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array:23 [ "pii" => "S1130140624000081" "issn" => "11301406" "doi" => "10.1016/j.riam.2024.06.001" "estado" => "S300" "fechaPublicacion" => "2024-01-01" "aid" => "648" "copyright" => "Asociación Española de Micología" "copyrightAnyo" => "2024" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Iberoam Micol. 2024;41:13-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S1130140624000068" "issn" => "11301406" "doi" => "10.1016/j.riam.2024.04.002" "estado" => "S300" "fechaPublicacion" => "2024-01-01" "aid" => "646" "copyright" => "Asociación Española de Micología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Iberoam Micol. 2024;41:17-26" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "<span class="elsevierStyleItalic">Pneumocystis carinii</span> infection drives upregulation of Fn1 expression that causes pulmonary fibrosis with an inflammatory response" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "17" "paginaFinal" => "26" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La infección por <span class="elsevierStyleItalic">Pneumocystis carinii</span> aumenta la expresión de Fn1 y provoca fibrosis pulmonar con respuesta inflamatoria" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 4341 "Ancho" => 2721 "Tamanyo" => 1275160 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Measurement of lung injury and inflammation magnitude in mice. (A) Weight changes; (B) lung coefficient; (C) macrophage infiltration was detected by IHC; (D) TNF-α, IL-6, IL-10, IL-1b, IL-8, NLRP3 and CD45 expression levels were detected by qRT-PCR; (E) NLRP3 expression level was detected by WB; (F) TNF-α, IL-6, IL-10, IL-1b and IL-8 expression levels were detected by ELISA; (G) Expression of CD45 in lung tissue of mice in each group was detected by IHC. *<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Wenwen Yu, Hua Ye, Yunlei Li, Xiaoqiong Bao, Yangyang Ni, Xiangxiang Chen, Yangjie Sun, Ali Chen, Weilong Zhou, Jifa Li" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Wenwen" "apellidos" => "Yu" ] 1 => array:2 [ "nombre" => "Hua" "apellidos" => "Ye" ] 2 => array:2 [ "nombre" => "Yunlei" "apellidos" => "Li" ] 3 => array:2 [ "nombre" => "Xiaoqiong" "apellidos" => "Bao" ] 4 => array:2 [ "nombre" => "Yangyang" "apellidos" => "Ni" ] 5 => array:2 [ "nombre" => "Xiangxiang" "apellidos" => "Chen" ] 6 => array:2 [ "nombre" => "Yangjie" "apellidos" => "Sun" ] 7 => array:2 [ "nombre" => "Ali" "apellidos" => "Chen" ] 8 => array:2 [ "nombre" => "Weilong" "apellidos" => "Zhou" ] 9 => array:2 [ "nombre" => "Jifa" "apellidos" => "Li" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130140624000068?idApp=UINPBA00004N" "url" => "/11301406/0000004100000001/v1_202410040500/S1130140624000068/v1_202410040500/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S113014062400007X" "issn" => "11301406" "doi" => "10.1016/j.riam.2024.04.003" "estado" => "S300" "fechaPublicacion" => "2024-01-01" "aid" => "647" "copyright" => "Asociación Española de Micología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Iberoam Micol. 2024;41:7-12" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Azole resistance in a clinical isolate of <span class="elsevierStyleItalic">Aspergillus fumigatus</span> from Chile" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "7" "paginaFinal" => "12" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Primer aislamiento clínico de <span class="elsevierStyleItalic">Aspergillus fumigatus</span> resistente a azoles en Chile" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1543 "Ancho" => 1600 "Tamanyo" => 515565 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Mutations observed in the Cyp51A sequences obtained from the isolates ChFC 132 and ChFC 104. (a) TR34 (red bar), (b) L98H (red arrow), and (c) F46Y/M172V/E427K (blue arrows).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Eduardo Álvarez Duarte, Nicolás Cepeda, Jean Miranda" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Álvarez Duarte" ] 1 => array:2 [ "nombre" => "Nicolás" "apellidos" => "Cepeda" ] 2 => array:2 [ "nombre" => "Jean" "apellidos" => "Miranda" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014062400007X?idApp=UINPBA00004N" "url" => "/11301406/0000004100000001/v1_202410040500/S113014062400007X/v1_202410040500/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Experimental study of specific and nonspecific blood culture bottles for the diagnosis of candidemia" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "13" "paginaFinal" => "16" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Leandre Carmem Wilot, Vanice Rodrigues Poester, Cecília Bittencourt Severo, Karine Ortiz Sanchotene, Bruna Muradás Esperon, Mariana Rodrigues Trápaga, David A. Stevens, Melissa Orzechowski Xavier" "autores" => array:8 [ 0 => array:3 [ "nombre" => "Leandre Carmem" "apellidos" => "Wilot" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "Vanice Rodrigues" "apellidos" => "Poester" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Cecília Bittencourt" "apellidos" => "Severo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Karine Ortiz" "apellidos" => "Sanchotene" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Bruna Muradás" "apellidos" => "Esperon" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Mariana Rodrigues" "apellidos" => "Trápaga" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "David A." "apellidos" => "Stevens" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 7 => array:4 [ "nombre" => "Melissa Orzechowski" "apellidos" => "Xavier" "email" => array:1 [ 0 => "melissaxavierfurg@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul (RS), Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Mycology Laboratory of FAMED-FURG, Rio Grande, Rio Grande do Sul (RS), Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul (RS), Brazil" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "California Institute for Medical Research, San Jose, California (CA), United States (USA)" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Division of Infectious Diseases and Geographic Medicine, Stanford University Medical School, Stanford, California (CA), United States (USA)" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estudio experimental de frascos de hemocultivo específicos y no específicos para el diagnóstico de candidemia" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1211 "Ancho" => 1633 "Tamanyo" => 105349 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Mean of time-to-detection (TTD) in hours of <span class="elsevierStyleItalic">Candida albicans</span>, <span class="elsevierStyleItalic">Nakaseomyces glabratus</span> (<span class="elsevierStyleItalic">Candida glabrata</span>), <span class="elsevierStyleItalic">Candida parapsilosis</span>, <span class="elsevierStyleItalic">Meyerozyma guilliermondii</span> (<span class="elsevierStyleItalic">Candida guilliermondii</span>), <span class="elsevierStyleItalic">Pichia kudriavzevii</span> (<span class="elsevierStyleItalic">Candida krusei</span>) and <span class="elsevierStyleItalic">Candida tropicalis</span> in BD BACTEC™ Plus Aerobic/F (Aero) and BD BACTEC™ Mycosis IC/F Lytic (Myco) bottles. <span class="elsevierStyleItalic">C. albicans</span> and <span class="elsevierStyleItalic">N. glabratus</span> were detected earlier in the Myco bottles than in the Aero bottles, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.018, respectively. TTD of <span class="elsevierStyleItalic">C. parapsilosis</span>, <span class="elsevierStyleItalic">M. guilliermondi</span> and <span class="elsevierStyleItalic">P. kudriavzevii</span> was similar in both bottles (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.3; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.8 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.16, respectively). <span class="elsevierStyleItalic">C. tropicalis</span> was detected earlier in the Aero bottles (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.014). *Statistical difference.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Candida</span> species are the fourth most common cause of bloodstream infections. Candidemia usually occurs in a healthcare setting and results in a high morbidity and mortality (up to 40%) of hospitalized patients.<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">17,19,9</span></a> The most common species causing candidemia are <span class="elsevierStyleItalic">Candida albicans</span>, <span class="elsevierStyleItalic">Candida parapsilosis</span>, <span class="elsevierStyleItalic">Candida tropicalis</span>, <span class="elsevierStyleItalic">Nakaseomyces glabratus</span> (<span class="elsevierStyleItalic">Candida glabrata</span>), <span class="elsevierStyleItalic">Pichia kudriavzevii</span> (<span class="elsevierStyleItalic">Candida krusei</span>) and <span class="elsevierStyleItalic">Meyerozyma guilliermondii</span> (<span class="elsevierStyleItalic">Candida guilliermondii</span>).<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">16,4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Risk factors for acquiring candidemia are long periods of hospitalization in intensive care units (ICU), exposure to broad-spectrum antibiotics, use of artificial devices (central venous catheter, intravascular lines, prosthetics, implantable cardiac devices), abdominal viscus loss of integrity, and abdominal surgery.<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">13,10,14</span></a> Furthermore, <span class="elsevierStyleItalic">Candida</span> infections often occur in patients with malignancies, immune compromise, or diabetes mellitus.