RESUMO
This study aimed to determine whether candiduria is associated with the occurrence of nosocomial candidaemia. In the case-control part of the study, 115 cases (nosocomial candidaemia) and 115 controls (nosocomial bacteraemia) were similar in age, severity of condition and time of hospitalisation. There was a significant association of candidaemia with candiduria (OR 9.79; 95% CI 2.14-44.76). In the microbiology part of the study, 23 pairs of Candida-positive urine and blood cultures were obtained from 23 patients. In ten (43%) cases, the urine and blood culture isolates belonged to different species, and molecular typing showed a difference in two of the 13 cases yielding the same species from both specimens. Overall, there was a significant association between candiduria and candidaemia, but the Candida isolates from urine and blood were different for 52% of the patients. Thus, the data indicated that the urinary tract was probably not a source for the candidaemia.
Assuntos
Candida/isolamento & purificação , Candidíase/microbiologia , Infecção Hospitalar/microbiologia , Fungemia/microbiologia , Infecções Urinárias/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Candida/classificação , Candidíase/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Infecção Hospitalar/epidemiologia , Primers do DNA/química , Eletroforese em Gel de Campo Pulsado/métodos , Feminino , Fungemia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Fatores de Risco , Infecções Urinárias/epidemiologiaRESUMO
More than 70 species of mycobacteria have been defined, and some can cause disease in humans, especially in immunocompromised patients. Species identification in most clinical laboratories is based on phenotypic characteristics and biochemical tests and final results are obtained only after two to four weeks. Quick identification methods, by reducing time for diagnosis, could expedite institution of specific treatment, increasing chances of success. PCR restriction-enzyme analysis (PRA) of the hsp65 gene was used as a rapid method for identification of 103 clinical isolates. Band patterns were interpreted by comparison with published tables and patterns available at an Internet site (http://www.hospvd.ch:8005). Concordant results of PRA and biochemical identification were obtained in 76 out of 83 isolates (91.5%). Results from 20 isolates could not be compared due to inconclusive PRA or biochemical identification. The results of this work showed that PRA could improve identification of mycobacteria in a routine setting because it is accurate, fast, and cheaper than conventional phenotypic identification.
Assuntos
Proteínas de Bactérias/genética , Chaperoninas/genética , Enzimas de Restrição do DNA/análise , Infecções por Mycobacterium/diagnóstico , Mycobacterium/isolamento & purificação , Reação em Cadeia da Polimerase/métodos , Mapeamento por Restrição/métodos , Chaperonina 60 , Enzimas de Restrição do DNA/economia , Mycobacterium/química , Infecções por Mycobacterium/microbiologia , Sensibilidade e EspecificidadeRESUMO
A cluster of six cases of fungemia among hematology, bone marrow transplant, and oncology patients was investigated in a case-control study (18 controls). The use of implantable and semi-implantable central venous catheters was significantly associated with cases (p = 0.016). The hands of three healthcare workers (HCWs) were positive for Candida parapsilosis. Electrophoretic karyotyping showed two profiles among patients and HCWs, and five among six unrelated strains. The profiles of two HCWs matched the ones of the patients they had handled. The patients' strains were moderate or strong slime producers, whereas none of the HCWs' were strong producers. In conclusion, our results indicated the occurrence of an outbreak C. parapsilosis fungemia related to long-term central venous catheters in which the hands of HCWs were implicated. The amount of slime production might be associated with the pathogenicity of the strains.
Assuntos
Candidíase/etiologia , Cateterismo Venoso Central/efeitos adversos , Infecção Hospitalar/epidemiologia , Fungemia/etiologia , Mãos/microbiologia , Pessoal de Saúde , Adolescente , Adulto , Idoso , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Fungemia/tratamento farmacológico , Fungemia/microbiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Apart from cryptococcosis and histoplasmosis, which are mycoses contained by T cell-mediated mechanisms of host defense, fungemia is rarely found in AIDS patients. The frequency of fungemia due to Candida spp. has been reported to be as low as 1%. We report a non-neutropenic AIDS patient who presented a candidemia which probably arose from her gastrointestinal tract.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Translocação Bacteriana , Candida albicans/fisiologia , Candidíase/microbiologia , Adulto , Candida albicans/isolamento & purificação , Feminino , HumanosRESUMO
Yeasts of the genus Candida have been recognized as important microorganisms responsible for nosocomial fungemia. Six blood-stream and two intravenous central catheter C. albicans strains were isolated from eight patients and studied by electrophoretic karyotyping of chromosomal DNA by pulsed-field gel electrophoresis. Seven chromosomal DNA profiles were identified. Two patients showed isolates with the same profile, suggesting nosocomial transmission. Karyotyping of C. albicans revealed an excellent discriminatory power among the isolates and may therefore be useful in the study of nosocomial candidemia.