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The study presents the echinocandin susceptibility profile of a multi-centre collection of pathogenic yeast isolates from Romanian tertiary hospitals. The 562 isolates were identified using ID32C strips, MALDI-TOF MS and DNA sequencing. Minimal inhibitory concentrations (MICs) of caspofungin (CAS), micafungin (MCA), and anidulafungin (ANI) were assessed and interpreted according to EUCAST guidelines. Minimal fungicidal concentrations (MFC) were determined by plating content from the clear MIC wells. The activity was considered fungicidal atMFC/MIC ≤ 4. The three echinocandins had strongly correlated MICs and high percentages of MIC essential agreement. Most often, MCA had the lowest MICs, followed by CAS and ANI. Against C. parapsilosis and C. kefyr, CAS had the lowest MIC values. The MIC50 values were between 0.03 and 0.25 mg/l, except C. parapsilosis. The MIC90 values were usually one dilution higher. MFCs and MICs were weakly correlated. ANI and MCA had the lowest MFC values. The MFC50 values were between 0.06 and 0.5 mg/l, except C. parapsilosis, C. guilliermondii, and C. dubliniensis. The MFC90 values were usually two dilutions higher. Based on EUCAST breakpoints, 47 isolates (8.4%) were resistant to at least one echinocandin, most often ANI. Most resistant isolates were of C. albicans, C. glabrata, and C. krusei. There were 17 isolates (3%) resistant to echinocandins and fluconazole and most belonged to the same three species. MCA and ANI had the highest rates of fungicidal activity. The high rates of echinocandin resistance and significant multidrug resistance make prophylaxis and empiric therapy difficult. [ABSTRACT FROM AUTHOR]

Objectives. Mycoplasma hominis and Ureaplasrra urealyticum play an im portant role in the etiology of vaginitis, cervicitis and pelvic inflammatory disease, nongonococcal urethritis, prostatitis, testicular inflammation, urinary stones and infertility. The aim of this study was to demonstrate the rate of incidence and antibiotic susceptibility of Mycoplasma hominis and Ureaplasma urealyticum isolated from urogenital infections in our area. Methods. By using commercial mycoplasma kit Mycoplasma IES, we investigated their incidence and antimicrobial resistance in patients with genital infection. The samples for testing genital mycoplasmas were collected by picking up vaginal or urethral secretion using sterile Dacron swabs. For men, urine and sperm samples were accepted for diagnostics, according to kit instructions. The culture of genital mycoplasmas was performed by using a commercial mycoplasma kit. The Quality Control was performed with Mycoplasma hominis ATCC 15488. Results. We examined 2,250 specimens, women (n = 2,084) and men (n = 166), between August - December 2014. Prevalence o f positive samples was 16.53% for U. urealyticum (UU) and 1.6%forM. hominis (MH). The median age of the positive patients was 31 years (range: 17-54 years). Among samples positive for UU, 94.6% were sensitive to levofloxacin, 25.6% to ofloxacin and 4,29% to ciprofloxacin. In MH isolates, 100% were sensitive to both levofloxacin and ofloxacin and only 45% to ciprofloxacin. Sensitivity for doxycycline was 86.7% for UU and 95.45% forMH. Regarding azythromycin, 93.15% UU and 10% MH were sensitive. All 13 male urine samples and 5 sperm samples were negative for UU and MH infections. Conclusions. In our study, levofloxacin and doxycycline were the most effective drugs for mycoplasma infections. Because of geographical differences among antibiotic resistance, local in-vitro susceptibility testing is recommended to avoid failure of therapy. Surveillance for antibiotic susceptibility is strongly recommended. [ABSTRACT FROM AUTHOR]

The article presents a case study of a patient with erythematotelangiectatic rosacea. The patient's clinical features included red, symmetrical areas on the face accompanied by slight pruritus and burning. In this patient with rosacea linked to Demodex folliculorum, laser desorption/ionization positivity was seen for Bacillus pumilus from lesional skin scrapings.