<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">20,2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In view of the severity of candidemia with high mortality of patients, an early diagnosis is the key to a better outcome.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a> The “gold standard” test for diagnosing candidemia is blood culture. Automated systems achieve higher rates of sensitivity, and are time-saving.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">8</span></a> Since bacterial or fungal agents can cause sepsis, culture bottles are designed to grow a spectrum of these microorganisms. BD BACTEC™ Plus Aerobic/F (Becton Dickinson, New Jersey, United States - USA) is designed to grow aerobic microorganisms, mostly bacterial, although yeasts can also grow, whereas BD BACTEC™ Mycosis IC/F Lytic (Becton Dickinson, New Jersey, USA) is designed more specifically for fungal growth due to its complementation with saponin 0.24% (blood lysing agent), ferric ammonium citrate, chloramphenicol and tobramycin (Becton Dickinson, New Jersey, USA), limiting bacterial growth and thus increasing the capacity for fungal detection.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">7,18</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Since an early diagnosis of candidemia is correlated with more favorable outcomes and reduction in the total cost of hospitalization, we studied the efficiency of a blood culture method specific to fungi, and compared the results to those obtained with the nonspecific bottle. We compared the performance of BD BACTEC™ Plus Aerobic/F with the BD BACTEC™ Mycosis IC/F Lytic culture bottle, using the automated BD BACTEC™ FX 40 blood culture system <span class="elsevierStyleItalic">in vitro</span> to evaluate the speed of detection of <span class="elsevierStyleItalic">Candida</span> species.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">Isolates from six species of <span class="elsevierStyleItalic">Candida</span>, representing the most common species encountered in blood cultures [<span class="elsevierStyleItalic">C. albicans</span> (number M7122), <span class="elsevierStyleItalic">C. parapsilosis</span> (number M6993), <span class="elsevierStyleItalic">C. tropicalis</span> (number M8459), <span class="elsevierStyleItalic">N. glabratus</span> (<span class="elsevierStyleItalic">C. glabrata</span>) (number M6674), <span class="elsevierStyleItalic">P. kudriavzevii</span> (<span class="elsevierStyleItalic">C. krusei</span>) (number M6666) and <span class="elsevierStyleItalic">M. guilliermondii</span> (<span class="elsevierStyleItalic">C. guilliermondii</span>) (number M7757)], from the fungal collection of the Mycology Laboratory (Faculdade de Medicina – FAMED/Universidade Federal do Rio Grande – FURG) were studied. All the isolates included (one for each species) were previously retrieved from their frozen stocks, subcultured on Sabouraud dextrose agar (SDA) plates, and colonies were identified using matrix-assisted laser desorption ionization-time-of-flight-mass spectrometry (MALDI-TOF-MS, Bruker Corporation®, Billerica, Massachusetts, USA, database flex control version 3.4).</p><p id="par0030" class="elsevierStylePara elsevierViewall">A yeast inoculum from young colonies was standardized (two days on Sabouraud agar at 25<span class="elsevierStyleHsp" style=""></span>°C) using a spectrophotometer (K37-UVVIS, KASVI, São José dos Pinhais, Brazil) (530<span class="elsevierStyleHsp" style=""></span>nm), according to the Clinical and Laboratory Standards Institute document M27-ED4,<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> and serial dilutions in sterile saline solution to achieve a concentration of 5–25 colony forming units (CFU) per ml were made. The inoculum concentration of all species was confirmed by plating 0.5<span class="elsevierStyleHsp" style=""></span>ml from the final solution onto Sabouraud dextrose agar plates (KASVI) that were incubated at 35<span class="elsevierStyleHsp" style=""></span>°C until growth for CFU counting.</p><p id="par0035" class="elsevierStylePara elsevierViewall">An aliquot of 0.5<span class="elsevierStyleHsp" style=""></span>ml of the standardized inoculum (5–25<span class="elsevierStyleHsp" style=""></span>CFU<span class="elsevierStyleHsp" style=""></span>ml<span class="elsevierStyleSup">−1</span>) of each <span class="elsevierStyleItalic">Candida</span> species was added to 2<span class="elsevierStyleHsp" style=""></span>ml of fresh uninfected whole blood samples (from healthy volunteers), resulting in a final concentration of 1–5<span class="elsevierStyleHsp" style=""></span>CFU<span class="elsevierStyleHsp" style=""></span>ml<span class="elsevierStyleSup">−1</span>. After homogenization, 1<span class="elsevierStyleHsp" style=""></span>ml of the experimentally infected blood was immediately inoculated