RESUMO
INTRODUCTION: Vibrio cholerae is a microorganism that causes acute diarrheal diseases and cholera, one of the leading causes of global morbidity and mortality, especially in children under five years old. It is present in many regions and has been isolated from diverse sources such as water, soil and food. Surveillance of this microorganism in Cuba from 1985 through June 1997 showed circulation of non-epidemic non-O1/non-O139 serogroups, but surveillance continued to identify distribution of V. cholerae serotypes and serogroups in the different geographic regions of the country during the following years, due to the risk of introducing cholera-causing serogroups that provoked cholera epidemics in other countries of the region. OBJECTIVE: Describe the temporalâspatial distribution of serogroups and serotypes of V. cholerae in Cuba. METHODS: A cross-sectional study was conducted that included isolates from passive surveillance of V. cholerae in 16 hygiene and epidemiology centers throughout Cuba from July 1997 through December 2019, submitted to the National Reference Laboratory for Acute Diarrheal Diseases of the Pedro Kourí Tropical Medicine Institute in Havana, Cuba. The timeline was subdivided into three five-year periods and one eight-year period. The centers submitting isolates were grouped into three geographical regions: western, central and eastern Cuba. A total of 1060 V. cholerae isolates were studied, from the 1438 samples sent from 15 Provincial Hygiene, Epidemiology and Microbiology Centers and the Municipal Hygiene, Epidemiology and Microbiology Center of the Isle of Youth Special Municipality. Genus, species and serotype of all specimens were studied and reviewed in the context of the outbreaks of acute diarrheal diseases reported in the country. RESULTS: All 1060 isolates were confirmed as V. cholerae. In the distribution by time period and region, the highest percentage occurred in the 2012â2019 period, and the eastern region contributed the most isolates in all periods. Approximately 63.9% (677/1060) were from outbreaks, and in the 2012â2019 period, the most epidemic-causing isolates came from the western region. Approximately 52.8% (560/1060) were identified as non-O1/non-O139 V. cholerae, and 47.2% (500/1060) as O1 V. cholerae; of these, 96.4% (482/500) corresponded to Ogawa serotype and 3.6% (18/500) to Inaba. Circulation of non-O1/non-O139 V. cholerae occurred throughout the entire period. The O1 serogroup began to circulate in 2012 and continued through 2016; however, since 2017, it has not been identified again. In the western region, there were smaller percentages of isolates of non-O1/non-O139 V. cholerae in all periods, except 2012â2019. In that period, V. cholerae O1 was identified to a lesser degree in the central region. CONCLUSIONS: Vibrio cholerae circulated in all three Cuban regions during the years studied, with a higher percentage of isolates of the non-O1/non-O139 serogroup, which caused outbreaks or sporadic cases of diarrhea in the eastern region, with the exception of the 2012â2019 period, when epidemic outbreaks of the O1 serogroup (which causes cholera) occurred in all three regions, with higher percentages in the western region.
Assuntos
Cólera , Vibrio cholerae , Criança , Adolescente , Humanos , Pré-Escolar , Cólera/epidemiologia , Estudos Transversais , Cuba/epidemiologia , Diarreia/epidemiologiaRESUMO
Introducción: El cólera es una infección intestinal aguda causada por cepas toxigénicas de Vibrio choleare. La rápida diseminación y emergencia de la multirresistencia que caracteriza a este patógeno, podría interferir en el éxito de la terapia antimicrobiana, por lo que constituye una prioridad monitorear los cambios en los patrones de susceptibilidad, como parte trascendental de la política de control de la resistencia antimicrobiana. Objetivo: Determinar el comportamiento de la resistencia antimicrobiana frente a los antimicrobianos de interés empleados en el tratamiento, la presencia de factores de virulencia enzimáticos y si existe relación entre ambos. Métodos: Se realizó un estudio descriptivo de corte transversal durante julio de 2012 a diciembre de 2015. Se estudiaron 500 aislamientos pertenecientes al cepario del Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto de Medicina Tropical Pedro Kourí, procedentes de brotes de enfermedades diarreicas agudas de la red nacional de laboratorios de Microbiología de Cuba. Se aplicaron métodos convencionales fenotípicos para determinar el comportamiento de la resistencia antimicrobiana, la presencia de factores enzimáticos y la relación de estos con la resistencia antimicrobiana. Resultados: Los mayores porcentajes de sensibilidad se obtuvieron frente a azitromicina (98 por ciento), doxiciclina (96 por ciento) y ciprofloxacina (93 por ciento) y de resistencia frente a ampicilina (100 por ciento) y trimetoprim-sulfametoxazol (99,4 por ciento). Se encontraron 44 aislados (8,8 por ciento) multirresistente. Todos los aislamientos poseían al menos dos enzimas extracelulares como factores de virulencia, las más frecuentes: gelatinasa (96 por ciento) y lecitinasa (95 por ciento). Conclusiones: Se evidencia una relación directa y proporcional entre la presencia de los factores de virulencia y resistencia antimicrobiana, sinergismo que surgiere mayor patogenicidad de los aislados estudiados procedentes de brotes epidémicos(AU)
