Antifungal activity of amniotic fluid against different Candida species

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(b) Dermoscopy: broken hairs, black dots and pustules." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Elisabeth Gómez-Moyano, Ana María Fernández-Sánchez, Vicente Crespo-Erchiga, Leandro Martínez-Pilar" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Elisabeth" "apellidos" => "Gómez-Moyano" ] 1 => array:2 [ "nombre" => "Ana María" "apellidos" => "Fernández-Sánchez" ] 2 => array:2 [ "nombre" => "Vicente" "apellidos" => "Crespo-Erchiga" ] 3 => array:2 [ "nombre" => "Leandro" "apellidos" => "Martínez-Pilar" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130140621000024?idApp=UINPBA00004N" "url" => "/11301406/0000003800000003/v2_202109250626/S1130140621000024/v2_202109250626/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1130140621000127" "issn" => "11301406" "doi" => "10.1016/j.riam.2020.12.005" "estado" => "S300" "fechaPublicacion" => "2021-07-01" "aid" => "590" "copyright" => "Asociación Española de Micología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Iberoam Micol. 2021;38:145-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Note" "titulo" => "In vitro interaction between glabridin and voriconazole against Aspergillus fumigatus isolates" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "145" "paginaFinal" => "147" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Interacción in vitro entre la glabridina y el voriconazol frente a aislamientos de Aspergillus fumigatus" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mojtaba Nabili, Narges Aslani, Tahereh Shokohi, Mohammad Taghi Hedayati, Fozieh Hassanmoghadam, Maryam Moazeni" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Mojtaba" "apellidos" => "Nabili" ] 1 => array:2 [ "nombre" => "Narges" "apellidos" => "Aslani" ] 2 => array:2 [ "nombre" => "Tahereh" "apellidos" => "Shokohi" ] 3 => array:2 [ "nombre" => "Mohammad Taghi" "apellidos" => "Hedayati" ] 4 => array:2 [ "nombre" => "Fozieh" "apellidos" => "Hassanmoghadam" ] 5 => array:2 [ "nombre" => "Maryam" "apellidos" => "Moazeni" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130140621000127?idApp=UINPBA00004N" "url" => "/11301406/0000003800000003/v2_202109250626/S1130140621000127/v2_202109250626/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Note" "titulo" => "Antifungal activity of amniotic fluid against different Candida species" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "148" "paginaFinal" => "150" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Sofia Maraki, Dimitra Stafylaki, Spyridon A. Karageorgos, Filippos Koutroumpakis, George Hamilos, Antonis Makrigiannakis, George Samonis" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Sofia" "apellidos" => "Maraki" "email" => array:1 [ 0 => "sofiamaraki@yahoo.gr" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Dimitra" "apellidos" => "Stafylaki" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Spyridon A." "apellidos" => "Karageorgos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Filippos" "apellidos" => "Koutroumpakis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "George" "apellidos" => "Hamilos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Antonis" "apellidos" => "Makrigiannakis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 6 => array:3 [ "nombre" => "George" "apellidos" => "Samonis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, Crete, Greece" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Division of Infectious Diseases, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Infectious Diseases Unit, University Hospital of Heraklion and University of Crete Medical School, Heraklion, Crete, Greece" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Department of Obstetrics and Gynecology, Medical School, University of Crete, Heraklion, Greece" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Actividad antifúngica del líquido amniótico contra diferentes especies de Candida" ] ] "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" => 735 "Ancho" => 2341 "Tamanyo" => 196246 ] ] "descripcion" => array:1 [ "en" => "Kinetics of growth of Candida clinical isolates in the presence of amniotic fluid versus Sabouraud broth (control). Each line represents the growth curve over time of a sole Candida isolate, grown either in amniotic fluid or in Sabouraud broth (control). Each symbol represents the log10 CFU value at different time points. p<0.0001; Student's t test." ] ] ] "textoCompleto" => "Candida species are part of the commensal genital microbiota of approximately 20% of asymptomatic, healthy women during reproductive age.<a class="elsevierStyleCrossRef" href="#bib0105">2</a> Colonization rates increase to about 30% in pregnant women, particularly during the third trimester, due to the high levels of circulating estrogens that promote yeast adhesion and germination.<a class="elsevierStyleCrossRefs" href="#bib0160">12,15</a> Among Candida species, Candida albicans is the most frequently isolated. However, due to the widespread use of azoles, other multidrug-resistant species, including Candida glabrata, Candida parapsilosis and Candida tropicalis, are emerging causes of systemic infections worldwide.<a class="elsevierStyleCrossRef" href="#bib0120">5</a> Despite the high vaginal Candida colonization rates, intrauterine fetal infections due to these yeasts are rarely encountered.<a class="elsevierStyleCrossRef" href="#bib0115">4</a> This observation is consistent with the antifungal properties of the amniotic fluid (AF) against Candida albicans.