into BD BACTEC™ Mycosis IC/F Lytic (Myco), and another 1<span class="elsevierStyleHsp" style=""></span>ml into the BD BACTEC™ Plus Aerobic/F culture (Aero) bottles. The bottles were incubated in the BACTEC™ FX40 at 37<span class="elsevierStyleHsp" style=""></span>°C, with continuous agitation until growth was detected. The time necessary to the BACTEC™ sensor to detect growth was analyzed, and an aliquot of 0.1<span class="elsevierStyleHsp" style=""></span>ml was spread on CHROMagar™ <span class="elsevierStyleItalic">Candida</span> Agar (DIFCO, Michigan, USA), incubated at 35<span class="elsevierStyleHsp" style=""></span>°C for 48<span class="elsevierStyleHsp" style=""></span>h, and resubmitted to MALDI-TOF-MS to confirm that the growth detected was pure and corresponded to the <span class="elsevierStyleItalic">Candida</span> species added, validating the experiment. All assays were performed in biological duplicates through two independent experiments performed on different days.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The time-to-detection (TTD) for each <span class="elsevierStyleItalic">Candida</span> species was registered through the BD System BACTEC™ FX 40 equipment, and the mean from both experiments was calculated. The results obtained with both the BD BACTEC™ Mycosis IC/F Lytic (Myco) and BD BACTEC™ Plus Aerobic/F (Aero) culture incubation system were compared using the Student's <span class="elsevierStyleItalic">t</span> test with SPSS 25.0® software (IBM, Chicago, USA). <span class="elsevierStyleItalic">p</span>-Values ≤0.05 were considered statistically significant.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Candida</span> was detected in all the blood samples experimentally infected in less than 45<span class="elsevierStyleHsp" style=""></span>h of incubation in both culture bottles (Myco and Aero). There were no significant differences in TTD results between the duplicate experiments (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">A significant decrease in TTD was observed in the Myco bottle when compared with the Aero bottle in the case of blood samples infected with <span class="elsevierStyleItalic">C. albicans</span> (mean of 27<span class="elsevierStyleHsp" style=""></span>h <span class="elsevierStyleItalic">versus</span> mean of 43<span class="elsevierStyleHsp" style=""></span>h; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02) and with <span class="elsevierStyleItalic">N. glabratus</span> (26<span class="elsevierStyleHsp" style=""></span>h <span class="elsevierStyleItalic">versus</span> 48<span class="elsevierStyleHsp" style=""></span>h; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.018). The TTD of <span class="elsevierStyleItalic">C. parapsilosis</span>, <span class="elsevierStyleItalic">M. guilliermondii</span> and <span class="elsevierStyleItalic">P. kudriavzevii</span> was similar in both culture bottles (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05), whereas the growth of <span class="elsevierStyleItalic">C. tropicalis</span> was detected earlier (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.014) in the Aero culture than in the Myco one (mean of 21<span class="elsevierStyleHsp" style=""></span>h <span class="elsevierStyleItalic">versus</span> 36<span class="elsevierStyleHsp" style=""></span>h) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall">Our study showed significant differences in the TTD when comparing the growth of several <span class="elsevierStyleItalic">Candida</span> species from blood experimentally infected in specific (Myco) and nonspecific (Aero) blood culture bottles. These differences in yeast detection between bottles could directly impact the patient's outcome, since a delay of 24–48<span class="elsevierStyleHsp" style=""></span>h in the diagnosis increases the mortality rate almost 100% (23.6–41.4%).<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">In our study, <span class="elsevierStyleItalic">C. albicans</span> was detected ∼17<span class="elsevierStyleHsp" style=""></span>h earlier in the specific bottle for fungal blood culture, which is consistent with the findings of Nawrot et al.,<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a> who reported a similar TTD (14.6<span class="elsevierStyleHsp" style=""></span>h) for <span class="elsevierStyleItalic">C. albicans</span>, a time that was shorter as well than the TTD obtained with the nonspecific bottles. Similarly, <span class="elsevierStyleItalic">N. glabratus</span> was detected 21.8<span class="elsevierStyleHsp" style=""></span>h earlier approximately using the specific culture bottles, and this finding aligns with the results reported by Posteraro et al.,<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a> who described a similar TTD of 14<span class="elsevierStyleHsp" style=""></span>h for this species.