Purpose: To present a case of possible comorbidity between Facticial dermatitis and Tinea corporis. Methods: A 56 year old woman presented with a history of intense pruritus on her arms; the clinical examination identifi ed linear and circular lesions on arms and calfs. Results: The mycological culture performed from circular cutaneous lesions was positive for Trichophyton tonsurans and the presumptive diagnosis of factitious dermatitis and Tinea corporis was made. Conclusions: Given the particularity of this case and that there are few studies that show a direct relation between psychiatric pathology and dermatological pathology and also considering the fact that it is hard to demonstrate that a skin condition is determined by a psychiatric disorder, we consider it is opportune to report this case. [ABSTRACT FROM AUTHOR]

In the literature, there are few publications which present data related to the infections of the urinary tract infections (UTI) of the patients who suffer from HiV/AIDS, although they represent an important cause which causes the death of these patients. The prevalence of the etiological agents differs according to the studied area. The urological complications in the case of HIV/ AIDS patients are often the result of a bacterial, parasitic, viral or fungal infections. The antiretroviral therapy increases the life span but, at the same time, it represents a favourable factor for infections, for exam pie, through the urolithiasis which they can produce. We set ourselves to review aspects related to UTI at this group of patients, having as a future objective the evaluation of this correlation in Romania. [ABSTRACT FROM AUTHOR]

Urinary tract infections (UTI) with Escherichia coli are among the most common infections presenting in general practice. Fluoroquinolones (FQs) are relied on for their empirical therapy but recent reports indicate a concerning increase in the percentage of FQ-resistant E. coli isolates in many countries, including Romania. Sixty E. coli strains with ciprofloxacin resistance and cephalosporin susceptibility isolated from urine specimens of non-hospitalized patients during a five-month period (October 2014 - February 2015) were further analyzed to determine the molecular basis of FQ resistance (i.e. mutations in chromosomal gyrA, gyrB, parC genes and presence of plasmid-borne qnrA, qnrB, qnrS, and aac(6'-Ib-cr genes), the phylogenetic background (i.e. phylogenetic groups A, B1, B2, C, D, E, F or clade I), O25b/ST131 status, and genetic relatedness inferred from the XbaI pulsed-field gel electrophoresis (PFGE) profiles as a measure of isolate-specific genetic composition. The PCR-based phylotyping showed that most strains were assigned to non-B2 phylogenetic groups (i.e. group A/21 strains, group B1/14 strains, group B2/10 strains, group C/8 strains, group D/3 strains, group F/4 strains). Already described chromosomal mutations associated to FQ resistance were found, the strains being double gyrA mutants (i.e. Ser83Leu, Asp87Asn) with one or two parC mutations (e.g. Ala56Thr, Ser80Ile, Glu84Gly). Seven percent of the strains harboured plasmid-borne genes qnrS1 (2 strains) and aac(6'-Ib-cr (2 strains). Based on the PCR results, 15% of the strains were members of the O25b/ST131 clone and possessed the gyrA/parC allele combination which is considered as hallmark of H30 subclone. PFGE genotyping revealed a genetically diverse population of FQ-resistant E. coli. ST131 strains displayed more homogeneous PFGE profiles than non-ST131. The ST131 cluster extended to 77.74% similarity versus 60% overall. These findings underscore the need for ongoing surveillance to capture the complexity of the emerging population of FQ-resistant strains disseminated across our community.

We examined group B streptococcus (GBS) isolates colonizing women at the 35-37 weeks of pregnancy. A total of 257 group B streptococcus (GBS) isolates for serotyped using direct agglutination with a set of commercially available antisera (Ia, Ib, II, III, IV, and V) and tested for susceptibility to antimicrobials (penicillin, macrolides, lincosamides, fluoroquinolones and tetracyclines). Fourteen isolates could not be serotyped with the antisera set used in the study. Serotype III was the predominant serotype (33%), followed by serotypes V (23%), and Ia (20%). Whereas all isolates were susceptible to penicillin, the rates of susceptibility to the other antimicrobials tested were the following: 91% for ofloxacin, 80% for clindamycin, 77% for erythromycin, and 4% for tetracycline. More than half (67%) of the macrolide resistant isolates belonged to serotypes V and III. A systematic surveillance of the autochthonous GBS serotypes, performed at the level of laboratories processing a high number of human specimens, is mandatory for strengthening the national epidemiological GBS surveillance. While penicillin remains the drug of choice for intrapartum prophylaxis, the resistance of autochthonous GBS isolates to other antibiotics should be actively monitored.