FUSARIUM LATERITIUM (NEES) AS AN AGENT OF FUNGEMIA IN A PATIENT INFECTED WITH THE HUMAN IMMUNODEFICIENCY VIRUS (HIV)

ABSTRACT Emerging fungal pathogens are associated with significant morbidity and mortality in the immunocompromised host. The association of fungi from the Fusarium genus with human infection in uncommon. The objective of this paper is to report the first case of fungaemia caused by Fusarium lateritium in a 42-year-old HIV-infected patient. Members of the genus Fusarium are ubiquitous fungi uncommonly associated with human infection. However, they have been described as emerging fungal pathogens associated with significant morbidity and mortality in immunocompromised hosts (2,6). Human infection usually occurs as a result of inoculation of organism through the body surface, thus causing skin infection, onychomycosis, keratitis, fungaemia, endophtalmitis and arthritis. The disseminated form may occur in patients with severe immunodeficiency (2), although rarely found in HIVpositive or AIDS patients (4). Species of Fusarium cause spread illness, but the invasive form has recently emerged as the more common etiological agent after solid-organ transplantation (9,10). Considering the increasing number of cases of HIV and the susceptibility to opportunistic mycosis, the objective of this study is to relate the first case of fungaemia caused by Fusarium lateritium in a HIV-positive patient. The patient is a 42-year-old Brazilian male, living as a gardener in Recife Metropolitan Region -Pernambuco State, Brazil. Upon arrival to the Hospital Correia Picanço ambulatory, Recife, PE, Brazil, the patient was submitted to physical examination, and skin lesions, necrotic nodules, axillar furuncle, fever, erythematous papules and abscesses were observed. Laboratory tests revealed 434/mm 3 CD4 blood cells counts and 4.670 copies/mm 3 of viral load. Venous blood samples were aseptically collected in three consecutive days, by venipuncture into VACUTAINER® tubes using EDTA anticoagulant. The samples were subcultured in biphasic Brain Heart Infusion (BHI) and incubated at 36.5°C for five days. The mycological diagnosis was carried out in the Medical Mycology Laboratory of Federal University of Pernambuco, Recife, PE, Brazil. Pure cultures were transferred to the surface of potato dextrose agar medium for taxonomic identification. The isolates were identified based on macroscopic and microscopic properties Among the numerous colonies on potato dextrose agar maintained at room temperature, one attained a diameter of 2.5cm after four days. The fungus presented slow growth and sparse aerial mycelium. Macroconidia were long with parallel walls, and the apical cells had a distinct beak shape, while basal cells were foot-shaped. Microconidial shapes varied from oval to spindle and kidney-shaped. Branched and unbranched monophialides were observed, and chlamydospores appeared singl

Rapid and reliable identification of intact Candida clinical isolates using MALDI-TOF ICMS

The significant increase in the frequency of candidiasis wide world has promoted the study and development of fast and reliable techniques aimed at the replacement of traditional methods used for identification and typing of Candida clinical isolates. Matrix Assisted Laser Desorption/Ionisation Time-Of-Flight lntact Cell Mass Spectrometry (MALDI-TOF ICMS) has been applied as current method for Candida identification in clinical laboratories. This method is reported as suitable fur routine identification in clinical laboratories and fast and reliable for identification of pathogenic yeasts. The main aim of this study was to compare MALDI-TOF ICMS performance with the classical phenotypic approach and molecular analyses to identify Candida species from clinical cases. Forty clinical Candida isolates preserved in URM Culture Collection fur I to 52 years were identified by morphological and biochemical analysis as Candida albicans (20), C. krusei (05), C. parapsilosis (11) and C. tropicalis (04). These identifications were compared with the discriminative capability of the new phenotypic approaches using MALDI-TOF ICMS. MALDI-TOF ICMS data demonstrated 15% discordance when compared with morphological and biochemical analyses. The discordant isolates were analysed by ITS sequencing which corroborated the MALDI-TOF ICMS identifications. Five Candida krusei isolates were renamed Issatchenkia orientalis by MALDI-TOF ICMS SARAMISTM database, which is their teleomorphic name. ln conclusion MALDI-TOF ICMS represents a rapid and reliable method of identifying Candida and also presents clear benefits when compared with the performance of existing daily routine methods applied at health centres and hospitals. Research leading to these results received funding from the European Community's Seventh Framework Program (FP7, 2007-2013), Research lnfrastructures Action, under grant agreement No. FP7-228310 (EMbaRC project). Thanks are also due to Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Brazil) for funding support.European Community's Seventh Fmmework Progmm (FP7, 2007-2013), Research lnfrastructures Action, under gmnt agreement No. FP7-228310 (EMbaRC project), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Brazil

Filamentous fungi from AIDS patient secretions and from the environmental air in hospital

