scholarly journals Pharmaceutical care in the context of an Extension Project to care for patients with vaginal candidiasis with the strategy of carrying out antifungal resistance testing and community health prevention

2020 ◽  
Vol 13 (9) ◽  
pp. 91
Author(s):  
M. L. Menz ◽  
L. N. Calil ◽  
F. M. Bittencourt ◽  
A. Mezzari
Keyword(s):  
Pharmaceutical Care ◽  
Inhibitory Concentration ◽  
Correct Diagnosis ◽  
Antifungal Resistance ◽  
Vaginal Candidiasis ◽  
Resistance Testing ◽  
Candida Spp ◽  
Susceptibility Tests

Vaginal candidiasis, fungal infection caused by species of Candida spp. that affects women of all ages, cultures, habits, social and economic conditions. Its frequency and epidemiology is already reported, but resistance and therapeutic failures have been recorded. Methodology: In the Laboratory of Clinical and Toxicological Analyzes of the Faculty of Pharmacy of UFRGS (LACT), cervicovaginal collections of women were performed for Candida research and determination of species, after which susceptibility tests were performed to fluconazole, itraconazole, ketoconazole and nystatin. With the results obtained complement with the Pharmaceutical Care Project. Results: C. albicans was identified in 37% and in non-albicans species, C. glabrata in 27%. C. albicans was more sensitive to antifungals than C. glabrata, which presented a minimum inhibitory concentration (MIC) higher than C. albicans. Conclusion: Antifungal resistance has increased due to the use in prophylaxis and treatments without the correct diagnosis, requiring a more careful look at these patients. Thus, it is necessary to follow up the diagnosis and treatment by the health professional, the pharmacist, who has knowledge of the drug therapy used and this is obtained by the Pharmaceutical Care acting in the Project.

scholarly journals Identification of female genital tract infectious agents in patients treated for cytopathological diagnosis

2020 ◽  
Vol 13 (9) ◽  
pp. 80
Author(s):  
J. S. Borges ◽  
V. M. Giudice ◽  
R. N. Leandro ◽  
K. V. Martinez ◽  
L. P. R. Silva ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Correct Diagnosis ◽  
Female Genital Tract ◽  
Positive Culture ◽  
Epidemiological Data ◽  
Vaginal Candidiasis ◽  
Yeast Culture ◽  
Infectious Agents ◽  
Candida Spp ◽  
Vaginal Sample

Vaginal candidiasis, fungal infection caused by species of Candida spp. that affects women of all ages, cultures, habits, social and economic conditions. The present study had as its main objective to determine the identification of Candida spp. isolated in a vaginal sample, collected together with the collection for the cytopathological exam, in women treated in a university extension project, aiming at allowing a suitable therapeutics afterwards. The extension project began in January 2014 to June 2019 at the UFRGS. The patients who sought the Laboratory of Clinical and Toxicological Analysis (LACT) of the Faculty of Pharmacy of UFRGS first answered a questionnaire to obtain epidemiological data. Cytopathological diagnosis, Papanicolao smear, and presence of Candida spp. yeast, culture and identification and Trichomonas vaginalis, light microscopy. During the study period, 227 patients, 25.11%, aged 15 to 82 years, presented positive culture for Candida spp. Six species were identified, C. albicans (40.35%), C. glabrata (28.07%) and C. parapsilosis, 15.79%. C. krusei, C. guilliermondii and C. tropicalis totaled (15.79%). Regarding the inflammatory process, present in 49.12%, in C. krusei (75%) and C. guilliermondii (100%), and absence in C. tropicalis. The correct diagnosis and treatment of patients with vaginal candidiasis, even if not considered sexually transmitted, enables to prevent contamination through direct contact, sexual or otherwise, with other individuals and the improvement of self-esteem and quality of life. The prevalence of Candida albicans is still the main cause of vaginal candidiasis, but not neglecting the increase in the number of cases associated with non-albicans species, as well as other infectious agents such as Trichomonas vaginalis, and bacteria. 

scholarly journals Prevalence and Antifungal Susceptibility of Candida albicans Causing Vulvovaginitis Among Pregnant Women in Lebanon

