Fátima Galán

Onychoprotothecosis due to Prototheca wickerhamii

Infection by Prototheca, microscopic, unicellular, aerobic, achlorophyllic algae closely related to the green algae Chlorella, is rare in man. Multiple species of Prototheca had been described. However, only three are recognized: P. wickerhamii, P. zopfii, and P. stagnora [1, 2]. P. wickerhamii and P. zopfii have been associated with human disease. Manifestations of protothecosis in humans occur as follows: olecranon bursitis, superficial cutaneous infections, apparently saprophytic contamination of the gastrointestinal tract, peritonitis and systemic infection [3–12]. In the last years different clinical forms of protothecosis have been reported, with increasing frequency in immunocompromised patients. We report herein a case of culture-proven protothecal ungueal infection.

Sexual forms of yeasts in clinical samples.

The sexual or teleomorphic state of yeasts has only been described in a few clinically involved species, mainly those of the Saccharomycetaceae family. With the aim of gathering information on their incidence in human pathology, a study has been made of a total of 2,135 strains isolated from clinical samples and cultivated in McClary agar. From these, 8 strains in teleomorphic state were identified: Kluyveromyces marxianus [1], Pichia anomala [2], Pichia farinosa [1], Pichia membranaefaciens [1] and Saccharomyces cerevisiae [3]. The two strains of P. anomala were responsible for fungemia; K. marxianus and the two strains of S. cerevisiae produced vaginitis; the other strains were oral cavity colonizers.

Increase in high resistance to penicillin of clinical isolates of Streptococcus pneumoniae in Cádiz, Spain.

The aim was to determine the increase and present standing of penicillin-resistant Streptococcus pneumoniae in Cádiz, Spain. We have studied retrospectively a total of 385 strains of S. pneumoniae obtained during the years 1991, 1993 and 1995. Strains tested were isolated from clinical samples of patients attended at the University Hospital Puerta del Mar of Cádiz, Spain. The resistance rate to penicillin was 71.2% (47.0% in 1991, 72.8% in 1993 and 89.3% in 1995). The percentage of strains with high resistance was 51.4%. The increase was from 29.4% in 1991 to 75.2% in 1995. The incidence of penicillin-resistant pneumococci was more marked in nasopharyngeal carrier children (75.8%) than in invasive strains (30.2%). The increase in high resistance to penicillin in clinical isolates of S. pneumoniae is very pronounced in Cádiz, Spain.

Infecciones por Mycobacterium simiae

Mycobacterium simiae is a slow-growing photochromogenic environmental mycobacterium, first described in 1965. Rarely associated with human infections, possibly due to its limited pathogenicity, it mainly produces lung infection in immunocompetent elderly patients with underlying lung disease, and in disseminated infections in immunosuppressed young patients with AIDS. A microbiological culture is needed to confirm the clinical suspicion, and genetic sequencing techniques are essential to correctly identify the species. Treating M. simiae infections is complicated, owing to the multiple resistance to tuberculous drugs and the lack of correlation between in vitro susceptibility data and in vivo response. Proper treatment is yet to be defined, but must include clarithromycin combined with other antimicrobials such as moxifloxacin and cotrimoxazole. It is possible that M. simiae infections are undiagnosed.