Introduction: Cholera is an acute intestinal infection caused by toxigenic strains of Vibrio choleare. The rapid dissemination and emergence of the multiresistance that characterizes this pathogen could interfere with the success of antimicrobial therapy, so it is a priority to monitor changes in susceptibility patterns, as a transcendental part of the resistance control policy antimicrobial. Objective: To determine the behavior of antimicrobial resistance against the antimicrobials of interest used in the treatment, the presence of enzymatic virulence factors and whether there is a relationship between them. Methods: A descriptive cross-sectional study was conducted during July 2012 to December 2015. Where 500 isolates belonging to the cepary of the National Reference Laboratory for Acute Diarrheal Diseases of the Institute of Tropical Medicine Pedro Kourí, from outbreaks of EDA of the national network of Microbiology laboratories in Cuba. Conventional phenotypic methods were applied to determine the behavior of antimicrobial resistance, the presence of enzymatic factors and their relationship with antimicrobial resistance. Results: The highest percentages of sensitivity were obtained against azithromycin (98 percent), doxycycline (96 percent) and ciprofloxacin (93 percent) and resistance to ampicillin (100 percent) and trimethoprim-sulfamethoxazole (99.4 percent). 44 isolated (8.8 percent) multi-resistant were found. All isolates had at least two extracellular enzymes as virulence factors, the most frequent: gelatinase (96 percent) and lecithinase (95 percent). Conclusions: There is a direct and proportional relationship between the presence of virulence factors and antimicrobial resistance, synergism that arises greater pathogenicity of the isolates studied from epidemic outbreaks(AU)
Assuntos
Humanos , Vibrio cholerae/isolamento & purificação , Fatores de Virulência/análise , Epidemiologia Descritiva , Estudos Transversais , Anti-Infecciosos/uso terapêuticoRESUMO
Introducción: En los países en vías de desarrollo las enfermedades diarreicas agudas son causa frecuente de morbilidad y mortalidad. Entre las primeras causas se encuentra Escherichia coli diarrogénicos, que afecta a pacientes en edades extremas de la vida y con inmunodeficiencias. Objetivo: Identificar los patotipos de Escherichia coli diarrogénicos que más inciden y los fenotipos de resistencia antimicrobiana expresados por el patotipo predominante. Métodos: Se estudiaron 184 aislamientos procedentes de 15 centros provinciales de Higiene, Epidemiología y Microbiología de Cuba e Isla de la Juventud. La investigación se realizó desde julio de 2012 hasta febrero de 2014. La identificación de género, especie y patotipos fue realizada por métodos de diagnóstico convencional y molecular. La determinación de la susceptibilidad antimicrobiana se realizó por el método de Bauer y Kirby, y las normas del Clinical and Laboratory Institute Standards de 2013. Resultados: Se identificaron 108 (58 por ciento) Escherichia coli diarrogénicos. Los patotipos confirmados fueron: en la PCR múltiple 1, 5 (6 por ciento) de Escherichia coli enteropatogénico, 4 (4 por ciento) de enterotoxigénico y 0 (0 por ciento) de enterohemorrágico. La PCR múltiple 2 reveló 72 (82 por ciento) Escherichia coli enteroagregativo, que resultó el predominante en el estudio. La PCR 3 (simple) detectó 7 (8 por ciento) de enteroinvasivo. El 100 por ciento del patotipo predominante mostró resistencia, al menos a un antimicrobiano de los probados, un solo patron de resistencia a dos antimicrobianos, y nueve patrones de multirresistencia. Conclusiones: El estudio demuestra la importancia del uso de pruebas moleculares rápidas para la confirmación de los patotipos de E. coli diarrogénicos, los que provocan deshidratación ligera, complicaciones graves y la muerte. Se logra identificar los cuatro patotipos más frecuentes y E. coli enteroagregativo, el de mayor incidencia en la población estudiada. El patotipo predominante mostró altos porcentaje de resistencia antimicrobiana a betalactámicos y buena sensibilidad antimicrobiana a los aminoglucósidos y cefalosporinas de tercera generación. La investigación aporta conocimientos, no revelados en estudios anteriores con aislados cubanos, lo que es considerado de alto valor para los clínicos, pediatras y epidemiólogos del país(AU)
