Acácio Gonçalves Rodrigues

Centro Hospitalar de São João, Oporto, Porto, Portugal

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Publications (34)94.41 Total impact

  • Maria Manuel Azevedo · Isabel Faria-Ramos · Luísa Cruz · Cidália Pina-Vaz · Acácio Gonçalves Rodrigues
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    ABSTRACT: Azole fungal resistance, is becoming a major public health problem in medicine in recent years. However, it was known in agriculture since several decades; the extensive use of these compounds results in contamination of air, plants and soil. The increasing frequency of life-threatening fungal infections and the increase of prophylactical use of azoles in high-risk patients, taken together with the evolutionary biology evidence that drug selection pressure is an important factor for the emergence and spread of drug resistance can result in a dramatic scenario. This study reviews the azole use in agricultural and in medical context and discusses the hypothetical link between its extensive use and the emergence of azole resistance among human fungal pathogens.
    Journal of Agricultural and Food Chemistry 08/2015; DOI:10.1021/acs.jafc.5b02728 · 3.11 Impact Factor
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    ABSTRACT: In vitro resistance to amphotericin B is an extremely rare event among pathogenic yeasts. However, in vivo response is sometimes reduced, resulting in an unfavorable outcome. Such adverse outcomes might be related with sub-fungicidal plasma concentrations. We aimed to clarify the mechanisms of liposomal amphotericin B (AMB-L, AmBisome)-induced lesions and the mechanisms responsible for yeast cell recovery following exposure at plasma concentrations. The physiological statuses developing following exposure to AMB-L at simulated plasma concentrations (20 to 0.1 mg/L) and at a constant concentration (3 mg/L) were assessed in a time-course assay, along 24 hours. Time-kill experiments were also carried out in the same AMB-L treatment conditions.Our results suggest that yeast cells develop compensatory responses, related to membrane polarization, metabolic activity and ROS production after exposure to high plasma concentrations (20 to 5 mg/L) during the first 6h; in the remaining 18h, when exposed to lower concentrations cells reveal almost full recovery with no evidence of fungicidal activity. In contrast, whenever cells are exposed to a constant concentration above the MIC, despite initially exhibiting compensatory stress responses, soon afterwards exhibit membrane depolarization, decrease of metabolic activity, increasing ROS production and lastly, programmed cell death and necrosis, thus succumbing to AMB-L fungicidal effect.This study may represent a step forward in the support of AMB-L use for clinical treatment of invasive fungal infections, since it demonstrates the importance of maintaining the levels of AMB-L above the MIC in the plasma and the tissues to ensure it produces its fungicidal effects. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
    Antimicrobial Agents and Chemotherapy 07/2015; DOI:10.1128/AAC.00575-15 · 4.45 Impact Factor
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    ABSTRACT: The authors performed a retrospective study to clarify the occurrence, causes, severity and predictors of concomitant injuries in pediatric patients with facial fractures in Portugal. The clinical records of children and adolescents (0-18 years) with facial fractures treated by the Department of Plastic, Reconstructive, and Aesthetic Surgery and of Maxillofacial Surgery of São João Hospital, in Porto, Portugal, over a period of 20 years (1993-2012) were reviewed. A total of 1416 patients with facial fractures were included in this study. Concomitant injuries were observed in 1015 (71.7%) patients. No significant associations were found between sex and concomitant injury. Head and neck injuries other than facial fractures occurred in 962 patients (67.7%), lower limb injuries in 122 (8.6%), upper limb injuries in 115 (8.1%), thoracic injuries in 89 (6.3%) and abdominal injuries in 47 (3.3%). Concomitant injuries occurred more frequently after motor vehicle accidents (car accident, motorcycle accident and car-pedestrian accident) compared with other etiologies (p < 0.001). The incidence of these facial fractures and their concomitant injuries is very high in Portugal. It is necessary to continue with the implementation of control measures and educational programs for the population, so that the number and severity of accidents causing fractures and their associated injuries continue to decrease. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
    Journal of Cranio-Maxillofacial Surgery 01/2015; 43(4). DOI:10.1016/j.jcms.2015.01.008 · 2.60 Impact Factor
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    Joana Barbosa · Acácio Gonçalves Rodrigues · Maria José Pérez · Cidália Pina-Vaz
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    ABSTRACT: Giardia duodenalis (syn. lamblia; syn. intestinalis) susceptibility testing is not routinely performed because the classical culture methods are very time-consuming and laborious. We developed a novel flow cytometry (FC) assay to evaluate the susceptibility of G. duodenalis trophozoites to metronidazole (MTZ). Different concentrations of MTZ were added to cultures of trophozoites (105/mL) and the cultures were incubated for different periods. The 50% inhibitory concentration was calculated and propidium iodide (PI) was used to quantify the number of dead cells. After treatment, PI-positive trophozoites increased with increasing drug concentration and exposure time. An excellent correlation was found between FC and the classical method. A novel, accurate and reliable method is now available to evaluate G. duodenalis viability.
