Rhizopus is fungus of the order Mucorales, responsible for invasive diseases called mucormycosis. The correct identification of these fungi is one of the main questions raised in the literature since the diagnosis is ...Rhizopus is fungus of the order Mucorales, responsible for invasive diseases called mucormycosis. The correct identification of these fungi is one of the main questions raised in the literature since the diagnosis is not simple, being the necessary detection in biopsies of infected tissues and isolation of the microorganism for identification by morphological and molecular methods. In vitro susceptibility testing results are not fully clear since there are reports showing that in vitro resistance does not always mean therapeutic failure. This paper describes a case of rhino-orbito-cerebral mucormycosis in a patient with alcoholic chronic pancreatitis and secondary mellitus diabetes involving microbiological diagnostic, antifungal susceptibility tests for conidia and hypha and clinical correlation. The causative agent was identified by morphological characteristics and DNA sequencing. Minimal Inhibitory Concentration (MIC) for amphotericin B (AMB), itraconazole (ITZ) and terbinafine (TERB) was determined by broth microdilution method. Standardization of the dynamic growth evaluation patterns using the automated system BCT (BioCell-Tracer?) was obtained allowing to determining hyphae growth control and evaluating the effect of different concentrations of amphotericin B, itraconazole and terbinafine directly on growing hyphae. The fractional inhibitory concentration (FIC) for the combination of the two antifungals that the patient received at the same time, terbinafine and itraconazole, was also determined trying to correlate with clinical outcome. Strains isolated of retro-orbital abscess were identified as Rhizopus oryzae. MIC results (MIC) testing conidia showed high sensibility to amphotericin B and itraconazole in comparison to the obtained for terbinafine. The tests in the automated system BCT using hyphae showed sensibility to all tested antifungal agents and the FIC results for combination in vitro between terbinafine and itraconazole showed synergism consistent with the therapeutic success obtained for the patient who received initial treatment with amphotericin B followed for maintenance treatment with the combination itraconazole and展开更多
The percentage of diabetic patients with contaminated lesions increases from 3% to 10%. Treatment with herbal products shows benefits in their use, as well as antioxidant and antifungal activities. Objective: to evalu...The percentage of diabetic patients with contaminated lesions increases from 3% to 10%. Treatment with herbal products shows benefits in their use, as well as antioxidant and antifungal activities. Objective: to evaluate the antimicrobial action of 10% banana peel gel and the contraction of diabetic and venous wounds. Methods: individual, analytical, interventional, longitudinal, prospective, randomized study from February to December 2015. Five patients were included in the study;3 with venous ulcer and 2 with diabetic wound. Application of 10% green banana peel gel and weekly samples were performed. After six days, the second collection was performed. The samples were seeded in the Mannitol salt agar culture medium, MacConkey agar and Saboraund agar with chloramphenicol for isolation of cocci and Gram-positive and Gram-negative bacilli;and fungi. The total counts of bacteria were determined by PCA (Plate Count Agar) and measurement of the lesion margin. There was a reduction of microorganisms with the use of the gel in 53.57% of the patients, and reduction of wound areas in 48.1%.展开更多
文摘Rhizopus is fungus of the order Mucorales, responsible for invasive diseases called mucormycosis. The correct identification of these fungi is one of the main questions raised in the literature since the diagnosis is not simple, being the necessary detection in biopsies of infected tissues and isolation of the microorganism for identification by morphological and molecular methods. In vitro susceptibility testing results are not fully clear since there are reports showing that in vitro resistance does not always mean therapeutic failure. This paper describes a case of rhino-orbito-cerebral mucormycosis in a patient with alcoholic chronic pancreatitis and secondary mellitus diabetes involving microbiological diagnostic, antifungal susceptibility tests for conidia and hypha and clinical correlation. The causative agent was identified by morphological characteristics and DNA sequencing. Minimal Inhibitory Concentration (MIC) for amphotericin B (AMB), itraconazole (ITZ) and terbinafine (TERB) was determined by broth microdilution method. Standardization of the dynamic growth evaluation patterns using the automated system BCT (BioCell-Tracer?) was obtained allowing to determining hyphae growth control and evaluating the effect of different concentrations of amphotericin B, itraconazole and terbinafine directly on growing hyphae. The fractional inhibitory concentration (FIC) for the combination of the two antifungals that the patient received at the same time, terbinafine and itraconazole, was also determined trying to correlate with clinical outcome. Strains isolated of retro-orbital abscess were identified as Rhizopus oryzae. MIC results (MIC) testing conidia showed high sensibility to amphotericin B and itraconazole in comparison to the obtained for terbinafine. The tests in the automated system BCT using hyphae showed sensibility to all tested antifungal agents and the FIC results for combination in vitro between terbinafine and itraconazole showed synergism consistent with the therapeutic success obtained for the patient who received initial treatment with amphotericin B followed for maintenance treatment with the combination itraconazole and
文摘The percentage of diabetic patients with contaminated lesions increases from 3% to 10%. Treatment with herbal products shows benefits in their use, as well as antioxidant and antifungal activities. Objective: to evaluate the antimicrobial action of 10% banana peel gel and the contraction of diabetic and venous wounds. Methods: individual, analytical, interventional, longitudinal, prospective, randomized study from February to December 2015. Five patients were included in the study;3 with venous ulcer and 2 with diabetic wound. Application of 10% green banana peel gel and weekly samples were performed. After six days, the second collection was performed. The samples were seeded in the Mannitol salt agar culture medium, MacConkey agar and Saboraund agar with chloramphenicol for isolation of cocci and Gram-positive and Gram-negative bacilli;and fungi. The total counts of bacteria were determined by PCA (Plate Count Agar) and measurement of the lesion margin. There was a reduction of microorganisms with the use of the gel in 53.57% of the patients, and reduction of wound areas in 48.1%.