2019 ◽  
Author(s):  
Nahed Ghaddar ◽  
Elie Anastasiadis ◽  
Rawad Halimeh ◽  
Ali Ghaddar ◽  
Rita Dhar ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Pregnant Women ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Test Method ◽  
Neonatal Outcomes ◽  
Vaginal Candidiasis ◽  
Adverse Neonatal Outcomes ◽  
Susceptibility Tests

Abstract Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 12 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results: Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42%, 41% and 17% of the women, respectively. C. albicans had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. The antifungal susceptibility tests of C. albicans isolates revealed 97.5%, 90%, 87.5% and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. . Conclusion: The current study revealed high incidence of both C. albicans and non-C. albicans strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.

scholarly journals Prevalence and Antifungal Susceptibility of Candida albicans Causing Vulvovaginitis Among Pregnant Women in Lebanon

2019 ◽  
Author(s):  
Nahed Ghaddar ◽  
Elie Anastasiadis ◽  
Rawad Halimeh ◽  
Ali Ghaddar ◽  
Rita Dhar ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Pregnant Women ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Test Method ◽  
Neonatal Outcomes ◽  
Vaginal Candidiasis ◽  
Adverse Neonatal Outcomes ◽  
Susceptibility Tests

Abstract Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 12 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results: Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42%, 41% and 17% of the women, respectively. C. albicans had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. The antifungal susceptibility tests of C. albicans isolates revealed 97.5%, 90%, 87.5% and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. . Conclusion: The current study revealed high incidence of both C. albicans and non-C. albicans strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.

scholarly journals Molecular Characterization and Antifungal Susceptibility of Candida Species Isolated From Vulvovaginitis in Jahrom City, South of Iran

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Gholamreza Shokoohi ◽  
Athar Rasekh-Jahromi ◽  
Kavous Solhjoo ◽  
Arash Hasannezhad ◽  
Sadegh Nouripour-Sisakht ◽  
...  
Keyword(s):  
Molecular Identification ◽  
Candida Species ◽  
Geometric Mean ◽  
Antifungal Susceptibility ◽  
Vulvovaginal Candidiasis ◽  
Vaginal Candidiasis ◽  
Candida Spp ◽  
Mean Values ◽  
Susceptibility Tests ◽  
Identification Techniques

Background: Vulvovaginal candidiasis (VVC) is a significant health issue due to Candida spp. Although Candida albicans is considered a major causative agent of vaginal candidiasis, non-albicans species have increased during previous decades. Objectives: This research aimed at molecular identification and assessing antifungal susceptibility of VVC isolated Candida spp. Methods: A professional physician examined two hundred and ninety-five suspected females with vaginitis. The specimens were collected by sterile cotton swabs. Swabs were inoculated on Sabouraud dextrose agar plates and then incubated for 48 - 72 hours at 35°C. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect all Candida species. Broth microdilution, according to the M27-A3 and M27-S4 CLSI documents, were employed for determining the antifungal susceptibility tests of caspofungin (CAS), voriconazole (VRC), itraconazole (ITC), fluconazole (FLU), clotrimazole (CLO), ketoconazole (KTO), amphotericin B (AMB), and nystatin (NYS). Results: A total of 295 females suspected of vulvovaginal candidiasis were examined. The culture results were positive in 50.5% (149 of 295) of specimens. According to molecular identification techniques, C. albicans 133/149 (89.2%), C. glabrata 8/149 (5.4%), and C. kefyr 2/149 (1.4%) were the main species. A mixed infection of C. albicans and C. glabrata 6/149 (4 %) was detected. The geometric mean values to all Candida strains were in increasing order as the following: CAS, 0.075 µg/mL; VRC, 0.091 µg/mL; ITC, 0.15 µg/mL; AMB, 0.22 µg/mL; CLO, 0.23 µg/mL; KTO, 0.28 µg/mL; NYS, 0.88 µg/mL; FLU, 1.48 µg/mL. Further, the MIC ranges of all Candida isolates to the tested antifungal agents were in increasing order as follows: CAS: 0.031 - 0.25 µg/mL, KTO and ITC: 0.031 - 2 µg/mL, VRC: 0.031 - 4 µg/mL, CLO and AMB: 0.031 - 8 µg/mL, NYS: 0.06 - 4 µg/mL, and FLU: 0.12 - 128 µg/mL. Conclusions: We reported 1 (7.2 %) C. glabrata isolate resistance to FLU and 2 (14.3%) C. glabrata isolates susceptible-dose-dependent (SDD) to CAS. We also reported 6 (4.5%), 5 (3.8%), and 2 (1.5%) C. albicans resistance to ITC, FLU, and AMB, respectively, but 100% C. albicans susceptible to CAS and VRC.

