Search

A candidemia é uma preocupação crescente em hospitais de todo o mundo, com distribuição de espécies de Candida não-albicans cada vez mais frequente em pacientes na UTI e alta taxa de mortalidade. Este estudo teve o objetivo de identificar as espécies de Candida, fatores de risco e taxas de resistência antifúngica no Estado do Rio Grande do Norte. Trata-se de um estudo transversal analítico descritivo, realizado de 2018 a 2020, com 50 pacientes internados em UTIs de três hospitais terciários, na cidade de Natal no Estado do Rio Grande do Norte. Não foram encontradas diferenças estatísticas relacionadas ao sexo, mas significância relacionada a faixa etária, principalmente nos menores de onze anos. C. albicans (48%), C. tropicalis (32%) e C. pelliculosa (6%) foram as mais prevalentes. Os principais fatores de risco para candidemia, entre os pacientes dos três hospitais foi o uso de sondagem vesical (94%), nutrição parenteral (84%), cateter venoso central (48%), corticoterapia (44%) e imunossupressão (44%). Quando comparados os casos de candidemia nos diferentes hospitais e apresentação das espécies de Candida, não houve diferença significativa na distribuição dos óbitos. Desta forma, especial atenção deve ser direcionada aqueles pacientes que apresentarem estes fatores de risco a fim de realizar uma terapia profilática prévia. O percentual de mortes foi de 16,67% no Hospital B e 25% no Hospital C, não obtivemos dados de óbito para os pacientes do Hospital A. Observou-se resistência de C. albicans a anidulafungina, micafungina, voriconazol e anfotericina B, bem como de C. tropicalis a estes dois últimos antifúngicos. C. pelliculosa também foi resistente ao voriconazol. Enquanto que C. parapsilosis e C. krusei apresentaram resistência à anidulafungina. A distribuição de espécies e susceptibilidade antifúngica de isolados de Candida provenientes de casos de candidemia trazem novas perspectivas ao entendimento desse grave panorama. Assim, fornece informações úteis sobre a epidemiologia, fatores de risco e padrão de susceptibilidade úteis para a seleção de agentes antifúngicos empíricos para pacientes com candidemia.

This study evaluated the effect of the protease inhibitor ritonavir (RIT) on Trichosporon asahii and Trichosporon inkin. Susceptibility to RIT was assessed by the broth microdilution assay and the effect of RIT on protease activity was evaluated using azoalbumin as substrate. RIT was tested for its anti-biofilm properties and RIT-treated biofilms were assessed regarding protease activity, ultrastructure and matrix composition. In addition, antifungal susceptibility, surface hydrophobicity and biofilm formation were evaluated after pre-incubation of planktonic cells with RIT for 15 days. RIT (200 μg ml−1) inhibited Trichosporon growth. RIT (100 μg ml−1) also reduced protease activity of planktonic and biofilm cells, decreased cell adhesion and biofilm formation, and altered the structure of the biofilm and the protein composition of the biofilm matrix. Pre-incubation with RIT (100 μg ml−1) increased the susceptibility to amphotericin B, and reduced surface hydrophobicity and cell adhesion. These re...

It is well known that prolonged antibiotic therapy alters the mucosal microbiota composition, increasing the risk of invasive fungal infection (IFI) in immunocompromised patients. The present study investigated the direct effect of β-lactam antibiotics cefepime (CEF) and amoxicillin (AMOX) on biofilm production by Candida albicans ATCC 10231. Antibacterials at the peak plasmatic concentration of each drug were tested against biofilms grown on polystyrene surfaces. Biofilms were evaluated for biomass production, metabolic activity, carbohydrate and protein contents, proteolytic activity, ultrastructure, and tolerance to antifungals. CEF and AMOX enhanced biofilm production by C. albicans ATCC 10231, stimulating biomass production, metabolic activity, viable cell counts, and proteolytic activity, as well as increased biovolume and thickness of these structures. Nevertheless, AMOX induced more significant changes in C. albicans biofilms than CEF. In addition, it was shown that AMOX increased the amount of chitin in these biofilms, making them more tolerant to caspofungin. Finally, it was seen that, in response to AMOX, C. albicans biofilms produce Hsp70 - a protein with chaperone function related to stressful conditions. These results may have a direct impact on the pathophysiology of opportunistic IFIs in patients at risk.