    Memórias do Instituto Oswaldo Cruz 11/2014; DOI:10.1590/0074-0276140267 · 1.57 Impact Factor
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    ABSTRACT: Candida krusei is an important agent of opportunistic infections that often displays resistance to several antifungals. We describe here the in vivo acquisition of resistance to voriconazole (VRC) by C. krusei isolates recovered from a leukemia patient during a long period of VRC therapy. In order to mimic the in vivo development of VRC resistance, a susceptible C. krusei isolate was exposed daily to 1 μg/ml of VRC in vitro. Interestingly, after 5 days of exposure to VRC, a MIC of 4 μg/ml was achieved; this value remained constant after 25 additional days of treatment with VRC and also after 30 consecutive days of incubation in VRC-free medium. Our objective was to determine the associated molecular resistance mechanisms, such as expression of efflux pump genes and ERG11 gene mutations, among the resistant strains. Synergistic effects between the efflux blocker tacrolimus (FK506) and VRC were found in all of the resistant strains. Moreover, ABC1 gene expression increased over time in both the in vivo- and in vitro-induced resistant strains, in contrast to the ABC2 and ERG11 genes, whose expression was invariably lower and constant. ERG11 gene sequencing showed two different types of mutations, i.e., heterozygosity at T1389T/C, corresponding to synonymous mutations, in C. krusei strains and a missense mutation at position T418C, resulting in a change from Tyr to His, among resistant C. krusei clinical isolates. This study highlights the relevance of ATP-dependent efflux pump (namely, Abc1p) activity in VRC resistance and describes new mutations in the ERG11 gene among resistant C. krusei clinical isolates.
    Antimicrobial Agents and Chemotherapy 05/2014; 58(8). DOI:10.1128/AAC.02603-14 · 4.45 Impact Factor
  • Ana Filipa Pedrosa · Carmen Lisboa · Acácio Gonçalves Rodrigues
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    ABSTRACT: Malassezia yeasts have long been considered commensal fungi, unable to elicit significant damage. However, they have been associated with a diversity of cutaneous diseases, namely pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis, atopic dermatitis, psoriasis, and confluent and reticulate papillomatosis. Several hypotheses have been proposed to explain the pathogenic mechanisms of these fungi, but none have been confirmed. More recently, such organisms have been increasingly isolated from bloodstream infections raising serious concern about these fungi. Given the difficulty to culture these yeasts to proceed with speciation and antimicrobial susceptibility tests, such procedures are most often not performed and the cutaneous infections are treated empirically. The recurring nature of superficial skin infections and the potential threat of systemic infections raise the need of faster and more sensitive techniques to achieve isolation, identification, and antimicrobial susceptibility profile. This article reviews and discusses the latest available data concerning Malassezia infections and recent developments about diagnostic methods, virulence mechanisms, and susceptibility testing.
