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Instituto Nacional de Salud Pública

2003, Number 6

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salud publica mex 2003; 45 (6)

Frequency of mycoses in immunosuppressed patients in a regional hospital in Mexico City

Hernández-Hernández F, Córdova-Martínez E, Manzano-Gayosso P, López-Alvarez R, Bazán-Mora E, López-Martínez R

Language: Spanish
References: 69
Page: 455-460
PDF size: 93.03 Kb.


ABSTRACT

Objective. To isolate and identify the fungi in specimens collected from immunocompromised patients seen in Mexico City hospital, and to assess their association with mycosis. Material and Methods. A total of 268 specimens from 108 patients were processed for mycological study, including direct examination, smears, cultures, and microcultures in specific media, in addition to biochemical tests. Most of the patients had been diagnosed with pulmonary tuberculosis and Acquired Immunodeficiency Syndrome (AIDS). Results. One hundred and eighty-three yeasts and 66 mycelial fungi were isolated. Forty-five mycoses were diagnosed; the most frequent mycosis was pulmonary candidosis (32 cases). Candida albicans and C parapsilosis were the predominant species associated with mycotic infection. Five Cryptococcus neoformans var. neoformans, one C albidus, three Histoplasma capsulatum and one Geotrichum candidum isolats were associated with mycosis. Conclusions. Of the studied patients, 41.6% showed a mycotic infection, principally associated with AIDS and pulmonary tuberculosis.


REFERENCES

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  2. Rüchel R. Mycotic infections in the immunocompromised patient. Rev Iberoam Micol 1996;13:S20-S24.

  3. López-Martínez R. Las micosis en la época del SIDA. Rev Med Inst Mex Seguro Soc 2000;38:421-423.

  4. Van den Saffele JK, Boelaert JR. Zygomicosis in HIV-positive patients: A review of the literature. Mycoses 1995;39:77-84.

  5. Coleman DC, Rinaldi MG, Haynes KA, Rex JH, Summerbell RC, Anaissie EJ et al. Importance of Candida species other than Candida albicans as opportunistic pathogens. Med Mycol 1998;36 (Suppl 1):156-165.

  6. Warnock DW. Immunological and other defects predisposing to fungal infection in the compromised host. En: Warnock DW, Ed. Fungal infection in the compromised patient. Nueva York (NY): John Wiley & Sons, 1982:29-48.

  7. Méndez-Tovar LJ, López-Martínez R, Macotela-Ruiz E, Manzano-Gayosso P, Serrano-Jaen L, Carmona-Castañón A et al. Variación en la frecuencia de micosis en México. Rev Argen Microbiol 1999;31:107-113.

  8. Casanova CL, Ruiz OI. Histoplasma capsulatum en sangre periférica de pacientes con SIDA. Informe de cuatro casos con elevación de deshidrogenasa láctica. Rev Invest Clin 1993;45:67-70.

  9. Esandi ME, Díaz E, Rello J. Significado de los aislamientos de Candida spp., Aspergillus spp. en muestras obtenidas con fibrobroncoscopio de pacientes no neutropénicos con infiltrados pulmonares. Rev Iberoam Micol 1999; 16:1-3.

  10. Pfaller MA, Herwald L. The clinical microbiology laboratory and infection control: Emerging pathogens, antimicrobial resistance, and new technology. Clin Infect Dis 1997;25:858-870.

  11. Castañón-Olivares LR, Arreguín-Espinosa R, Ruiz-Palacios SG, López-Martínez R. Frequency of Cryptococcus species and varieties in Mexico and their comparison with some Latin American countries. Rev Latinoam Microbiol 2000; 42:35-40.

  12. Walsh TJ, Pizzo PA. Laboratory diagnosis of candidiasis. En: Bodey GP, Ed. Candidiasis: Pathogenesis, diagnosis, and treatment. 2nd ed. Nueva York (NY): Raven Press, 1993:109-130.