<a class="elsevierStyleCrossRefs" href="#bib0145">9,11</a> However, there is no information on AF activity against non-C. albicans Candida species.In this study we evaluated the antifungal effect of AF obtained during the 38th–41st week of gestation against C. albicans, C. glabrata, and C. parapsilosis clinical isolates. The study included 23 pregnant women followed up at the Obstetrics Department of the University Hospital of Heraklion, in Crete, Greece, from November 2015 to May 2016. The demographics and clinical details of the 23 AF donors are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. The requirements to be enrolled were being in a gestational age of 38–41 weeks at delivery, and giving birth by cesarean section without having taken antibiotics in the previous month. Ethical approval for the study was obtained by the IRB of the hospital (15095/30-3-2016). Written consent was signed by each study participant.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Amniotic fluid samples were obtained under aseptic conditions by aspirating through the amniotic sac during cesarean section. All women had intact membranes. Samples contaminated with meconium or blood were excluded. The first 10ml of the amniotic fluid were discarded in order to avoid blood, and the remainder was collected in sterile tubes and immediately centrifuged at 3000rpm for 15min. The supernatant was frozen at −80°C until further processing.The strains used to assay the inhibitory activity of AF were recovered from patients with invasive candidiasis and identified by sequencing of the internal transcribed spacer 1 and 2 (ITS1-5.8SrRNA-ITS2). The isolates are stored in the library of the Department of Clinical Microbiology and Microbial Pathogenesis of the University Hospital of Heraklion, Greece and are available upon request. The sequences of all three isolates were submitted to Genbank, being assigned the following accession numbers: Candida albicans B 8268 (GenBank accession no. MW616800), Candida glabrata B 81348 (GenBank accession no. MW616799), and Candida parapsilosis B 81524 (GenBank accession no. MW616798). The activity of the main antifungal agents against these isolates are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. Yeasts grown overnight on Sabouraud dextrose agar (bioMérieux, Marcy L’ Etoile, France) were suspended in sterile normal saline. Serial dilutions of the suspensions with additional normal saline to achieve a concentration of 104yeasts/ml were made. From this final dilution, 0.2ml were added to 1.8ml of amniotic fluid, and other 0.2ml to 1.8ml of Sabouraud broth. The latter was the positive control for Candida growth. Amniotic fluids and controls were incubated at 37°C for 48h. Aliquots of 0.2ml were collected both from the amniotic fluids under testing and the controls at 0, 4, 8, 12, 24, and 48h, being serially diluted with normal saline up to 10−12. Samples of 0.1ml of each dilution were streaked on Sabouraud dextrose agar plates, which were incubated for 48h at 37°C, and colony forming units (CFUs) were counted.<a class="elsevierStyleCrossRef" href="#bib0130">7</a> All experiments were performed in triplicate, in order to check the reproducibility of the results. Differences in CFUs between control and AF samples were compared by unpaired Student's t-test. Statistical significance was set at p<0.05. All statistical analyses were performed with Graphpad Prism, V.4 (GraphPad Software Inc, CA, USA).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>As shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, all 23 AF samples possessed a significant inhibitory activity against all three clinical isolates of Candida. The antifungal activity of AF was more pronounced against C. glabrata, since all AF samples prevented this species from growing (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). In contrast, when compared to the initial inoculum (0h), minimal growth was observed in C. albicans (with certain AF samples) and C. parapsilosis (all AF samples) at 48h (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Azole-resistant non-C. albicansCandida species, including C. glabrata, are increasingly encountered as causes of urogenital infections worldwide.<a class="elsevierStyleCrossRef" href="#bib0180">16</a> Despite the increased rates of Candida vaginal colonization during pregnancy, intrauterine infections are extremely uncommon.<a class="elsevierStyleCrossRefs" href="#bib0115">4,10</a> This is suggestive of a host effector mechanism with specific antifungal properties, including the antifungal properties of AF. Antimicrobial components of AF include cytokines and host defense proteins, including defensins, lactoferrin, lysozyme, and other antimicrobial peptides.<a class="elsevierStyleCrossRef" href="#bib0125">6</a> In particular, beta-defensin 2 (HBD-2) has been documented as a molecule that prevents Candida proliferation in vitro.<a class="elsevierStyleCrossRef" href="#bib0185">17</a> Previous works also attributed the antifungal activity of AF to spermine,<a class="elsevierStyleCrossRef" href="#bib0170">14</a> and to anti-Candida antibodies.<a class="elsevierStyleCrossRef" href="#bib0165">13</a>Several researchers studied the antibacterial activity of AF against aerobic and anaerobic bacteria.<a class="elsevierStyleCrossRefs" href="#bib0110">3,18</a> The inhibitory activity of AF against C. albicans has been shown previously.