</p><p id="par0065" class="elsevierStylePara elsevierViewall">This difference between the two bottles may be attributed to the presence of saponins in the Myco bottles, which enhances yeast recovery due to blood lysis and, consequently, accelerates fungal detection. Moreover, the presence of ferric ammonium citrate in the Myco bottles provides an iron source for fungi, and the medium includes carbohydrate and/or protein sources as well (according to Becton Dickinson, New Jersey, USA) to accelerate yeast growth.<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">8,6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Many hospitals do not have access to or do not use the specific blood culture bottle for growing fungi in routine clinical diagnosis. Considering the difference (TTD) found in our study among <span class="elsevierStyleItalic">Candida</span> species, a local evaluation of the epidemiology in each center is necessary to analyze the cost–benefit of using both bottles. In addition, a factor that should also be considered is the volume of blood that is required for inoculating two bottles, particularly an issue in neonatal ICUs, considering the difficulty of obtaining sufficient blood from neonatal patients.</p><p id="par0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">C. tropicalis</span> was detected approximately 15<span class="elsevierStyleHsp" style=""></span>h later in the specific blood bottles in our study, in agreement with previously reported data (16.3<span class="elsevierStyleHsp" style=""></span>h later) by Jekarl et al.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a> On the other hand, <span class="elsevierStyleItalic">C. albicans</span> (the agent of ∼50% of candidemia cases in Brazil),<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a> plus the second most prevalent agent among <span class="elsevierStyleItalic">Candida</span>-related species, <span class="elsevierStyleItalic">N. glabratus</span>, were detected significantly earlier in the fungal-specific bottle. The probable impact in reducing mortality rates may justify the importance of using both bottles (Aero and Myco) routinely in the hospital.</p><p id="par0080" class="elsevierStylePara elsevierViewall">This would improve the diagnosis of candidemia and allow a more rapid clinical intervention, resulting in a favorable outcome of the patients. The usage of both bottles would also lead to a shorter period of hospital stay and, consequently, a reduction in the cost of hospitalization, off setting any increased diagnostic laboratory costs. A limitation of our study was the use of a less-than-minimum volume (3<span class="elsevierStyleHsp" style=""></span>ml) of blood sample than that suggested by the manufacturers; however, we tried to reproduce the usual situation encountered with blood samples from patients in neonatal ICU. Another limitation was testing only one isolate for each species; thus, we suggest including more isolates per species in future studies, considering the biological differences that clinical strains can present. Further studies should also evaluate the time-of-detection of mixed species of <span class="elsevierStyleItalic">Candida</span>, as well as mixed bacteria and <span class="elsevierStyleItalic">Candida</span>, using the Aero and Myco bottles, to simulate mixed infections.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Funding</span><p id="par0085" class="elsevierStylePara elsevierViewall">No funding was provided.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Authors’ contributions</span><p id="par0090" class="elsevierStylePara elsevierViewall">All authors contributed significantly to the study, covering conception, design, data acquisition, analysis, interpretation, article drafting, critical content revision, and final version approval.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Melissa Orzechowski Xavier: Conceptualization, Methodology, Supervision, Validation, Software, Writing – reviewing and editing; Leandre Carmem Wilot and Vanice Rodrigues Poester: Formal analysis, Writing – original draft preparation, Visualization, Investigation; Karine Ortiz Sanchotene, Bruna Muradás Esperon, Mariana Rodrigues Trápaga and David A. Stevens: Writing – reviewing and editing.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Competing interests</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare that, to their knowledge, they do not have competing financial interests or personal relationships that could have influenced the work reported in this paper.