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Id: biblio-859840
Autor: Santos, Paula Slomp; Lana, Daiane Flores Dalla; Mezzari, Adelina.
Título: Candida auris: emergence and epidemiology of a highly pathogenic yeast
Fonte: Clin. biomed. res;37(3):247-254, 2017. tab.
Idioma: en.
Resumo: Candida auris is a multidrug-resistant emerging yeast, which was responsible for healthcare-associated infection outbreaks, and was cataloged as a new species in 2009, after being isolated from a patient's ear canal secretion in Japan. Since the notification of this first occurrence, numerous cases have been reported throughout the world, including Brazil. C. auris affects mainly inpatients, patients in intensive care units, exposed to broad-spectrum antifungal medications and who make use of vascular catheters. Currently, this yeast is one of the main responsible for invasive infections in hospitals and has been cause of concern by authorities and organs due to its rapid dissemination and difficult treatment caused by its low susceptibility to antifungal agents traditionally used in clinical practice. As a contributor to the severity of infections associated with C. auris, the transmission mechanism is still unknown, which implies in a lack of control of the microorganism and high mortality rates. Thus, this literature review presents relevant information in order to alert the importance of C. auris as an etiological agent of systemic infections, as well as its epidemiology and the real challenges of the treatment (AU)
Descritores: Candida/patogenicidade
Candidíase/epidemiologia
-Anti-Infecciosos/uso terapêutico
Antifúngicos/uso terapêutico
Candida/efeitos dos fármacos
Candida/isolamento & purificação
Candidíase/diagnóstico
Candidíase/tratamento farmacológico
Candidíase/microbiologia
Farmacorresistência Fúngica Múltipla
Limites: Humanos
Tipo de Publ: Revisão
Responsável: BR18.1 - Biblioteca FAMED/HCPA


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Id: lil-795822
Autor: Brazão, Maria AngéLica B; Brazão, Fabio V; Maia, José Guilherme S; Monteiro, Marta C.
Título: Antibacterial activity of the Piper aduncum oil and dillapiole, its main constituent, against multidrug-resistant strains / Actividad antibacteriana del aceite de Piper aduncum y dillapiole, su componente principal, frente a cepas resistentes a múltiples fármacos
Fonte: Bol. latinoam. Caribe plantas med. aromát;13(6):517-526, nov.2014. ilus, tab.
Idioma: en.
Resumo: The study aimed to evaluate the bactericidal activity of oil essential and dillapiole from P. aduncum against standard and multidrug-resistant strains of Staphylococcus spp. The oil showed antimicrobial action against these strains, but better results were obtained for the standards strains of S. epidermidis and S. aureus, with MIC of 250 and 500 ug/mL, respectively. Dillapiolle was less effective than the oil against the same standard and multi-drug resistant strains (MIC =1000 ug/mL). However, when dillapiolle was tested in combination with myristicin, another component of the oil, it increased its bactericidal activity and showed a synergistic action...

El objetivo del estudio fue evaluar la actividad bactericida de los aceites esenciales y dillapiole de P. aduncum contra cepas estándar y multirresistentes de Staphylococcus spp. El aceite mostró acción antimicrobiana frente a estas cepas, pero se obtuvo mejores resultados para las cepas de S. epidermidis y S. aureus, con MIC de 250 y 500 ug/ml, respectivamente. Dillapiolle fue menos eficaz que el aceite contra cepas estándar y multirresistentes (MIC = 1000 ug/ml). Sin embargo, cuando dillapiolle fue probado en combinación con la miristicina, otro componente del aceite, que aumentó su actividad bactericida y mostró una acción sinérgica...
Descritores: Óleos Voláteis/farmacologia
Antibacterianos/farmacologia
Extratos Vegetais/farmacologia
Piper/química
-Compostos Alílicos/farmacologia
Compostos de Benzil/farmacologia
Farmacorresistência Fúngica Múltipla
Monoterpenos/farmacologia
Staphylococcus
Limites: Humanos
Responsável: CL1.1 - Biblioteca Central


