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Id: biblio-1045660
Autor: Mah-Lee, R; Barrow, G.
Título: A case of systemic cryptococcal disease in HIV infection
Fonte: West Indian med. j;62(4):374-376, 2013. ilus.
Idioma: en.
Descritores: Infecções Oportunistas Relacionadas com a AIDS/diagnóstico
Criptococose/diagnóstico
-Fluconazol/uso terapêutico
Anfotericina B/uso terapêutico
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico
Criptococose/tratamento farmacológico
Antifúngicos/uso terapêutico
Limites: Humanos
Masculino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: biblio-899739
Autor: Tiraboschi, Iris Nora; Pozzi, Natalia Cintia; Farías, Luciana; García, Susana; Fernández, Norma Beatriz.
Título: Epidemiología, especies, resistencia antifúngica y evolución de las candidemias en un hospital universitario de Buenos Aires, Argentina, durante 16 años / Epidemiology, species, antifungal resistance and outcome of candidemia in a university hospital in Buenos Aires, Argentina for 16 years
Fonte: Rev. chil. infectol;34(5):431-440, oct. 2017. tab, graf.
Idioma: es.
Resumo: Resumen Introducción: La epidemiologia de las candidemias varía en cada región. Objetivos: Conocer la epidemiología de las candidemias en un hospital durante 16 años. Material y Métodos: Se revisaron los episodios de candidemia ocurridos en el Hospital de Clínicas de Buenos Aires desde 01/01/98 al 31/12/13. Resultados: Se identificaron 374 episodios de candidemia. La incidencia fue de 2,21/1.000 egresos y aumentó de 1,96 (1998-2005) a 2,25 (2006-2013) (p = 0,023). Se diagnosticaron: 5,4% en neonatos, 1,7% en lactantes, 6,5% en niños mayores, 31,8% en adultos y 52,7% en adultos mayores de 64 años. Los episodios fueron causados por C. albicans (40,9%), C. parapsilosis (21,7%), C. tropicalis (15,5%), C. glabrata (13,9%), otras especies de Candida (5,1%) y candidemias multiespecies (2,9%). El 5,3% de los aislados fue resistente a fluconazol. Setenta y cuatro por ciento de los pacientes recibió tratamiento; 70,3% lo inició con fluconazol, 25% con anfotericina B desoxicolato y 4,7% con equinocandinas o anfotericinas lipídicas. Se retiró 81% de los catéteres venosos centrales. La mortalidad fue de 47,9%, pero fue de 60,8% para los adultos mayores. Conclusión: La incidencia de candidemias se incrementó a través de los años, fue mayor en los adultos mayores y esta población tuvo peor evolución.

Background: The epidemiology of candidemia vary by region. Aim: To determine the epidemiology of candidemia in a hospital for 16 years. Material and Methods: Episodes of candidemia occurred in the Hospital de Clinicas of Buenos Aires were reviewed, from 01/01/98 to 31/12/13. Results: 374 episodes of candidemia were identified. The incidence was 2.21/1,000 discharges and increased from 1.96 (1998-2005) to 2.25 (2006-2013) (p = 0.023). Candidemia was diagnosed: 5.4% in neonates, 1.7% in infants, 6.5% in children, 31.8% in adults and 52.7% in elderly adults over 64 years old. The episodes were caused by C. albicans (40.9%), C. parapsilosis (21.7%), C. tropicalis (15.5%), C. glabrata (13.9%), other species of Candida (5.1%) and more than one species of Candida (2.9%). The 5.3% of the isolates were resistant to fluconazole. 74% of patients were treated. Initial treatments were with fluconazole (70.3%), amphotericin B deoxycholate (25%), echinocandins or lipidic amphotericin (4,7%). The 81% of central venous catheters were taken off. Mortality rate was of 47.9%, but in the elderly adults was of 60.8%. Conclusion: The incidence of candidemia showed an increase over the years. It was higher in the elderly adults, being the group with worse outcomes.