    Journal of the American Academy of Dermatology 02/2014; 71(1). DOI:10.1016/j.jaad.2013.12.022 · 5.00 Impact Factor
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    Joana Barbosa · Maria José Espinar · Acácio Gonçalves Rodrigues · Cidália Pina-Vaz
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    ABSTRACT: Cryptosporidium spp., Giardia lamblia y Encephalitozoon intestinalis, oportunistas emergentes Cryptosporidium spp., Giardia lamblia y Encephalitozoon intestinalis emergent opportunists RESUMEN Es un hecho conocido que las infecciones oportunistas por protozoos y hongos han aumentado en los últimos años, debido especialmente al aumento de las infecciones por VIH. Cryptosporidium spp., Giardia lamblia y Encephalitozoon intestinalis son protozoos y hongo, respectivamente, mundialmente reconocidos como agentes oportunistas emergentes, responsables de brotes epidémicos provocados por la ingestión de agua potable contaminada, incluso después de una correcta desinfección. La ingestión de estos protozoos puede provocar diferentes grados de enfermedad, entre aguda o leve (población sana) hasta situaciones más graves y agresivas, hasta a veces mortales (pacientes inmunocomprometidos y/o inmunodeprimidos). A pesar de ser responsables de muchos brotes epidémicos, su diagnóstico de laboratorio permanece arduo y trabajoso, incluso utilizando las nuevas técnicas desarrolladas en los últimos años. En esta revisión se resumen las consideraciones generales de estos oportunistas emergentes, así como los métodos de diagnóstico más usuales, incluso los más recientes y específicos. Palabras clave: Oportunistas emergentes, protozoos, hongos, Cryptosporidium spp., Giardia lamblia, Encephalitozoon intestinalis. SUMMARY Epidemiological data, regarding parasitic and fungi opportunist infections, have changed in the last years, especially due to HIV infection. Cryptosporidium spp., Giardia lamblia and Encephalitozoon intestinalis are protozoan and fungi, respectively, worldwide known as opportunistic emergent agents, being responsible by epidemic outbreaks after ingestion of contaminated water, even following a correct disinfection treatment. Its ingestion can cause different effects on individuals' health, from light or acute among the healthy population, to serious, aggressive or even deadly among the immunodepressed or immunocompromised patients. Contaminated water ingestion can result in outbreaks but protozoa laboratory diagnosis still remains very laborious, even after the development of more sensitive and specific techniques in the last years. In this paper, a revision of these emergent opportunists, their main characteristics and diagnostic tools are described, including the most recent and specific techniques.
  • Joana Barbosa · Sofia Costa-de-Oliveira · Ana Teresa Silva · Acácio Gonçalves Rodrigues · Cidália Pina-Vaz
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    ABSTRACT: Pneumocystis jirovecii is an opportunistic pathogen responsible for severe pneumonia in immunocompromised patients. Flow cytometry (FC) is a method widely used in different areas of clinical diagnosis like hematology and immunology. Recently it has started to be used in microbiology with a great potential for diagnosis of emergent microorganisms in clinical samples, especially when present in low numbers. The detection of Pneumocystis jirovecii in respiratory samples can be performed by FC, using specific monoclonal antibodies. Considering clinical diagnosis as a reference method, we previously showed FC to be 100% sensitive and specific when compared to immunofluorescence. Being an automated method, it is faster and less subject to human error than microscopic evaluation.