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Id: lil-663709
Autor: Escandón, Patricia; de Bedout, Catalina; Lizarazo, Jairo; Agudelo, Clara Inés; Tobón, Ángela; Bello, Solmara; Restrepo, Ángela; Castañeda, Elizabeth.
Autor: Grupo Colombiano para el Estudio de la Criptococosis.
Título: Cryptococcosis in Colombia: Results of the national surveillance program for the years 2006-2010 / Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010
Fonte: Biomédica (Bogotá);32(3):386-398, jul.-set. 2012. ilus, graf, mapas, tab.
Idioma: en.
Resumo: Introduction: A survey on cryptococcosis is being conducted regularly in Colombia since 1997. We present hereby the results corresponding to patients diagnosed from 2006 to 2010. Objective: To analyze the data obtained during this period. Materials and methods: Retrospective analysis of the corresponding surveys. Results: A total of 526 surveys originating from 72% of the Colombian political divisions were received during the 5-year period. Most patients (76.6%) were males and 74.9% were 21-50 years old. The most prevalent risk factor was HIV infection (83.5%) with cryptococcosis defining AIDS in 23% of the cases. In the general population the estimated mean annual incidence rate for cryptococcosis was 2.4 x 106 inhabitants while in AIDS patients this rate rose to 3.3 x 103. In 474 surveys stating clinical features, most frequent complaints were headache 84.5%, fever 63.4%, nausea and vomiting 57.5%, mental alterations 46.3%, meningeal signs 33.0%, cough 26.4% and visual alterations 24.5%. Neurocryptococcosis was recorded in 81.8% of the cases. Laboratory diagnosis was based on direct examination, culture and latex in 29.3% cases. From 413 Cryptococcus isolates analyzed, 95.6% were identified as C. neoformans var. grubii, 1% C. neoformans var. neoformans, and 3.4% C. gattii. Treatment was reported for 71.6% of the cases with amphotericin B alone or in combination with fluconazole prescribed in 28%. Conclusions: Surveys done through passive surveillance continue to be sentinel markers for HIV infection and represent a systematic approach to the study of opportunistic problems regularly afflicting AIDS patients since cryptococcosis requires no compulsory notification in Colombia.

Introducción. Desde 1997 se viene realizando un programa nacional de vigilancia sobre la criptococosis en Colombia. Se presentan los resultados correspondientes a los pacientes diagnosticados entre el 2006 y el 2010. Objetivo. Analizar los datos obtenidos durante este periodo. Materiales y métodos. Análisis retrospectivo de las encuestas. Resultados. Durante los cinco años mencionados se recibieron 526 encuestas representativas del 72 % de la división política colombiana. La mayoría de pacientes (76,6 %) eran hombres y 74,9 % estaban entre los 21 y los 50 años. El factor de riesgo prevalente fue la infección por VIH (83,5 %), y la criptococosis definió el sida en 23 % de los casos. La incidencia anual promedio en la población general fue de 2,4 por un millón de habitantes mientras que, en pacientes con sida, aumentó a 3,3 por 1.000. En 474 encuestas se informaron manifestaciones clínicas; las más frecuentes fueron: cefalea (84,5 %), fiebre (63,4 %), náuseas y vómito (57,5 %), alteraciones mentales (46,3 %), signos meníngeos (33 %), tos (26,4 %) y alteraciones visuales (24,5 %). La neurocriptococosis se reportó en 81,8 % de los casos. El diagnóstico se hizo por examen directo, cultivo y antigenemia en 29,3 % de los casos. De 413 aislamientos recuperados, 95,6 % fueron C. neoformans var. grubii, 1 % C. neoformans var. neoformans, y 3,4 % C. gattii. En 71,6 % de los casos para el tratamiento se administró anfotericina B y en 28 % se combinó con fluconazol. Conclusiones. La vigilancia pasiva continúa siendo un marcador centinela para la infección por VIH, y constituye una aproximación sistemática al estudio de infecciones oportunistas en pacientes con sida, debido a que la criptococosis no es de notificación obligatoria en Colombia.
Descritores: Criptococose/epidemiologia
-Infecções Oportunistas Relacionadas com a AIDS/epidemiologia
Anfotericina B/administração & dosagem
Anfotericina B/uso terapêutico
Antifúngicos/uso terapêutico
Antígenos de Fungos/sangue
Colômbia/epidemiologia
Criptococose/diagnóstico
Criptococose/tratamento farmacológico
Criptococose/microbiologia
Cryptococcus gattii/imunologia
Cryptococcus gattii/isolamento & purificação
Cryptococcus neoformans/imunologia
Cryptococcus neoformans/isolamento & purificação
Farmacorresistência Fúngica Múltipla
Fluconazol/administração & dosagem
Fluconazol/uso terapêutico
Inquéritos Epidemiológicos
Incidência
Vigilância da População
Estudos Retrospectivos
Avaliação de Sintomas
Limites: Adolescente
Adulto
Idoso
Criança
Feminino
Humanos
Masculino
Pessoa de Meia-Idade
Adulto Jovem
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: CO332 - Facultad de Medicina


