Susceptibility profile of 200 bloodstream isolates of Candida spp. collected from Brazilian tertiary care hospitals.

We evaluated the antifungal susceptibility profile of 200 recent bloodstream isolates of Candida spp. sequentially obtained from patients admitted to five tertiary care hospitals in Brazil. Isolates were identified by classical methods and the antifungal susceptibility profile was determined by the NCCLS microbroth assay method.

Nosocomial infections among HIV-positive and HIV-negative patients in a Brazilian infectious diseases unit.

Background: Some researchers observed that HIV-infected patients have a higher risk of acquiring nosocomial infections (NI). This study compared the incidence of NI among HIV-positive and HIV-negative inpatients.

Methods: Patients from an infectious diseases ward who were classified as positive and negative regarding their HIV status were followed-up for 21 months in a prospective cohort study.

Nasal MRSA colonization of AIDS Patients cared for in a Brazilian university hospital.

Weekly culture surveillance was conducted over a 2-year period to determine the incidence of methicillin-resistant Staphylococcus aureus nasal colonization among acquired immunodeficiency syndrome patients cared for in a day-care unit and in an infectious diseases unit. Analysis of genomic DNA profiles showed a predominant pattern in both units.

Extrusion of fluorescein diacetate by multidrug-resistant Candida albicans.

Over-expression of multidrug efflux transporters causes Candida albicans cells to be resistant to azole antifungal agents. There are several kinds of indicator for multidrug resistance (MDR) phenotype of higher eukaryotic cells. Calcein AM is a prefluorochrome that is known as a substrate for multidrug efflux transporters of mammalian cells.

Atypical Cryptococcus neoformans isolate from an HIV-infected patient in Brazil.

Cryptococcus neoformans is an important fungal pathogen in immunocompromised hosts. Capsulation, urease and melanin synthesis activity of the fungus are well known virulence factors. Although artificial melanin-deficient mutants of Cr.

First isolation of Candida dubliniensis in Rio Grande do Sul, Brazil.

Candida dubliniensis is a newly recognized species closely phylogenetically related to Candida albicans and is commonly associated with oral candidiasis in human immunodeficiency virus-positive patients. In this paper we report the isolation of three strains of C. dubliniensis, from AIDS patients, in the state of Rio Grande do Sul (Brazil).

Effect of Antifungal Agents on Candida spp. and Pichia anomala Isolated from Oropharyngeal Candidiasis of AIDS Patients in a University Hospital in Brazil.

In order to determine the clinical significance of oropharyngeal candidiasis in AIDS patients, 44 isolates collected from individual clinical episodes were evaluated. The isolates were identified by microbiologic standard methods and in vitro antifungal susceptibility testing was evaluated for amphotericin B, fluconazole, flucytosine, miconazole, itraconazole, and ketoconazole according to the National Committee for Clinical Laboratory Standards. Candida albicans ATCC90028 was used as control for the MICs.

A new PCR primer for the identification of Paracoccidioides brasiliensis based on rRNA sequences coding the internal transcribed spacers (ITS) and 5 x 8S regions.

Internal transcribed spacer (ITS) genes including the 5.8S ribosomal (r)RNA of Paracoccidioides brasiliensis were amplified and the DNA sequences were determined. Based on a comparison of the sequence information, a new polymerase chain reaction (PCR) primer pair was designed for specific amplification of DNA for P.

Geographic grouping of Cryptococcus neoformans var. gattii by random amplified polymorphic DNA fingerprint patterns and ITS sequence divergence.

Eleven reference strains of Cryptococcus neoformans var. gattii were analyzed by random amplified polymorphic DNA (RAPD) patterns using three oligo primers. Three major RAPD pattern profiles (profiles I, II and III) were identified with A-1 oligo primer.

Enterobacter cloacae sepsis outbreak in a newborn unit caused by contaminated total parenteral nutrition solution.

Objective: The study aimed to investigate an outbreak caused by Enterobacter cloacae in a neonate intensive care unit.

Design: A descriptive study of an outbreak of sepsis in high-risk neonates was used.

Setting: The study was set in a tertiary care university teaching hospital.

High rate of non-albicans candidemia in Brazilian tertiary care hospitals.

In order to evaluate the epidemiology of candidemia in Brazil, we performed a prospective multicenter study conducted in six general hospitals from São Paulo and Rio de Janeiro, We enrolled a total of 145 candidemic patients (85 males) with a median age of 32 years. Non-albicans species accounted for 63% of all episodes and the species most frequently causing candidemia were C. albicans (37%), C.

Infection control in a Brazilian regional multihospital system.

Objective: This study describes the organization of infection control committees in a Brazilian multihospital system, identifying their major problems. Our goal is to discuss the main deficiencies in infection control and to target some interventions that can improve the efficiency of these actions in Brazilian hospitals.

Design And Setting: We used a descriptive epidemiologic design.

Colorimetric MTT assessment of antifungal activity of D0870 against fluconazole-resistant Candida albicans.