<a class="elsevierStyleCrossRefs" href="#bib0100">1,8,9,11,13,14</a> This is the first study on the activity of AF against C. albicans and other Candida species. Our results show that AF has inhibitory activity not only against C. albicans, but also against C. glabrata and C. parapsilosis. Only C. glabrata growth was completely inhibited by all 23 AF samples.The in vitro antifungal activity of AF against C. albicans, C. glabrata and C. parapsilosis likely exists also in vivo, thus contributing to the prevention of intraamniotic fungal infections. It would be interesting to study the activity of AF against Candida auris and other emerging Candida species. In particular, it is important to understand whether the antifungal activity of AF is mediated by the restriction of important growth factors to the pathogen (e.g., nutritional immunity) or the presence of antimicrobial peptides (e.g. defensins).FundingThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Conflict of interestThe authors declare that they have no competing interests." "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:3 [ "identificador" => "xres1577131" "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" => "xpalclavsec1421266" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1577132" "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" => "xpalclavsec1421265" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] 6 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-05-24" "fechaAceptado" => "2021-02-26" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1421266" "palabras" => array:5 [ 0 => "Amniotic fluid" 1 => "Antifungal activity" 2 => "Candida albicans" 3 => "Candida glabrata" 4 => "Candida parapsilosis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1421265" "palabras" => array:5 [ 0 => "Líquido amniótico" 1 => "Actividad antifúngica" 2 => "Candida albicans" 3 => "Candida glabrata" 4 => "Candida parapsilosis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "BackgroundAlthough Candida is a commensal of the urogenital tract, intrauterine fungal infections are extremely uncommon in clinical practice. AimsIn the present work we evaluated whether amniotic fluid (AF) possesses direct antifungal activity against clinical isolates of Candidaalbicans and other Candida species. MethodsA total of 23 AF samples from pregnant women with gestational age of 38–41 weeks were obtained under aseptic conditions by the aspiration of the amniotic sac during cesarean section. Different Candida species were inoculated in amniotic fluid and Sabouraud broth, used as control, and were incubated at 37°C for 48h. Quantitative cultures of test samples and controls were performed at 0, 4, 8, 12, 24, and 48h. ResultsAF collected from 23 pregnant women had consistent and significant inhibitory activity against all Candida isolates tested. Nonetheless, a complete inhibition of growth by all 23 AF samples tested was observed only against Candida glabrata. ConclusionsIt is likely that the antifungal activity of the AF against C. albicans, C. glabrata and Candida parapsilosis observed in vitro also exists in vivo, contributing to protect against intrauterine fungal infections." "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" => "AntecedentesAunque Candida es un comensal del tracto urogenital, las infecciones fúngicas intrauterinas son extremadamente poco frecuentes en la práctica clínica. ObjetivosEn el presente trabajo evaluamos si el líquido amniótico posee actividad antifúngica directa contra aislamientos clínicos de Candida albicans y otras especies del género Candida. MétodosSe obtuvieron un total de 23 muestras de líquido amniótico de mujeres embarazadas con edad gestacional de 38 a 41 semanas en condiciones asépticas por aspiración del saco amniótico durante la cesárea. Se inocularon diferentes especies de Candida en líquido amniótico y caldo Sabouraud, que se usó como control, y se incubaron a 37°C durante 48h. Se realizaron cultivos cuantitativos de las muestras y controles a las 0, 4, 8, 12, 24 y 48h. ResultadosEl líquido amniótico recogido de 23 mujeres embarazadas tuvo actividad inhibidora consistente y significativa contra todos los aislamientos de Candida probados. No obstante, la inhibición completa del crecimiento con las 23 muestras de líquido amniótico analizadas se observó solo frente a Candida glabrata. ConclusionesProbablemente la actividad antifúngica del líquido amniótico observada in vitro contra C. albicans, C. glabrata y Candida parapsilosis también existe in vivo, y contribuye a la protección de las infecciones fúngicas intrauterinas." "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:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 735 "Ancho" => 2341 "Tamanyo" => 196246 ] ] "descripcion" => array:1 [ "en" => "Kinetics of growth of Candida clinical isolates in the presence of amniotic fluid versus Sabouraud broth (control). Each line represents the growth curve over time of a sole Candida isolate, grown either in amniotic fluid or in Sabouraud broth (control). Each symbol represents the log10 CFU value at different time points. p<0.0001; Student's t test." ] ] 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:1 [ "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" 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">Characteristics \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">Value \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">Age in years (mean±SD) \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.6±5.44 \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">Ethnicity (Greek/immigrant) \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21/2 \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">Gestational weeks (mean±SD) \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.3±0.98 \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">Previous pregnancies \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 \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">Use of antibiotics \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \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">Use of antifungals \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \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">Use of steroids \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \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">Smoking \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \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">Diabetes \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \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">Other comorbidities \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2703664.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Demographics and clinical characteristics of the 23 AF donor women." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "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" 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">Antifungal agent \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">C. albicans(B 8268) \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">C. glabrata (B 81348) \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">C. parapsilosis (B 81524) \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">Amphotericin B \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">0.125 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.25 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.19 \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">Flucytocine \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">0.38 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.032 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.38 \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">Ketoconazole \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">0.125 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.094 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.032 \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">Fluconazole \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">0.5 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \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">Voriconazole \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">0.064 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.032 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.012 \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">Posaconazole \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">0.75 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.75 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.008 \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">Caspofungin \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">0.094 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.125 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 \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">Micafungin \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">0.032 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.008 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 \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">Anidulafungin \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">0.008 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.012 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.25 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2703663.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Minimum inhibitory concentrations (μg/ml) of nine antifungal agents against the three clinical isolates. E-test was the method used." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib0100" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stunted growth of Candida albicans in human amniotic fluid in vitro" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Auger" 1 => "G. Marquis" 2 => "L. Dallaire" 3 => "J. Joly" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Lab Med" "fecha" => "1980" "volumen" => "95" "paginaInicial" => "272" "paginaFinal" => "281" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0105" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vaginal yeast colonization in nonpregnant women: a longitudinal study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.H. Beigi" 1 => "L.A. Meyn" 2 => "D.M. Moore" 3 => "M.A. Krohn" 4 => "S.L. Hillier" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Obstet Gynecol" "fecha" => "2004" "volumen" => "104" "paginaInicial" => "926" "paginaFinal" => "930" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0110" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Potere lisozimico del liquido amniotico e potere antilisozimico del meconio" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. 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Wiznitzer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/BF02718273" "Revista" => array:6 [ "tituloSerie" => "Arch Gynecol Obstet" "fecha" => "1992" "volumen" => "251" "paginaInicial" => "9" "paginaFinal" => "15" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1550392" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0120" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-albicansCandida infection: an emerging threat" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.C. Deorukhkar" 1 => "S. Saini" 2 => "S. 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Antifungal activity of amniotic fluid against different Candida species