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Id: lil-634688
Autor: Córdoba, Susana; Vivot, Walter; Bosco-Borgeat, Maria E; Taverna, Constanza; Szusz, Wanda; Murisengo, Omar; Isla, Guillermina; Davel, Graciela.
Autor: The Red Nacional De Laboratorios De Micologia.
Título: Species distribution and susceptibility profile of yeasts isolated from blood cultures: results of a multicenter active laboratory-based surveillance study in Argentina
Fonte: Rev. argent. microbiol;43(3):176-185, jun.-set. 2011. tab.
Idioma: en.
Resumo: The Mycology Department of the Instituto Nacional de Enfermedades Infecciosas "Dr. C. Malbrán", conducted the Second National Multicenter Survey on Fungemia due to Yeasts in Argentina. The aim was to obtain updated data of the frequency of the causative species encountered and their in vitro susceptibility to seven antifungal agents. Yeast species were identified by micromorphological and biochemical studies. Antifungal susceptibility testing was performed by the reference microdilution method E.Def 7.1 of the European Committee on Antibiotic Susceptibility Testing (EUCAST). A total of 461 viable yeasts were identified. The most frequent species were: Candida albicans (38.4 %), Candida parapsilosis (26 %), Candida tropicalis (15.4 %) and Candida glabrata (4.3 %). Other uncommon species, such as Candida viswanathii (0.6 %), Candida haemulonii (0.4 %), Candida inconspicua (0.2 %) and Candida fermentati (0.2 %) were also isolated. Among the Candida spp., 5.4 % and 1.6 % were resistant to fluconazole and voriconazole, respectively. Itraconazole and caspofungin were the most efficient agents against all Candida spp. tested (MIC < 1 mg/l). For anidulafungin, 21.6 % of C. parapsilosis showed a MIC value of 4 mg/l. Fluconazole was less active against 53.1 % of Cryptococcus neoformans (MIC > 8 mg/l), 75 % of Trichosporon spp., and 100 % of Rhodotorula spp., Geotrichum candidum, Saccharomyces cerevisiae. The global percentage of mortality was 20 %. The presence of uncommon species reinforces the need for performing continuous laboratory surveillance in order to monitor possible changes, not only in the epidemiological distribution of species, but also in the resistance to antifungal drugs.

