitalized pediatric patients and adult HIV patients from 5 institutions of Buenos Aires City and suburbs, and La Plata City, during the period 1993-1995, in order to obtain local and updated information. Candida albicans was the etiologic agent recovered in 87% of the 214 HIV positive patients with oropharyngeal candidosis, and in 50% of the 209 hospitalized pediatric patients. In the latter group 28% of these infections were due to Candida parapsilosis and 18% to Candida tropicalis, but only 2% and 4% of oral candidosis were caused by these organisms. Detection of Malassezia furfur and Hansenula anomala, responsible of systemic infections, and Trichosporon beigelii, isolated from a burn patient, were considered remarkable since these organisms appear to be emerging pathogens. Azole resistant species as Candida krusei and C. glabrata were mostly recovered from HIV positive patients, exposed to fluconazole treatment. A very low number of amfotericin B "resistant" yeasts (n = 9) were observed in both groups. However, resistance to azole drugs, particularly to fluconazole, was found in pediatric patients (13%) and in HIV infected adults (34%).