Introduction: Acute diarrheal disease is a frequent cause of morbidity and mortality in developing countries. One of the leading causes is diarrheagenic Escherichia coli, which affects patients at extreme ages and with immunodeficiencies. Objective: Identify the most active pathotypes of diarrheagenic Escherichia coli and the antimicrobial resistance phenotypes expressed by the prevailing pathotype. Methods: A study was conducted from July 2012 to February 2014 of 184 isolates obtained from 15 provincial Hygiene, Epidemiology and Microbiology Centers in Cuba and the Isle of Youth. Identification of the genus, species and pathotypes was based on conventional and molecular diagnostic methods. Determination of antimicrobial susceptibility was performed by the Bauer-Kirby method in compliance with guidelines from the Clinical and Laboratory Standards Institute of 2013. Results: A total 108 (58 percent) diarrheagenic Escherichia coli were identified. The following pathotypes were confirmed: Multiplex PCR 1 revealed 5 (6 percent) enteropathogenic, 4 (4 percent) enterotoxigenic and 0 (0 percent ) enterohemorrhagic Escherichia coli. Multiplex PCR 2 found 72 (82 percent) enteroaggregative Escherichia coli, which was the prevailing type in the study. PCR 3 (simple) detected 7 (8 percent) enteroinvasive Escherichia coli. 100 percent of the prevailing pathotype displayed resistance to at least one of the antimicrobials tested, a single resistance pattern to two antimicrobials, and nine multiresistance patterns. Conclusions: The study showed the importance of the use of rapid molecular tests to confirm diarrheagenic E. coli pathotypes, which cause mild dehydration, serious complications and death. Identification could be done of the four most common pathotypes and enteroaggregative E. coli, the one with the highest incidence in the study population. The prevailing pathotype displayed high percentages of antimicrobial resistance to beta-lactams and good antimicrobial sensitivity to third-generation cephalosporins and aminoglycosides. The study contributed knowledge not revealed by previous research about Cuban isolates. Such information is considered to be highly valuable for clinicians, pediatricians and epidemiologists in the country(AU)
Assuntos
Humanos , Masculino , Feminino , Resistência Microbiana a Medicamentos/genética , Escherichia coli/isolamento & purificação , Escherichia coli/patogenicidade , Infecções por Escherichia coli/complicaçõesRESUMO
. Vibrio cholerae no-O1, no-O139 es el tercer grupo de bacterias del género Vibrio que con más frecuencia producen diarreas. Sobrevive en los ambientes acuáticos, utilizando la formación de biopelícula como mecanismo de supervivencia que propicia la transmisión de la enfermedad diarreica. Desde 1977 se caracterizan aislados de V. cholerae con resistencia múltiple, y algunos de los mecanismos involucrados incluyen la producción de β-lactamasas de espectro extendido (BLEE). Este trabajo tuvo como objetivo determinar la formación de biopelícula en los aislados cubanos de V. cholerae no-O1, no-O139, causantes de enfermedad diarreica aguda (EDA), y detectar la producción de BLEE en aquellos con resistencia total e intermedia a ampicilina. Se realizó un estudio descriptivo de corte transversal, entre enero 2014 y junio 2015. Se estudiaron 55 aislados caracterizados previamente, que formaban parte del cepario del Laboratorio Nacional de Referencia de EDA del Instituto Pedro Kourí. Para la determinación fenotípica de BLEE se estudiaron 43, de los que ya se conocía su susceptibilidad a ampicilina. El 54,5 por ciento de los aislados resultaron positivos a la formación de biopelícula, y predominaron los clasificados como formadores moderados (46,6 por ciento ) y débiles (36,6 por ciento ). De los 34 resistentes a ampicilina, 26,5 por ciento resultaron positivos a la producción de BLEE. En el caso de los nueve aislados con resistencia intermedia a ampicilina, 44,4 por ciento resultaron positivos. Los resultados del presente estudio contribuyen al conocimiento sobre la capacidad que tienen de persistir en el ambiente y permiten profundizar sobre los mecanismos de resistencia a los antimicrobianos(AU)
