AVALIAÇÃO DE INFECÇÃO POR Candida glabrata EM HOSPITAL PÚBLICO TERCIÁRIO

Abstract

Introduction. The nomenclature of the Candida genus was accepted as an official name only in 1954, to accommodate a group of yeasts that presented specific mycological characteristics. In the epidemiological context, they are opportunistic pathogens found in several environments, but mainly in the human body, which can cause since superficial until systemic infections. The present study aimed the Candda glabrata – the molecular identification of the isolates obtained from different clinical specimens of hospitalized patients, its distribution as to the hospital units, and the evaluation of the susceptibility/resistance to antifungal compounds belonged to different pharmacological groups. Patients and Methods. Isolates from several clinical specimens obtained from 80 patients admitted at different hospital units of a tertiary hospital were studied. The molecular identification was performed using the MALDI-TOF MS, and the evaluation of the susceptibility antifungal testing was carried out according to the EUCAST procedures for six compounds – one polienic (amphotericin B deoxycholate – AmB), two triazole compounds (fluconazole-FLC and vorionazole-VRC), and three equinocandins (caspofungin, micafungin and anidulafungin). Results. All the isolates were identified as Candida glabrata stricto sensu. These strains presented susceptibility to AmB, to the three equinocandins, and to VRC, but intermediate susceptibility to FLC. The prevalence of resistance to AmB and to VRC was higher than to the equinocandins. Although into the susceptibility range, the minimal inhibitory concentration of AmB, anidulafungin, and micafungin found in the present study was higher than those published by EUCAST, taken as a reference. Conclusions. The present study permits to conclude that the strain Candida glabrata stricto sensu predominates in the different clinical specimens isolated from patients of this region, and that they are not susceptible to fluconazole. For this reason, this triazole compound cannot be the first choice to treat severe patients from this region. The high prevalence of elevated minimal inhibitory concentrations, although into the susceptibility range, indicates the need not only the identification of the Candida spp. at the level of species, but also the evaluation of the susceptibility profile of all the Candida glabrata isolates, whose results must be send to the clinical staff.