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C Canteros

Publications and source records attributed to C Canteros.

11 recordsLinked to original sources

Maxillary sinusitis caused by Actinomucor elegans.

We report the first case of maxillary sinusitis caused by Actinomucor elegans in an 11-year-old patient. Histopathological and mycological examinations of surgical maxillary sinuses samples showed coenocytic hyphae characteristic of mucoraceous fungi. The fungi recovered had stolons and rhizoids, nonapophyseal and globose sporangia, and whorled branched sporangiophores and was identified as A. elegans. After surgical cleaning and chemotherapy with amphotericin B administered intravenously and by irrigation, the patient became asymptomatic and the mycological study results were negative.

Amphotericin B↗

Timed-kill curves for Cryptococcus neoformans isolated from patients with AIDS.

Infection with Cryptococcus neoformans is an increasing problem in immunocompromised patients, particularly those with acquired immune deficiency syndrome (AIDS). Amphotericin B and fluconazole are currently acceptable therapies for cryptococcal meningitis; however, their effects remain suboptimal and recurrence or treatment failure is still a problem. Antifungal susceptibility testing may be an important tool for guiding therapy, but for C. neoformans, a reliable method is still not available. This retrospective study evaluated minimal inhibitory concentration (MIC) for amphotericin B and fluconazole, and minimal fungicidal concentration (MFC) and timed-kill curves for amphotericin B against 16 clinical isolates of C. neoformans obtained from AIDS patients with cryptococcal meningitis. No correlation between clinical outcome and MIC was observed for amphotericin B. In selected cases, the MFC seemed to be a better predictor of outcome than MIC. In this study, amphotericin B timed-kill curves appeared to show a correlation with clinical outcome of the 16 patients with AIDS-associated cryptococcal meningitis. These in vitro tests must be further evaluated in prospective studies to confirm their potential usefulness for guiding cryptococcal meningitis therapy.

AIDS-Related Opportunistic Infections↗

In vitro susceptibility studies of Cryptococcus neoformans isolated from patients with no clinical response to amphotericin B therapy.

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.

Acquired Immunodeficiency Syndrome↗

[Multicenter study on nosocomial candidiasis in the Republic of Argentina].

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.

Antifungal Agents↗

[Multicenter study of superficial mycoses in Argentina. EMMS Group].

Dermatomycoses are an important sanitary problem. Our country counts with partial epidemiological data only referred to a few geographical areas. The aim of our work was to perform a multicenter study with the participation of 15 medical centers located at the Capital City and in 11 Provinces of Argentina with different socioeconomical and cultural characteristics. Between October and December 1998, 851 ambulatory patients of both sexes (58% female, 42% male) with lesions compatible with mycoses in skin, nails or scalp were studied. Only 51.6% of the patients had mycoses confirmed by direct microscopic examination and/ or culture. Dermatophytes caused 69.3% of the diagnosticated infections, yeast 12.2% and Malassezia furfur 13.3%. Agents of dermatomycoses most frequently isolated were T. rubrum (52.7%), T. mentagrophytes (19.2%) and M. canis (14.2%). C. albicans was the predominant causative agent of yeast infections (44.4%). In children below 11 years old, the most frequent infections were tinea capitis 55.4% (M. canis 60%, T. tonsurans and M. gypseum 8.3%) and tinea corporis 20% (M. canis 46%, T. mentagrophytes 30%). The most frequent localizations in adult were toenail and feet (63%) (T. rubrum 47.3% and 45.7%, T. mentagrophytes 9.5% and 23.4%, respectively), fingernail 15.6% (C. albicans 25% and T. rubrum 8.3%) and trunk and extremities 12.2% (M. furfur 57.5% and T. mentagrophytes 14.9%). Direct examination allowed the diagnosis of 94.66% of all positive samples and 91.74% of the cases with positive isolation.

Adolescent↗

[Nosocomial transmission of Candida albicans in newborn infants].

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.

Candida albicans↗

[Molecular characterization of autochthonous clinical isolates of Histoplasma capsulatum var. capsulatum using RAPD-PCR].