16S rRNA methylases confer high-level resistance to aminoglycosides which are used to treat serious infections caused by gram-negative bacteria, such as Acinetobacter spp. Some genes encoding these enzymes are disseminated worldwide, while others were detected in only some countries. The objective was to characterize the susceptibility profile to aminoglycosides (amikacin and gentamicin) of clinical isolates of Acinetobacter spp. from an oncological hospital in Recife, and given the resistance to both antimicrobials, to characterize minimal inhibitory concentrations (MICs) of amikacin, gentamicin and tobramycin, the occurrence of 16S rRNA methylase genes (armA, rmtB, rmtC and rmtD) and of s-lactamase gene (blaKPC) and the clonal profile. Isolates resistant to both antimicrobials, amikacin and gentamicin, were selected by disk diffusion technique in Mueller–Hinton agar and identified. Broth microdilution was conducted to determine MICs of amikacin, gentamicin, and tobramycin. These isolates were subjected to polymerase chain reaction and pulsed-field gel electrophoresis. Among 23 analyzed isolates, 12 (52.2%) were resistant to gentamicin and amikacin and identified as Acinetobacter baumannii. Among these, 11 (91.7%), 12 (100%), and 9 (75%) isolates showed respectively MICs > 256 µg/mL of amikacin, > 64 µg/mL of gentamicin, and > 64 µg/mL of tobramycin. The armA gene was found in 12 (100%) isolates and 6 (50%) showed coexistence of armA, rmtB, and rmtC genes. The rmtD and blaKPC genes were not detected. These isolates showed high genetic similarity (92%) and were classified as clone A. Elaboration and fulfillment of measures are thus essential to prevent the spread of this resistance mechanism.

The aim of this study is to verify the action of the aqueous leaf extract Ziziphus joazeiro in the eradication of bacterial and fungal biofilms, and to compare these effects with the stem bark extracts, as well as with conventional standard drugs. The presence of secondary metabolites was observed through phytochemical prospection assays. The effect of the aqueous extract on microbial biofilm formation was observed by OD600 nm absorbance and the crystal violet assay. For bacterial and fungal biofilms, chlorhexidine gluconate and fluconazole, respectively, were used as positive controls. Phytochemical characterization showed the presence of secondary metabolite classes common to both extracts such as flavonoids, steroids and saponins. In particular, in the aqueous leaf extract phenols, condensed tannins and alkaloids were observed. Eradication results using the aqueous leaf extract showed an inhibition of the microbial biofilm mass, moreover the biofilms were more sensitive to the bark extract, which presented a greater inhibition number and an action similar to standard drugs. It is important to highlight the leaf extract showed significant eradication at the lowest concentrations for mature yeast biofilms, thus demonstrating its potential to modify microbial resistance susceptibility. Bacterial and fungal biofilm eradication results using the Ziziphus joazeiro aqueous extracts presented a biofilm inhibition effect for both, moreover the results support the ethnopharmacological knowledge surrounding the use of Ziziphus joazeiro stems in the community. In comparison, the bark extract presented a more effective treatment than the leaf extract against biofilms, presenting inhibition levels similar to the used standard drugs.

Emergent fungal infections are uncommon conditions which frequently lead to death. To our knowledge, only a few cases of invasive infection by Cystobasidium minutum (previously known as Rhodotorula minuta) have been reported. Moreover, several factors are responsible for deep site infections, such as catheter-related fungemia. This report describes the first case report of Cystobasidium minutum causing fungemia in Brazil. The pathogens fungemia was demonstrated by catheter and blood culture-proven, and both yeasts were identified by sequences of D1/D2 rDNA region. After the end of antifungal therapy and catheter removal, a second blood culture was found to be negative and the clinical signs and symptoms of the patient improved.

Yeast biotechnologies are a cornerstone to modern lifestyle in all spheres of society, as their products are essential for the economy and industrial activities. The life cycle of many yeasts such as Candida alternates between diplophase and haplophase. Both ploidies can exist as stable cultures; however, it has been shown that wild haploid yeast efficiently cross in poor environments, whereas wild diploid species hybridize predominantly in rich nutrient surroundings. Some Candida species have had their ploidy engineered to produce various important biomolecules useful to the detergent, food, pharmaceutical and other industries. Several works show that MALDI-TOF MS has become an ideal platform for ploidy analysis. Recent reports have shown that antimicrobial peptides (AMP) present enhanced hydrophobic interaction towards cell membranes. In this work, the authors explored a modified AMP named Clavanin A (CLAVMO) as an unprecedented bioreceptor capable of differentiating the molecular composition of the cell wall of Candida spp. A thin film of poly(3-thiophene acetic acid) (PTAA) was electropolymerized to avail the covalent immobilization of amino-functionalized titanium dioxide nanoparticles (TiO2NPs) whose electrochemical properties are excellent to provide a discernable redox response. Electrochemical impedance spectroscopy (EIS) and atomic force microscopy (AFM) were used to characterize the biosensor assembly and the biorecognition process. Additionally, MALDI-TOF was employed to confirm ploidy of Candida strains used in this work. Our results suggest that TiO2NPs_CLAVMO biosensor is a suitable biological probe that can be used to detect and differentiate Candida species based on their ploidy. For instance, C. Albicans and C. tropicalis, which are close related species known for being diploid presented higher impedimetric response than haploid species C.krusei and C. glabrata. The proposed biosensor stands out as a useful alternative for highly sensitive differentiation of Candida yeast cells, without the intricacies of MALDI-TOF sample preparation. The biodetection event and its electrochemical evaluation took less than 20 min to perform. The platform showed stability for over a week, a linear detection range between 101-106 CFU mL-1 and limits of detection (LODs) between 2 and 3 CFU mL-1.