Actividad antifúngica del líquido amniótico contra diferentes especies de Candida

Sofia Marakia,

Corresponding author

sofiamaraki@yahoo.gr

Corresponding author.

, Dimitra Stafylakia, Spyridon A. Karageorgosb, Filippos Koutroumpakisc, George Hamilosa, Antonis Makrigiannakisd, George Samonisc

a Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, Crete, Greece

b Division of Infectious Diseases, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

c Infectious Diseases Unit, University Hospital of Heraklion and University of Crete Medical School, Heraklion, Crete, Greece

d Department of Obstetrics and Gynecology, Medical School, University of Crete, Heraklion, Greece

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            "entidad" => "Department of Clinical Microbiology and Microbial Pathogenesis&#44; University Hospital of Heraklion&#44; Crete&#44; Greece"
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        "titulo" => "Actividad antif&#250;ngica del l&#237;quido amni&#243;tico contra diferentes especies de <span class="elsevierStyleItalic">Candida</span>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Kinetics of growth of <span class="elsevierStyleItalic">Candida</span> clinical isolates in the presence of amniotic fluid <span class="elsevierStyleItalic">versus</span> Sabouraud broth &#40;control&#41;&#46; Each line represents the growth curve over time of a sole <span class="elsevierStyleItalic">Candida</span> isolate&#44; grown either in amniotic fluid or in Sabouraud broth &#40;control&#41;&#46; Each symbol represents the log10 CFU value at different time points&#46; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#59; Student&#39;s <span class="elsevierStyleItalic">t</span> test&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Candida</span> species are part of the commensal genital microbiota of approximately 20&#37; of asymptomatic&#44; healthy women during reproductive age&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a> Colonization rates increase to about 30&#37; in pregnant women&#44; particularly during the third trimester&#44; due to the high levels of circulating estrogens that promote yeast adhesion and germination&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">12&#44;15</span></a> Among <span class="elsevierStyleItalic">Candida</span> species&#44; <span class="elsevierStyleItalic">Candida albicans</span> is the most frequently isolated&#46; However&#44; due to the widespread use of azoles&#44; other multidrug-resistant species&#44; including <span class="elsevierStyleItalic">Candida glabrata</span>&#44; <span class="elsevierStyleItalic">Candida parapsilosis</span> and <span class="elsevierStyleItalic">Candida tropicalis</span>&#44; are emerging causes of systemic infections worldwide&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">5</span></a> Despite the high vaginal <span class="elsevierStyleItalic">Candida</span> colonization rates&#44; intrauterine fetal infections due to these yeasts are rarely encountered&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">4</span></a> This observation is consistent with the antifungal properties of the amniotic fluid &#40;AF&#41; against <span class="elsevierStyleItalic">Candida albicans</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">9&#44;11</span></a> However&#44; there is no information on AF activity against non-<span class="elsevierStyleItalic">C&#46; albicans Candida</span> species&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In this study we evaluated the antifungal effect of AF obtained during the 38th&#8211;41st week of gestation against <span class="elsevierStyleItalic">C&#46; albicans</span>&#44; <span class="elsevierStyleItalic">C&#46; glabrata</span>&#44; and <span class="elsevierStyleItalic">C&#46; parapsilosis</span> clinical isolates&#46; The study included 23 pregnant women followed up at the Obstetrics Department of the University Hospital of Heraklion&#44; in Crete&#44; Greece&#44; from November 2015 to May 2016&#46; The demographics and clinical details of the 23 AF donors are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The requirements to be enrolled were being in a gestational age of 38&#8211;41 weeks at delivery&#44; and giving birth by cesarean section without having taken antibiotics in the previous month&#46; Ethical approval for the study was obtained by the IRB of the hospital &#40;15095&#47;30-3-2016&#41;&#46; Written consent was signed by each study participant&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Amniotic fluid samples were obtained under aseptic conditions by aspirating through the amniotic sac during cesarean section&#46; All women had intact membranes&#46; Samples contaminated with meconium or blood were excluded&#46; The first 10<span class="elsevierStyleHsp" style=""></span>ml of the amniotic fluid were discarded in order to avoid blood&#44; and the remainder was collected in sterile tubes and immediately centrifuged at 3000<span class="elsevierStyleHsp" style=""></span>rpm for 15<span class="elsevierStyleHsp" style=""></span>min&#46; The supernatant was frozen at &#8722;80<span class="elsevierStyleHsp" style=""></span>&#176;C until further processing&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The strains used to assay the inhibitory activity of AF were recovered from patients with invasive candidiasis and identified by sequencing of the internal transcribed spacer 1 and 2 &#40;ITS1-5&#46;8SrRNA-ITS2&#41;&#46; The isolates are stored in the library of the Department of Clinical Microbiology and Microbial Pathogenesis of the University Hospital of Heraklion&#44; Greece and are available upon request&#46; The sequences of all three isolates were submitted to Genbank&#44; being assigned the following accession numbers&#58; <span class="elsevierStyleItalic">Candida albicans</span> B 8268 &#40;GenBank accession no&#46; MW616800&#41;&#44; <span class="elsevierStyleItalic">Candida glabrata</span> B 