The in vitro antifungal activity of D0870 against eight isolates of fluconazole-resistant Candida albicans was compared with that of itraconazole, ketoconazole and miconazole. The colorimetric MTT [3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H tetrazolium bromide] assay was used to assess the antifungal activities. The 50% minimum inhibitory concentration (MIC50) of D0870 was below 0.

New PCR primer pairs specific for Cryptococcus neoformans serotype A or B prepared on the basis of random amplified polymorphic DNA fingerprint pattern analyses.

Thirty-three strains of Cryptococcus neoformans were isolated from clinical specimens, including specimens from AIDS patients in Brazil, and were classified into two serotypes; we detected 31 and 2 strains of serotypes A and B, respectively. Random amplified polymorphic DNA (RAPD) fingerprint pattern analyses of these strains of serotypes A and B showed that the patterns were similar for strains of each serotype when three 10-mer primers were used as the RAPD primers. Comparative studies of the fingerprint patterns of the study isolates with those of the reference strains also showed that the RAPD patterns for strains of each serotype were related and that most of the fingerprint bands existed commonly for all strains of each serotype tested.

Risk factors for death in patients with candidemia.

Objective: To analyze possible risk factors for death among patients with nosocomial candidemia. To identify risk factors for death in patients with candidemia, we analyzed demographic, clinical, and microbiological data.

Setting: Six tertiary hospitals in Brazil.

Relative frequency of nosocomial microorganisms at UNICAMP University Hospital from 1987 to 1994.

The frequency of microorganisms identified in nosocomial infections at Unicamp University Hospital from 1987 to 1994 was analysed. The most common microorganism was S. aureus (20.

Candida parapsilosis fungemia associated with implantable and semi-implantable central venous catheters and the hands of healthcare workers.

A cluster of six cases of fungemia among hematology, bone marrow transplant, and oncology patients was investigated in a case-control study (18 controls). The use of implantable and semi-implantable central venous catheters was significantly associated with cases (p = 0.016).

Gastrointestinal translocation as a possible source of candidemia in an AIDS patient.

Apart from cryptococcosis and histoplasmosis, which are mycoses contained by T cell-mediated mechanisms of host defense, fungemia is rarely found in AIDS patients. The frequency of fungemia due to Candida spp. has been reported to be as low as 1%.

Molecular typing of Candida albicans strains isolated from nosocomial candidemia.

Yeasts of the genus Candida have been recognized as important microorganisms responsible for nosocomial fungemia. Six blood-stream and two intravenous central catheter C. albicans strains were isolated from eight patients and studied by electrophoretic karyotyping of chromosomal DNA by pulsed-field gel electrophoresis.

Molecular epidemiology for local outbreaks of methicillin resistant Staphylococcus aureus (MRSA). The need for several methods.

Subtyping isolates may be useful for epidemiological studies of methicillin-resistant-Staphylococcus aureus (MRSA) outbreaks. Among subtyping methods, DNA-based techniques have been applied very effectively for this purpose. An outbreak of MRSA infections took place in one hospital in Barcelona early during 1991.

Genotypic variation and slime production among blood and catheter isolates of Candida parapsilosis.

Candida parapsilosis is an important nosocomial pathogen that can proliferate in high concentrations of glucose and form biofilms on prosthetic materials. We investigated the genotypic diversity and slime production among 31 isolates of C. parapsilosis from individual patients with bloodstream or catheter infections.

Application of genomic DNA subtyping by pulsed field gel electrophoresis and restriction enzyme analysis of plasmid DNA to characterize methicillin-resistant Staphylococcus aureus from two nosocomial outbreaks.

Pulsed-field gel electrophoresis (PFGE) and restriction enzyme analysis of plasmid DNA (REAP) were applied to study the epidemiologic relationship among methicillin-resistant Staphylococcus aureus (MRSA) isolates from outbreaks in two hospitals in São Paulo, Brazil: 82 MRSA isolates, 73 from a university hospital and nine from a general adult intensive care unit of a private hospital, were collected from 62 patients: 95% of the MRSAs were also resistant to gentamicin and ciprofloxacin. REAP subtyping of both collections identified six different subtypes: 55 (72.6%) MRSAs from the university hospital and nine isolates from the private hospital shared the same epidemic REAP subtype.

[Paracoccidioidomycosis and infection by the human immunodeficiency virus].

We present two cases of paracoccidioidomycosis, one occurring in an AIDS patient and the other in an HIV infected man. This is the first report of such association. The first patient, which was already followed for HIV infection (group IV-A) presented with high fever and hepatosplenomegaly.

A new treatment for large cerebral paracoccidioidomycosis.

A patient with a large paracoccidioidal granuloma in the right fronto-parietal region was treated with sulfamethoxazole-trimethoprim alone, without the use of amphotericin B or any surgical measures. The authors stress the excellent therapeutic results through a twenty-six month follow-up, documented by repeated CT scans.