Descritores: Candida/isolamento & purificação
Fluconazol/uso terapêutico
Infecção Hospitalar/tratamento farmacológico
Infecção Hospitalar/epidemiologia
Candidemia/tratamento farmacológico
Candidemia/epidemiologia
Antifúngicos/uso terapêutico
-Argentina/epidemiologia
Fatores de Tempo
Candida/efeitos dos fármacos
Testes de Sensibilidade Microbiana
Infecção Hospitalar/microbiologia
Incidência
Análise Multivariada
Estudos Retrospectivos
Fatores de Risco
Distribuição por Idade
Farmacorresistência Fúngica
Candidemia/microbiologia
Cateteres Venosos Centrais/efeitos adversos
Hospitais Universitários
Limites: Humanos
Masculino
Feminino
Recém-Nascido
Lactente
Pré-Escolar
Criança
Adolescente
Adulto
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Adulto Jovem
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1252340
Autor: Villacís Villacís, Anny Gabriela; Ávila Tandazo, Marly Katherine; Silverio, Carmen.
Título: Evaluación de susceptibilidad en cándidas spp por colorimetría obtenida en gestantes de un hospital obstétrico / Susceptibility evaluation in candida spp by colorimetry obtained in pregnant women from an obstetric hospital / Avaliação da suscetibilidade em cândida spp por colorimetria obtida em gestantes de um hospital obstétrico
Fonte: Vive (El Alto);3(9):227-246, dic. 2020. ilus.
Idioma: es.
Resumo: INTRODUCCIÓN: las infecciones fúngicas ocasionadas por levaduras del género Cándida son extremadamente comunes en mujeres de edad reproductiva, y constituyen un motivo de atención medica de salud. OBJETIVO: evaluar la susceptibilidad de Cándidas spp, mediante el método colorimétrico (Integral Yeast System Plus). MÉTODO: fue de tipo descriptivo, transversal; se recopiló información mediante observación directa en campo y el análisis documental para obtener información bibliográfica de tipo secundaria. RESULTADOS: de los 72 casos encontrados de Cándida Albicans revela que son susceptibles a la anfotericina B (2ug/ml); de los 5 casos encontrados de Cándida Krusei revela que son sensibles a la Anfotericina B (2ug/ml); De 1 caso encontrado de Cándida Parapsilosis revela sensibilidad en la Nistatina (1.25ug/ml). En este estudio la prevalencia de la infección por Cándida fue del (44.98%). CONCLUSIONES: Cándida Albicans fue la especie más común aislada en las mujeres embarazadas representando un 72%, En la evaluación de la susceptibilidad a través del kit Integral System Yeast Plus se obtuvo que Cándida Albicans es susceptible a Anfotericina B, Flucitosina entre otros, en Cándida Glabrata se obtuvo que es sensible a la Nistatina, Anfotericina B, susceptible entre otros, en Cándida Krusei se obtuvo que es sensible a la Anfotericina B, Clotrimazol, Miconazol, susceptibles a la Nistatina, Voriconazol y resistente a la Flucitosina, Ketoconazol, Itraconazol y Fluconazol.

INTRODUCTION: fungal infections caused by yeast of the genus Candida are extremely common in women of reproductive age, and constitute a reason for medical health care. OBJECTIVE: to evaluate the susceptibility of Candida spp, using the colorimetric method (Integral Yeast System Plus). METHOD: it was descriptive, transversal; Information was collected through direct observation in the field and documentary analysis to obtain secondary bibliographic information. RESULTS: of the 72 cases found, Candida Albicans reveals that they are susceptible to amphotericin B (2ug / ml); of the 5 cases found, Candida Krusei reveals that they are sensitive to Amphotericin B (2ug / ml); Of 1 case found of Candida Parapsilosis reveals sensitivity in Nystatin (1.25ug / ml). In this study, the prevalence of Candida infection was (44.98%). CONCLUSIONS: Candida Albicans was the most common species isolated in pregnant women, representing 72%. In the evaluation of susceptibility through the Integral System Yeast Plus kit it was obtained that Candida Albicans is susceptible to Amphotericin B, Flucytosine among others, in Candida Glabrata was obtained that it is sensitive to Nystatin, Amphotericin B, susceptible among others, in Candida Krusei it was obtained that it is sensitive to Amphotericin B, Clotrimazole, Miconazole, susceptible to Nystatin, Voriconazole and resistant to Flucytosin, Ketoconazole, Itraconazole and Fluconazole.

