Biomedical subjects

W Vivot

Publications and source records attributed to W Vivot.

8 recordsLinked to original sources

PubMedDate not supplied

[Vaginal candidiasis: etiology and sensitivity profile to antifungal agents in clinical use].

Candida vaginitis is one of the most frequent infection of the female genital tract with a high incidence. Approximately 75% of sexually active women suffer at least one episode of Candida vaginitis and 10% of them have recurrent episodes. Pregnancy, diabetes mellitus and antibiotic treatment are the most common predisposing factors, C. albicans is the etiologic agent most frequently found. The widespread reports of fluconazole resistance in Candida species and the selection of non Candida albicans prompted the study of species distribution of vulvovaginal candidiasis and their in vitro susceptibility against current antifungal agents. A total of 314 women with vaginal infection were studied. Yeasts were isolated from 104 patients with vulvovaginal candidiasis. The following species were identified: C. albicans 87.5%, C. glabrata 8.6% and 3.9% included C. krusei, C. famata, C. tropicalis and S. cerevisiae. The minimal inhibitory concentration (MIC) was determined for nystatin, isoconazole, fluconazole and ketoconazole, using a broth microdilution method based on NCCLS procedure. Although most of the isolates were C. albicans, the high percentage of C. glabrata recovered suggests the need to identify the yeasts isolated. Fluconazole resistant C. albicans were isolated in 13.46% of the cases. Thus, further studies are required to correlate the possible role of these strains in recurrent vulvovaginal candidiasis.

Adolescent↗

PubMedDate not supplied

[Multicenter study of fungemia due to yeasts in Argentina].

The incidence of candidemia has increased approximately 500% in high-complexity hospitals. A change in the spectrum of Candida infections due to species other than Candida albicans has also been detected. Between April 1999 and April 2000 a multicenter study was performed in order to determine the species distribution associated to candidemias in Argentina and the susceptibility profile of the isolates to the current antifungal drugs. Thirty six institutions have participated. All the 265 yeast strains isolated from blood cultures were identified by morphological, physiological, and biochemical tests. The antifungal susceptibility testing of isolates was performed based on the reference NCCLS procedure. The distribution of species was: Candida albicans (40.75%), Candida parapsilosis (28.67%), Candida tropicalis (15.84%), Candida famata (3.77%), Cryptococcus neoformans (3.77%), Candida glabrata (2.64%), and others (4.53%). Most of the isolates were susceptible to amphotericin B, fluconazole and itraconazole. Mortality associated to the fungemia by yeasts episodes (n=265) was 30%, lower than results previously determined (33-54%). The mortality percentage in patients who received antifungal therapy versus patients without treatment was 26.3% and 47%, respectively.

Amphotericin B↗

PubMedDate not supplied

[Disk diffusion method for fluconazole susceptibility testing of Candida spp. isolates].

In order to standardize and evaluate a disk diffusion method with visual reading to detect in vitro fluconazole susceptibility of yeast, 1193 clinical isolates were tested. These included 584 Candida albicans, 196 Candida parapsilosis, 200 Candida tropicalis, 113 Candida glabrata, 50 Candida krusei and 50 Candida spp. and other opportunistic yeasts. The disks were manufactured in the INEI-ANLIS "Dr. Carlos G. Malbrán. The disk diffusion method results were compared to MIC results obtained by the reference CLSI M27-A2 broth microdilution method modified by EUCAST. The interpretative breakpoints for in vitro susceptibility testing of fluconazole were established at: zone diameter > or =16 mm for MIC < or =8 microg/ml (susceptible isolates), between 9 and 15 mm for MIC = 16-32 microg/ml (susceptible dose-dependent isolates), and < or =8 mm for MIC > or =64 microg/ml (resistant isolates). Overall agreement between the two methods was 94.7%, with 0.2% very major errors, and 0.3% major errors. Inter - and intralaboratory agreement was good. The disk diffusion method for drug susceptibility testing of Candida spp. isolates is inexpensive, reliable and reproducible. However, when the inhibition zone diameter is < or =15 mm, it is advisable to test the isolate by the reference microdilution method.