scholarly journals Pancreatic carcinoma: The contribution of CA 19-9 to the enhancement of diagnostic precision of imaging techniques

2003 ◽  
Vol 11 (3) ◽  
pp. 219-219
Author(s):  
Jasna Trifunovic ◽  
Ljubomir Muzikravic ◽  
Mladen Prvulovic ◽  
Svetlana Salma ◽  
Borislava Nikolin ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Carcinoma ◽  
Imaging Techniques ◽  
Correct Diagnosis ◽  
False Negative ◽  
Focal Lesions ◽  
Disease Staging ◽  
Pancreatic Pathology

Background: Ultrasonography (US) and magnetic resonance (MR) are the most important imaging techniques in the diagnostics of pancreatic carcinoma and disease staging; they are also very useful in monitoring and follow-up of treatment efficacy. The problems with imaging diagnostics arise in certain cases of pancreatic focal lesions - for example in the differentiation of focal chronic pancreatitis and pancreatic carcinoma. Our objectives were the evaluation of US and MR reliability and determination of the importance of oncomarker CA 19-9 in the diagnostics of pancreatic carcinoma. Methods: Our investigation included patients with pancreatic focal mass suspected of malignancy. All patients were examined by ultrasonography, MR, and ultrasound-guided needle biopsy. Cytopathologic examination of the bioptic samples was used to diagnose the disease. Oncomarker CA 19-9 was done in all patients. Results: MR imaging and US examination made possible the correct diagnosis of carcinoma in case of 17 patients; in three patients with focal chronic pancreatitis the diagnosis was false positive. No case of false negative diagnosis was found. The value of oncomarker CA 19-9 was determined and it was clearly positive (over 150 U/ml) in all patients. Conclusion Imaging techniques gave good results in the evaluation of pancreatic pathology. However, when using imaging techniques differential diagnosis between focal chronic pancreatitis and pancreatic carcinoma seems to be major problem. Correlation of imaging technique and identification of CA 19-9 has an important role in the diagnostics of pancreatic carcinoma. Imaging techniques and identification of oncomarker CA 19-9 are complementary methods in the examination and diagnostics of pancreatic carcinoma and they allow better precision of diagnosis of pancreatic focal lesions.

scholarly journals The activity of micafungin against clinical isolates of non-albicans Candida spp.

2015 ◽  
Vol 28 (1) ◽  
pp. 13-16
Author(s):  
Anna Biernasiuk ◽  
Ewelina Dobiecka ◽  
Grazyna Zdzienicka ◽  
Anna Malm
Keyword(s):  
Minimal Inhibitory Concentration ◽  
Inhibitory Concentration ◽  
Test Procedure ◽  
Risk Groups ◽  
Medical Problem ◽  
Clinical Isolates ◽  
In Vitro Activity ◽  
Candida Spp

Abstract Infections caused by non-albicans Candida spp. are an important medical problem in people from risk groups, e.g. hematooncological patients. The aim of this paper was to analyse the in vitro activity of micafungin against 30 clinical isolates of non-albicans Candida spp. (C. glabrata, C. famata, C. tropicalis, C. inconspicua, C. lusitaniae, C. parapsilosis, C. krusei) by way of the E-test procedure, allowing determination of minimal inhibitory concentration (MIC). Data presented in this paper indicate that most of the studied clinical isolates - 27 (90%) showed sensitivity to micafungin, with MIC values ranging from 0.004 to 2 mg/l, while 3 (10%) isolates, including 2 isolates of C. tropicalis and 1 isolate of C. famata, were resistant to micafungin, with MIC values > 32 mg/l. The MIC50 and MIC90 values of micafungin, defined as MIC inhibited growth of 50% or 90% of the isolates studied, were 0.008 mg/l or 2 mg/l, respectively. In the case of C. glabrata isolates, MICs ranged from 0.004 to 0.016 mg/l, while MIC50 was 0.004 mg/l and MIC90 - 0.008 mg/l. Our data confirm the utility of micafungin for the therapy of the infections caused by non-albicans Candida spp., especially C. glabrata.