Coccidioidomycosis is a fungal infection caused by Coccidioides immitis or Coccidioides posadasii. These fungi are known to thrive in desert climate. Fungi produce infectious arthroconidia in soil, they are aerosolized in the air and when inhaled by humans, usually cause infections such as pneumonia. The first cases of coccidioidomycosis in Brazil were reported in 1978. Since then, there have been other reports mainly from desert regions of Northeastern Brazil. The present report describes three cases of coccidioidomycosis on male farmers from Serra Talhada county, Pernambuco State, who developed pneumonia and were subsequently diagnosed with pulmonary coccidioidomycosis. These three farmers were successfully treated with oral fluconazole. They reported having hunted armadillos in a rural and arid area of Pernambuco State. Armadillos are known to be carriers of Coccidioides. This is the first report of infection caused by Coccidioides in Pernambuco State, Brazil.

Background Candidemia is a life-threatening fungal infection characterized by the presence of Candida in the blood. Aims To describe the clinical–epidemiological features and main risk factors among patients with candidemia admitted to Intensive Care Unit. Methods A cross-sectional, retrospective and observational study was performed between January 2015 and July 2016. Laboratory reports and medical records from ICU patients admitted to a public hospital in northeastern Brazil were analyzed. Results There were 1573 admissions and 67 of them were positive for candidemia. The majority of patients were male (53.3%) and remained at the hospital for more than seven days (86.6%). Non-C. albicans Candida infections (60%) were predominant. Broad-spectrum antibiotic therapy was prescribed in 98.4% of the cases. The most frequent underlying diseases were sepsis (73.3%), presence of solid tumors (15%), respiratory condition (60%), urinary tract disease (56.6%) and gastrointestinal tract diseases (23.3%). Surgeries were carried out on 43% of the patients, consisting of 23.3% abdominal surgeries, with a mortality rate of 92.8%. Risk factors were venous central access (93.3%), mechanical ventilation (81.6%), nasoenteral tube (83.3%), nasogastric tube (25%), indwelling bladder catheter (88.3%), diabetes mellitus (55%) and tracheostomy (36.6%). Statistical analysis correlated the use of indwelling bladder catheter with a higher mortality rate (r = 0.07412, p = 0.0353). Conclusions The current study reveals the high case fatality rates among critically ill patients suffering from candidemia admitted to ICU. Herein, we highlight the importance of identifying non-C. albicans Candida species and reinforce the idea of carrying out epidemiological surveillances and antifungal susceptibility tests.

We report a case of invasive infection due to Saprochaete capitata in a patient with hematological malignancies after chemotherapy treatment and empiric antifungal therapy with caspofungin. Although severely immunocompromised the patient survived been treated with amphotericin B lipid complex associated with voriconazole.

Cryptococcus neoformans var. grubii is considered to be the major cause of cryptococcosis in immunosuppressed patients. Understanding cell wall glycoproteins using lectins is of medical interest and can contribute to specific therapy. The aim of this study was to evaluate the carbohydrates on the cell wall of Cryptococcus neoformans var. grubii clinical isolates, using a fluorescein isothiocyanate-lectin binding protocol. Thirty yeast strains stocked in the culture collection were cultivated for 2 days at 30 °C with shaking. Cells were obtained by centrifugation, washed in phosphate-buffered saline, and a suspension of 107 cells/mL was obtained. To determine the binding profile of lectins, concanavalin A (Con A), wheat germ agglutinin (WGA), Ulex europaeus agglutinin I (UEA-I), and peanut agglutinin (PNA) conjugated to fluorescein were used. All the tested clinical isolates of Cryptococcus neoformans var. grubii were intensely stained by WGA, moderately stained by Con A, and weakly stained by PNA and UEA-I. Thus, Cryptococcus can be detected in clinical specimens such as blood and cerebrospinal fluid using the fluorescent lectin WGA, which may be considered as an option for detection in cases of suspected cryptococcosis with low laboratory sensitivity. Future applications may be developed using this basic tool.