INTRODUÇÃO: as infecções fúngicas causadas por leveduras do gênero Candida são extremamente comuns em mulheres em idade reprodutiva e constituem motivo de cuidados médicos. OBJETIVO: avaliar a suscetibilidade de Candida spp, por meio do método colorimétrico (Integral Yeast System Plus). MÉTODO: foi descritivo, transversal; as informações foram coletadas por meio de observação direta em campo e análise documental para obtenção de informações bibliográficas secundárias. RESULTADOS: Dos 72 casos encontrados, Cândida Albicans revelou ser suscetíveis à anfotericina B (2ug /ml); dos 5 casos encontrados, Candida Krusei revela que são sensíveis à Anfotericina B (2ug / ml); de 1 caso encontrado de Candida Parapsilosis revela sensibilidade na Nistatina (1,25ug / ml). Neste estudo, a prevalência de infecção por Candida foi (44,98%). CONCLUSÕES: Cândida Albicans foi a espécie mais comum isolada em gestantes, representando 72%. Na avaliação da susceptibilidade através do kit Integral System Yeast Plus foi obtido que Candida Albicans é suscetível à Anfotericina B, Flucitosina entre outras, em Cândida Glabrata foi obtido que é sensível a Nistatina, Anfotericina B, suscetível entre outras, em Candida Krusei foi obtido que é sensível a Anfotericina B, Clotrimazol, Miconazol, suscetível a Nistatina, Voriconazol e resistente a Flucitosina, Cetoconazol, Itraconazol e Fluconazol.
Descritores: Candida
Candida albicans
Anfotericina B
Colorimetria
Candida glabrata
Gestantes
-Fluconazol
Prevalência
Clotrimazol
Itraconazol
Voriconazol
Flucitosina
Candida parapsilosis
Infecções
Miconazol
Limites: Humanos
Feminino
Gravidez
Adulto
Tipo de Publ: Estudo Observacional
Responsável: BO138.1 - Biblioteca Central


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Id: biblio-915548
Autor: Girelli, Kely Marcia; Benedetti, Volmir Pitt.
Título: Perfil de sensibilidade de candida albicans frente ao fluconazol isolados de diferentes sítios anatômicos / Candida albicans sensitivity profile against fluconazole isolated from different anatomical locations
Fonte: Arq. ciências saúde UNIPAR;22(3):171-175, Set-Dez. 2018.
Idioma: pt.
Resumo: O gênero Candida compreende leveduras redondas ou ovaladas que acarretam em uma diversidade de infecções que recebem o nome de candidíase. O curso dessas infecções depende muito do sistema imunológico do indivíduo. Candida albicans é a principal espécie envolvida em infecções no ser humano. Estudos indicam que esta espécie é responsável por 60% dos isolados de amostras clínicas. As infecções fúngicas causadas por leveduras do gênero Candida são frequentemente tratadas com antifúngicos azólicos, principalmente, o fluconazol. A resistência a agentes antifúngicos, como a que acontece com o fluconazol, pode ter diferentes origens, dentre elas cita-se a alteração da enzima alvo, que por consequência diminui a ligação do fármaco, redução dos efeitos tóxicos da droga, aumento da quantidade de enzima alvo ou também pela acumulação intracelular da droga. Neste contexto, esta pesquisa avaliou o perfil de sensibilidade de isolados de Candida albicans frente ao fluconazol, com diferentes grupos de pacientes e diferentes sítios anatômicos. A avaliação da suscetibilidade das leveduras com determinação da Concentração Inibitória Mínima (CIM) ao fluconazol foi realizada utilizando - se o E-test em ágar Mueller-Hinton suplementado, seguindo o documento M44-A2, do Clinical and Laboratory Standards Institute (CLSI). Os critérios para a classificação dos padrões de suscetibilidade seguiram o documento M27-A3. Nesta pesquisa foi constatado que 100% dos isolados de Candida albicans eram sensíveis ao fluconazol e que não houve diferença estatística nos valores de CIM, quando confrontado ao gênero, faixa etária, tipo de paciente, a única diferença encontrada nos valores de CIM, ocorreu quando se comparou ao sitio anatômico, pois os isolados de corrente sanguínea apresentaram os maiores valores de concentração inibitória mínima frente ao fluconazol.

