Assuntos
Humanos , Masculino , História do Século XX , História do Século XXI , Médicos/história , Pesquisadores/história , Uruguai , AutobiografiaRESUMO
BACKGROUND: Yeasts represent the second cause of nail fungal infection in the world, and Candida albicans and Candida parapsilosis are the two most common species. OBJECTIVES: To determine the yeast species frequency and their in vitro antifungal susceptibility, obtained from patients with clinical features suggestive of onychomycosis. METHODS: A prospective study was carried out in four dermatological care centers in Mexico from 2004 to 2007. Clinical diagnosis was corroborated by direct examination and culture. The yeast species was determined by morphological and biochemical tests. An antifungal susceptibility test to ketoconazole, itraconazole and fluconazole by the broth microdilution method was performed on each isolate (document M27-A2). RESULTS: One hundred sixty-six yeast isolates were obtained; the most frequently found species were C. parapsilosis (31.9%), C. albicans (22.4%) and Candida guilliermondii (12.7%). Of all isolates, 51 showed resistance to one or several of the azole compounds: 33 to itraconazole, 12 to ketoconazole and 6 to fluconazole. It was remarkable that the four Candida glabrata isolates were resistant to the three azole compounds; C. guilliermondii and Candida famata were resistant to itraconazole in 42.9% and 54.5%, respectively. CONCLUSION: The results obtained show the importance of identifying the aetiological agent and antifungal susceptibility testing in order to avoid therapeutic failures in onychomycosis.
Assuntos
Antifúngicos/farmacologia , Onicomicose/microbiologia , Leveduras/isolamento & purificação , Adulto , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candidíase Cutânea/epidemiologia , Candidíase Cutânea/microbiologia , Farmacorresistência Fúngica , Fluconazol/farmacologia , Humanos , Itraconazol/farmacologia , Cetoconazol/farmacologia , México/epidemiologia , Onicomicose/epidemiologia , Pichia/efeitos dos fármacos , Pichia/isolamento & purificação , Estudos Prospectivos , Rhodotorula/efeitos dos fármacos , Rhodotorula/isolamento & purificação , Especificidade da Espécie , Trichosporon/efeitos dos fármacos , Trichosporon/isolamento & purificação , Leveduras/efeitos dos fármacosRESUMO
The in vitro susceptibility of 62 isolates of Sporothrix schenckii in its mycelial form, from Latin-American countries (Peru, Venezuela, Brazil and Uruguay) and Spain, to amphotericin B (AB), itraconazole (IZ), posaconazole (PZ) and terbinafine (TB) was determined by measuring the MICs and minimum fungicidal concentrations (MFCs) using a standardized Clinical and Laboratory Standards Institute method. In general, TB was the most active drug, with the lowest geometric mean (GM) MIC and MFC values amongst isolates from the five countries tested. IZ and PZ showed almost the same activity against all strains tested, except for isolates from Uruguay where IZ gave the highest GM MIC (10.68 mg l(-1)). AB showed the widest MIC range (0.03-16.0 mg l(-1)); however, this drug was less active against 79 % of isolates (MICs above 1 mg l(-1)). MFCs were 5 to 20 times higher than the MICs, but the lowest GM MFC and range values were found for TB. IZ and PZ gave the highest GM MFC. MFC may be a better predictor of therapeutic response than MIC, especially in immunosuppressed patients, making the use of IZ and PZ an inappropriate treatment. There were some differences in susceptibility according to the geographical source of the isolates, with the MIC being lower for TB in Venezuelan strains (P=0.066) and the MFC higher for PZ in Peruvian strains (P=0.02). Thus, geographical origin may be important for appropriate treatment, and may relate to the identification of species of the S. schenckii complex.
Assuntos
Antifúngicos/farmacologia , Farmacorresistência Fúngica , Sporothrix/efeitos dos fármacos , Testes de Sensibilidade Microbiana , América do SulRESUMO
BACKGROUND: Candida is frequently seen in urinalysis studies in patients with diabetes mellitus. The objective was to determine the presence and clinical significance of candiduria, and to identify the different isolated Candida species and their in vitro susceptibility pattern to different antifungal agents by means of the broth microdilution method. METHODS: We studied the urine from 50 type 2 diabetes mellitus (DMT2) patients. 24 patients had controlled DMT2 and 26 non-controlled DMT2. RESULTS: Twenty-three Candida spp. positive cultures were obtained, of which 17 were obtained from the non-controlled DMT2 patients; 30.7% of the isolates were caused by Candida infection. The main isolated species were C. glabrata (48%) and C. albicans (35%). Itraconazole, amphotericine B, and ketoconazole showed less antifungal activity in C. glabrata isolates, whereas fluconazole and voriconazole displayed higher antifungal activity. CONCLUSIONS: It is important to search routinely for yeast in the urine of DMT2 patients to detect candidiasis, and to perform antifungal susceptibility tests to Candida isolates in order to establish antifungal therapy for these patients.
Assuntos
Candidíase/urina , Diabetes Mellitus Tipo 2/microbiologia , Diabetes Mellitus Tipo 2/urina , Infecções Urinárias/microbiologia , Infecções Urinárias/urina , Adulto , Idoso , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-IdadeRESUMO
Se ha evaluado la utilidad del metodo de difusion en agar NeoSensitabs para determinar la sensibilidad in vitro de 52 aislamientos de hongos filamentosos dematiaceos a diez antifungicos: anfotericina B.5-fluorocitosina, Ketoconasol, fluconazol, itraconazol, terbinafina, bifonazol, miconazol, clotrimazol, y griseofulvina. Para la preparacion del inoculo se ultilizo un metodo espectrofotometrico empleandose los medios de Shadomy y Casitone agar (CAS), simultaneamente. Todos los aislamientos fueron sensibles, al itraconazol, terbinafina y bifonazol. Al ketonazol el 90,4% resultaron sensibles al miconazol el 71% y al clotrimazol el 46%. El 63% de las cepas fueron sensibles a la anfotericina B y el 28,8% resistente. Por el contrario, el 94,2% de los aislamientos resultaron resistentes a la griseofulvina y el 96% al flucanazol. El 100% de las cepas fueron resistentes a la 5-fluorocitosina. Las zonas de inhibicion no mostraron variaciones en cuanto a la sensibilidad dependiendo del medio; sin embargo, hubo un mejor desarrollo fungico en el medio CAS. Las variaciones en la sensibiblidad observadas con especies como Exophiala spinifera y Fonsecaea pedrosi justificarian el estudio de la sensibiblidad in vitro para valorar el tratamiento clinico con antifungicos. Estos resultados demuestran que el metodo de difusion en agar NeoSensitabs es facil de realizar, rapido y economico por lo que esta al alcance de muchos laboratorios clinicos para el estudio de la sensibilidad in vitro en mochos dematiaceos
Assuntos
Antifúngicos/análise , Antifúngicos/imunologia , Antifúngicos/síntese química , Antifúngicos/uso terapêutico , Ágar/farmacologia , Ágar/metabolismoRESUMO
Se compara la técnica de Aglutinación Directa (AD) utilizando muestras de sangre total desecada en papel de filtro, con la técnica de ELISA y la misma AD utilizando muestras de suero de los mismos pacientes, para la detección de anti-cuerpos antitoxoplasmas. Los rsultados muestran la validez del método de la sangre desecada en papel de filtro para la detección de anticuerpos antitoxoplasma con la técnica de AD, y se considera su utilidad en los estudios epidemiológicos de campo