81348 &#40;GenBank accession no&#46; MW616799&#41;&#44; and <span class="elsevierStyleItalic">Candida parapsilosis</span> B 81524 &#40;GenBank accession no&#46; MW616798&#41;&#46; The activity of the main antifungal agents against these isolates are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; Yeasts grown overnight on Sabouraud dextrose agar &#40;bioM&#233;rieux&#44; Marcy L&#8217; Etoile&#44; France&#41; were suspended in sterile normal saline&#46; Serial dilutions of the suspensions with additional normal saline to achieve a concentration of 10<span class="elsevierStyleSup">4</span><span class="elsevierStyleHsp" style=""></span>yeasts&#47;ml were made&#46; From this final dilution&#44; 0&#46;2<span class="elsevierStyleHsp" style=""></span>ml were added to 1&#46;8<span class="elsevierStyleHsp" style=""></span>ml of amniotic fluid&#44; and other 0&#46;2<span class="elsevierStyleHsp" style=""></span>ml to 1&#46;8<span class="elsevierStyleHsp" style=""></span>ml of Sabouraud broth&#46; The latter was the positive control for <span class="elsevierStyleItalic">Candida</span> growth&#46; Amniotic fluids and controls were incubated at 37<span class="elsevierStyleHsp" style=""></span>&#176;C for 48<span class="elsevierStyleHsp" style=""></span>h&#46; Aliquots of 0&#46;2<span class="elsevierStyleHsp" style=""></span>ml were collected both from the amniotic fluids under testing and the controls at 0&#44; 4&#44; 8&#44; 12&#44; 24&#44; and 48<span class="elsevierStyleHsp" style=""></span>h&#44; being serially diluted with normal saline up to 10<span class="elsevierStyleSup">&#8722;12</span>&#46; Samples of 0&#46;1<span class="elsevierStyleHsp" style=""></span>ml of each dilution were streaked on Sabouraud dextrose agar plates&#44; which were incubated for 48<span class="elsevierStyleHsp" style=""></span>h at 37<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; and colony forming units &#40;CFUs&#41; were counted&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">7</span></a> All experiments were performed in triplicate&#44; in order to check the reproducibility of the results&#46; Differences in CFUs between control and AF samples were compared by unpaired Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#46; Statistical significance was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; All statistical analyses were performed with Graphpad Prism&#44; V&#46;4 &#40;GraphPad Software Inc&#44; CA&#44; USA&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">As shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; all 23 AF samples possessed a significant inhibitory activity against all three clinical isolates of <span class="elsevierStyleItalic">Candida</span>&#46; The antifungal activity of AF was more pronounced against <span class="elsevierStyleItalic">C&#46; glabrata</span>&#44; since all AF samples prevented this species from growing &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; In contrast&#44; when compared to the initial inoculum &#40;0<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; minimal growth was observed in <span class="elsevierStyleItalic">C&#46; albicans</span> &#40;with certain AF samples&#41; and <span class="elsevierStyleItalic">C&#46; parapsilosis</span> &#40;all AF samples&#41; at 48<span class="elsevierStyleHsp" style=""></span>h &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Azole-resistant non-<span class="elsevierStyleItalic">C&#46; albicans</span><span class="elsevierStyleItalic">Candida</span> species&#44; including <span class="elsevierStyleItalic">C&#46; glabrata</span>&#44; are increasingly encountered as causes of urogenital infections worldwide&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a> Despite the increased rates of <span class="elsevierStyleItalic">Candida</span> vaginal colonization during pregnancy&#44; intrauterine infections are extremely uncommon&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">4&#44;10</span></a> This is suggestive of a host effector mechanism with specific antifungal properties&#44; including the antifungal properties of AF&#46; Antimicrobial components of AF include cytokines and host defense proteins&#44; including defensins&#44; lactoferrin&#44; lysozyme&#44; and other antimicrobial peptides&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">6</span></a> In particular&#44; beta-defensin 2 &#40;HBD-2&#41; has been documented as a molecule that prevents <span class="elsevierStyleItalic">Candida</span> proliferation <span class="elsevierStyleItalic">in vitro</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">17</span></a> Previous works also attributed the antifungal activity of AF to spermine&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> and to anti-<span class="elsevierStyleItalic">Candida</span> antibodies&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Several researchers studied the antibacterial activity of AF against aerobic and anaerobic bacteria&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">3&#44;18</span></a> The inhibitory activity of AF against <span class="elsevierStyleItalic">C&#46; albicans</span> has been shown previously&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">1&#44;8&#44;9&#44;11&#44;13&#44;14</span></a> This is the first study on the activity of AF against <span class="elsevierStyleItalic">C&#46; albicans</span> and other <span class="elsevierStyleItalic">Candida</span> species&#46; Our results show that AF has inhibitory activity not only against <span class="elsevierStyleItalic">C&#46; albicans</span>&#44; but also against <span class="elsevierStyleItalic">C&#46; glabrata</span> and <span class="elsevierStyleItalic">C&#46; parapsilosis</span>&#46; Only <span class="elsevierStyleItalic">C&#46; glabrata</span> growth was completely inhibited by all 23 AF samples&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">in vitro</span> antifungal activity of AF against <span class="elsevierStyleItalic">C&#46; albicans</span>&#44; <span