scholarly journals The accuracy of four commercial broth microdilution tests in the determination of the minimum inhibitory concentration of colistin

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Erlangga Yusuf ◽  
Mireille van Westreenen ◽  
Wil Goessens ◽  
Peter Croughs
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Antimicrobial Susceptibility ◽  
Inhibitory Concentration ◽  
Clinical Isolates ◽  
Reference Standard ◽  
Broth Microdilution ◽  
Antimicrobial Susceptibility Tests ◽  
Susceptibility Tests ◽  
Composite Reference Standard

Abstract Colistin is considered as one of the last-resort antibiotics and reliable antimicrobial susceptibility testing is therefore crucial. The reference standard for AST according to EUCAST and CLSI is broth microdilution (BMD). However, BMD is labor intensive to perform. Commercial antimicrobial susceptibility tests derived from BMD method are available. We investigated the performance of four different commercial tests: Sensititre™, SensiTest™ Colistin, Micronaut MIC Strip Colistin and UMIC Colistin using 70 clinical isolates (half of them was deemed by VITEK2 as resistant), including isolates from cystic fibrosis patients and mcr-1 bearing isolates. We used two reference standards: BMD and composite MIC as determined by all four tests. Sensititre™ had essential agreement (EA, defined as minimum inhibitory concentration within ± 1 dilution) of 87% and 89% compared to BMD and composite reference standard, respectively. For SensiTest™, the EA’s were 93% and 90%. For UMIC, 87% and 90%, and for Micronaut, 83% and 84%. All four tests demonstrated categorical agreement (CA) above 90%. CA for SensiTest™ and Micronaut was both 96%, UMIC 94%, and Sensititre™ 93%. All tests were reproducible as tested in two quality control isolates. In conclusion, in clinical isolates from a large referral center, the four commercial tests for determination of colistin minimum inhibitory concentrations showed acceptable performance.

scholarly journals Prevalence and Antifungal Susceptibility of Candida albicans Causing Vulvovaginitis Among Pregnant Women in Lebanon

2019 ◽  
Author(s):  
Nahed Ghaddar ◽  
Elie Anastasiadis ◽  
Rawad Halimeh ◽  
Ali Ghaddar ◽  
Rita Dhar ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Pregnant Women ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Test Method ◽  
Neonatal Outcomes ◽  
Vaginal Candidiasis ◽  
Adverse Neonatal Outcomes ◽  
Susceptibility Tests

Abstract Background: Vaginal candidiasis is frequently prevalent in pregnant women and is associated with sepsis and adverse neonatal outcomes. This study determined the presence of Candida species in symptomatic pregnant women and evaluated the antifungal susceptibility profile of the isolated strains. It also aimed to explore whether Candida species predicts gestational complications and adverse neonatal outcomes. Methods: A total of 258 pregnant women at 35 to 37 week of gestation participated in this study. Vaginal swabs from these patients were collected at various obstetrics and gynecology clinics in Lebanon for a period of 12 months. Candida isolates were identified at species level and antifungal susceptibility of Candida albicans to fluconazole (FCZ), amphotericin B (AMB), itraconazole (ICZ) and voriconazole (VCZ) was determined by the agar-based E-test method. Results: Among 258 women tested, 100 (39%) were positive for Candida species. C. albicans, C. glabrata and C. krusei were isolated from 42%, 41% and 17% of the women, respectively. C. albicans had significant positive associations with gestational diabetes while C. kreusi or C. glabrata had significant positive associations with gestational complications and vaginal discharge. The antifungal susceptibility tests of C. albicans isolates revealed 97.5%, 90%, 87.5% and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. . Conclusion: The current study revealed high incidence of both C. albicans and non-C. albicans strains causing vulvovaginitis among pregnant women in Beirut, Lebanon. Whereas the susceptibility rates of C. albicans against AMB and VCZ were high, FCZ and ICZ proved comparatively less efficacious. The resistance profile of circulating C. albicans among pregnant women can predict the best outcome of appropriate prophylaxis or treatment of neonatal candidiasis. Vaginal candida colonization might lead to adverse neonatal outcome or gestational complications thus Candida screening as antennal follow up is advised.