    Methods in molecular biology (Clifton, N.J.) 01/2013; 968:203-11. DOI:10.1007/978-1-62703-257-5_16 · 1.29 Impact Factor
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    ABSTRACT: The mechanism(s) responsible for breast capsular contracture (CC) remain unknown, but inflammatory pathways play a role. Various molecules have been attached to implant shells in the hope of modifying or preventing CC. The intrinsic antibacterial and antifungal activities of chitosan and related oligochitosan molecules lend themselves well to the study of the infectious hypothesis; chitosan's ability to bind to growth factors, its hemostatic action, and its ability to activate macrophages, cause cytokine stimulation, and increase the production of transforming growth factor (TGF)-β1 allow study of the hypertrophic scar hypothesis. The authors perform a comprehensive evaluation, in a rabbit model, of the relationship between CC and histological, microbiological, and immunological characteristics in the presence of a chitooligosaccharide (COS) mixture and a low molecular weight chitosan (LMWC). Eleven adult New Zealand rabbits were each implanted with three silicone implants: a control implant, one impregnated with COS, and one impregnated with LMWC. At four-week sacrifice, microdialysates were obtained in the capsule-implant interfaces for tumor necrosis factor alpha (TNF-α) and interleukin-8 (IL-8) level assessment. Histological and microbiological analyses were performed. Baker grade III/IV contractures were observed in the LMWC group, with thick capsules, dense connective tissue, and decreased IL-8 levels (p < .05) compared to control and COS groups. Capsule tissue bacterial types and microdialysate TNF-α levels were similar among all groups. Chitosan-associated silicone implantation in a rabbit model resulted in Baker grade III/IV CC. This preclinical study may provide a model to test various mechanistic hypotheses of breast capsule formation and subsequent CC.
    Aesthetic Surgery Journal 07/2011; 31(5):540-50. DOI:10.1177/1090820X11411475 · 2.03 Impact Factor
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    ABSTRACT: A prospective study to assess fungaemia was conducted for 12 months at a Portuguese University Hospital. A total of 35 Candida albicans isolates obtained from 12 patients with fungaemia were compared by a multiplex PCR system using four microsatellite loci. Blood isolates were evaluated against concomitant isolates from urine, lower respiratory secretions and central venous catheters, as well as with successive isolates recovered from recurrent episodes of fungaemia. The data analyzed included the department of admission, underlying diseases and antifungal therapy. The susceptibility phenotypes of all isolates to amphotericin B, fluconazole, itraconazole, voriconazole and caspofungin were determined according to the CLSI M27-A3 protocol. We observed a high degree of similarity between successive blood isolates and between blood and concomitant isolates from other sites of the same patient. This is suggestive of the recurrence of fungaemia and was due to the same strain, possibly as a result of the failure of antifungal therapy. The genetic similarity observed between some strains isolated from different patients suggested the likelihood that they were hospital acquired. Distinct patients were infected by the same strain at different time periods, and an increase in antifungal resistance was observed over time for some of these strains. Hospital-acquired exogenous nosocomial infections can be associated with higher risks of antifungal resistance and need to be closely monitored. Particular attention should also be given to endogenous non-blood Candida isolates which can be critical in high risk patients, as they often can become invasive in immunodeficient individuals.
