COLONIZAÇÃO POR ASPERGILLUS EM PACIENTES INTERNADOS EM HOSPITAL PÚBLICO DE CAMPO GRANDE, MS.

Abstract

Aspergillosis is an invasive mycosis caused by filamentous fungi of the genus Aspergillus. Adherence of these fungi in lungs is the key factor for colonization mechanism, which predisposes host to aspergillosis in its mild allergic forms, which may progress to pulmonary infiltrate with hemoptysis and eosinophilia, or, more severe forms, such as obstructive alveolar disease during invasive process. Patients with altered epithelium, or who have had previous necrotic episodes, may present pulmonary cavities that facilitate the installation and filamentation of Aspergillus conidia, resulting in masses called aspergillomas. When invasion is limited to lung, there is invasive pulmonary aspergillosis, and when there is dissemination through the blood to other organs, there is disseminated aspergillosis. The present work aimed to contribute to knowledge of respiratory colonization by Aspergillus species and their resistance phenotypes. Ninety-four Aspergillus isolates were used, from respiratory samples from patients treated between January 2017 and April 2021, in a tertiary public teaching hospital, located in the city of Campo Grande, Mato Grosso do Sul. The recovery of isolates was carried out after sowing. in routine media, such as Sabouraud dextrose agar and/or chloramphenicol potato agar, and incubated at 37°C. Five Sections were identified: Fumigati (37%), Flavi (33%), Nigri (27%), Usti (2%) and Terrei (1%). The screening test for itraconazol (4mg/L) was performed for all isolates and only one (1.1%) isolate from Section Flavi showed a positive result. The minimum inhibitory concentration values of itraconazole, voriconazole, posaconazole and amphotericin B were determined for each section and, according to clinical breakpoints of the European reference standard EUCAST. The resistance was 11.7% (11/94) being 9.6% (9/94) from the Fumigati Section, followed by Flavi Section and Nigri Section (1%; 1/94, each). As these are opportunistic species, with A. fumigatus associated with high mortality rates in hospitalized patients, occurrence of colonization by resistant strains may represent a risk for development of aspergillosis refractory to therapy in azole treated patients.