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Biomedical subjects

Francisco Solís

Publications and source records attributed to Francisco Solís.

5 recordsLinked to original sources

Risk factors for pulmonary Aspergillus terreus infection in patients with positive culture for filamentous fungi.

BACKGROUND: Invasive aspergillosis (IA) is a common fungal infection in immunocompromised patients and has a high mortality rate. Among patients with IA, Aspergillus terreus infections have become a growing concern in the past few years. OBJECTIVE: To determine the clinical risk factors for isolation of and respiratory infection by A terreus in patients with culture findings positive for filamentous fungi. METHODS: Cohort study of 505 consecutive isolates of filamentous fungi in 332 patients from one center. A terreus was present in 46 isolates from 40 patients (9.1%). Clinical histories were reviewed to identify the risk factors related to isolation of and infection by A terreus, which were grouped into three categories (ie, host factors, factors related to immunosuppression, and factors related to hospitalization), and were analyzed using a multiple logistic regression model. RESULTS: A total of 192 of 505 isolates studied (38%) were due to invasive respiratory infection. A total of 27 of 46 cultures (58.7%) that were positive for A terreus were due to invasive infection (odds ratio [OR], 2.53; 95% confidence interval [CI], 1.37 to 4.69; p = 0.034). The factors associated with invasive A terreus infection were prophylactic use of amphotericin B aerosols (OR, 27.8; 95% CI, 6.7 to 109.7; p = 0.001) and mechanical ventilation (OR, 3.3; 95% CI, 1.02 to 10.9; p = 0.04). Transplantation was associated with a lower risk of A terreus infection (OR, 0.2; 95% CI, 0.046 to 0.789; p = 0.02). CONCLUSIONS: In patients with culture findings positive for filamentous fungi, the prophylactic use of amphotericin B aerosols and mechanical ventilation are associated with a higher risk of A terreus infections. In these patients, transplantation is associated with a lower risk of isolation and respiratory infection by A terreus.

Administration, Inhalation↗

Susceptibility of filamentous fungi to voriconazole tested by two microdilution methods.

The growing number of fungal infections, coupled with emerging resistance to classical antifungal agents, has led to the development of new agents, among them voriconazole. Susceptibility to voriconazole was tested by two microdilution techniques: the National Committee for Clinical Laboratory Standards reference method M38-A and a colorimetric method, Sensititre YeastOne. The study tested a total of 244 isolates: 223 Aspergillus (136 Aspergillus fumigatus, 37 A. niger, 26 A. terreus, 16 A. flavus, 7 A. nidulans, and 1 A. ustus), 14 Fusarium (8 Fusarium moniliformis, and 6 F. oxysporum), 6 Scedosporium apiospermum, and 1 Rhizomucor pusillus strain and four control strains (Candida parapsilosis ATCC 22019, C. krusei ATCC 6258, A. fumigatus ATCC 204305, and A. flavus ATCC 204304). For all tested species except one F. moniliforme strain and R. pusillus, the MIC, the MIC at which 50% of the isolates are inhibited (MIC(50)), and MIC(90) ranges of </=1 microg/ml were obtained for voriconazole, indicating excellent activity against these species. The high rate of agreement between the two methods used (97 to 99%) suggests that the Sensititre YeastOne colorimetric method may be a valuable tool for determining the susceptibility of filamentous fungi to voriconazole.

Antifungal Agents↗

In vitro activity of voriconazole against Prototheca wickerhamii: comparative evaluation of sensititre and NCCLS M27-A2 methods of detection.

A total of 104 Prototheca wickerhamii isolates and two control strains were tested for susceptibility to voriconazole using the Sensititre YeastOne colorimetric antifungal plate and NCCLS reference method. Voriconazole was highly active against all isolates, with an MIC at which 90% of isolates were inhibited of < or = 0.5 microg/ml. Comparison of MICs obtained with the Sensititre product and the NCCLS method demonstrated agreement (100% +/- 2 log2 dilutions) between the two methods. Voriconazole may offer an option for the treatment of Prototheca sp. infections, and its efficacy should be established through clinical experience.

Antifungal Agents↗

Comparison of two microdilution methods for testing susceptibility of Candida spp. to voriconazole.

The growing number of fungal infections, coupled with emerging resistance to classical antifungal agents, has led to the development of new agents, among them voriconazole. Susceptibility to voriconazole was tested by using two microdilution techniques: the reference method described in National Committee for Clinical Laboratory Standards document M27-A2 and a colorimetric method, Sensititre YeastOne. A total of 272 Candida isolates (132 of Candida albicans, 62 of C. parapsilosis, 33 of Candida glabrata, 21 of C. krusei, 15 of C. tropicalis, and 9 of C. lusitaniae) and two control strains (C. parapsilosis ATCC 22019 and C. krusei ATCC 6258) were tested. There was a high rate of agreement between the two methods used (97 to 100%).

Antifungal Agents↗

[CHROMAgar Candida with fluconazole: comparison with microdilution techniques].

INTRODUCTION: The increasing incidence of fungal infections and the reported emergence of resistance to antifungal agents call for the development of techniques for in vitro measurement of antifungal susceptibility that will enable prediction of clinical outcome in patients suffering from these infections. METHODS. Susceptibility to fluconazole was tested in 156 clinical yeast isolates (109, Candida albicans; 19, C. parapsilosis; 12, C. glabrata; 11, C. tropicalis; 2, C. krusei; 1, C. pelliculosa; 1, C. lambica, and 1, Saccharomyces cerevisiae) and two control strains (C. krusei ATCC 6258 and C. parapsilosis ATCC 22019) using a simple screening method, CHROMAgar Candida with fluconazole (8 micro g/ml). This method was compared with two broth microdilution techniques: the reference method (NCCLS, document M27-A) and Sensititre(TM) YeastOne. RESULTS: Sensititre(TM) YeastOne showed close agreement with NCCLS M27-A results for all species (C. albicans and non albicans). CHROMAgar Candida with fluconazole (8 micro g/ml) yielded results matching those of the two broth microdilution methods for sensitive strains and strains highly resistant to fluconazole (C. krusei and C. glabrata), but performed less well with strains displaying dose-dependent susceptibility. CONCLUSION: These data suggest that CHROMAgar Candida with fluconazole (8 micro g/ml), appears to be a rapid, simple and sensitive screening method for detection and identification of fluconazole-susceptible and -highly resistant yeasts. However, additional methods should be used to determine whether positive growth in this medium is due to resistant strains (MIC > or = 64 micro g/ml) or to strains displaying dose-dependent susceptibility (MIC 16-32 micro g/ml). The usefulness of CHROMAgar Candida with fluconazole depends on the sample source and the species under study.

Antifungal Agents↗