class="elsevierStyleItalic">C&#46; glabrata</span> and <span class="elsevierStyleItalic">C&#46; parapsilosis</span> likely exists also <span class="elsevierStyleItalic">in vivo</span>&#44; thus contributing to the prevention of intraamniotic fungal infections&#46; It would be interesting to study the activity of AF against <span class="elsevierStyleItalic">Candida auris</span> and other emerging <span class="elsevierStyleItalic">Candida</span> species&#46; In particular&#44; it is important to understand whether the antifungal activity of AF is mediated by the restriction of important growth factors to the pathogen &#40;<span class="elsevierStyleItalic">e&#46;g&#46;</span>&#44; nutritional immunity&#41; or the presence of antimicrobial peptides &#40;<span class="elsevierStyleItalic">e&#46;g&#46;</span> defensins&#41;&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflict of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that they have no competing interests&#46;</p></span></span>"
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            0 => "Amniotic fluid"
            1 => "Antifungal activity"
            2 => "<span class="elsevierStyleItalic">Candida albicans</span>"
            3 => "<span class="elsevierStyleItalic">Candida glabrata</span>"
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            0 => "L&#237;quido amni&#243;tico"
            1 => "Actividad antif&#250;ngica"
            2 => "<span class="elsevierStyleItalic">Candida albicans</span>"
            3 => "<span class="elsevierStyleItalic">Candida glabrata</span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Although <span class="elsevierStyleItalic">Candida</span> is a commensal of the urogenital tract&#44; intrauterine fungal infections are extremely uncommon in clinical practice&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Aims</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In the present work we evaluated whether amniotic fluid &#40;AF&#41; possesses direct antifungal activity against clinical isolates of <span class="elsevierStyleItalic">Candida</span><span class="elsevierStyleItalic">albicans</span> and other <span class="elsevierStyleItalic">Candida</span> species&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 23 AF samples from pregnant women with gestational age of 38&#8211;41 weeks were obtained under aseptic conditions by the aspiration of the amniotic sac during cesarean section&#46; Different <span class="elsevierStyleItalic">Candida</span> species were inoculated in amniotic fluid and Sabouraud broth&#44; used as control&#44; and were incubated at 37<span class="elsevierStyleHsp" style=""></span>&#176;C for 48<span class="elsevierStyleHsp" style=""></span>h&#46; Quantitative cultures of test samples and controls were performed at 0&#44; 4&#44; 8&#44; 12&#44; 24&#44; and 48<span class="elsevierStyleHsp" style=""></span>h&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">AF collected from 23 pregnant women had consistent and significant inhibitory activity against all <span class="elsevierStyleItalic">Candida</span> isolates tested&#46; Nonetheless&#44; a complete inhibition of growth by all 23 AF samples tested was observed only against <span class="elsevierStyleItalic">Candida glabrata</span>&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">It is likely that the antifungal activity of the AF against <span class="elsevierStyleItalic">C&#46; albicans</span>&#44; <span class="elsevierStyleItalic">C&#46; glabrata</span> and <span class="elsevierStyleItalic">Candida parapsilosis</span> observed <span class="elsevierStyleItalic">in vitro</span> also exists <span class="elsevierStyleItalic">in vivo</span>&#44; contributing to protect against intrauterine fungal infections&#46;</p></span>"
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      "es" => array:3 [
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Aunque <span class="elsevierStyleItalic">Candida</span> es un comensal del tracto urogenital&#44; las infecciones f&#250;ngicas intrauterinas son extremadamente poco frecuentes en la pr&#225;ctica cl&#237;nica&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">En el presente trabajo evaluamos si el l&#237;quido amni&#243;tico posee actividad antif&#250;ngica directa contra aislamientos cl&#237;nicos de <span class="elsevierStyleItalic">Candida albicans</span> y otras especies del g&#233;nero <span class="elsevierStyleItalic">Candida</span>&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se obtuvieron un total de 23 muestras de l&#237;quido amni&#243;tico de mujeres embarazadas con edad gestacional de 38 a 41 semanas en condiciones as&#233;pticas por aspiraci&#243;n del saco amni&#243;tico durante la ces&#225;rea&#46; Se inocularon diferentes especies de <span class="elsevierStyleItalic">Candida</span> en l&#237;quido amni&#243;tico y caldo Sabouraud&#44; que se us&#243; como control&#44; y se incubaron a 37<span class="elsevierStyleHsp" style=""></span>&#176;C durante 48<span class="elsevierStyleHsp" style=""></span>h&#46; Se realizaron cultivos cuantitativos de las muestras y controles a las 0&#44; 4&#44; 8&#44; 12&#44; 24 y 48<span class="elsevierStyleHsp" style=""></span>h&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">El l&#237;quido amni&#243;tico recogido de 23 mujeres embarazadas tuvo actividad inhibidora consistente y significativa contra todos los aislamientos de <span class="elsevierStyleItalic">Candida</span> probados&#46; No obstante&#44; la inhibici&#243;n completa del crecimiento con las 23 muestras de l&#237;quido amni&#243;tico analizadas se observ&#243; solo frente a <span class="elsevierStyleItalic">Candida glabrata</span>&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Probablemente la actividad antif&#250;ngica del l&#237;quido amni&#243;tico observada <span class="elsevierStyleItalic">in vitro</span> contra <span class="elsevierStyleItalic">C&#46; albicans</span>&#44; <span