Cryptococcus spp. em unidades básicas de saúde de Campo Grande - MS : tipagem molecular e susceptibilidade antifúngica

Abstract

Cryptococcosis is a systemic and opportunistic fungal disease acquired by inhaling infectious fungal particles dispersed in the environment. The etiological agents of this disease are encapsulated yeasts that belong to the Cryptococcus neoformans and Cryptococcus gattii complexes. Avian feces, especially pigeons (Columba livia) are considered to be mechanical vectors of Cryptococcus spp. The objective of this study was to investigate the presence of Cryptococcus spp. in samples of pigeon droppings from 27 Basic Health Units (BHU) in Campo Grande, Mato Grosso do Sul; identify the molecular type and determine its susceptibility to antifungals. The collections were performed using spatulas to scrape the material and then stored in a sterile universal collector. The yeasts were identified by phenotypic (culture on Niger seed agar, canavanine-glycine-bromothymol blue agar - CGB and urease) and genotypic (PCR-RFLP of URA5 gene) techniques. Susceptibility to the antifungals amphotericin B, fluconazole, itraconazole and voriconazole was determined by the broth microdilution method standardized by the European Committee on Antimicrobial Susceptibility Testing. A total of 354 samples of pigeon droppings were collected in 27 BHU distributed in the seven macroregions of the city. Cryptococcus of the C. neoformans complex, molecular type VNI, were isolated in 12 samples. Cryptococcus neoformans, VNI, the most prevalent molecular type in cases of cryptococcosis in the Midwest region of Brazil, is present in pigeon droppings of units providing basic health care. Control measures are necessary to decrease the exposure of susceptible people and municipal civil servants to the infectious propagules of this important opportunistic fungus.