-
Julio García-Rodríguez,
Emilia Cantón,
Javier Pemán,
Maria Alvarez,
Guillermo Ezpeleta,
Amelia Gómez-Nieto,
Isabel Iglesias,
Estrella Martín-Mazuelos,
Inmaculada Ramírez-de Ocariz, Antonio Rezusta,
Gloria Royo-García
[show abstract]
[hide abstract]
ABSTRACT: INTRODUCTION: There are few epidemiological studies on candidaemia in the paediatric population in Spain. We sought to determine the epidemiology of candidaemia in these patients. METHODS: Prospective, observational and multicentre study in 44 Spanish hospitals. All candidaemia episodes in paediatric patients from 0 to 15 years old between January 2009 and February 2010 were studied. RESULTS: There were 197 episodes and 200 species were isolated. The most frequent species was Candida parapsilosis sensu stricto (43%), followed by C. albicans (36%), C. tropicalis (6%), C. orthopsilosis, and C. glabrata (4%) respectively. C. albicans was the most prevalent in newborns, and C. parapsilosis was most frequent in the other age groups. As regards the regions of Spain, C. albicans was most prevalent in patients from Catalonia, the Balearic Islands and Canary Islands, and C. parapsilosis in patients from Andalusia, Castilla-León, Galicia, Valencia, and Madrid. The rate of resistance to fluconazole was 1.5% (4.1% with the new species-specific Clinical and Laboratory Standards Institute [CLSI] criteria). Fluconazole resistance was lower in neonates than the other age groups. The Neonatal Wards were the areas with most episodes (31.5%). In the multivariate analysis, the variables associated independently with candidaemia due to C. albicans were: catheter (OR: 5.967; 95% CI: 1.614-22.057; P=.007) and prematurity (OR: 2.229; 95% CI: 1.141- 4.631; P=.020). CONCLUSIONS: The epidemiology of paediatric candidaemia varies between Spanish regions, but, globally, C. parapsilosis and C. albicans, are respectively, the first and second most frequently isolated species, and they show resistance rates to fluconazole of less than 5%.
Enfermedades Infecciosas y Microbiología Clínica 02/2013; · 1.49 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Nine staphylococcal strains of human and animal origin with a lincomycin-resistant/erythromycin-susceptible phenotype and carrying vga genes were characterised to determine the genetic elements involved in the dissemination of these uncommon resistance genes. These strains were typed by multilocus sequence typing (MLST), staphylococcal cassette chromosome mec (SCCmec) and/or spa typing. Antimicrobial susceptibility was studied by disk diffusion and agar dilution methods. Presence of the genes lnu(A), lnu(B), vga(A), vga(A)v, vga(B), vga(C), vga(E), lsa(B) and cfr was studied by PCR. Transformation experiments were carried out in all strains, and the plasmid or chromosomal gene location was determined by Southern blot analysis. Genetic environments of the vga genes were analysed by PCR mapping or inverse PCR and sequencing. Five meticillin-resistant Staphylococcus aureus (MRSA) ST398 strains and three Staphylococcus epidermidis strains harboured the gene vga(A), and one MRSA-ST8 strain contained the gene vga(A)v. One MRSA-ST398 strain, which also contained the gene lnu(A), showed the highest minimum inhibitory concentration (MIC) to lincomycin. The vga(A)v-positive strain presented lower MIC values than the vga(A)-positive strains. Presence of the pVGA plasmid was confirmed in two MRSA-ST398 strains. Four novel vga(A)-carrying plasmids were detected: pUR2355 (in two MRSA and one meticillin-susceptible S. epidermidis); pUR4128 (one MRSA); pUR3036 [one meticillin-resistant S. epidermidis (MRSE)]; and pUR3937 (one MRSE). The plasmid pUR4128 was very similar to pUR2355. Plasmids pUR3036 and pUR3937 were related and were very similar to plasmid pSE-12228-06. The gene vga(A)v was located in a transposon analogous to Tn5406. Therefore, four novel vga(A)-carrying plasmids and a variant of Tn5406 were identified in this study.