Distribución de especies y perfil de sensibilidad de levaduras aisladas de hemocultivos: resultados de un estudio multicéntrico de vigilancia de laboratorio en Argentina. El Departamento Micología del Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán" condujo el segundo estudio multicéntrico nacional sobre funge- mias debidas a levaduras. El objetivo fue obtener datos actualizados sobre la distribución de especies y la sensibilidad in vitro frente a siete antifúngicos. Las levaduras fueron identificadas mediante el estudio de la micromorfología y la realización de pruebas bioquímicas. La determinación de la sensibilidad se realizó según el método de referencia E.Def 7.1 del European Committee on Antibiotic Susceptibility Testing (EUCAST). Se identificaron 461 levaduras. Las especies más frecuentes fueron Candida albicans (38,4 %), Candida parapsilosis (26 %), Candida tropicalis (15,4 %) y Candida glabrata (4,3 %). Se aislaron otras especies menos comunes, como Candida viswanathii (0,6 %), Candida haemulonii (0,4 %), Candida inconspicua (0,2 %) y Candida fermentati (0,2 %). Entre las especies del género Candida, el 5,4 % y el 1,6 % fueron resistentes al fluconazol y al voriconazol, respectivamente. El itraconazol y la caspofungina fueron los antifúngicos más eficaces in vitro frente a las especies de Candida evaluadas (CIM < 1 mg/l). Para la anidulafungina, el 21,6 % de los aislamientos de C. parapsilosis mostraron una CIM de 4 mg/l. El fluconazol fue menos activo para el 53,1 % de los aislamientos de Cryptococcus neoformans (CIM > 8 mg/l), el 75 % de los aislamientos de Trichosporon spp. y el 100 % de los aislamientos de Rhodotorula spp., Geotrichum candidum y Saccharomyces cerevisiae. El porcentaje de mortalidad fue del 20 %. La presencia de especies infrecuentes refuerza la necesidad de realizar la continua vigilancia de laboratorio con el fin de monitorear posibles cambios, no solo en la epidemiología de las especies causantes de fungemia, sino también en la resistencia a los antifúngicos.
Descritores: Antifúngicos/farmacologia
Infecção Hospitalar/microbiologia
Farmacorresistência Fúngica
Fungemia/microbiologia
Vigilância da População
Leveduras/isolamento & purificação
-Argentina/epidemiologia
Infecção Hospitalar/tratamento farmacológico
Infecção Hospitalar/mortalidade
Bases de Dados Factuais
Farmacorresistência Fúngica Múltipla
Fungemia/tratamento farmacológico
Fungemia/mortalidade
Laboratórios Hospitalares
Testes de Sensibilidade Microbiana
Estudos Prospectivos
Especificidade da Espécie
Leveduras/classificação
Leveduras/efeitos dos fármacos
Limites: Adulto
Criança
Feminino
Humanos
Masculino
Tipo de Publ: Estudo Multicêntrico
Responsável: AR1.2 - Instituto de Investigaciónes Epidemiológicas


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Id: lil-634683
Autor: Maldonado, Ivana; Fernández Canigia, Liliana; Vivot, Walter; Domecq, Patricia; Davel, Graciela; Córdoba, Susana.
Título: Evaluación de tres métodos para la detección de la sensibilidad in vitro de especies de Candida a los antifúngicos / Evaluation of three methods for in vitro detection of antifungal susceptibility of Candida species
Fonte: Rev. argent. microbiol;43(2):120-126, jun. 2011. tab.
Idioma: es.
Resumo: Los métodos de referencia E. Def 7.1 y M27-A3, que detectan resistencia in vitro a los antifúngicos, son onerosos y muy laboriosos, por lo que su implementación en los laboratorios hospitalarios es limitada. Existen técnicas comerciales de simple realización, que permitirían obtener resultados comparables a los que se obtienen con los métodos estándares. Los objetivos de esta investigación fueron: a) comparar los resultados de concentración inhibitoria mínima obtenidos según el método de referencia E.Def 7.1 con los obtenidos mediante el empleo del equipo comercial ATB® Fungus 3 en un conjunto de 82 aislamientos clínicos de Candida spp. frente a los siguientes antifúngicos: anfotericina B, 5-fluorocitosina, fluconazol e itraconazol; b) comparar en ese mismo conjunto de aislamientos los resultados del estudio de sensibilidad al fluconazol por difusión en agar empleando tabletas Neo-SensitabsTM o discos Malbrán con los que se obtienen por el método de referencia. La concordancia general entre el método de referencia y el ATB® Fungus 3 fue del 90,2 %, mientras que la concordancia del método de referencia con los métodos por difusión con discos y con tabletas alcanzó el 96,3% y el 92,7 %, respectivamente. El ATB® Fungus 3 fue eficaz para determinar la sensibilidad a la anfotericina B y a la 5-fluorocitosina, pero se observaron discrepancias al evaluar la sensibilidad a los azoles. Los métodos por difusión resultaron útiles para determinar la sensibilidad al fluconazol; sin embargo, observamos 3 discrepancias muy mayores, 1 mayor y 2 menores con el método de difusión con tabletas, mientras que con los discos solo se produjeron 3 discrepancias menores.