The aim of our work was to determine the genotypic relatedness among H. capsulatum isolates from Argentinian patients with or without AIDS and isolates from other sources and geographic origins. We analyzed band patterns of 16 isolates obtained by RAPD-PCR, 11 Argentinian clinical isolates (8 from patients with AIDS and 3 from patients without AIDS), 2 strains from the CDC, 2 isolates from Mexico and one isolate from Uruguay. With the band patterns obtained, we built a dendrogram, which showed 3 major groups. Group I contained 2 isolates from Mexico, group II 1 strain from CDC and group III included 13 isolates, and was divided into 4 subgroups. Subgroup IIIa contained 2 isolates from patients with and without AIDS. Subgroup IIIb included isolates from patients without AIDS from Chaco. Subgroup IIIc contained 7 isolates from Argentina (from Buenos Aires province) and the Uruguayan isolate (6 isolates from patients with AIDS). Subgroup IIId included only one strain from CDC. All the Argentinian and the Uruguayan isolates went into group III, subgroups IIIa, IIIb and IIIc. This is a preliminary study; however, a relatedness of the RAPD-PCR band patterns and the geographic origin was observed. Although there might be a probable association between immunocompromised patients with AIDS and infective capability of some H. capsulatum isolates, further studies with a larger number of isolates from different sources and geographic origins are necessary to confirm these results.

AIDS-Related Opportunistic Infections↗

[Electrophoretic karyotypes and genomic DNA restriction fragment analysis: their usefulness as tools in the epidemiological study of Candid parapsilosis].

During the past decades, several studies have reported an increase in the incidence of nosocomial candidosis. In a prospective study, performed at the Departamento de Micología, INEI, ANLIS Dr. C. G. Malbrán and the Servicio de Neonatología and Microbiología, Hospital de Niños Sor María Ludovica, from October 1995 to December 1996, 167 patients with candidosis were detected. Candida species isolated were C. albicans (53.1%), C. parapsilosis (26.5%) and C. tropicalis (14.8%). The aim of this work was to characterize the clinical C. parapsilosis isolates from pediatric patients hospitalized in two neonatal intensive care units from the same hospital and to evaluate the usefulness of electrophoretic karyotype (EK) and restriction endonuclease analysis of genomic DNA (REAG) using a low frequency digestion enzyme. EK of all isolates disclosed 12 banding patterns and REAG with endonuclease Sfi I showed only 5 groups. However, isolates from the control group could not be separated from the clinical isolates. The isolates within each dendogram group for EK or REAG were apparently unrelated. Our results show that EK yields better results than REAG, but that it falls short of the desired discrimination, which suggests that these techniques do not seem to be useful for studying nosocomial C. parapsilosis outbreaks.

Argentina↗

[Yeast infections: causative agents and their antifungal resistance in hospitalized pediatric patients and HIV-positive adults].

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%).

AIDS-Related Opportunistic Infections↗

[Candida dubliniensis: 1st isolation in Argentina].

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.

AIDS-Related Opportunistic Infections↗

[Specific fungal antisera production in rabbits].

A method for fungic antisera production against Aspergillus fumigatus, Histoplasma capsulatum, Paracoccidioides brasiliensis and Coccidioides immitis in rabbits was evaluated. Intradermic via and antigen in the dilution used for routine tests (UD) were employed to produce positive control serum for immunodiffusion test in agar gel. A. fumigatus, H. capsulatum and C. immitis antigens were prepared as described in CDC's Procedure Manual, P. brasiliensis antigen was prepared as previously described by Pires de Camargo. All rabbits produced antibodies against the different specific antigens in the primary response peak and after each booster. The titer obtained in secondary response was similar or smaller than the primary response in all cases. However, bands of similar quality and intensity were obtained by immunoprecipitation in agar gel tests. Although the antibody titers proved to be similar, higher or lower concentration of antigen used in the primary immunization produced fewer and smeared bands, respectively. This effect was evaluated in A. fumigatus only. Specific antisera production with this method proved to be easy and yielded high quality antisera. The major advantages of this method are: a) reduced number of inoculations, b) fast and simple standardisation of the antigen needed, c) equally useful for all the fungal species used so far. Therefore we strongly recommend this method.

Animals↗