International journal of antimicrobial agents 08/2012; 40(4):306-12. · 3.03 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The photoprocesses involved in hypericin photoinactivation of three different Candida species (C. albicans, C. parapsilosis and C. krusei) have been examined. Production of singlet oxygen from the triplet state and of superoxide from both the triplet state and the semiquinone radical anion are demonstrated. Hydrogen peroxide is formed downstream of these early events. The outcome of the photodynamic treatments is dictated by the intracellular distribution of hypericin, which is different in the three species and affects the ability of hypericin to produce the different reactive oxygen species and trigger cell-death pathways. The results are in line with the previously-observed different susceptibilities of the three Candida species to hypericin photodynamic treatments.
Photochemical and Photobiological Sciences 05/2012; 11(6):1099-107. · 2.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Three closely related Klebsiella pneumoniae strains isolated from the same patient harboured bla(CTX-M-15), bla(OXA-1), bla(SHV-11), qnrS1, aac(6')-Ib-cr, oqxAB, aac(3)-II and aph(3')-Ia genes. Two of the isolates were recovered after treatment with meropenem and showed resistance to carbapenems. Sequencing of ompK35 and ompK36 porin genes of the carbapenem-resistant strains revealed the presence of premature stop codons in both, and OmpK35 and OmpK36 porins were not detected by SDS-PAGE. One carbepenem-resistant strain showed a high amount of LamB protein and did not express OmpK26 porin whereas the other strain expressed OmpK26 but not LamB. The lack of major porins apparently causes changes in the expression of other, specific, porins.
Journal of Medical Microbiology 01/2012; 61(Pt 5):672-7. · 2.50 Impact Factor
-
Antonio Rezusta,
Patricia López-Chicón,
Manuel P Paz-Cristobal,
Mireia Alemany-Ribes,
David Royo-Díez,
Montserrat Agut,
Carlos Semino,
Santi Nonell,
Ma Jose Revillo,
Carmen Aspiroz,
Yolanda Gilaberte
[show abstract]
[hide abstract]
ABSTRACT: Hypericin is a natural photosensitizer considered for the new generation of photodynamic therapy (PDT) drugs. The aim of this study was to evaluate the in vitro fungicidal effect of hypericin PDT on various Candida spp., assessing its photocytotoxicity to keratinocytes (HaCaT) and dermal fibroblasts (hNDF) to determine possible side effects. A 3 log fungicidal effect was observed at 0.5 McFarland for two Candida albicans strains, Candida parapsilosis and Candida krusei with hypericin concentrations of 0.625, 1.25, 2.5 and 40 μm, respectively, at a fluence of 18 J cm(-2) (LED lamp emitting at 602 ± 10 nm). To obtain a 6 log reduction, significantly higher hypericin concentrations and light doses were needed (C. albicans 5 μM, C. parapsilosis 320 μM and C. krusei 320 μM; light dose 37 J cm(-2)). Keratinocytes and fibroblasts can be preserved by keeping the hypericin concentration below 1 μm and the light dose below 37 J cm(-2). C. albicans appears to be suitable for treatment with hypericin PDT without significant damage to cutaneous cells.
Photochemistry and Photobiology 11/2011; 88(3):613-9. · 2.41 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The clonal lineages, resistance mechanisms and virulence traits of tetracycline-resistant (Tet(R)) methicillin-resistant Staphylococcus aureus (MRSA) strains isolated in a Spanish hospital during 2009 and 2010 were investigated.
Fifty-two Tet(R) MRSA strains from unrelated patients were included in this study. Susceptibility to 26 antimicrobial agents was determined and 24 resistance genes were tested for by PCR. The sequences of the genes grlA and gyrA were analysed in all ciprofloxacin-resistant MRSA isolates. For all strains, spa, SCCmec and agr typing was implemented. Multilocus sequence typing was performed for 16 representative strains of the different spa types. The presence of the genes tst, lukF/lukS-PV, eta, etb, etd and cna was investigated by PCR.