Extraction and Phytochemicals Determination of Traditional Medicinal Plants for Anti-microbial Susceptibility Test

2020 ◽  
Vol 2020 ◽  
Author(s):  
Firew Admasu
Keyword(s):  
Antimicrobial Activity ◽  
Medicinal Plants ◽  
Traditional Medicine ◽  
Crude Extract ◽  
Susceptibility Test ◽  
Plant Sample ◽  
Traditional Medicinal Plants ◽  
Traditional Health Care ◽  
Susceptibility Tests

Abstract: The study were conducted at Dilla University, College of Natural Sciences, Biological Sciences laboratories. Background: Ethiopia is a country with many ethnic groups, cultures and beliefs which in turn have contributed to the high diversity of traditional health care knowledge and practices of traditional medicine from local growth plants, animals and minerals for various physical and mental disorders of human and livestock population that passed from generation to generation for centuries. Medicinal plants contributors to pharmaceutical, agricultural and food industries in the world. The use of medicinal plants in the industrialized societies has been traced to extraction and development of several drugs used in order to heel some diseases having inhibiting effect against pathogenic microorganism. Objective: The main objective of this study was Extraction and Phytochemicals determination of traditional medicinal plants for anti microbial susceptibility test. Methodology: The extraction and identification of some phytochemicals crude compound which used for antimicrobial susceptibility test from plant sample such as Ocimum lamiifolium (OL), Croton maerosth (Cm) and Ruta chalepesis (RC) were conducted. Plant samples are collected, powdered using mortal and pistil and extracted using ethanol and some susceptibility tests were performed to identify some phytochemicals compound. Result: The main result of Antimicrobial activity test showed that the crude extract of OL has the highest zone of inhibition. The highest yield of crude extract (38.21%) was obtained from Croton maerosth (CM) which followed by Ruta chalepesis (RC) (32.43%). However, the lowest yield (28.37%) was obtained from Oscpmum lamifolium (OL). Conclusion: Traditional Medicine is used by many people to managing numerous conditions; it’s accessible and effective on antimicrobial activity. Therefore, it plays a significant role by reducing life-threatening ailments of people and other animals.

EVALUASI KESESUAIAN PELAKSANAAN PROBITY AUDIT PADA BPKP PUSAT DENGAN PEDOMAN PROBITY AUDIT PENGADAAN BARANG/JASA PEMERINTAH

INFO ARTHA ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 17-34
Author(s):  
Fadlil Usman
Keyword(s):  
Public Sector ◽  
Real Time ◽  
Procurement Process ◽  
Assessment Activity

Probity audit is an independence assessment activity to ensure the goods/services procurement processes have been implemented consistently appropriate with the principle of upholding integrity, uprightness, honesty and fulfill certain occur legislation aimed for improving the accountability for the use of public sector fund. Probity audit is done in real time simultaneously with the goods/services procurement process. This study aims to evaluate the suitability of the implementation of probity audit conducted by BPKP Headquarter as agency that initiated the implementation of probity audit in Indonesia compared with the Probity audit Guidelines for Procurement of Goods/Services as criteria. The results of this study indicate that the implementation of probity audit conducted by BPKP Headquarter has been implemented adequately, but there are activities that do not fit the criteria, especially in the activities of the determination of the scope of the audit, the preparation of working papers and the follow-up monitoring of the audit results. Probity audit merupakan kegiatan penilaian (independen) untuk memastikan bahwa proses pengadaan barang/jasa telah dilaksanakan secara konsisten sesuai dengan prinsip penegakan integritas, kebenaran, kejujuran dan memenuhi ketentuan perundangan yang berlaku yang bertujuan meningkatkan akuntabilitas penggunaan dana sektor publik. Probity audit dilakukan secara real time yaitu bersamaan dengan pelaksanaan pengadaan barang/jasa. Penelitian ini bertujuan untuk melakukan evaluasi kesesuaian pelaksanaan probity audit yang dilakukan oleh BPKP Pusat selaku instansi yang menginisiasi pelaksanaan probity audit di Indonesia dibandingkan dengan kriteria berupa Pedoman Probity audit Pengadaan Barang/Jasa Pemerintah. Hasil dari penelitian ini menunjukkan bahwa pelaksanaan probity audit yang dilakukan oleh BPKP Pusat sudah dilaksanakan secara memadai, namun masih terdapat hal yang belum sesuai dengan kriteria terutama dalam kegiatan penentuan ruang lingkup audit, penyusunan kertas kerja dan pemantauan terhadap tindak lanjut hasil audit.

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