The Candida genus comprises gram-positive round or oval yeasts, which lead to a diversity of infections known as candidiasis. The course of such infections depends greatly on the individual's immune system. Candida albicans is the main species involved in the infection in humans. Studies indicate that this species is responsible for 60% of isolates from clinical samples. Fungal infections caused by yeasts of the Candida genus are often treated with azole antifungals, mainly fluconazole. Resistance to antifungal agents such as fluconazole can have different origins, among which the alteration of the target enzyme, which consequently decreases the drug's binding, the reduction in the toxic effects of the drug, the increase in the amount of enzyme or intracellular accumulation of the drug. Within this context, this study assessed the sensitivity profile of Candida albicans isolates against fluconazole, with different patient groups and different anatomical sites. The assessment of yeast susceptibility with the Minimum Inhibitory Concentration (MIC) to fluconazole determined using the E-test on supplemented Mueller-Hinton agar, following the M44-A2 document from the Clinical and Laboratory Standards Institute (CLSI). The susceptibility patterns were classified according to criteria in document M27-A3. In this study, 100% of Candida albicans isolates were sensitive to fluconazole, and no statistical difference were presented in MIC values when compared to gender, age and patient type, with the only difference found in MIC values occurring when compared to the anatomical site, since bloodstream isolates presented the highest values of minimum inhibitory concentration against fluconazole.
Descritores: Candida
Fluconazol
Resistência à Doença
Responsável: BR1532.9 - CEDIC - Coordenadoria de Editoração e Divulgação Científica


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Id: biblio-1041438
Autor: Mattos, Karine; Rodrigues, Luana Carbonera; Oliveira, Kelly Mari Pires de; Diniz, Pedro Fernando; Marques, Luiza Inahê; Araujo, Adriana Almeida; Chang, Marilene Rodrigues.
Título: Variability in the clinical distributions of Candida species and the emergence of azole-resistant non-Candida albicans species in public hospitals in the Midwest region of Brazil
Fonte: Rev. Soc. Bras. Med. Trop;50(6):843-847, Nov.-Dec. 2017. tab.
Idioma: en.
Resumo: Abstract INTRODUCTION Incidence and antifungal susceptibility of Candida spp. from two teaching public hospitals are described. METHODS The minimum inhibitory concentrations of fluconazole, voriconazole, itraconazole, and amphotericin B were determined using Clinical Laboratory Standard Institute broth microdilution and genomic differentiation using PCR. RESULTS Of 221 Candida isolates, 50.2% were obtained from intensive care unit patients; 71.5% were recovered from urine and 9.1% from bloodstream samples. Candida parapsilosis sensu stricto was the most common candidemia agent. CONCLUSIONS We observed variations in Candida species distribution in hospitals in the same geographic region and documented the emergence of non-C. albicans species resistant to azoles.
Descritores: Candida/efeitos dos fármacos
Candidíase/microbiologia
Antifúngicos/farmacologia
-Brasil
Candida/classificação
Candida/genética
Testes de Sensibilidade Microbiana
Fluconazol/farmacologia
Anfotericina B/farmacologia
Itraconazol/farmacologia
Farmacorresistência Fúngica
Voriconazol/farmacologia
Hospitais Públicos
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Recém-Nascido
Lactente
Pré-Escolar
Adolescente
Adulto
Adulto Jovem
Responsável: BR1.1 - BIREME


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ALVES, Sydney Hartz
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Id: biblio-842827
Autor: Reginato, Cássia Franco; Bandeira, Laíssa Arévalo; Zanette, Régis Adriel; Santurio, Janio Morais; Alves, Sydney Hartz; Danesi, Cristiane Cademartori.