    Medical mycology: official publication of the International Society for Human and Animal Mycology 04/2011; 49(3):248-52. DOI:10.3109/13693786.2010.511633 · 2.26 Impact Factor
  • Ana Filipa Bastos Pedrosa · Acácio Gonçalves Rodrigues
    The Journal of trauma 02/2011; 70(2):498-506. DOI:10.1097/TA.0b013e3181f2d4fb · 2.96 Impact Factor
  • Maria José Espinar · Rita Rocha · Manuela Ribeiro · Acácio Gonçalves Rodrigues · Cidália Pina-Vaz
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    ABSTRACT: The VITEK 2 automated system (bioMérieux) is one of the most widely used instruments in clinical microbiology laboratories for the identification and evaluation of the susceptibility profiles of bacteria including the detection of extended-spectrum β-lactamases (ESBLs) produced by Escherichia coli, Klebsiella pneumoniae and Klebsiella oxytoca. Currently, the Clinical and Laboratory Standards Institute recommends the use of ESBL confirmatory tests in addition to standard susceptibility testing. In order to evaluate the accuracy of VITEK 2-positive results regarding clinical isolates of E. coli (n = 110) and K. pneumoniae (n = 72), four additional ESBL detection systems were compared: the Phoenix Automated Microbiology System (BD Diagnostic Systems) and the MicroScan WalkAway-96 System (Dade Behring), and two manual systems as confirmatory tests, the Etest (AB Biodisk) and double disc diffusion (DDS) test. Epidemiological data regarding the tested strains were also collected and their susceptibility phenotypes were determined. The four methods resulted in concordant results for 126 of the 182 strains. However, the different tests displayed distinct results: the VITEK 2 system was in disagreement in 23.9 % of cases with DDS, in 15.3 % with Etest, in 23 % with the MicroScan WalkAway-96 System and in 23.6 % with the Phoenix Automated Microbiology System. Epidemiological data indicated that the majority of ESBL-positive E. coli strains were isolated from patients admitted to internal medicine wards (72.7 %), whilst K. pneumoniae ESBL-positive isolates were equally distributed between internal medicine wards (45.8 %) and intensive care units (45.8 %). Most of these strains were isolated from urine. In contrast to ESBL-negative isolates, the ESBL-positive strains displayed multiple drug resistance, namely to quinolones, aminoglycosides and trimethoprim-sulfamethoxazole. No significant resistance to carbapenems was detected. Overall, this study demonstrates the need for a confirmatory test following positive ESBL detection with the VITEK 2 system (panel AST-037), which appears to yield a large number of false-positive results.
    Journal of Medical Microbiology 02/2011; 60(Pt 6):756-60. DOI:10.1099/jmm.0.024075-0 · 2.27 Impact Factor
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    ABSTRACT: This is the first case report of Candida glabrata-disseminated candidiasis describing the acquisition of echinocandin resistance following anidulafungin treatment. The initial isolates recovered were susceptible to echinocandins. However, during 27 days of anidulafungin treatment, two resistant strains were isolated (from the blood and peritoneal fluid). The resistant peritoneal fluid isolate exhibited a Ser663Pro mutation in position 1987 of FKS2 HS1 (hot spot 1), whereas the resistant blood isolate displayed a phenylalanine deletion (Phe659).
    Antimicrobial Agents and Chemotherapy 12/2010; 55(3):1312-4. DOI:10.1128/AAC.00589-10 · 4.45 Impact Factor
  • Cidália Pina-Vaz · Acácio Gonçalves Rodrigues
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    ABSTRACT: Flow cytometry has found wide applications in areas like haematology and immunology, but also presents great potential in microbiology. The susceptibility of clinical isolates of Candida and Cryptococcus to antifungal compounds can be assayed by flow cytometry using fluorescent probes like FUN-1, propidium iodide and JC-1, with several advantages. Following 1 or 2 h of incubation, depending on the antifungal compound, versus 48 h of the classical methods, it is possible to establish the different susceptibility profiles. Additionally, it provides information regarding the mechanisms of action and might infer about resistance mechanisms.
    Methods in molecular biology (Clifton, N.J.) 01/2010; 638:281-9. DOI:10.1007/978-1-60761-611-5_21 · 1.29 Impact Factor
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    Carmen Lisboa · António Santos · Filomena Azevedo · Cidália Pina-Vaz · Acácio Gonçalves Rodrigues
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    ABSTRACT: The diagnosis of candida balanitis should be based upon both clinical and mycological data. The procedure of material collection is a critical issue to confirm or rule out the clinical diagnosis of candida balanitis. To compare direct impression of the glans on the agar surface of solid culture media with the collection of genital exudates with cotton swab for the diagnosis of candida balanitis. A prospective cross-sectional study was carried out during a 36-month period. Sexually transmitted disease clinic attendees with balanitis and asymptomatic men were included. Specimens for yeast culture were collected from the glans penis and inner preputial layer using the direct impression on CHROMagar candida medium and by swabbing with a sterile cotton swab. Among 478 men enrolled, 189 had balanitis. The prevalence of candida balanitis was 17.8% (85/478) confirmed after culture by direct impression; the swab method detected only 54/85 (63.5%) of these men. Of the 289 asymptomatic men, 36 (12.5%) yielded Candida spp; the swab method detected only 38.9% of these men. The risk of having candida balanitis is 8.9 (IC 95% 2.48 to 32.04) whenever the number of candida colonies recovered by direct impression was greater than 10. Direct impression on CHROMagar candida medium resulted in the highest Candida spp recovery rate. More than 10 colonies yielded by impression culture were statistically associated with candida balanitis. This method shows the ideal profile for sampling the male genital area for yeasts and should be included in the management of balanitis.