Fifteen different spa types, four of them new ones, were detected among the 52 strains, being associated with the following clonal complexes (CCs): CC398 (67.3%), CC1 (11.5%), CC5 (11.5%) and CC8 (9.6%). A novel sequence type (ST), ST2077, belonging to CC398 was identified. Most MRSA CC398 strains were typed as SCCmecV-agrI. In addition to β-lactam resistance, isolates showed resistance to (gene/number of strains): tetracycline [tet(K)/36, tet(L)/8 and tet(M)/48], macrolides and lincosamides [erm(B)/6, erm(C)/25, erm(T)/2, msr(A)/msr(B)/4 and mph(C)/4], aminoglycosides [aac(6')-Ie-aph(2')-Ia/8, ant(4')-Ia/13 and aph(3')-IIIa/15], trimethoprim [dfrS1/2 and dfrK/3] and mupirocin (mupA/3). Strains investigated for mutations mediating quinolone resistance revealed an S80F exchange in GrlA and different changes in GyrA. Three strains were Panton-Valentine leucocidin-positive (ST8 and ST94) and 41 strains were cna-positive. All MRSA isolates were negative for the genes tst, eta, etb and etd.
Tetracycline resistance could be a good marker for MRSA CC398, although this resistance can also be found in other lineages.
Journal of Antimicrobial Chemotherapy 11/2011; 67(2):330-4. · 5.07 Impact Factor
-
Journal of the American Academy of Dermatology 09/2011; 65(3):669-71. · 3.99 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Onychomycosis is one of the most prevalent fungal infections in the population with a higher rate of treatment failures. Photodynamic therapy (PDT) is based on the use of photosensitizers with light of an accurate wavelength, and in the presence of oxygen, reactive oxygen species are produced which induce cell death. PDT is widely used to treat non-melanoma skin cancer, and other indications are being investigated, especially in superficial infections.
To determine the effectiveness of PDT in a case of onychomycosis caused by moulds.
A 75-year-old woman was diagnosed with onychomycosis caused by Acremonium sclerotigenum in the 5th finger. She was treated with 3 sessions of PDT with methyl-aminolevulinate (MAL) separated by 15 days.
The patient achieved mycological and clinical cure and remains asymptomatic after 12 months of follow up.
This case illustrates the potential usefulness of MAL-PDT for onychomycosis. Its effectiveness, lack of adverse effects and satisfaction on the part of physicians and patients, suggest a promising future for this therapy in the management of superficial fungal infections, such as onychomycosis.
Revista iberoamericana de micología. 04/2011; 28(4):191-3.
-
Enfermedades Infecciosas y Microbiología Clínica 04/2011; 29(8):626-8. · 1.49 Impact Factor
-
Javier Pemán,
Emilia Cantón,
Juan José Camarena Miñana,
Julia Alcoba Florez,
Julia Echeverria,
David Navarro Ortega,
José Martínez Alarcón,
Dionisia Fontanals,
Bárbara Gomila Sard,
Buenaventura Buendía Moreno, [......],
María Alvarez Fernández,
Ferrán Sánchez Reus,
Isabel Fernández Natal,
Gloria Royo García,
Guillermo Ezpeleta,
Estrella Martín-Mazuelos,
Isabel Iglesias, Antonio Rezusta,
Inmaculada Ramírez de Ocariz,
Amelia Gómez Nieto
[show abstract]
[hide abstract]
ABSTRACT: Recent epidemiological surveillance studies have reported an increase in fungaemia caused by non-Candida albicans species, as well as a decrease in fluconazole susceptibility.
To evaluate changes in the epidemiology of fungaemia in Spain comparing data from a new surveillance epidemiological study conducted in 2009 with a previous study carried out from 1997 to 1999 (Pemán J, et al. Eur J Clin Microbiol Infect Dis. 2005).
From January 2009 to February 2010, 44 Spanish hospitals participated in a prospective multicentre fungaemia surveillance study to ascertain whether there have been changes in the epidemiology and fluconazole susceptibility. Susceptibility was determined by the colorimetric method Sensititre Yeast One. Demographic and clinical data and the first isolate of each episode were gathered.
