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.

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One hundred forty-three penicillinase-producing Neisseria gonorrhoeae (PPNG) isolates obtained in Argentina from 2008 and 2012 were examined to detect bla TEM-135 genes and to investigate plasmid profiles and multiantigen sequence types. Forty-two PPNG isolates were found to carry TEM-135, and two contained a new TEM derivative characterized as TEM-220. The bla TEM-135 allele was carried by the Toronto/Rio and African plasmids. Molecular epidemiology revealed that two bla TEM-135 isolates were related to previously described isolates from Thailand and China, indicating a common evolutionary origin.A ntibiotic resistance in Neisseria gonorrhoeae is a global public health problem (1). Through the years, N. gonorrhoeae has developed resistance to the first-line antibiotics used for treatment (2). Penicillinase-producing N. gonorrhoeae (PPNG) isolates with plasmid-mediated high-level resistance to penicillin were first reported in 1976 and have spread since then (3). These first PPNG isolates contained TEM-1-type ␤-lactamase plasmids encoded by transposon TnA (Tn2), which are responsible for the transference and dissemination of resistance (4). To date, eight plasmid types have been described in N. gonorrhoeae and named after their epidemiological origin as African, Toronto/Rio, Asian, Nîmes, New Zealand, Johannesburg, and Australian plasmids (5-7). The PPNG isolates carrying a bla TEM-135 gene were found in Thailand, Japan, and China and recently reported in Australia and 15 other countries (8-12). TEM-135 differs from TEM-1 by a single nucleotide substitution at position 539, resulting in a single amino acid substitution, M182T. This substitution is also found in TEM-type extended-spectrum ␤-lactamase (ESBL) but has little effect on enzyme activity, and it has been proposed to stabilize substitutions near the active site, which collaboratively results in the emergence of a stable ESBL (13-15). The first PPNG isolate in Argentina was reported in 1980 and has since been disseminated in our country (16). The prevalence of PPNG isolates has been increasing through the years, with the highest level of 40% in the 1990's. The aim of this study was to detect bla TEM-135 and investigate plasmid types carrying ␤-lactamase in the PPNG strains in 2008 and 2012 in Argentina.We studied 49 and 94 PPNG isolates collected in 2008 and 2012, respectively, from GASSP-AR, which includes 70 laboratories distributed all around the country. The MIC S (g/ml) of penicillin, ciprofloxacin, ceftriaxone, and azithromycin for the isolates were determined by the agar dilution method (17, 18). The N. gonorrhoeae ATCC 49226 and World Health Organization (WHO) reference strains were used for quality control in antimicrobial susceptibility testing (19). Mismatch amplification mutation assay (MAMA) PCR was performed to identify the bla TEM-135 allele, and TEM PCR was used to recognize both the bla TEM-1 and bla . The whole bla TEM , porB, and tbpB genes of all isolates that were MAMA PCR positive were amplified and sequenced to confirm the bla TEM-1...

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.

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