Vibrio cholerae non-O1, non-O139 is the third bacterium group from the genus Vibrio most commonly causing diarrhea. It survives in aquatic environments, using the formation of biofilm as a survival mechanism facilitating the transmission of diarrheal disease. Multi-drug resistant V. cholerae isolates have been characterized since the year 1977, and some of the mechanisms involved include the production of extended-spectrum β-lactamases (ESBLs). The purpose of the study was to determine the formation of biofilm in Cuban isolates of V. cholerae non-O1, non-O139 causing acute diarrheal disease (ADD), and detect the production of ESBLs in those with total or intermediate resistance to ampicillin. A descriptive cross-sectional study was conducted from January 2014 to June 2015. The study sample was 55 previously characterized isolates obtained from the strain collection at the ADD National Reference Laboratory of Pedro Kourí Institute. For phenotypic determination of ESBLs, 43 were studied which were known to be susceptible to ampicillin. 54.5 percent of the isolates tested positive for biofilm formation, with a predominance of those classified as moderate (46.6 percent) and weak (36.6 percent) biofilm producers. Of the 34 isolates resistant to ampicillin, 26.5 percent were positive for ESBL production. Of the 9 with intermediate ampicillin resistance, 44.4 % were positive. The results of the present study contribute knowledge about their ability to persist in the environment, and provide insight into antimicrobial resistance mechanisms(AU)
Assuntos
Humanos , Masculino , Feminino , Vibrio cholerae não O1/isolamento & purificação , Disenteria/prevenção & controle , Epidemiologia Descritiva , Estudos TransversaisRESUMO
INTRODUCTION: The acute diarrheal diseases are one of the main causes of morbidity and mortality in children aged under 5 years and in the general population; this demands a great deal of care in the healthcare services. The situation worsens due to the overuse of antimicrobials and the development of bacterial resistance, being the latter an emerging health problem in different areas of the world. Among the causative microorganisms of acute diarrheal diseases are those of Aeromonas genus, recognized as second risk emerging pathogens. OBJECTIVES: To determine the most frequently isolated Aeromonas species in fecal samples from acute diarrheal patients and their antimicrobial susceptibility. METHODS: The Bauer-Kirby's method allowed identifying the susceptibility to several antimicrobials of 100 isolated samples coming from the provincial hygiene and epidemiology centers during 2007 and 2008. RESULTS: Identification of the species was accomplished in 67% of isolates, being A. caviae (33%) y A. hydrophila (29%) the predominant species. It was demonstrated that 100% of isolates got resistant to at least one of the studied antimicrobials. Drug resistance to cefalotine, sulfonamides and nalidixic acid showed the highest percentages. CONCLUSIONS: Tetracycline and chloramphenicol are recommended as the drugs of choice for treating intestinal infections caused by these microorganisms in Cuba.
Assuntos
Aeromonas/classificação , Aeromonas/genética , Diarreia/microbiologia , Doença Aguda , Aeromonas/isolamento & purificação , Humanos , FenótipoRESUMO
Introducción: la re-emergencia de cólera en Haití estableció un nuevo reservorio para el incremento de la séptima pandemia. Esto provocó su diseminación a República Dominicana y a otros países de la región del Caribe, como Cuba y México. Objetivo: estudiar la susceptibilidad antimicrobiana de aislamientos de Vibrio cholerae O1, serotipo Ogawa, biotipo El Tor aisladas de pacientes durante el evento epidemiológico de cólera ocurrido en Cuba entre junio de 2012 y agosto de 2013. Métodos: se realizó el estudio de la susceptibilidad antimicrobiana in vitro en 144 aislamientos de V. cholerae, mediante el método de Bauer-Kirby frente a nueve antimicrobianos: ampicilina, sulfonamida, trimetoprim/sulfametoxazol, cloranfenicol, tetraciclina, doxiciclina, azitromicina, ciprofloxacina y gentamicina, según las normas del Instituto de Estándares de Laboratorio Clínico de los Estados Unidos de América. Resultados: el total de los aislamientos resultaron resistentes al trimetoprim-sulfametoxazol; el 98,7 por ciento lo fue a la sulfonamida y el 90,3 por ciento a la ampicilina. Se obtuvieron valores de sensibilidad intermedia para ciprofloxacina (30,6 por ciento) y cloranfenicol (27,1 por ciento). Se apreciaron niveles de sensibilidad superior al 92 por ciento a los antimicrobianos de primera línea en el tratamiento de la enfermedad (doxiciclina, tetraciclina y azitromicina), así como también a la gentamicina. No se observaron cepas multirresistentes. Conclusiones: los datos aportados por este trabajo demuestran la efectividad in vitro de los antimicrobianos utilizados en el tratamiento la enfermedad diarreica aguda causada por V. cholerae en Cuba(AU)