The majority of microorganisms present a community lifestyle, establishing biofilm ecosystems. However, little is known about its formation in emergent Candida species involved in catheter-related infections. Thus, various techniques may be used in the biofilm detection to elucidate structure and clinical impact. In this context, we report the ability of emergent Candida species (Candida haemulonii, C. lusitaniae, C. pelliculosa, C.guilliermondii, C. famata and C. ciferrii) on developing well structured biofilms with cell viability and architecture, using optical coherence tomography (OCT). This new approach was compared with XTT analyses and Scanning Electron Microscopy (SEM). A positive correlation between oxidative activity (XTT) and OCT results (r = 0.8752, p < 0.0001) was observed. SEM images demonstrated cells attachment, multilayer and morphologic characteristics of the biofilm structure. C. lusitaniae was the emergent species which revealed the highest scattering extension length and oxidative metabolism when evaluated by OCT and XTT methods, respectively. Herein, information on C. ciferri biofilm structure were presented for the first time. The OCT results are independently among Candida strains and no species-specific pattern was observed. Our findings strongly contribute for clinical management based on the knowledge of pathogenicity mechanisms involving emergent yeasts.

The aim of this study was to evaluate the effect of promethazine on the antifungal minimum inhibitory concentrations against planktonic cells and mature biofilms of Candida tropicalis, as well as investigate its potential mechanisms of cell damage against this yeast species. Three C. tropicalis isolates (two azole-resistant and one azole-susceptible) were evaluated for their planktonic and biofilm susceptibility to promethazine alone and in combination with itraconazole, fluconazole, voriconazole, amphotericin B, and caspofungin. The antifungal activity of promethazine against C. tropicalis was investigated by performing time-kill curve assays and assessing rhodamine 6G efflux, cell size/granularity, membrane integrity, and mitochondrial transmembrane potential, through flow cytometry. Promethazine showed antifungal activity against planktonic cells and biofilms at concentrations of 64 and 128 μg/ml, respectively. The addition of two subinhibitory concentrations of promethazine reduced the antifungal MICs for all tested azole drugs against planktonic growth, reversing the resistance phenotype to all azoles. Promethazine decreased the efflux of rhodamine 6G in an azole-resistant strain. Moreover, promethazine decreased cell size/granularity and caused membrane damage, and mitochondrial membrane depolarization. In conclusion, promethazine presented synergy with azole antifungals against resistant C. tropicalis and exhibited in vitro cytotoxicity against C. tropicalis, altering cell size/granularity, membrane integrity, and mitochondrial function, demonstrating potential mechanisms of cell damage against this yeast species.

This study aimed to prepare a complex of 2-hydroxypropyl-β-cyclodextrin (HP-β-CD) and 6CN10, a poorly water soluble 2-aminothiophene derivative with antifungal properties, by freeze-drying technique. The complex was characterized by thermal analysis, infrared/Raman spectroscopy, X-ray diffraction and scanning electron microscopy. In addition, we used the data of the phase solubility study, 1H, and 2D NMR spectroscopy and molecular modeling in order to investigate the interactions between 6CN10 and HP-β-CD. The apparent solubility of 6CN10 with HP-β-CD increased more than 29 fold. The phase solubility assay in water at 25 oC showed an AP-type curve, with an apparent stability constant K1:1 and K1:2 of 96 and 0.1989 M-1, respectively. The results of IR, NMR and docking indicate that 6CN10 is able to form complexes with HP-β-CD (1:1 and 1:2 stoichiometric ratios), generating the formation of inclusion and preferably, non-inclusion complexes. The antifungal activity against Cryptococcus neoformans demonstrated the superior performance of the complex (46.66 µg mL-1) when compared with the free drug (166.66-333.33 µg mL-1). The present study provides useful information for the potential application of complexation with low soluble compounds and about the type of complex formation between 6CN10 and HP-β-CD.

Microbial culture collections underpin biotechnology applications and are important resources for clinical microbiology by supplying reference strains and/or performing microbial identifications as a service. Proteomic profiles by MALDI-TOF MS have been used for Candida spp. identification in clinical laboratories and demonstrated to be a fast and reliable technique for the routine identification of pathogenic yeasts. The main aim of this study was to apply MALDI-TOF MS combined with classical phenotypic and molecular approaches to identify Candida clinical isolates preserved from 1 up to 52 years in a Brazilian culture collection and assess its value for the identification of yeasts preserved in this type of collections. Forty Candida spp. clinical isolates were identified by morphological and biochemical analyses. Identifications were also performed by the new proteomic approach based on MALDI-TOF MS. Results demonstrated 15% discordance when compared with morphological and biochemical analyses. Discordant isolates were analysed by ITS sequencing, which confirmed the MALDI-TOF MS identifications and these strains were renamed in the culture collection catalogue. In conclusion, proteomic profiles by MALDI-TOF MS represents a rapid and reliable method for identifying clinical Candida species preserved in culture collections and may present clear benefits when compared with the performance of existing daily routine methods applied at health centres and hospitals., Research leading to these results received partial funding from the European Community's Seventh Framework Program (FP7, 2007-2013), Research Infrastructures Action, under grant agreement No. FP7-228310 (EMbaRC project). Thanks are also due to Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES, Brazil) for funding support