Mediante la toma de muestras de secreciones orofaríngeas, nasales y del oído externo de 50 pacientes con Síndrome de Inmunodeficiencia Adquirida (SIDA-AIDS) y del aire de las salas de tratamiento de los mismos, se obtuvieron 238 muestras: 87 de las secreciones y 151 del aire, Se aislaron 29 spp. de hongos filamentosos de los especímenes clínicos y 38 del aire. En las secreciones de los pacientes, el grupo forma: Mycelia sterilia, y Fusarium oxysporum, F. lateritium, Aspergillus parasiticus, fueron los Hyphomycetes más representativos y los géneros Aspergillus y Fusarium constituyeron el 47% de los  aislamientos en proporciones semejantes.En el ambiente hospitalario, el grupo forma Mycelia sterilia y las especies C. sphaerospermum, Aspergilus sydowii y  C. cladosporioides fueron los Hyphomycetes más representativos y los generos Aspergillus y Penicillium constituyeron el 47,7% de los aislamientos . Los taxa más comunes que se presentaron al mismo tiempo en los pacientes como en su ambiente fueron: Mycelia sterilia, C. sphaerospermum, A.sydowii, A.restrictus y P.implicatum

Bloodstream infection by candida in patients with hematologic neoplasia: polyphasic taxonomy and antifungal susceptibility / Infecção sanguínea por candida em pacientes com neoplasia hematológica: taxonomia polifásica e suscetibilidade antifúngica

Bloodstream infection (BSI) by species of Candida has been identified as an important cause of death in patients with neutropenia who undergo chemotherapy for the treatment of hematologic malignancies This study aimed to verify the occurrence of bloodstream infections by Candida species in patients admitted to the haematology-oncology service of a public hospital specialized in the treatment of cancer in Northeast Brazil.  A total of 105 clinical samples from 62 patients with haematological malignancies were analyzed at the Laboratory of Medical Mycology at the Federal University of Pernambuco. Only 7 of 105 individuals were in the ICU environment. The mycological diagnosis was performed through automation (BACTEC 9120 / PHOENIX™), proteomic identification (MALDI-TOF MS) and molecular analysis (PCR). The antifungal susceptibility test followed the bloodstream infection recommendations of Clinical & Laboratory Standards Institute. Among the samples studied, nine strains (8,57%) were of the genus Candida, being six C. tropicalis and three C. albicans. The isolates were completely susceptible to the antifungal agents tested. Deaths occurred in 66,6% of the cases. Patients with hematologic malignancies hospitalized in intensive care and the state of septic shock present a higher risk of occurrence of BSI by Candida and death by this opportunistic pathogen

Representações sociais dos sentimentos vivenciados pelo paciente portador de neoplasia

The aim was to identify the social representations about cancer of patients undergoing cancer treatment. This is an exploratory-descriptive study with a qualitative approach with data that used the research grounds following assumptions of the proposed Theory of Social Representations. The research had a total of 92 patients of various cancer diagnoses during chemotherapy treatment. Data were collected through individual interviews, using a semi-structured questionnaire where the patient had to enumerate the first 5 words that came to their mind from the most important to the least important. Among the words evoked, the ones that were repeated the most were fear, death and treatment, sadness and healing. Evidencing, therefore, the fear that the patient feels in the face of cancer. In the fifth line of words, the most evoked terms were healing, faith, God, hope. At the beginning of the treatment, the patient is afraid of a disease that still has an important psychosocial impact on his daily life. Oncological therapy performed with quality and efficiency, by qualified professionals who assist the patient in all its dimensions, who know parts of their feelings during treatment, can help to reduce suffering and reduce the physical and psychological impacts on the patient.Objetivou-se identificar as representações sociais sobre o câncer dos pacientes em tratamento oncológico. Trata-se de um estudo exploratório-descritivo com abordagem qualitativa com dados que utilizaram fundamentação da pesquisa seguindo pressupostos da Teoria das Representações Sociais proposta. A pesquisa teve o total de 92 pacientes de diversos diagnósticos de câncer durante o tratamento quimioterápico. Os dados foram coletados por meio de entrevistas individuais, utilizando um questionário semiestruturado onde o paciente precisou enumerar as 5 primeiras palavras que viessem a sua cabeça da de maior importância para a de menor importância. Entre as palavras evocadas as que mais se repetiram foram medo, morte e tratamento, tristeza e cura. Evidenciando, portanto, o temor que o paciente sente frente o câncer. Na quinta linha de palavras os termos mais evocados foram cura, fé, Deus, esperança. No início do tratamento, o paciente encontra-se temeroso diante de uma doença que ainda tem uma repercussão psicossocial importante no seu dia-a-dia. A terapêutica oncológica realizada com qualidade e eficiência, por profissionais qualificados que assistem o paciente em todas as suas dimensões que conhecem partes de seus sentimentos durante o tratamento, pode auxiliar na redução do sofrimento e diminuir os impactos físicos e psíquicos no paciente