Caracterização e identificação de leveduras do gênero Candida em pacientes transplantados de medula óssea

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2011-08-31

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Universidade Federal de Goiás

Resumo

Fungal infections in immunocompromised patients, especially in hospitalized individuals, which are submitted to differente types of treatment have increased in recent decades and are cause of death of these patients. The diagnoses of infection as well as the correct identification of the fungus, in addition to the in vitro susceptibility tests are important to control the disease and thus avoid death. This work was conducted to identify the species that causes candidemia in patients with hematologic malignancies and in those submitted to bone marrow transplantation from Araujo Jorge Hospital in the city of Goiânia. The main predisposing factors for the acquisition of candidiasis, the virulence factors inherent to the microorganism, as well as the in vitro susceptibility to different antifungal agents of Candida isolates were verified in this work. Clinical samples from patients were collected and cultived in brain heart infusion and Sabouraud agar dextrose and incubated at room temperature and at 36ºC. The identification of yeasts was performed by culture in cornmeal agar to check the chlamydospore production, by germ tube production in fetal bovine serum plus 1% tween 80, by inoculation onto chromogenic agar, CHROMagar and methods of assimilation of carbohydrates. The isolates were subjected to hemolytic activity and proteinase testing as well as to in vitro susceptibility testing using broth microdilution and Etest methods. Of the 410 clinical samples originated from 144 transplant patients we identified eleven yeasts, included three (3) Candida albicans, five (5) C. parapsilosis, one (1) C. tropicalis and two (2) Candida spp. All isolates of C. parapsilosis were susceptible to all antifungal agents, while two (2) isolates of C. albicans and one (1) C. tropicalis were resistant to three azole derivatives, fluconazole, itraconazole and voriconazole. Candida spp isolates did not show hemolytic activity, they were not able to secrete the enzyme proteinase either, they were resistant to fluconazole, itraconazole and amphotericin B and susceptible to caspofungin and voriconazole. In this study we can conclude that C. parapsilosis was prevalent, showing that the emergence of Candida non albicans. Besides we can conclude that in vitro susceptibility tests are of great importance for the adequate therapy to avoid the death of patients.

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Citação

SILVA, Hildene Meneses e. Characterization and identification of Candida species in bone marrow transplant patients. 2011. 67 f. Dissertação (Mestrado em Medicina) - Universidade Federal de Goiás, Goiânia, 2011.