Objetivou-se com esta pesquisa isolar e identificar leveduras da cavidade oral e traqueia de aves de rapina. Para este estudo, utilizaram-se 17 aves de rapina (três carcarás (Caracara plancus), 11 gaviões-carijós (Rupornis magnirostris), 1 coruja-das-torres (Tyto furcata) e duas corujas-orelhuda (Rhinoptynx clamator). As amostras foram colhidas da cavidade oral e traqueia com auxílio de swabs estéreis. Foram cultivadas 34 amostras em ágar Sabouraud dextrose com cloranfenicol (100 mg/L) e incubadas em aerobiose à temperatura ambiente por um período mínimo de sete dias e máximo de 15 dias, sendo observadas diariamente. Foram isolados 14 (93,3%) amostras de leveduras da cavidade oral e apenas uma (6,7%) da traqueia. Dos 15 isolados, 14 (93,3%) foram obtidos de amostras de gavião-carijós (Rupornis magnirostris) e uma (6,67%) em carcará (Caracara plancus). As espécies identificadas foram: Candida albicans (13,3%), C. parapsilosis (20%), C. tropicallis (26,7%), C. magnoliae (6,78%), Candida sp. (13,3%) e Trichosporon cutaneum (20%). O isolamento e identificação de leveduras em aves de rapina é epidemiologicamente importante para uma melhor compreensão dos processos patológicos na cavidade oral e na traqueia das espécies estudadas, uma vez que seu conhecimento permite adoção de medidas para a prevenção de doenças causadas por esses agentes oportunistas.

Objective: To report atypical morphological features of Trichophyton (T.) tonsurans strains associated with tinea capitis. Methods: Eighty-two T. tonsurans strains isolated in Ceará, Brazil, were analyzed regarding macro and micromorphological features and nutritional patterns. Results: Fifty-two samples presented abundant chlamydoconidia, which were produced in chains. Macroscopically, these strains developed small glabrous colonies that were firmly attached to the surface of the culture medium, with few or no aerial mycelia and intense rusty yellow pigmentation. Seven strains did not grow with stimulus from thiamine. Samples were heterogeneous regarding urease production and none presented in vitro hair perforation. Conclusions: The observation of T. tonsurans strains with distinct phenotypic features indicates the need to revise the taxonomic criteria for routine identification of this dermatophyte.

Several studies have been developed regarding human health risks associated with the recreational use of beaches contaminated with domestic sewage. These wastes contain various micro-organisms, including Candida tropicalis. In this context, the objective of this study was to characterize C. tropicalis isolates from the sandy beach of Ponta Negra, Natal, Rio Grande do Norte, Brazil, regarding the expression of in vitro virulence factors, adaptation to osmotic stress and susceptibility to antifungal drugs. We analyzed 62 environmental isolates and observed a great variation among them for the various virulence factors evaluated. In general, environmental isolates were more adherent to human buccal epithelial cells (HBEC) than C. tropicalis ATCC13803 reference strain, besides the fact they were also highly biofilm producers. Most of the isolates presented wrinkled phenotypes on Spider medium (34 isolates, 54.8%). The majority of the isolates also showed higher proteinase production than control strains, but low phospholipase activity. In addition, 35 isolates (56.4%) had high hemolytic activity (hemolysis index > 0.55). With regard to C. tropicalis resistance to osmotic stress, 85.4% of the isolates were able to grow in a liquid medium containing 15% sodium chloride. The strains were highly resistant to the azoles tested (fluconazole, voriconazole and itraconazole). Fifteen strains were resistant to the three azoles tested (24.2%). Some strains were also resistant to amphotericin B (14 isolates; 22.6%), while all of them were susceptible for the echinocandins tested, except for a single strain of intermediate susceptibility to micafungin. Our results demonstrate that C. tropicalis isolated from the sand can fully express virulence attributes and showed a high persistence capacity on the coastal environment; in addition of showing high minimal inhibitory concentrations to several antifungal drugs used in current clinical practice, demonstrating that environmental isolates may have pathogenic potential.

Summary Various researchers have concluded that lectins are useful reagents for the study of fungal cell wall surface glycoconjugates. In this study, we evaluated the expression of N-acetyl-d-glucosamine, l-fucose, d-galactose and glucose/mannose on the cell wall surface of Trichophyton tonsurans and other keratinophilic filamentous fungi, using a simple lectin-binding protocol. The fungal cultures used were isolated from soils obtained from public parks by the hair-bait technique. The lectin assays used concanavalin A (Con A), wheat germ agglutinin (WGA), Ulex europeus agglutinin I (UEA-I) and peanut agglutinin (PNA), all conjugated with horseradish peroxidase. Adhesive tape was placed sticky-side down over the fungal colony, gently pressed and then removed. The fungal-tape samples were incubated with the lectin for 1 h at 4 °C. Lectin binding was visualised using 3,3-diaminobendizine (DAB) and hydrogen peroxidase. There was a high expression of N-acetyl-d-glucosamine on the cell wall surface of all fungi species tested, whereas the expression of l-fucose, d-galactose and glucose/mannose demonstrated inter-specific variations. The lectin-binding assay presented in this article eliminates many of the laborious steps involved in other protocols. The amount and quality of the mycelium and spores immobilised by the adhesive tapes were suitable for obtaining the carbohydrate profile in glycoconjugates of the cell wall surface of filamentous fungi.

