Candida africana taxonomical status is controversial. It was proposed as a separate species within the Candida albicans species complex; however, phylogenetic analyses suggested that it is an unusual variety of C. albicans. The prevalence of C. albicans-related species (Candida dubliniensis and C. africana) as vulvovaginal pathogens is not known in Argentina. Moreover, data on antifungal susceptibility of isolates causing vulvovaginal candidiasis is scarce. The aims of this study were to establish the prevalence of C. dubliniensis and C. africana in vaginal samples and to evaluate the antifungal susceptibilities of vaginal C. albicans species complex strains. We used a molecular-based method coupled with a new pooled DNA extraction methodology to differentiate C. dubliniensis and C. africana in a collection of 287 strains originally identified as C. albicans isolated from an Argentinian hospital during 2013. Antifungal susceptibilities to fluconazole, clotrimazole, itraconazole, voriconazole, nystatin, amphotericin B and terbinafine were evaluated by using the CLSI M27-A3 and M27-S4 documents. Of the 287 isolates, 4 C. dubliniensis and one C. africana strains (1.39% and 0.35% prevalence, respectively) were identified. This is the first description of C. africana in Argentina and its identification was confirmed by sequencing the ITS2 region and the hwp1 gene. C. dubliniensis and C. africana strains showed very low MIC values for all the tested antifungals. Fluconazole-reduced-susceptibility and azole cross-resistance were observed in 3.55% and 1.41% of the C. albicans isolates, respectively. These results demonstrate that antifungal resistance is still a rare phenomenon in this kind of isolates.
Vulvovaginal candidiasis is one of the most common mycosis. However, the information about antifungal susceptibilities of the yeasts causing this infection is scant. We studied 121 yeasts isolated from 118 patients with vulvovaginal candidiasis. The isolates were identified by phenotypic and molecular methods, including four phenotypic methods described to differentiate Candida albicans from C. dubliniensis. Antifungal susceptibility testing was performed according to CLSI documents M27A3 and M27S4 using the drugs available as treatment option in the hospital. Diabetes, any antibacterial and amoxicillin treatment were statistically linked with vulvovaginal candidiasis, while oral contraceptives were not considered a risk factor. Previous azole-based over-the-counter antifungal treatment was statistically associated with non-C.albicans yeasts infections. The most common isolated yeast species was C. albicans (85.2 %) followed by C. glabrata (5 %), Saccharomyces cerevisiae (3.3 %), and C. dubliniensis (2.5 %). Fluconazole- and itraconazole-reduced susceptibility was observed in ten and in only one C. albicans strains, respectively. All the C. glabrata isolates showed low fluconazole MICs. Clotrimazole showed excellent potency against all but seven isolates (three C. glabrata, two S. cerevisiae, one C. albicans and one Picchia anomala). Any of the strains showed nystatin reduced susceptibility. On the other hand, terbinafine was the less potent drug. Antifungal resistance is still a rare phenomenon supporting the use of azole antifungals as empirical treatment of vulvovaginal candidiasis.
e333using PapilloCheck (Greiner Bio-One), which evaluates 24 different HPV genotypes (18 high-risk and 6 low risk).Results: Positivity were 38,37% and 72.1% for cervical cytology and penile lesion biopsies, respectively. Multiple infections account for 41,5% in cervical cytology, and 61.3% in penile lesion biopsies. Of 1311 found viruses in cervical cytilogy, 73,7% were high risk, and of 68 found viruses in penile lesion biopsies 42.6% were high risk.In cervical cytology, positivity (P < 0,0001) and high risk genotypes (P = 0,0087) increased with the degree of cell injury. Moreover, the seven most common genotypes in normal cervical cytology were 16Additionally, hyperkeratosis (P = 0.003), irregular acanthosis (P = 0.003), and papillomatosis (P = 0.037) were associated with HPV in penile lesion biopsies. On the other hand, parakeratosis (P = 0.046), koilocitotic atypia (P < 0.0001), hyperplasia (P = 0.024) and loss of basal polarity (P = 0.024) were more prevalent in multiple infections than in simple.Conclusion: There are differences in positivity, multiple infections, and high risk genotypes prevalence between cervical cytology and penile lesions. Also, proportion of positivity and high risk genotypes increase with degree of cell injury in cervical cytology. Some cellular/hystological changes are significantly associated with HPV and multiple infections in penile lesion biopsies. http://dx.
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