Reference methods E.Def 7.1 and M27-A3 detect in vitro resistance; however, they are expensive and very laborious. Thus, their actual use in hospital laboratories is limited. There are commercial techniques available, having easier accessibility and development, which would yield results comparable to those of the reference methods. The objectives of this study were: a) to compare the results of minimal inhibitory concentration of 82 Candida spp. clinic isolates according to reference method E.Def 7.1 and ATB® Fungus 3; b) to compare the results of fluconazole susceptibility testing by disk diffusion in agar with Neo-SensitabsTM tablets and Malbrán disks with those of the reference methods. Minimal inhibitory concentration for amphotericin B, 5-flucytosine, fluconazole and itraconazole was performed according to the E.Def 7.1 and the ATB Fungus 3 methods and diffusion was carried out with fluconazole disks and tablets. General concordance between the reference method and ATB Fungus 3 was 90.2 % and 96.3 and 92.7% for diffusion with disks and tablets. The ATB Fungus 3 method was effective to determine susceptibility against amphotericin B and 5-flucytosine; however, discrepancies were observed with azole drugs. Disk diffusion methods are useful to determine susceptibility to fluconazole; however, 3 very major, 1 major and 2 minor errors were observed with the tablets, whereas only 3 minor errors were observed with the disks.
Descritores: Antifúngicos/farmacologia
Candida/efeitos dos fármacos
Farmacorresistência Fúngica
Testes de Sensibilidade Microbiana/métodos
-Argentina
Anfotericina B/farmacologia
Candidíase/microbiologia
Testes de Sensibilidade a Antimicrobianos por Disco-Difusão
Farmacorresistência Fúngica Múltipla
Fluconazol/farmacologia
Flucitosina/farmacologia
Itraconazol/farmacologia
Reprodutibilidade dos Testes
Especificidade da Espécie
Comprimidos
Limites: Feminino
Humanos
Masculino
Tipo de Publ: Estudo Comparativo
Estudo de Avaliação
Responsável: AR1.2 - Instituto de Investigaciónes Epidemiológicas