  13. López-Martínez R, Méndez-Tovar LJ, Hernández-Hernández F, Castañón-Olivares LR. Micología médica. Procedimientos para el diagnóstico de laboratorio. México, DF: Trillas, 1995:83-129.

  14. Looder J. The yeasts. A taxonomic study. 2nd ed. Amsterdam:North Holland Publishing Company, 1970.

  15. Staib F. Cryptococcus neoformans und Guizotia abyssinica (syn. G. oleifera) Farbreaktion fhr C. neoformans. Z Hyg 1962;148:466-475.

  16. Kwon-Chung KJ, Polachek I, Bennett JE. Improved diagnostic medium for separation of Cryptococcus neoformans var neoformans (serotype A and D) and Cryptococcus neoformans var gattii (serotype B and C). J Clin Microbiol 1982;15:535-537.

  17. Staib P, Morschhäuser J. Chlamydospore formation on Staib agar as a species-specific characteristic of Candida dubliniensis. Mycoses 1999; 42:521-524.

  18. Pitt JI. The genus Penicillium and its teleomorphic states Eupenicillium and Talaromyces. Nueva York (NY):Academic Press, 1979.

  19. Raper KB, Fennell DI. The genus Aspergillus. Baltimore (MD): William & Wilkins,1965.

  20. Samson RA, Hoekstra ES, Van Oorschot CA. Introduction to foodborne fungi. 2nd ed. The Netherlands: Centraalbureau Voor Schimmelcultures, 1984.

  21. Zumla A, Squire SB, Chintu C, Grange JM. The tuberculosis pandemic: Implications for health in the tropics. Trans R Soc Trop Med Hyg 1999;93:113-117.

  22. García-García ML, Valdespino-Gómez JL, García-Sancho MC, Salcedo-Alvarez RA, Zacarías F, Sepúlveda-Amor J. Epidemiology of AIDS and tuberculosis. Bull Pan Am Health Organ 1995;29:37-58.

  23. Pfaller M. Epidemiology and control of fungal infections. Clin Infect Dis 1994;19 (Suppl 1):S8-S13.

  24. Vargas-Montiel IL, Vargas-Caminos N, Molero M, Urbina M, Urdaneta A. Candida in biological human samples. Rev Invest Clin 1999;40:245-255.

  25. Staib F, Arastéh K. Chlamydospore formation on Staib agar. Observations made before Candida dubliniensis was described. Mycoses 2001; 44:23-27.

  26. Jabra-Rizk MA, Baqui AAMA, Kelly JI, Falkler WA, Merz WG, Meiller TF. Identification of Candida dubliniensis in a prospective study of patients in the United States. J Clin Microbiol 1999;37:321-326.

  27. Kamei K, McCullough MJ, Stevens DA. Initial case of Candida dubliniensis infection from Asia: Non-mucosal infection. Med Mycol 2000;38:81-83.

  28. Ruhnke M, Schmidt-Westhausen A, Morschhäuser J. Development of simultaneous resistance to fluconazole in Candida albicans and Candida dubliniensis in a patient with AIDS. J Antimicrob Chemother 2000;46:291-295.

  29. Krumholz R. Pulmonary cryptococcosis. A case due to Cryptococcus albidus. Am Rev Respir Dis 1972;105:421-424.

  30. Kordossis T, Avlami A, Velegraki A, Stefanou I, Georgakopoulos G, Papalambrou C et al. First report of Cryptococcus laurentii meningitis and a fatal case of Cryptococcus albidus cryptococcaemia in AIDS patients. Med Mycol 1998;36:335-339.

  31. Miyagawa T, Hamagami S, Tanigawa N. Cryptococcus albidus-induced 2000;161:961-966.

  32. Vanden-Bossche H, Dromer F, Improvisi I, Lozano-Chiu M, Rex JH, Sanglard D. Antifungal drug resistance in pathogenic fungi. Med Mycol 1998;36 (Suppl 1):119-128.