A total of 1,377 isolates from 1,357 fungaemia episodes were collected, 46.7% from patients older than 64years and 8.6% from children less than 1 year old. C. albicans (44.7%), Candida parapsilosis (29.1%), Candida glabrata (11.5%), Candida tropicalis (8.2%), and Candida krusei (1.9%) were the most frequent species isolated. Distribution varied with the geographical area. C. albicans incidence has increased significantly in the last 10years in Cataluña (39.1 vs. 54.7%, P=0.03) and decreased in the Valencian Community (49.1 vs. 34.6%, P=0.002) and Extremadura (58.3 vs. 20%, P=0.01). Susceptibility to fluconazole was similar for all geographical areas, although resistance in C. albicans was ten times greater for patients aged more than 64years. The overall rate of fluconazole resistance (MIC > 32 mg/L) has decreased with respect to that obtained 10years ago (3.7 vs. 2.5%) mainly in C. albicans (3 vs. 1.6%).
In the last ten years, species distribution and fluconazole susceptibility have not significantly changed, although a lower rate of fluconazole resistance has been observed. Species distribution varies with hospital, hospitalization Unit and geographical area.
Revista iberoamericana de micología. 03/2011; 28(2):91-9.
-
Elena Ruiz, Antonio Rezusta,
Yolanda Sáenz,
Rosa Rocha-Gracia,
Laura Vinué,
Ana Vindel,
Cruz Villuendas,
Maria Luisa Azañedo,
Maria Luisa Monforte,
Maria José Revillo,
Carmen Torres
Diagnostic microbiology and infectious disease 02/2011; 69(2):236-8. · 2.45 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Malassezia pachydermatis is a yeast of importance in both veterinary and human medicine.
To know if M. pachydermatis grow on mycological media with high concentrations of gentamycin.
Twenty M. pachydermatis strains were streaked on Sabouraud Dextrose Agar plates with different concentrations of gentamycin.
All isolates were inhibited when high concentrations of gentamycin were added.
The use of plates with high concentrations of gentamycin can lead to some important misdiagnoses: firstly, false-negative cultures, and secondly, an erroneous classification of M. pachydermatis as a lipid-dependent species. Moreover, all of this could be useful in two therapeutic fields: i) in animals, topical gentamycin could be an efficacious treatment for a disease such as external otitis in dogs; ii) in humans, we hypothesize that gentamycin could be regarded as a possible therapy ("antibiotic-lock") for catheter-associated Malassezia spp. infections.
Revista Iberoamericana de Micología 02/2010; 27(1):20-1. · 1.16 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Here we report on two isolates of Candida glabrata recovered from urine samples collected from of an Intensive Care Unit patient. D1/D2 and ITS 1+2 rDNA sequence analysis confirmed its identification. The isolates were cholesterol dependent and resistant to Amphotericin B.
Medical Mycology 06/2008; 46(3):265-8. · 2.46 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Members of the fungal genus Chaetomium usually colonize cellulose-containing plant remains but on rare occasions may cause opportunistic mycoses and cutaneous infection in otherwise healthy individuals. To our knowledge, there have been only five credible descriptions of onychomycosis caused by members of this genus and only two of these contained information on therapy. We describe the first case of Chaetomium globosum onychomycosis recorded in Spain. The etiologic significance of the fungus was confirmed by its repeated isolation at different times, to the exclusion of dermatophytes. Clinically, the affected nails showed an excellent response to terbinafine and complete cure appeared to have been attained.
Medical Mycology 06/2007; 45(3):279-82. · 2.46 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to characterize the resistance mechanism in four clinical and five intestinal vancomycin-resistant Enterococcus faecium strains with VanB phenotype recovered from unrelated patients confined in two Spanish hospitals and to determine their clonal relationships. MIC values for vancomycin and teicoplanin were 16-32 and 0.5 microg ml-1, respectively. The mechanism of vancomycin resistance, as well as the genetic environment of the implicated gene, was analysed by PCR and sequencing. The vanB2 gene was detected in all nine E. faecium strains and the intergenic vanSB-YB region showed the characteristic mutations of the vanB2 subtype. Two possibly related PFGE patterns, A (seven strains) and B (two strains), were distinguished among these enterococci. The vanXB-ORFC intergenic region was amplified in the nine strains and two amino acid changes were detected in the protein encoded by the vanXB gene in strains of pattern A with respect to those of pattern B. The vanB2 gene cluster was integrated into Tn5382 in all nine strains, being pbp5 gene-linked to this transposon. The ant(6')-Ia, aph(3')-IIIa and erm(B) genes were also detected in all of the strains. Both isolates with PFGE pattern B contained the esp gene. In summary, vanB2-containing E. faecium strains with indistinguishable PFGE patterns were recovered from seven patients from two Spanish hospitals.