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Id: lil-595842
Autor: Brito, Graziella Nuernberg Back; Inocêncio, Aline Cássia; Querido, Sílvia Maria Rodrigues; Jorge, Antonio Olavo Cardoso; Koga-Ito, Cristiane Yumi.
Título: In vitro antifungal susceptibility of Candida spp. oral isolates from HIV-positive patients and control individuals
Fonte: Braz. oral res;25(1):28-33, Jan.-Feb. 2011. tab.
Idioma: en.
Resumo: Oropharyngeal candidiasis is the most common fungal infection among HIV-positive patients. This condition can be treated with either systemic or topical antifungal agents; treatments are usually indicated empirically on the basis of clinical data. The knowledge of in vitro antifungal susceptibility is important to determine correct therapeutic guides for the treatment of fungal infections. Therefore, the objective of this study was to determine the antifungal susceptibility profile of oral Candida isolates from HIV-positive patients and control individuals. Amphotericin B, fluconazole, flucytosine, nystatin and ketoconazole were tested according to the methodology of microdilution proposed by the Clinical and Laboratory Standards Institute (CLSI); results were recorded in values of minimal inhibitory concentration (MIC). A total of 71 Candida isolates from HIV-positive patients were examined with the following species represented: C. albicans (59), C. tropicalis (9), C. glabrata (1), C. guilliermondii (1) and C. krusei (1). A total of 15 Candida isolates were evaluated from control individuals comprised of 11 C. albicans and 4 C. tropicalis samples. Our results demonstrated that the tested antifungal agents showed good activity for most isolates from both groups; however, variability in MIC values among isolates was observed.
Descritores: Antifúngicos/farmacologia
Candida/isolamento & purificação
Farmacorresistência Fúngica Múltipla
Infecções por HIV/microbiologia
-Anfotericina B/farmacologia
Estudos de Casos e Controles
Candida/efeitos dos fármacos
Fluconazol/farmacologia
Flucitosina/farmacologia
Cetoconazol/farmacologia
Testes de Sensibilidade Microbiana
Nistatina/farmacologia
Fatores de Tempo
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: lil-549394
Autor: Pieterse, Reneé; Todorov, Svetoslav D.
Título: Bacteriocins: exploring alternatives to antibiotics in mastitis treatment
Fonte: Braz. j. microbiol;41(3):542-562, Oct. 2010. tab.
Idioma: en.
Resumo: Mastitis is considered to be the most costly disease affecting the dairy industry. Management strategies involve the extensive use of antibiotics to treat and prevent this disease. Prophylactic dosages of antibiotics used in mastitis control programmes could select for strains with resistance to antibiotics. In addition, a strong drive towards reducing antibiotic residues in animal food products has lead to research in finding alternative antimicrobial agents. In this review we have focus on the pathogenesis of the mastitis in dairy cows, existing antibiotic treatments and possible alternative for application of bacteriocins from lactic acid bacteria in the treatment and prevention of this disease.
Descritores: Bacteriocinas/isolamento & purificação
Farmacorresistência Fúngica Múltipla
Leite/microbiologia
Mastite Bovina
-Bovinos
Amostras de Alimentos
Métodos
Técnicas
Limites: Animais
Bovinos
Tipo de Publ: Revisão
Responsável: BR32.1 - Serviço de Biblioteca e Informação Biomédica


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Id: lil-528179
Autor: Claudino, A. L. R; Peixoto Junior, R. F; Melhem, M. S. C; Szeszs, M. W; Lyon, J. P; Chavasco, J. K; Franco, M. C.
Título: Mutants with heteroresistance to amphotericin B and fluconazole in Candida
Fonte: Braz. j. microbiol;40(4):943-951, Oct.-Dec. 2009. tab.
Idioma: en.
Resumo: Several studies have reported the occurrence of infections caused by Candida yeasts as well as the increasing prevalence of non albicans species. The aim of the present work is focused on the obtaining of heteroresistance to amphotericin B and fluconazole in Candida species using two distinct methodologies: selection and induction. Resistant samples were obtained by selective pressure using a medium with fluconazole for growth, followed by growth in a medium with amphotericin B. The selective pressure was also created beginning with growth in amphotericin B medium followed by growth in fluconazole medium. Concomitantly, samples were submitted to the induction of resistance through cultivation in increasing concentrations of fluconazole, followed by cultivation in increasing concentrations of amphotericin B. Subsequently, the induction began with amphotericin B followed by fluconazole. Three samples resistant to fluconazole and amphotericin B were obtained, two by induction (C. glabrata and C. tropicalis) and one by selection (C. tropicalis). Both C. tropicalis originated from the same wild sample. After successive transfers for drug free medium, only the sample obtained by selection was able to maintain the resistance phenotype. These results suggest that the phenotype of heteroresitance to fluconazole and amphotericin B can be produced by two methodologies: selection and induction.
Descritores: Antifúngicos/análise
Candida
Candidíase
Resistência Microbiana a Medicamentos
Farmacorresistência Fúngica Múltipla
Fluconazol/análise
Técnicas In Vitro
Leveduras
-Amostras de Medicamentos
Métodos
Prevalência
Técnicas
Tipo de Publ: Estudo Comparativo
Responsável: BR32.1 - Serviço de Biblioteca e Informação Biomédica