  33. Singh N. Trends in the epidemiology of opportunistic fungal infections: Predisposing factors and the impact of antimicrobial use practices. Clin Infect Dis 2001;33:1692-1696.

  34. Rees JR, Pinner RW, Hajjeh RA, Brandt ME, Reingold AL. The epidemiological features of invasive mycotic infections in the San

  35. Francisco Bay Area, 1992-1993: Results of population-based laboratory active surveillance. Clin Infect Dis 1998;27:1138-1147. summer-type hypersensitivity pneumonitis. Am J Respir Crit Care Med.

  36. Fridkin SK, Jarvis WR. Epidemiology of nosocomial fungal infections. Clin Microbiol Rev 1996;9:499-511.

  37. Rüchel R. Mycotic infections in the immunocompromised patient. Rev Iberoam Micol 1996;13:S20-S24.

  38. López-Martínez R. Las micosis en la época del SIDA. Rev Med Inst Mex Seguro Soc 2000;38:421-423.

  39. Van den Saffele JK, Boelaert JR. Zygomicosis in HIV-positive patients: A review of the literature. Mycoses 1995;39:77-84.

  40. Coleman DC, Rinaldi MG, Haynes KA, Rex JH, Summerbell RC, Anaissie EJ et al. Importance of Candida species other than Candida albicans as opportunistic pathogens. Med Mycol 1998;36 (Suppl 1):156-165.

  41. Warnock DW. Immunological and other defects predisposing to fungal infection in the compromised host. En: Warnock DW, Ed. Fungal infection in the compromised patient. Nueva York (NY): John Wiley & Sons, 1982:29-48.

  42. Méndez-Tovar LJ, López-Martínez R, Macotela-Ruiz E, Manzano-Gayosso P, Serrano-Jaen L, Carmona-Castañón A et al. Variación en la frecuencia de micosis en México. Rev Argen Microbiol 1999;31:107-113.

  43. Casanova CL, Ruiz OI. Histoplasma capsulatum en sangre periférica de pacientes con SIDA. Informe de cuatro casos con elevación de deshidrogenasa láctica. Rev Invest Clin 1993;45:67-70.

  44. Esandi ME, Díaz E, Rello J. Significado de los aislamientos de Candida spp., Aspergillus spp. en muestras obtenidas con fibrobroncoscopio de pacientes no neutropénicos con infiltrados pulmonares. Rev Iberoam Micol 1999; 16:1-3.

  45. Pfaller MA, Herwald L. The clinical microbiology laboratory and infection control: Emerging pathogens, antimicrobial resistance, and new technology. Clin Infect Dis 1997;25:858-870.

  46. Castañón-Olivares LR, Arreguín-Espinosa R, Ruiz-Palacios SG, López-Martínez R. Frequency of Cryptococcus species and varieties in Mexico and their comparison with some Latin American countries. Rev Latinoam Microbiol 2000; 42:35-40.

  47. Walsh TJ, Pizzo PA. Laboratory diagnosis of candidiasis. En: Bodey GP, Ed. Candidiasis: Pathogenesis, diagnosis, and treatment. 2nd ed. Nueva York (NY): Raven Press, 1993:109-130.

  48. López-Martínez R, Méndez-Tovar LJ, Hernández-Hernández F, Castañón-Olivares LR. Micología médica. Procedimientos para el diagnóstico de laboratorio. México, DF: Trillas, 1995:83-129.

  49. Looder J. The yeasts. A taxonomic study. 2nd ed. Amsterdam: North Holland Publishing Company, 1970.

  50. Staib F. Cryptococcus neoformans und Guizotia abyssinica (syn. G. oleifera) Farbreaktion fhr C. neoformans. Z Hyg 1962;148:466-475.