Introduction: re-emergence of cholera in Haiti created a new reservoir for the increase of the seventh pandemic. This resulted in its spread to the Dominican Republic and other Caribbean countries, such as Cuba and Mexico. Objectives: study the antimicrobial susceptibility of isolates of Vibrio cholerae O1, Ogawa serotype, El Tor biotype, obtained from patients during the cholera epidemiological event occurring in Cuba from June 2012 to August 2013. Methods: a study was conducted of 144 V. cholerae isolates using the Bauer-Kirby method to determine in vitro susceptibility to nine antimicrobials: ampicillin, sulfonamide, trimethoprim/sulfamethoxazole, chloramphenicol, tetracycline, doxycycline, azithromycin, ciprofloxacin and gentamicin, in compliance with standards from the U.S. Clinical and Laboratory Standards Institute. Results: all isolates were resistant to trimethoprim/sulfamethoxazole; 98.7 percent to sulfonamide and 90.3 percent to ampicillin. Intermediate sensitivity values were obtained for ciprofloxacin (30.6 percent) and chloramphenicol (27.1 percent). Sensitivity levels above 92 percent were found for first-line antimicrobials (doxycycline, tetracycline and azithromycin), as well as gentamicin. Multi-drug resistant strains were not found. Conclusions: results reveal the effectiveness in vitro of the antimicrobials used in Cuba to treat acute diarrheal disease caused by V. cholerae(AU)
Assuntos
Resistência Microbiana a Medicamentos , Vibrio cholerae O1/isolamento & purificação , Testes de Sensibilidade Microbiana/métodos , Cuba , Anti-Infecciosos/uso terapêuticoRESUMO
In vitro antifungal susceptibility testing is really necessary at present in medical mycology laboratories. Minimal inhibitory concentration of 210 Candida yeast strains isolated from HIV/AIDS patients with oral lesions was determined to find out susceptibility to fluconazole and amphotericin B. A CLSI's M27A2 protocol-based dilution micromethod was used. C. albicans was predominant (62.4%)followed by C. glabrata, C. parapsilosis, and C. tropicalis. Regarding amphotericin B, the mode value and MIC50 were 0.125 microg/mL, which indicated the effectiveness of this drug in vitro conditions. Only C. krusei strain showed a minimal inhibitory concentration over 1 microg/mL. 8.1% of strains were resistent to fluconazole whereas 8.1% was dose-depending susceptible. The less susceptible species were C. krusei and C. glabrata. The achieved results laid the foundations for wider studies to be made in the Cuban context and indicated the need of keeping surveillance on the behaviour of clinical yeast isolates to antifungal drugs.
Assuntos
Anfotericina B/farmacologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Farmacorresistência Fúngica , Fluconazol/farmacologia , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Candida/classificação , Candida/isolamento & purificação , Candidíase Bucal/microbiologia , Relação Dose-Resposta a Droga , Farmacorresistência Fúngica Múltipla , Humanos , Técnicas In Vitro , Testes de Sensibilidade Microbiana , Especificidade da EspécieRESUMO
INTRODUCCIÓN: las enfermedades diarreicas agudas constituyen una de las principales causas de morbilidad y mortalidad en los niños menores de 5 años y en la población general, esto ocasiona una gran demanda de atención en los servicios de salud. La situación se agrava por el abuso de los antimicrobianos y el desarrollo de resistencia bacteriana, suceso que hoy día constituye un problema emergente de salud en diversas regiones del mundo. Entre los microorganismos causantes de enfermedades diarreicas agudas se encuentran los pertenecientes al género Aeromonas, los cuales han sido reconocidos como patógenos emergentes de riesgo II. OBJETIVOS: determinar las especies de Aeromonas más frecuentemente aisladas a partir de muestras de heces de pacientes con enfermedades diarreicas agudas y su susceptibilidad antimicrobiana. MÉTODOS: se determinó la susceptibilidad mediante el método de Bauer-Kirby frente a diferentes antimicrobianos a 100 aislamientos remitidos desde los centros provinciales de higiene y epidemiología del país durante 2007-2008. RESULTADOS: En 67 por ciento de los aislamientos se logró la identificación hasta especie, se observó el predominio de A. caviae (33 por ciento) y A. hydrophila (29 por ciento). Se demostró que 100 por ciento de los aislamientos resultaron resistentes al menos a un antimicrobiano de los investigados. El porcentaje más elevado de resistencia se observó frente a la cefalotina, las sulfonamidas y el ácido nalidíxico. CONCLUSIONES: se propone a la tetraciclina y el cloranfenicol como fármacos de elección para el tratamiento de las infecciones intestinales producidas por estos microorganismos en Cuba.