class="elsevierStyleItalic">C&#46; glabrata</span> y <span class="elsevierStyleItalic">Candida parapsilosis</span> tambi&#233;n existe <span class="elsevierStyleItalic">in vivo</span>&#44; y contribuye a la protecci&#243;n de las infecciones f&#250;ngicas intrauterinas&#46;</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" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Kinetics of growth of <span class="elsevierStyleItalic">Candida</span> clinical isolates in the presence of amniotic fluid <span class="elsevierStyleItalic">versus</span> Sabouraud broth &#40;control&#41;&#46; Each line represents the growth curve over time of a sole <span class="elsevierStyleItalic">Candida</span> isolate&#44; grown either in amniotic fluid or in Sabouraud broth &#40;control&#41;&#46; Each symbol represents the log10 CFU value at different time points&#46; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#59; Student&#39;s <span class="elsevierStyleItalic">t</span> test&#46;</p>"
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                  <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" 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">Characteristics&nbsp;\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">Value&nbsp;\t\t\t\t\t\t\n
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                  \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">Age in years &#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#41;&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;44&nbsp;\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">Ethnicity &#40;Greek&#47;immigrant&#41;&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#47;2&nbsp;\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">Gestational weeks &#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#41;&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;98&nbsp;\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">Previous pregnancies&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\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">Use of antibiotics&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\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">Use of antifungals&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\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">Use of steroids&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\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">Smoking&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\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">Diabetes&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\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">Other comorbidities&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Demographics and clinical characteristics of the 23 AF donor women&#46;</p>"
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        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
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        "tabla" => array:1 [
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            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" 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">Antifungal agent&nbsp;\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"><span class="elsevierStyleItalic">C&#46; albicans</span>&#40;B 8268&#41;&nbsp;\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"><span class="elsevierStyleItalic">C&#46; glabrata</span> &#40;B 81348&#41;&nbsp;\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"><span class="elsevierStyleItalic">C&#46; parapsilosis</span> &#40;B 81524&#41;&nbsp;\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">Amphotericin B&nbsp;\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">0&#46;125&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;25&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;19&nbsp;\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">Flucytocine&nbsp;\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">0&#46;38&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;032&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;38&nbsp;\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">Ketoconazole&nbsp;\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">0&#46;125&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;094&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;032&nbsp;\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">Fluconazole&nbsp;\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">0&#46;5&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\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">Voriconazole&nbsp;\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">0&#46;064&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;032&nbsp;\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;012&nbsp;\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">Posaconazole&nbsp;\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">0&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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Article information

ISSN: 11301406
Original language: English

DOI:10.1016/j.riam.2021.02.002

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Year/Month	Html	Pdf	Total

2024 November	1	0	1
2024 October	32	1	33
2024 September	34	4	38
2024 August	29	2	31
2024 July	30	3	33
2024 June	31	5	36
2024 May	19	5	24
2024 April	28	6	34
2024 March	32	1	33
2024 February	25	8	33
2024 January	33	2	35
2023 December	32	4	36
2023 November	38	10	48
2023 October	58	15	73
2023 September	51	3	54
2023 August	22	2	24
2023 July	29	1	30
2023 June	60	10	70
2023 May	83	3	86
2023 April	86	14	100
2023 March	36	4	40
2023 February	40	6	46
2023 January	24	10	34
2022 December	32	17	49
2022 November	48	12	60
2022 October	35	17	52
2022 September	33	23	56
2022 August	17	34	51
2022 July	18	10	28
2021 October	0	2	2
2021 August	0	2	2
2021 July	0	2	2

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