Antifungal Agents↗

PubMedDate not supplied

[Causal agents of onychomycosis].

The results obtained with 307 specimens from putatively immunocompetent patients between May 1991 and May 1992 were reviewed, to determine the frequency of isolation of fungal species causing onychomycoses. Sixty eight percent of the specimen were positive for microscopic examination and/or cultures. Onychomycoses occurred with double frequency in women than in men (Table 1), and 77% of cases were diagnosed in patients aged between 30 and 70 years (Figure 1). Out of 182 patients with positive cultures, 60% were affected by dermatophytes and 39% by yeasts; molds (Aspergillus spp.) were isolated in only two cases (Table 3). Neither Corynebacterium spp., nor Malasezzia furfur were detected. In toe nails Trichophyton rubrum predominated over yeasts being isolated in 72.9% of the cases; yeasts other than Candida albicans were isolated in 12.3%, Trichophyton mentagrophytes in 10%, while Aspergillus spp., C. albicans and Epidermophyton floccosum in only 1.6%. On the other hand, in finger nails yeasts predominated: C. albicans was isolated in 46.7% of cases, other yeasts in 43.3%; and T. rubrum in the remaining 10%. Out of 41 isolations of yeasts other than C. albicans, 42% were C. parapsilosis, 16% Debaryomyces hansenii, 6% C. pulcherrima, 6% Trichosporum cutaneum and 6% C. famata (Figure 2).

Adolescent↗

PubMedDate not supplied

[Incidence of various etiologic agents of superficial mycosis].

In a retrospective review of laboratory records at the Department of Mycology, National Institute of Microbiology "Dr. Carlos G. Malbrán", during the period June 1989-July 1991, 1225 putatively immunocompetent cases of superficial mycoses were identified. Ninety five percent of these patients were adults and 5% children. Among the total cases, dermatomycoses were caused, 67.6% by dermatophytes, 25.9% by yeasts, 5.9% by Malassezia furfur. and 0.5% by other fungi, as proven by the isolation of the etiological agents. (Figure 1, Table 2). Among the dermatophytes Trichophyton rubrum and Trichophyton mentagrophytes greatly predominated accounting for 66.6% and 20.0% of the isolates, respectively, whereas Microsporum canis (8.0%). Epidermophyton floccosum (5.1%) and Microsporum gypseum (0.3%) were found with less frequency (Figure 2). Nails (47%) were the most common source of isolates in adults, followed by feet (28%), smooth skin (15%), groin (5%) and hands (2%) (Table 1). Regarding the relative efficiency of the diagnostic methods, the analyses of laboratory results evidenced that, 98% of the cases with clinical findings compatible with mycoses and 76% of the cases with positive cultures (Table 1) were identified by microscopic observation.

Adult↗

PubMedDate not supplied

[In vitro sensitivity tests for yeasts: evaluation of a micromethod].

A microdilution antifungal susceptibility test for yeasts was evaluated, based on the macro broth dilution method standardized by the National Committee for Clinical Laboratory Standards (NCCLS) Subcommittee on Antifungal Susceptibility Testing. Both methods were compared using six reference strains with different patterns of susceptibility to the following antifungal drugs: amphotericin B (AMB), flucytosine (5FC), fluconazole (FCZ), itraconazole (ITZ), ketoconazole (KTZ) and miconazole (MCZ). Minimal inhibitory concentration (MIC) results obtained by both methods differed only in 1 or 2 dilutions. Microdilution MIC's determined as visual endpoints and as quantitative measurement of 80% inhibition of relative growth showed a significant correlation (p < 0.001) for AMB, 5FC, FCZ, MCZ and ITZ, conversely no correlation (p = 1.00) for KTZ was observed as determined with 47 local isolates of Candida albicans.

Antifungal Agents↗

PubMedDate not supplied

[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↗

PubMedDate not supplied

[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↗