INTRODUCTION: the acute diarrheal diseases are one of the main causes of morbidity and mortality in children aged under 5 years and in the general population; this demands a great deal of care in the healthcare services. The situation worsens due to the overuse of antimicrobials and the development of bacterial resistance, being the latter an emerging health problem in different areas of the world. Among the causative microorganisms of acute diarrheal diseases are those of Aeromonas genus, recognized as second risk emerging pathogens. OBJECTIVES: to determine the most frequently isolated Aeromonas species in fecal samples from acute diarrheal patients and their antimicrobial susceptibility. METHODS: the Bauer-Kirby´s method allowed identifying the susceptibility to several antimicrobials of 100 isolated samples coming from the provincial hygiene and epidemiology centers during 2007 and 2008. RESULTS: identification of the species was accomplished in 67 percent of isolates, being A. caviae (33 percent) y A. hydrophila (29 percent) the predominant species. It was demonstrated that 100 percent of isolates got resistant to at least one of the studied antimicrobials. Drug resistance to cefalotine, sulfonamides and nalidixic acid showed the highest percentages. CONCLUSIONS: tetracycline and chloramphenicol are recommended as the drugs of choice for treating intestinal infections caused by these microorganisms in Cuba.
Assuntos
Humanos , Aeromonas/classificação , Aeromonas/genética , Diarreia/microbiologia , Doença Aguda , Aeromonas/isolamento & purificação , FenótipoRESUMO
Las pruebas de sensibilidad in vitro a los agentes antifúngicos se han convertido en una necesidad actual de los laboratorios de micología médica. Se determinó la concentración mínima inhibitoria de 210 cepas de levaduras del género Candida aisladas de pacientes VIH/SIDA que presentaban lesiones orales, con el objetivo de conocer la sensibilidad a fluconazol y anfotericina B. Fue utilizado un micrométodo de dilución según el protocolo M27A2 del CLSI. C. albicans fue la especie predominante (62,4 por ciento), seguida, en orden de frecuencia, de C. glabrata, C. parapsilosis, C. krusei y C. tropicalis. Frente a la anfotericina B el valor de la moda y la CMI50 fue de 0,125 µg/mL, lo que indica la efectividad in vitro de este fármaco. Solo una cepa (C. krusei) mostró una concentración mínima inhibitoria superior a 1 µg/mL. De las cepas, 8,1 por ciento resultó resistente al fluconazol y 8,1 por ciento sensible dependiente de la dosis. Las especies que se comportaron menos sensibles fueron C. krusei y C. glabrata. Los resultados obtenidos sentaron las bases para estudios más amplios en el medio cubano y sugirieron la necesidad de continuar la vigilancia del comportamiento de los aislamientos clínicos de levaduras frente a los agentes antifúngicos.
In vitro antifungal susceptibility testing is really necessary at present in medical mycology laboratories. Minimal inhibitory concentration of 210 Candida yeast strains isolated from HIV/AIDS patients with oral lesions was determined to find out susceptibility to fluconazole and amphotericin B. A CLSI´s M27A2 protocol-based dilution micromethod was used. C. albicans was predominant (62.4 percent)followed by C. glabrata, C. parapsilosis, and C. tropicalis. Regarding amphotericin B, the mode value and MIC50 were 0,125 µg/mL, which indicated the effectiveness of this drug in vitro conditions. Only C. krusei strain showed a minimal inhibitory concentration over 1 µg/mL. 8.1 percent of strains were resistent to fluconazole whereas 8.1 percent was dose- depending susceptible. The less susceptible species were C. krusei and C. glabrata. The achieved results laid the foundations for wider studies to be made in the Cuban context and indicated the need of keeping surveillance on the behaviour of clinical yeast isolates to antifungal drugs.