Título: Antifungal activity of synthetic antiseptics and natural compounds against Candida dubliniensis before and after in vitro fluconazole exposure
Fonte: Rev. Soc. Bras. Med. Trop;50(1):75-79, Jan.-Feb. 2017. tab.
Idioma: en.
Projeto: Conselho Nacional de Desenvolvimento Científico e Tecnológico.
Resumo: ABSTRACT INTRODUCTION: This study evaluated the susceptibilities of oral candidiasis-derived Candida albicans, fluconazole-resistant (FR) Candida dubliniensis, and fluconazole-susceptible (FS) C. dubliniensis to synthetic antiseptics [chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), and triclosan (TRC)] and natural compounds (carvacrol, eugenol and thymol). METHODS: Susceptibility tests were performed based on the M27-A3 reference method. The fluconazole-resistant C. dubliniensis strains were obtained after prolonged in vitro exposure to increasing fluconazole concentrations. The geometric mean values for minimum inhibitory concentrations and minimum fungicidal concentrations were compared among the groups. RESULTS: Fluconazole-susceptible C. dubliniensis was more sensitive to CPC and TRC than FR C. dubliniensis and C. albicans were. However, eugenol and thymol were more active against FR C. dubliniensis. The fungicidal activities of CHX and TRC were similar for the three groups, and FR C. dubliniensis and C. albicans had similar sensitivities to CPC. CONCLUSIONS: The resistance of C. dubliniensis to fluconazole affects its sensitivity the synthetic antiseptics and natural compounds that were tested.
Descritores: Candida/efeitos dos fármacos
Fluconazol/farmacologia
Anti-Infecciosos Locais/farmacologia
Antifúngicos/farmacologia
-Timol/farmacologia
Triclosan/farmacologia
Candida/isolamento & purificação
Candida/classificação
Candida albicans/efeitos dos fármacos
Eugenol/farmacologia
Testes de Sensibilidade Microbiana
Cetilpiridínio/farmacologia
Clorexidina/farmacologia
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-957424
Autor: Pedras, Mariana Junqueira; Carvalho, Janaína de Pina; Silva, Rosiana Estéfane da; Ramalho, Dario Brock; Senna, Maria Camilo Ribeiro de; Moreira, Hugo Silva Assis; Martinho, Lorena Zaine Matos; Rabello, Ana; Cota, Gláucia.
Título: Mucosal leishmaniasis: the experience of a Brazilian referral center
Fonte: Rev. Soc. Bras. Med. Trop;51(3):318-323, Apr.-June 2018. tab, graf.
Idioma: en.
Resumo: Abstract INTRODUCTION Pentavalent antimonials (Sbv) are the most commonly used drugs for the treatment of mucosal leishmaniasis (ML), despite their high toxicity and only moderate efficacy. The aim of this study was to report therapeutic responses with different available options for ML. METHODS This study was based on a review of clinical records of 35 patients (24 men and 11 women) treated between 2009 and 2015. RESULTS The median age of patients was 63 years, and the median duration of the disease was 24 months. Seventeen patients received Sbv, while nine patients were treated with liposomal amphotericin B (AmB), and another nine patients were treated with fluconazole. Patients treated with AmB received a total median accumulated dose of 2550mg. The mean duration of azole use was 120 days, and the daily dose ranged from 450 to 900mg. At the three-month follow-up visit, the cure rate was 35%, 67%, and 22% for Sbv, AmB, and azole groups, respectively. At the six-month follow-up visit, the cure rates for Sbv, AmB, and azole groups were 71%, 78%, and 33%, respectively. CONCLUSIONS There is a scarcity of effective ML treatment alternatives, and based on our observations, fluconazole is not a valid treatment option.
Descritores: Leishmaniose Mucocutânea/tratamento farmacológico
Fluconazol/uso terapêutico
Anfotericina B/uso terapêutico
Antimônio/uso terapêutico
Antiprotozoários/uso terapêutico
-Índice de Gravidade de Doença
Resultado do Tratamento
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Idoso
Idoso de 80 Anos ou mais
Responsável: BR1.1 - BIREME


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Id: biblio-1041467
Autor: Spalanzani, Regiane Nogueira; Mattos, Karine; Marques, Luiza Inahe; Barros, Pedro Fernando Diniz; Pereira, Pamela Iruama Peres; Paniago, Anamaria Mello Miranda; Mendes, Rinaldo Poncio; Chang, Marilene Rodrigues.