This work was based on the analysis of digital images of histochemical profile from subcutaneous lesions in sporotrichosis (ST) and chromoblastomycosis (CM) patients. An additional aim was the detection of carbohydrate expression using lectin histochemical analysis of the different carbohydrates in the fungal cell wall from four different species (Sporothrix schenckii, Fonsecaea pedrosoi, Phialophora verrucosa, and Cladophialophora carrionii) associated with diseases mentioned earlier. Slides from tissue biopsies from ST and CM positive patients (n=10, each) were stained according to routine techniques. Slides were incubated with 25 μg/ml of Con A lectins and WGA conjugated to peroxidase. Digital image analysis was carried out in a workstation using OPTIMAS™ software system. Routine histochemistry results indicated that there is significantly higher collagen deposition and elastic fibers in ST characteristic lesions compared with that found in CM cases. The ST interstitial fibrosis area was larger than in CM lesions. Comparative lectin binding showed a positive and intense lectin staining pattern in the cell wall of S. schenckii, suggesting a higher expression of glucose/mannose and N-acetyl glucosamine in their cell surface as evidenced by Con A and WGA, respectively. However, these lectins were not effective to recognize some carbohydrates moieties in the F. pedrosoi, P. verrucosa, and C. carrionii. Such findings contribute to additional information about specific recognition processes between fungal parasites and their host cell targets may be mediated by the interaction of carbohydrate-binding proteins, such as lectins, on the surface of one type of cell that combine with complementary sugars on the surface of another cells into fibro-connective tissues associated with lesions.

Many studies have described the adherence of Candida albicans to epithelial cells but little is known about Candida parapsilosis adhesion and its role in host cell surface recognition. This study was designed to evaluate the correlation between the adherence of 20 C. albicans and 12 C. parapsilosis strains to human buccal epithelial cells and the expression of fungal cell surface carbohydrates using lectin histochemistry. Adherence assays were carried out by incubating epithelial cells in yeast suspensions (10(7) cells ml(-1) ) and peroxidase conjugated lectins (Con A, WGA, UEA I and PNA at 25 μg ml(-1) ) were used for lectin histochemistry. The results showed that adherence was overall greater for C. albicans than for C. parapsilosis (P < 0.01) and that the individual strain differences correlated with a high content of cell surface α-l-fucose residues as indicated by the UEA I staining pattern. Based on the saccharide specificity of the lectins used, these results suggest that l-fucose residues on cell surface glycoconjugates may represent recognition molecules for interactions between the yeast strain studied and the host (r = 0.6985, P = 0.0045). In addition, our results indicated the presence of α-d-glucose/α-d-mannose, N-acetyl-D-glucosamine/N-acetylneuraminic acid and D-galactose/N-acetyl-D-galactosamine in fungal cell wall.

Trichosporon species are usually opportunistic pathogens. Here, we present a case of esophagitis caused by T. inkin in a 54-year-old woman with pulmonary cancer and severe neutropenia in whom the susceptibility profile of the isolate against azoles and polyenes was verified. The patient was diagnosed with esophagitis grade I of Wilcox, presenting scattered whitish plaques and exudates in upper two-thirds of the esophageal mucosa. Antifungal therapy involving oral fluconazole (150 mg/day for 14 days) was ineffective. In vitro, the isolate showed no resistance to this azole and sensitivity to amphotericin B. Since T. inkin is of growing importance as an agent of invasive infections in immunocompromised patients, we stress that the diagnosis of esophagitis by this species should be followed by an assessment of the therapeutic sensitivity of the strain involved.

Aims: The in vitro activity of ciclopirox olamine was evaluated against Cryptococcus spp. obtained from the cerebrospinal fluid (CSF) of immunocompromised patients. Methods and Results: The antifungal activity of ciclopirox olamine was tested against Cryptococcus spp. obtained from the CSF of immunocompromised patients, using amphotericin B and fluconazole as controls. The minimal inhibitory concentration was determined following the microdilution method indicated by the Clinical and Laboratory Standards Institute. The minimal fungicide concentration was determined by the absence of growth on Sabouraud dextrose agar. The data obtained showed that antifungal activity of ciclopirox olamine ranged from 0·25 to 1 μg ml−1. Conclusions: This paper underscores the importance of the antifungal potential of ciclopirox olamine against Cryptococcus spp. as an alternative treatment against systemic cryptococosis. In vivo experiments are essential for future medical use. Significance and Impact of the Study: This was the first time that ciclopirox olamine was tested against Cryptococcus spp. using the reference method. The antifungal activity of this drug against this species suggests an applicable potential for systemic cryptococcosis therapy.