  51. Kwon-Chung KJ, Polachek I, Bennett JE. Improved diagnostic medium for separation of Cryptococcus neoformans var neoformans (serotype A and D) and Cryptococcus neoformans var gattii (serotype B and C). J Clin Microbiol 1982;15:535-537.

  52. Staib P, Morschhäuser J. Chlamydospore formation on Staib agar as a species-specific characteristic of Candida dubliniensis. Mycoses 1999; 42:521-524.

  53. Pitt JI. The genus Penicillium and its teleomorphic states Eupenicillium and Talaromyces. Nueva York (NY): Academic Press, 1979.

  54. Raper KB, Fennell DI. The genus Aspergillus. Baltimore (MD): William & Wilkins,1965.

  55. Samson RA, Hoekstra ES, Van Oorschot CA. Introduction to foodborne fungi. 2nd ed. The Netherlands: Centraalbureau Voor Schimmelcultures, 1984.

  56. Zumla A, Squire SB, Chintu C, Grange JM. The tuberculosis pandemic: Implications for health in the tropics. Trans R Soc Trop Med Hyg 1999;93:113-117.

  57. García-García ML, Valdespino-Gómez JL, García-Sancho MC, Salcedo-Alvarez RA, Zacarías F, Sepúlveda-Amor J. Epidemiology of AIDS and tuberculosis. Bull Pan Am Health Organ 1995;29:37-58.

  58. Pfaller M. Epidemiology and control of fungal infections. Clin Infect Dis 1994;19 (Suppl 1):S8-S13.

  59. Vargas-Montiel IL, Vargas-Caminos N, Molero M, Urbina M, Urdaneta A. Candida in biological human samples. Rev Invest Clin 1999;40:245-255.

  60. Staib F, Arastéh K. Chlamydospore formation on Staib agar. Observations made before Candida dubliniensis was described. Mycoses 2001; 44:23-27.

  61. Jabra-Rizk MA, Baqui AAMA, Kelly JI, Falkler WA, Merz WG, Meiller TF. Identification of Candida dubliniensis in a prospective study of patients in the United States. J Clin Microbiol 1999;37:321-326.

  62. Kamei K, McCullough MJ, Stevens DA. Initial case of Candida dubliniensis infection from Asia: Non-mucosal infection. Med Mycol 2000;38:81-83.

  63. Ruhnke M, Schmidt-Westhausen A, Morschhäuser J. Development of simultaneous resistance to fluconazole in Candida albicans and Candida dubliniensis in a patient with AIDS. J Antimicrob Chemother 2000;46:291-295.

  64. Krumholz R. Pulmonary cryptococcosis. A case due to Cryptococcus albidus. Am Rev Respir Dis 1972;105:421-424.

  65. Kordossis T, Avlami A, Velegraki A, Stefanou I, Georgakopoulos G, Papalambrou C et al. First report of Cryptococcus laurentii meningitis and a fatal case of Cryptococcus albidus cryptococcaemia in AIDS patients. Med Mycol 1998;36:335-339.

  66. Miyagawa T, Hamagami S, Tanigawa N. Cryptococcus albidus-induced 2000;161:961-966.

  67. Vanden-Bossche H, Dromer F, Improvisi I, Lozano-Chiu M, Rex JH, Sanglard D. Antifungal drug resistance in pathogenic fungi. Med Mycol 1998;36 (Suppl 1):119-128.

  68. Singh N. Trends in the epidemiology of opportunistic fungal infections: Predisposing factors and the impact of antimicrobial use practices. Clin Infect Dis 2001;33:1692-1696.

  69. Rees JR, Pinner RW, Hajjeh RA, Brandt ME, Reingold AL. The epidemiological features of invasive mycotic infections in the San Francisco Bay Area, 1992-1993: Results of population-based laboratory active surveillance. Clin Infect Dis 1998;27:1138-1147. summer-type hypersensitivity pneumonitis. Am J Respir Crit Care Med.




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