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C Marcano

Publications and source records attributed to C Marcano.

7 recordsLinked to original sources

In vitro susceptibility of 137 Candida sp. isolates from HIV positive patients to several antifungal drugs.

Oropharyngeal candidiasis caused by various species of Candida is one of the most common infections in HIV seropositive or AIDS patients. Drug resistance among these yeasts is an increasing problem. We studied the frequency of resistance profile to fluconazole, itraconazole, ketoconazole, amphotericin B and terbinafine of 137 isolates of Candida sp. From HIV positive or AIDS patients with oropharyngeal candidiasis at Instituto de Inmunología, U.C.V. and the Hospital "Jose Ignacio Baldó", Caracas Venezuela, using the well diffusion susceptibility test (Magaldi et al.). We found that nearly 10% of C. albicans isolates were primarily fluconazole resistant, 45% of C. albicans isolates from patients with previous treatment were resistant to fluconazole, of which 93% showed cross-resistance to itraconazole, and even about 30% of C. tropicalis (n = 13) were resistant to fluconazole and/or itraconazole. To this respect, several recent reports have been described antifungal cross-resistance among azoles. Therefore, we consider that C. tropicalis should be added to the growing list of yeast in which antifungal drug resistance is common. This report could be useful for therapeutic aspect in AIDS patients with oral candidiasis.

AIDS-Related Opportunistic Infections↗

[Effectiveness of econazole on pregnant women with vulvo-vaginal candidiasis].

Among the female patients attending the out patient clinic of the Obstetric Service of the University Hospital of Caracas, Venezuela a hundred were chosen who presented vaginal discharge and itching. The presence of C. albicans and the existence of candidiasis in the vulvo-vagina of the 100 pregnant women was investigated. Those patients where candidiasis was found, were also investigated as to the simultaneous presence of C. albicans in the mouth and the anal skin. Gyno-Pevaryl therapy was performed by administering one 150 mg ovule daily for three consecutive days. At the same time, their partners were treated with Pevaryl 1% cream. The post-therapy control was made 36 hours after conclusion of treatment and further check-up were made one week and two weeks later. Only those patients who attended the post-treatment controls were taken into account for the evaluation of the results. C. albicans was identified in 60 cases by nascent culture of the vulvar secretions, using a bile-agar medium. Of these, 50 had vulvo-vaginal candidiasis (hyphae and blastospores on direct examination). 92% of the women with vulvo-vaginal candidiasis complained about pruritus at the moment of the examination. No significant differences were observed with respect to the age, the period of gestation and parity of the positive and negative patients. Of the 40 patients who attended only the first control, 23 were cured (57.5%), 9 improved (22.5%) and 8 (20%) were not cured. The cure rate increased to 70% and 72.5% taking into account those patients, who also attended the second and the third consecutive treatment sessions, respectively. In those patients suffering from vulvo-vaginal candidiasis, 37.5% were found to be carriers of C. albicans in the mouth and 70% also in the anal region. This seems to indicate that the mouth and the anal region can constitute the source of re-infection in the majority of the cases following topical vaginal treatment.

Adolescent↗

[Tinea unguis caused by Nannizzia gypsea (+)].

We describe a case of tinea unguis in a 20 year old female student from Caracas. The peri-ungual skin of a thumb appeared altered first and, since 6 months, the lamina was being progressively invaded and destroyed. At the direct mycologic examination numerous, regular and irregular, hyaline fungal hyphae were visible. Culture was performed 9 times: several molds did grow, among which, eight times, we got numerous colonies of a strain that has been identified to Nannizzia gypsea (+). Owing to the rarity of the observation the bases for the diagnosis are discussed and the pertinent literature is reviewed.

Adult↗

[Toothbrushes in the ecology of Candida albicans].

Two hundred and twenty nine patients were sorted out at random from different services at the Hospital Universitario de Caracas, Venezuela, to investigate simultaneously the presence of Candida albicans in the mouth and in their toothbrushes. None of them showed signs of candidiasis. From the oral cavity of each patient two samples were taken by rubbing throughout the mucous membrane. One of them was cultured in oxgall agar and the other one in diluted milk agar. At the same time, the toothbrushes of the patients were cultured in oxgall agar or in diluted milk agar. The results showed evidence of C. albicans in the mouth of 28% of the patients hospitalized for different reasons, and in the 18% of the toothbrushes studied. Both media were found equally efficient for the diagnosis and identification of C. albicans in nascent culture, even with material contaminated with other yeasts and bacteria. The use of dental prosthesis, in patients without teeth and those with a few teeth, appears to be a predisposing factor for the colonization by C. albicans in healthy mouths. Out of 57 healthy mouth-carriers of C. albicans, 33 (58% of them ) had also C. albicans in their toothbrushes. These findings seem to point to the toothbrushes as being the possible reservoir and reinfection source in some cases of candidiasis. To patients suffering with oral candidiasis the use of some method for disinfecting the toothbrushes must be recommended when planning the treatment.

Candida albicans↗