Journal of Medical Microbiology 10/2006; 55(Pt 9):1237-43. · 2.50 Impact Factor
-
Acta Dermato Venereologica 02/2006; 86(2):154-5. · 3.18 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Microsporum canis is a ubiquitous dermatophyte that commonly causes human infections. Since contact with infected animals is the usual way of infection, tracing its source is an essential preventive measure.
To type isolates of M. canis from human patients whose skin was affected, and from some animals (dogs and cats) that were closely associated to the patients.
The inter-single-sequence-repeat-PCR (ISSR-PCR) technique has been used for typing 24 isolates of M. canis. Seventeen isolates tested were from human patients, 5 from cats and 1 from a dog
A total of 21 genotypes were identified. The same genotype was found infecting a patient and a cat that was living closely with him, but another member of the same family proved to be infected with two genotypes different from that. Clinical specimens from two patients had been contaminated with the same genotype, probably in the laboratory where the samples were handled.
These results demonstrate that ISSR-PCR polymorphism is a reliable method for the identification of the M. canis strains.
Journal of Dermatological Science 08/2005; 39(1):17-21. · 3.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In vitro fungistatic and fungicidal activities of voriconazole were evaluated against 114 isolates of Candida spp. MICs were determined using the NCCLS M27-A2 broth microdilution method. Minimum fungicidal concentrations (MFCs) were defined as the lowest drug concentrations that yielded < or = 5 colonies (> or = 98% killing activity). The fungicidal activity could be only evaluated against 45.6% of the isolates (52 of 114 isolates) because trailing growth occurred, and 30 of these 52 isolates (57.69%) showed MFC values < or = 1 mg/l. There was little or no fungicidal activity against C. albicans and C. tropicalis. In contrast, all C. krusei were killed by 1-2 mg/l voriconazole. In conclusion, our data show that the fungicidal effect of voriconazole against Candida spp. is species dependent.
International Journal of Antimicrobial Agents 04/2005; 25(3):264-7. · 4.13 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Chronic necrotizing pulmonary aspergillosis is not common and usually involves mildly immunosuppressed patients. We present a case of a 58-year-old man with a history of mining-related pneumoconiosis and corticosteroid therapy who developed bilateral pulmonary infiltrates and subsequent cavitation. The patient was treated at first as having community-acquired pneumonia and was only belatedly diagnosed as suffering from aspergillosis after Aspergillus fumigatus precipitins appeared in blood and the same fungus grew from bronchoalveolar lavage fluid. A transthoracic needle biopsy revealed fungal filaments present in material extracted from a pulmonary lesion that was visible on scans. Treatment with amphotericin B, begun at the time that aspergillosis was diagnosed, proved to be ineffective, as was a later change to amphotericin B lipid complex. The diagnosis was confirmed at necropsy.
Medical Mycology 09/2004; 42(4):369-71. · 2.46 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Amplification of specific sequences of the ITS1 and ITS2 regions and the intervening 5.8S rRNA gene has lead to the identification of four separate genotypes in Candida dubliniensis. Using primers specific for each genotype, we have studied the prevalence of these genotypes among 68 clinical isolates, mostly from Spanish patients infected by HIV. The majority of the isolates tested belonged to genotype 1 (97%), while only one isolate each from genotypes 2 (1.5%) and 3 (1.5%) were detected in the oral cavity of two patients with HIV infection.
Revista Iberoamericana de Micología 04/2004; 21(1):20-3. · 1.16 Impact Factor