Título: Clinical and laboratorial features of oral candidiasis in HIV-positive patients
Fonte: Rev. Soc. Bras. Med. Trop;51(3):352-356, Apr.-June 2018. tab.
Idioma: en.
Resumo: Abstract INTRODUCTION We describe the clinical and laboratorial features of oral candidiasis in 66 HIV-positive patients. METHODS: Polymerase chain reaction-based techniques were performed for differentiation of Candida spp. isolated from patients at a public teaching hospital in Midwest Brazil. RESULTS: Oral lesions, mainly pseudomembranous, were significantly related to higher levels of immunosuppression. Of 45 Candida isolates, 66.7% were C. albicans. Most of the isolates were susceptible to the antifungal drugs tested. CONCLUSIONS: Oral lesions were associated with higher immunosuppression levels. Lower susceptibility to antifungals by non-albicans isolates supports the importance of surveillance studies using susceptibility tests to aid in the treatment.
Descritores: Candida/efeitos dos fármacos
Candidíase Bucal/diagnóstico
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico
Antifúngicos/farmacologia
-Brasil
Candida/isolamento & purificação
Candida/classificação
Candidíase Bucal/microbiologia
Resistência Microbiana a Medicamentos
Testes de Sensibilidade Microbiana
Fluconazol/farmacologia
Anfotericina B/farmacologia
Técnicas de Tipagem Micológica
Infecções Oportunistas Relacionadas com a AIDS/microbiologia
Itraconazol/farmacologia
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-990445
Autor: Benedetti, Volmir Pitt; Savi, Daiani Cristina; Aluizio, Rodrigo; Adamoski, Douglas; Kava, Vanessa; Galli-Terasawa, Lygia Vitória; Glienke, Chirlei.
Título: ERG11 gene polymorphisms and susceptibility to fluconazole in candida isolates from diabetic and kidney transplant patients
Fonte: Rev. Soc. Bras. Med. Trop;52:e20180473, 2019. tab.
Idioma: en.
Resumo: Abstract INTRODUCTION: Candidiasis is the most frequent opportunistic mycosis in humans and can cause mortality, particularly in immunodeficient patients. One major concern is the increasing number of infections caused by drug-resistant Candidas trains, as these cannot be efficiently treated with standard therapeutics. The most common mechanism of fluconazole resistance in Candida is mutation of ERG11, a gene involved in the biosynthesis of ergosterol, a compound essential for cell integrity and membrane function. METHODS: Based on this knowledge, we investigated polymorphisms in the ERG11 gene of 3 Candida species isolated from immunocompromised and immunocompetent patients. In addition, we correlated the genetic data with the fluconazole susceptibility profile of the Candida isolates. RESULTS: A total of 80 Candida albicans, 8 Candida tropicalis and 6 Candida glabrata isolates were obtained from the saliva of diabetic, kidney transplant and immunocompetent patients. Isolates were considered susceptible to fluconazole if the minimum inhibitory concentration was lower than 8 μg/mL. The amino acid mutations F105L, D116E, K119N, S137L, and K128T were observed in C. albicans isolates, and T224C and G263A were found in C. tropicalis isolates. CONCLUSIONS: Despite the high number of polymorphisms observed, the mutations occurred in regions that are not predicted to interfere with ergosterol synthesis, and therefore are not related to fluconazole resistance.
Descritores: Polimorfismo Genético/efeitos dos fármacos
Candida/efeitos dos fármacos
Candida/genética
Fluconazol/farmacologia
Transplante de Rim
Diabetes Mellitus/microbiologia
Antifúngicos/farmacologia
-Valores de Referência
Saliva/microbiologia
Candida/isolamento & purificação
DNA Fúngico/genética
Testes de Sensibilidade Microbiana
Reação em Cadeia da Polimerase
Farmacorresistência Fúngica/genética
Imunocompetência
Pessoa de Meia-Idade
Mutação/efeitos dos fármacos
Limites: Humanos
Masculino
Feminino
Adulto
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-978048
Autor: Castillo-Martínez, Nydia A; Mouriño-Pérez, Rosa R; Cornejo-Bravo, José M; Gaitán-Cepeda, Luis A.