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Id: lil-526211
Autor: Duque, Clara María; Uribe, Olga Lucía; Soto, Andrés Felipe; Alarcón, Juan.
Título: Candidiasis vulvovaginal en un grupo mujeres gestantes de Medellín / Vulvovaginal candidiasis in a group of pregnant women from Medellín
Fonte: Infectio;13(1):14-20, 2009. tab, graf.
Idioma: es.
Resumo: Introducción. En la mujer embarazada, factores como la carga hormonal y los altos niveles de glucogéno favorecen la colonización y la infección vaginal por levaduras. Objetivo. Determinar la prevalencia de levaduras del género Candida, aisladas de muestras de flujo vaginal de un grupo de mujeres embarazadas de la ciudad de Medellín y evaluar la sensibilidad a los antifúngicos. Materiales y métodos. Estudio descriptivo en el cual se estudiaron 300 mujeres gestantes que acudieron a los programas de control prenatal de diferentes IPS de Medellín, en el período de febrero de 2006 a junio de 2007. Se determinó la prevalencia de Candida spp. mediante cultivo e identificación de las levaduras obtenidas, y se determinó la sensibilidad a fluconazol e itraconazol por el método comercial del ATB fungus. A las cepas en las que se evidenció crecimiento residual en fluconazol por dicho método, se les realizó antibiograma por los métodos avalados por el Clinical and Laboratory Standards Institute (CLSI) microdilución M27-A y método de difusión en disco M-44P. Resultados. La prevalencia de Candida spp. fue de 33,3% (C. albicans, 77%; C. parapsilosis, 11%; C. tropicalis, 5%; C. glabrata, 3%; C. guillermondii, 2%; C. kefyr, 1%, y C. famata, 1%). Todos los aislamientos mostraron sensibilidad al fluconazol. Se halló resistencia al itraconazol en 9% de los aislamientos de C. albicans y en 100% de los de C. glabrata. El 2,5% de los aislamientos de C. albicans y el 100% de los de C. kefyr resultaron sensibles dependiente de la dosis a dicho antifúngico. Conclusiones. C. albicans fue la levadura más frecuentemente aislada de flujo vaginal, seguida por patógenos emergentes, como C. parapsilosis y C. tropicalis. En la población estudiada, las levaduras del género Candida son aún ampliamente sensibles a los antifúngicos. Se recomienda la identificación de la levadura a nivel de especie y hacer pruebas de sensibilidad en el caso de falla terapéutica y en infecciones recidivantes.

During pregnancy, risk factors such as the high hormonal load and high levels of glucogen allow vaginal colonization and infection by yeasts. Objective: To determine the prevalence of Candida spp. isolated from samples of vaginal discharge from pregnant women in Medellín and to test their sensitivity to antimycotic agents. Materials and methods: Descriptive study in which 300 pregnant women were tested between February 2006 to June 2007. The prevalence of Candida spp. was determined by culture, the yeasts were identified, and the sensitivity to fluconazole and itraconazole was determined by the ATB fungus method; the strains with residual growth in fluconazole by such method were submitted to antibiogram by the methods approved by the CLSI. Results: The prevalence of Candida spp. was 33.3% (C. albicans, 77%). All the isolations showed sensitivity to fluconazole. Resistance to itraconazole was found in 9% of C. albicans isolates, and in 100% of C. glabrata; 2.5% of the isolates of C. albicans and 100% of C. kefyr resulted sensitive dose-dependent to such antymicotyc. Conclusions: C. albicans was the yeast most frequently isolated from vaginal discharge, followed by emergent pathogens such as C. parasilopsis and C. tropicalis. In the studied population, yeasts from the Candida gender were still very sensitive to antimycotic agets. It is recommended to identify the yeast to its gender and to perform sensitivity tests in case of therapeutic failure or in recurrent infections.
Descritores: Antifúngicos
Candidíase
Farmacorresistência Fúngica Múltipla
Gravidez
-Colômbia
Responsável: CO42.1 - Biblioteca Nacional de Salud José Celestino Mutis