    Sexually transmitted infections 10/2009; 86(1):32-5. DOI:10.1136/sti.2009.037820 · 3.08 Impact Factor
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    Joana Barbosa · Acácio Gonçalves Rodrigues · Cidália Pina-Vaz
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    ABSTRACT: Encephalitozoon intestinalis is responsible for intestinal disease in patients with AIDS and immunocompetent patients. The infectious form is a small spore that is resistant to water treatment procedures. Its detection is very important, but detection is very cumbersome and time-consuming. Our main objective was to develop and optimize a specific flow cytometric (FC) protocol for the detection of E. intestinalis in hospital tap water and human feces. To determine the optimal specific antibody (Microspor-FA) concentration, a known concentration of E. intestinalis spores (Waterborne, Inc.) was suspended in hospital tap water and stool specimens with different concentrations of Microspor-FA, and the tap water and stool specimens were incubated under different conditions. The sensitivity limit and specificity were also evaluated. To study spore infectivity, double staining with propidium iodide (PI) and Microspor-FA was undertaken. Distinct approaches for filtration and centrifugation of the stool specimens were used. E. intestinalis spores stained with 10 microg/ml of Microspor-FA at 25 degrees C overnight provided the best results. The detection limit was 5 x 10(4) spores/ml, and good specificity was demonstrated. Simultaneous staining with Microspor-FA and PI ensured that the E. intestinalis spores were dead and therefore noninfectious. With the stool specimens, better spore recovery was observed with a saturated solution of NaCl and centrifugation at 1,500 x g for 15 min. A new approach for the detection of E. intestinalis from tap water or human feces that ensures that the spores are not viable is now available and represents an important step for the prevention of this threat to public health.
    Clinical and vaccine Immunology: CVI 06/2009; 16(7):1021-4. DOI:10.1128/CVI.00031-09 · 2.37 Impact Factor
  • Carmen Lisboa · Alcina Ferreira · Carlos Resende · Acácio Gonçalves Rodrigues
    International journal of dermatology 05/2009; 48(4):445-6. DOI:10.1111/j.1365-4632.2009.03919.x · 1.23 Impact Factor
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    ABSTRACT: Candida parapsilosis is a common isolate from clinical fungal infectious episodes. Resistance of C. parapsilosis to azoles has been increasingly reported. To analyse the development of resistance in C. parapsilosis, four azole-susceptible clinical strains and one American Type Culture Collection type strain were cultured in the presence of fluconazole, voriconazole and posaconazole at different concentrations. The isolates developed variable degrees of azole resistance according to the antifungal used. Fluconazole was the fastest inducer while posaconazole was the slowest. Fluconazole and voriconazole induced resistance to themselves and each other, but not to posaconazole. Posaconazole induced resistance to all azoles. Developed resistance was stable; it could be confirmed after 30 days of subculture in drug-free medium. Azole-resistant isolates revealed a homogeneous population structure; the role of azole transporter efflux pumps was minor after evaluation by microdilution and cytometric assays with efflux pump blockers (verapamil, ibuprofen and carbonyl cyanide 3-chloro-phenylhydrazone). We conclude that the rapid development of azole resistance occurs by a mechanism that might involve mutation of genes responsible for ergosterol biosynthesis pathway, stressed by exposure to antifungals.