Título: Factores relacionados a candidiasis oral en niños y adolescentes con VIH, caracterización de especies y susceptibilidad antifúngica / Factors related to oral candidiasis in HIV children and adolescents, species characterization and antifungal susceptibility
Fonte: Rev. chil. infectol;35(4):377-385, ago. 2018. tab.
Idioma: es.
Resumo: Resumen Introducción: Se desconocen los factores asociados a la candidiasis oral en población pediátrica con infección por VIH de los países en desarrollo. Objetivo: Identificar los factores asociados a la colonización por Candida, candidiasis oral y la susceptibilidad in vitro a antifúngicos, en niños y adolescentes con infección por VIH institucionalizados en la ciudad de Tijuana, México. Materiales y Métodos: Se examinó la cavidad oral de 30 niños y adolescentes con infección por VIH, se obtuvo una muestra de la mucosa oral para identificar las especies de Candida mediante cultivo y auxonograma. La susceptibilidad a los antifúngicos se determinó de acuerdo al CLSI. Los indicadores del estado inmunológico y falla virológica se clasificaron conforme a la OMS. Resultados: Se identificaron seis especies de Candida, 53% colonizantes y 47% causantes de candidiasis. Los factores asociados a candidiasis fueron alta carga viral (p = 0,001), menor recuento de LTCD4+ (p = 0,002) y esquema TARAA (p ≤ 0,014). La especie prevalente fue C. glabrata (33%); sin embargo, C. albicans (27%) fue más resistente a fluconazol (p = 0,001). Las especies resistentes a itraconazol se identificaron en esquemas que incluyen un INNTR (p = 0,041). Conclusiones: Los niños y adolescentes con infección por VIH institucionalizados mostraron una prevalencia elevada de Candida spp. colonizante y resistencia a los antifúngicos relacionada con los INNTR .

Background: Factors associated with candidiasis and colonization in HIV-positive children and adolescents in developing countries are not well understood. Aim: To identify the factors associated with oral Candida colonization and candidiasis in institutionalized HIV-positive children and adolescents in Tijuana, México, as well as the response of the isolates to antifungals. Materials and Methods: Sample of the oral mucosa of 30 HIV positive children and adolescents were obtained to isolate and identify Candida species by culture and metabolic profile. Antifungal drugs susceptibility was determined according to CLSI. Indicators of immunological and virologic failure were classified in accordance to WHO criteria. Results: Six Candida species were identified from oral mucosa, 53% colonizers and 47% in candidiasis. Factors associated with candidiasis and oral colonization were viral load (p = 0,001), CD4+ counts (p = 0,002) and HAART regimen (p ≤ 0,014). The most prevalent species was C. glabrata (33%), but C. albicans (27%) was more resistant to fluconazole (p = 0,001). Itraconazol resistant species were identified in regimens that include an NNRTI (p = 0,041). Conclusion: HIV-positive children and adolescents living in an orphanage showed high prevalence of colonizing Candida spp. and resistance to antifungals, related to NNRTI.
Descritores: Candida albicans/isolamento & purificação
Candidíase Bucal/microbiologia
Infecções por HIV/complicações
Infecções Oportunistas Relacionadas com a AIDS/microbiologia
Mucosa Bucal/microbiologia
-Candida albicans/classificação
Candidíase Bucal/classificação
Candidíase Bucal/tratamento farmacológico
Fluconazol/uso terapêutico
Infecções por HIV/tratamento farmacológico
Estudos Transversais
Estudos Prospectivos
Fatores de Risco
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico
Itraconazol/uso terapêutico
Carga Viral
Farmacorresistência Fúngica
México
Antifúngicos/uso terapêutico
Limites: Humanos
Masculino
Feminino
Lactente
Pré-Escolar
Criança
Adolescente
Adulto
Adulto Jovem
Responsável: CL1.1 - Biblioteca Central



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