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres2261512" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Aims" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1888123" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres2261513" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivos" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1888122" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Material and methods" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Results" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Funding" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Authors’ contributions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Competing interests" ] 10 => array:2 [ "identificador" => "xack779184" "titulo" => "Acknowledgments" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2024-04-30" "fechaAceptado" => "2024-06-24" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1888123" "palabras" => array:5 [ 0 => "<span class="elsevierStyleItalic">Candida albicans</span>" 1 => "<span class="elsevierStyleItalic">Candida</span> species" 2 => "Fungemia" 3 => "Time-to-detection (TTD)" 4 => "Early diagnosis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1888122" "palabras" => array:5 [ 0 => "<span class="elsevierStyleItalic">Candida albicans</span>" 1 => "Especies de <span class="elsevierStyleItalic">Candida</span>" 2 => "Fungemia" 3 => "Tiempo de detección" 4 => "Diagnóstico precoz" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Early diagnosis of candidemia is critical for the correct management and treatment of patients.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Aims</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To test the efficacy of different blood culture bottles in the growth of <span class="elsevierStyleItalic">Candida</span> strains.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We compared the performance of BD BACTEC™ Plus Aerobic/F (Aero) culture bottles with the specific BD BACTEC™ Mycosis IC/F Lytic (Myco) culture bottles using the BD BACTEC™ FX 40 automated blood culture system to determine the mean time-to-detection (TTD) in <span class="elsevierStyleItalic">Candida</span> species. One isolate each of six <span class="elsevierStyleItalic">Candida</span> species was inoculated into blood culture bottles (final concentration, 1–5<span class="elsevierStyleHsp" style=""></span>CFU<span class="elsevierStyleHsp" style=""></span>ml<span class="elsevierStyleSup">−1</span>) and incubated at 37<span class="elsevierStyleHsp" style=""></span>°C until automated growth detection.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Candida albicans</span> and <span class="elsevierStyleItalic">Nakaseomyces glabratus</span> (<span class="elsevierStyleItalic">Candida glabrata</span>) were detected earlier in the specific culture bottle, whereas <span class="elsevierStyleItalic">Candida tropicalis</span> was detected earlier in the nonspecific bottle; <span class="elsevierStyleItalic">Candida parapsilosis</span>, <span class="elsevierStyleItalic">Pichia kudriavzevii</span> (<span class="elsevierStyleItalic">Candida krusei</span>), and <span class="elsevierStyleItalic">Meyerozyma guilliermondii</span> (<span class="elsevierStyleItalic">Candida guilliermondii</span>) presented similar TTD in both bottles.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Our study suggests the suitability of using both bottles in clinical laboratories for a faster diagnosis and prompt starting of any treatment.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Aims" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El diagnóstico precoz de la candidemia es fundamental para el correcto manejo y tratamiento de los pacientes.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Comprobar la eficacia de diferentes frascos de hemocultivo en el crecimiento de cepas de <span class="elsevierStyleItalic">Candida</span>.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Métodos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Comparamos el rendimiento de los frascos de cultivo BD BACTEC™ Plus Aerobic/F (Aero) con los frascos de cultivo BD BACTEC™ Mycosis IC/F Lytic (Myco) específicos utilizando el sistema automatizado de hemocultivo BD BACTEC™ FX 40 para determinar la media de tiempo de detección (TTD) de especies de <span class="elsevierStyleItalic">Candida</span>. Se inoculó un aislamiento de cada una de seis especies de <span class="elsevierStyleItalic">Candida</span> en los frascos de hemocultivo (concentración final, 1-5<span class="elsevierStyleHsp" style=""></span>CFU<span class="elsevierStyleHsp" style=""></span>ml<span class="elsevierStyleSup">−1</span>) y se incubaron a 37<span class="elsevierStyleHsp" style=""></span>°C hasta la detección automática del crecimiento.