White piedra is a fungal infection characterized by nodules comprised of Trichosporon species and restricted to the extrafollicular portion of the hair shaft. The diagnosis is based on clinical and mycological characteristics, and must be confirmed with a precise identification of the etiological agent. This research aimed to develop an in vitro infection model of white piedra and analyze its morphological and ultra-structural aspects. In the process, hair infection was induced using eight isolates of the genus Trichosporon maintained in the Culture Collection Micoteca URM. The ITS and IGS1 regions were sequenced for taxonomic confirmation. Scanning Electron Microscope (SEM) was performed at the Strategic Center for Northeast Technologies (CETENE). The scanning electron microscope was equipped with an Energy Dispersion Spectrometer (EDS). The Trichosporon isolates were identified as Trichosporon asahii (6) and Trichosporon montevideense (2) by internal transcript spacer (ITS) region and intergenic spacer 1 region (IGS1) sequencing. All eight strains were used to induce the in vitro hair infection, and nodules formed after the incubation period. Temperature variations and high humidity were not observed to be related to the development of this hair disease. The main chemical constituents detected in the nodules were carbon, nitrogen and oxygen, as well as a low level of sulfur. The absence of calcium, combined with the low level of sulfur, might explain the soft nature of the white piedra nodules. This study demonstrated that several Trichosporon species may be responsible for causing white piedra.

Candidemia is a frequent condition in Neonatal Intensive Care Units (NICU) and usually complicates the newborns clinical course. Several factors are responsible for candidiasis, such as prematurity and use of broad-spectrum antibiotics, and in these cases, there are the involvement of various Candida species, as C. albicans, and C. parapsilosis. However, other species as C. haemulonii has been rarely described in candidemia cases, being considered an emergent pathogen. Thus, we report a case of neonatal candidemia by C. haemulonii and a review of literature of fungemia by this yeast. The patient was a neonate with gestational age of 26 weeks and birth weight of 660 g hospitalized in a NICU from a Brazilian hospital. The identification of the etiological agent was performed by phenotypic methods, scanning electron microscopy, sequencing of the ITS region of rDNA, and mass spectrometry. Antifungal susceptibility testing was carried out according to the Clinical Laboratories and Standards Institute guidelines. The newborn was diagnosed with candidemia by C. haemulonii resistant to amphotericin B with minimal inhibitory concentration (MIC) of 8 µg/mL, sensitive to fluconazole (MIC: 8 µg/mL) and voriconazole (MIC: 0.12 µg/mL). The treatment with fluconazole (12 mg/kg/day) was established with good outcome. Candidemia by C. haemulonii is still being limited to a few sporadic cases in adults with endemic and restricted occurrences in neonates. Usually, the therapy with amphotericin B is ineffective against this species. Our results showed the importance of the mycological diagnosis associated to antifungigrama for the successful clinical management followed by important epidemiological data.

Various researchers have concluded that lectins are useful reagents for the study of fungal cell wall surface glycoconjugates. In this study, we evaluated the expression of N-acetyl-D-glucosamine, L-fucose, D-galactose and glucose/mannose on the cell wall surface of Trichophyton tonsurans and other keratinophilic filamentous fungi, using a simple lectin-binding protocol. The fungal cultures used were isolated from soils obtained from public parks by the hair-bait technique. The lectin assays used concanavalin A (Con A), wheat germ agglutinin (WGA), Ulex europeus agglutinin I (UEA-I) and peanut agglutinin (PNA), all conjugated with horseradish peroxidase. Adhesive tape was placed sticky-side down over the fungal colony, gently pressed and then removed. The fungal-tape samples were incubated with the lectin for 1 h at 4 °C. Lectin binding was visualised using 3,3-diaminobendizine (DAB) and hydrogen peroxidase. There was a high expression of N-acetyl-D-glucosamine on the cell wall surface of all fungi species tested, whereas the expression of L-fucose, D-galactose and glucose/mannose demonstrated inter-specific variations. The lectin-binding assay presented in this article eliminates many of the laborious steps involved in other protocols. The amount and quality of the mycelium and spores immobilised by the adhesive tapes were suitable for obtaining the carbohydrate profile in glycoconjugates of the cell wall surface of filamentous fungi.