    FEMS Yeast Research 05/2009; 9(4):626-33. DOI:10.1111/j.1567-1364.2009.00508.x · 2.44 Impact Factor
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    ABSTRACT: Several mechanisms may be associated with Candida albicans resistance to azoles. Ibuprofen was described as being able to revert resistance related to efflux activity in Candida. The aim of this study was to uncover the molecular base of antifungal resistance in C. albicans clinical strains that could be reverted by ibuprofen. Sixty-two clinical isolates and five control strains of C. albicans were studied: the azole susceptibility phenotype was determined according to the Clinical Laboratory for Standards Institute, M27-A2 protocol and minimal inhibitory concentration values were recalculated with ibuprofen (100 microg mL(-1)); synergistic studies between fluconazole and FK506, a Cdr1p inhibitor, were performed using an agar disk diffusion assay and were compared with ibuprofen results. Gene expression was quantified by real-time PCR, with and without ibuprofen, regarding CDR1, CDR2, MDR1, encoding for efflux pumps, and ERG11, encoding for azole target protein. A correlation between susceptibility phenotype and resistance gene expression profiles was determined. Ibuprofen and FK506 showed a clear synergistic effect when combined with fluconazole. Resistant isolates reverting to susceptible after incubation with ibuprofen showed CDR1 and CDR2 overexpression especially of the latter. Conversely, strains that did not revert displayed a remarkable increase in ERG11 expression along with CDR genes. Ibuprofen did not alter resistance gene expression significantly (P>0.05), probably acting as a Cdrp blocker.
    FEMS Yeast Research 03/2009; 9(4):618-25. DOI:10.1111/j.1567-1364.2009.00504.x · 2.44 Impact Factor
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    Carmen Lisboa · Alcina Ferreira · Carlos Resende · Acácio Gonçalves Rodrigues
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    ABSTRACT: Balanitis is defined as inflammation of the glans penis, often involving the prepuce (balanoposthitis). It is a common condition due to a wide variety of causes with infection being the most frequent and several microorganisms reported. The clinical aspect is often non specific. The management of balanoposthitis remains a clinical challenge. To evaluate the prevalence of infectious balanitis, its management, clinical features, laboratory procedures and treatment options. One hundred eighteen patients with infectious balanitis were evaluated between 1995 and 2004 and laboratory data were collected. Balanitis was diagnosed in 219 (10.7%) of the men that have attended the sexually transmitted disease (STD) Clinic. One hundred eighteen (53.9%) had clinically been assumed to suffer from infectious balanitis. In 75 (63.6%) patients the diagnosis was confirmed by culture studies. Candida albicans was isolated from 24 patients. Staphylococcus spp. and groups B and D Streptococci were the most frequently isolated bacteria. All men were uncircumcised. Ninety-one (77.1%) of infectious balanitis patients were treated with antifungal agents. Twelve patients with infectious noncandida balanitis were treated with general antibiotic therapy. Fifty-five (46.6%) patients had a follow-up of 3 to 12 months during which recurrences were registered in 7 (12.7%) patients. Infectious balanitis was a common condition, affecting 53.9 % of male STD clinic patients in this study. Candida spp. were the most frequently isolated microorganisms. The clinical aspect is of little value in predicting the infectious agent associated with balanoposthitis.
    International journal of dermatology 03/2009; 48(2):121-4. DOI:10.1111/j.1365-4632.2009.03966.x · 1.23 Impact Factor

Publication Stats

346 Citations
94.41 Total Impact Points

Institutions

  • 2015
    • Centro Hospitalar de São João
      Oporto, Porto, Portugal
  • 2004–2015
    • University of Porto
      • Faculty of Medicine
      Oporto, Porto, Portugal
  • 2011
    • Hospital de São João
      Oporto, Porto, Portugal
  • 2009
    • MIT Portugal
      Porto Salvo, Lisbon, Portugal