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Candida albicans</span> y <span class="elsevierStyleItalic">Nakaseomyces glabratus</span> (<span class="elsevierStyleItalic">Candida glabrata</span>) se detectaron antes en el frasco de cultivo específico, mientras que <span class="elsevierStyleItalic">Candida tropicalis</span> se detectó antes en el frasco no específico; <span class="elsevierStyleItalic">Candida parapsilosis</span>, <span class="elsevierStyleItalic">Pichia kudriavzevii</span> (<span class="elsevierStyleItalic">Candida krusei</span>) y <span class="elsevierStyleItalic">Meyerozyma guilliermondii</span> (<span class="elsevierStyleItalic">Candida guilliermondii</span>) presentaron TTD similares en ambas botellas.</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Nuestro estudio sugiere el uso simultáneo de ambos frascos en los laboratorios clínicos para un diagnóstico más rápido y un inicio inmediato del tratamiento.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivos" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1211 "Ancho" => 1633 "Tamanyo" => 105349 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Mean of time-to-detection (TTD) in hours of <span class="elsevierStyleItalic">Candida albicans</span>, <span class="elsevierStyleItalic">Nakaseomyces glabratus</span> (<span class="elsevierStyleItalic">Candida glabrata</span>), <span class="elsevierStyleItalic">Candida parapsilosis</span>, <span class="elsevierStyleItalic">Meyerozyma guilliermondii</span> (<span class="elsevierStyleItalic">Candida guilliermondii</span>), <span class="elsevierStyleItalic">Pichia kudriavzevii</span> (<span class="elsevierStyleItalic">Candida krusei</span>) and <span class="elsevierStyleItalic">Candida tropicalis</span> in BD BACTEC™ Plus Aerobic/F (Aero) and BD BACTEC™ Mycosis IC/F Lytic (Myco) bottles. <span class="elsevierStyleItalic">C. albicans</span> and <span class="elsevierStyleItalic">N. glabratus</span> were detected earlier in the Myco bottles than in the Aero bottles, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.018, respectively. TTD of <span class="elsevierStyleItalic">C. parapsilosis</span>, <span class="elsevierStyleItalic">M. guilliermondi</span> and <span class="elsevierStyleItalic">P. kudriavzevii</span> was similar in both bottles (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.3; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.8 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.16, respectively). <span class="elsevierStyleItalic">C. tropicalis</span> was detected earlier in the Aero bottles (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.014). *Statistical difference.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">x¯: mean value.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Species \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Aero bottle (TTD [h])</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Myco bottle (TTD [h])</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Assay 1 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Assay 2 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">x¯ \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Assay 1 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Assay 2 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">x¯ \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Candida albicans</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Nakaseomyces glabratus</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.43 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Candida parapsilosis</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.69 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Meyerozyma guilliermondii</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Pichia kudriavzevii</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.43 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Candida tropicalis</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35.75 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3678490.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Time-to-detection (TTD) in hours obtained from two blood cultures each of <span class="elsevierStyleItalic">Candida albicans</span>, <span class="elsevierStyleItalic">Nakaseomyces glabratus</span> (<span class="elsevierStyleItalic">Candida glabrata</span>), <span class="elsevierStyleItalic">Candida parapsilosis</span>, <span class="elsevierStyleItalic">Meyerozyma guilliermondii</span> (<span class="elsevierStyleItalic">Candida guilliermondii</span>), <span class="elsevierStyleItalic">Pichia kudriavzevii</span> (<span class="elsevierStyleItalic">Candida krusei</span>), and <span class="elsevierStyleItalic">Candida tropicalis</span> in BD BACTEC™ Plus Aerobic/F (Aero) or BD BACTEC™ Mycosis IC/F Lytic (Myco) bottles.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0105" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reference method for broth dilution antifungal susceptibility testing of yeasts, M27ED4" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.B. 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