Infecções por leveduras são freqüentes em imunocomprometidos, contudo espécies emergentes têm alterado o perfil epidemiológico. A habilidade de secretar proteases tem sido associada à patogenicidade do gênero Candida. Esta pesquisa teve como objetivos diagnosticar leveduroses em pacientes imunocomprometidos e avaliar a virulência dos agentes etiológicos baseado em teste de secreção de protease utilizando soro de albumina bovina como substrato. Do total de 104 pacientes estudados, 19 apresentaram episódios de leveduroses. O trato respiratório (63,2%), seguido pelo trato urinário (10,5%) foram os locais mais comuns de infecção. Candida albicans, Candida parapsilosis, Candida tropicalis e espécies emergentes como Candida krusei e Candida guilliermondii foram isoladas. Cinco isolados de Candida parapsilosis e um de Candida albicans e Candida guilliermondii exibiram alta atividade enzimática. Concluímos que a caracterização enzimática de isolados de Candida pode ser um útil marcador prognóstico, especialmente em imunocomprometidos, uma vez que leveduroses nestes pacientes são geralmente graves. Yeast infections are common in immunocompromised patients, although emerging species have been changing the epidemiological profile. The ability to secrete proteinases has been associated with pathogenicity within the genus Candida. This study had the aims of diagnosing yeast infections in immunocompromised patients and evaluating the virulence of the etiological agents, based on a proteinase secretion assay using bovine serum albumin as a substrate. Out of a total of 104 patients studied, 19 presented episodes of yeast infection. The respiratory tract (63.2%), followed by the urinary tract (10.5%), were the most common sites of infection. Candida albicans, Candida parapsilosis, Candida tropicalis and emerging species such as Candida krusei and Candida guilliermondii were isolated. Five isolates of Candida parapsilosis and one of Candida albicans and Candida guilliermondii exhibited high enzymatic activity. We conclude that enzymatic characterization of Candida isolates may be a useful prognostic marker, especially among immunocompromised individuals, since yeast infections in such patients are generally serious.

Yeast infections are common in immunocompromised patients, although emerging species have been changing the epidemiological profile. The ability to secrete proteinases has been associated with pathogenicity within the genus Candida. This study had the aims of diagnosing yeast infections in immunocompromised patients and evaluating the virulence of the etiological agents, based on a proteinase secretion assay using bovine serum albumin as a substrate. Out of a total of 104 patients studied, 19 presented episodes of yeast infection. The respiratory tract (63.2%), followed by the urinary tract (10.5%), were the most common sites of infection. Candida albicans, Candida parapsilosis, Candida tropicalis and emerging species such as Candida krusei and Candida guilliermondii were isolated. Five isolates of Candida parapsilosis and one of Candida albicans and Candida guilliermondii exhibited high enzymatic activity. We conclude that enzymatic characterization of Candida isolates may be a useful prognostic marker, especially among immunocompromised individuals, since yeast infections in such patients are generally serious.

Submitted by ROBERTO PAULO CORREIA DE ARAÚJO (ppgorgsistem@ufba.br) on 2016-09-15T16:37:40Z No. of bitstreams: 1 9_v.7_2.pdf: 85549 bytes, checksum: 04b5d557a5b3c4a2848de834e7c1818c (MD5) Made available in DSpace on 2016-09-15T16:37:40Z (GMT). No. of bitstreams: 1 9_v.7_2.pdf: 85549 bytes, checksum: 04b5d557a5b3c4a2848de834e7c1818c (MD5) Previous issue date: 2008-05 Atualmente, micoses subcutâneas, como a esporotricose (ST) e cromomicose (CM), possuem grande incidência na América Latina. Seus sinais clínicos ocorrem inicialmente com a formação de nódulos gomosos na ST e lesões eritematosas e verrucosas na CM, ambas evoluindo para lesões granulomatosas, geralmente combinadas com pseudocarcinomas, formadas principalmente pelo sistema fagocítico-mononuclear, plasmócitos e células gigantes tipo Langerhans. Como conseqüência dessa resposta imune, as células inflamatórias intensificam seu metabolismo e aumenta a síntese protéica, o que conduz a formação de micronúcleos. Os micronúcleos são porções da cromatina oriundas de mitoses aberrantes. Este estudo tem como objetivo quantificar o número médio de micronúcleos por célula inflamatória nas lesões cutâneas de ST e CM. Foram selecionadas biópsias de tecido epidérmico de pacientes portadores de ST (n=10) ou CM (n=10). Realizou-se citoquímica pela coloração com a reação de Feulgen e a contracoloração com Fast Green. Os resultados obtidos indicam que a freqüência dos micronúcleos é significativamente mais alta nas lesões características de ST, quando comparada à dos casos de CM (p

Infections caused by emerging Cryptococcus non-neoformans species are being reported with increasingly frequency. Here, we present a case of fungaemia by Cryptococcus laurentii in a woman receiving aggressive immunosuppressive therapy for cervical neoplasia. Three venous blood samples were aseptically collected on consecutive days and C. laurentii was isolated and identified through phenotypic and molecular methods. After central venous catheter removal and appropriate antifungal therapy, the patient showed significant improvement and blood culture became negative. Thus, patients following immunosuppressive therapies and using invasive medical devices are at risk of C. laurentii blood infections. Keywords: Cryptococcus laurentii, Fungaemia, Cancer