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Id: lil-518758
Autor: Mímica, Lycia Mara Jenne; Ueda, Suely Mitoi Ykko; Martino, Marines Dalla Valle; Navarini, Alessandra; Martini, Izabel Julien.
Título: Diagnóstico de infecção por Candida: avaliação de testes de identificação de espécies e caracterização do perfil de suscetibilidade / Candida infection diagnosis: evaluation of Candida species identification and characterization of susceptibility profile
Fonte: J. bras. patol. med. lab;45(1):17-23, fev. 2009. graf, tab.
Idioma: pt.
Resumo: INTRODUÇÃO: Infecções invasivas provocadas por Candida são importantes causas de morbidade e mortalidade. O sucesso do tratamento dessas infecções depende da identificação da espécie e do padrão de sensibilidade aos antifúngicos. Portanto, diagnóstico rápido e específico é fundamental para a precoce introdução de terapêutica adequada. OBJETIVOS: Avaliar diferentes métodos diagnósticos de determinação de espécies de Candida e caracterizar, entre as espécies identificadas, o padrão de sensibilidade aos diferentes antifúngicos. MATERIAL E MÉTODOS: A identificação das espécies de Candida presentes em amostras de diferentes materiais biológicos foi realizada pelo cultivo em CHROMagar® Candida e pela técnica de reação em cadeia da polimerase tipo Nested (N-PCR). O padrão de sensibilidade das amostras foi avaliado pela utilização de Etest®. RESULTADO: CHROMagar® caracterizou 50 por cento das amostras como Candida albicans; 20,8 por cento, Candida tropicalis; 2,4 por cento, Candida krusei e 26,9 por cento, outras espécies (não determinadas). As cepas de C. albicans e C. tropicalis foram caracterizadas por CHROMagar® e N-PCR. Porém cepas de outras espécies, indeterminadas em CHROMagar®, caracterizaram-se como C. parapsilosis em N-PCR. Cepas de C. krusei e C. tropicalis apresentaram perfil de resistência a, respectivamente, fluconazol e 5-fluocitosina. Quanto ao itraconazol, observou-se padrão de resistência em cepas de C. albicans e C. tropicalis. DISCUSSÃO: As técnicas metodológicas utilizadas são de fácil reprodutibilidade e alta especificidade, fornecendo diagnóstico complementar, e o emprego do Etest® viabiliza a precoce introdução de tratamento específico. CONCLUSÃO: O crescente aparecimento de espécies de Candida resistentes aos azólicos confirma a importância de monitorar possíveis mudanças na distribuição das espécies patogênicas e dos padrões de sensibilidade.

BACKGROUND: Invasive infections by Candida are an important cause of morbidity and mortality. The successful treatment of these infections depends on the identification of the species and on the sensitivity pattern to antifungal agents. A quick and specific diagnosis is essential to introduce appropriate therapy. OBJECTIVES: Assess different diagnostic methods to determine Candida species and evaluate the sensitivity pattern to different antifungal agents among the identified ones. MATERIAL AND METHODS: The identification of Candida species present in samples of different biological materials was conducted through CHROMagar® Candida culture and Nested-PCR. The sensitivity pattern was assessed using Etest®. RESULTS: The culture of samples on CHROMagar® revealed 50 percent Candida albicans, 20.8 percent Candida tropicalis, 2.4 percent Candida krusei, and 26.9 percent other undetermined species. Samples of Candida albicans and Candida tropicalis were identified through CHROMagar® and N-PCR. Species that were not determined through CHROMagar® were characterized as Candida parapsilosis by N-PCR. Resistance to fluconazole, 5-fluocytosine was detected, respectively, in Candida krusei and Candida tropicalis samples. Both Candida albicans and Candida tropicalis samples showed resistance to itraconazole. DISCUSSION: The methods applied are easily reproducible and highly specific, which allows complementary diagnosis. The determination of the susceptibility profile by Etest® enables the early introduction of specific treatment. CONCLUSION: The growing appearance of Candida species resistant to azole confirms the importance of monitoring possible changes in the distribution of pathogenic species and in the sensitivity pattern.
Descritores: Antifúngicos/uso terapêutico
Candida/isolamento & purificação
Candidíase/diagnóstico
Candidíase/tratamento farmacológico
-Candida/classificação
Farmacorresistência Fúngica Múltipla
Testes de Sensibilidade Microbiana
Sensibilidade e Especificidade
Limites: Humanos
Responsável: BR14.1 - Biblioteca Central



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