RESUMO
BACKGROUND: The number of fungal infections has increased in recent years in Rio Grande do Sul (RS), Brazil. Epidemiological studies are important for proper control of infections. AIMS: To evaluate the etiology of fungal infections in patients in RS, from 2003 to 2015. METHODS: This is a retrospective and longitudinal study carried out at Mycology Department of Central Laboratory of RS; 13,707 samples were evaluated. The variables sex, age, site of infection, and etiologic agent were analyzed. Susceptibility of Candida to fluconazole was tested in isolates from samples collected in 2015 from 51 outpatients. RESULTS: Of the 13,707 samples, 840 cases (6.12%) of fungal infections were found and included in the analyses; female gender accounted for the 55.9% of the cases. The main fungus was Candida albicans (450 cases, 53.38%; p<0.001). Onychomycosis was the most frequent infection in superficial mycoses. Systemic mycoses accounted for 54.05% of the cases, from which 68.8% occurred in males, mainly HIV-positive (33.11%), and the main etiologic agent in these cases was Cryptococcus neoformans (73.13%). Among 51 samples tested for susceptibility to fluconazole, 78.43% of Candida isolates were susceptible; 5.88% were susceptible in a dose-dependent manner, and 15.69% were resistant. CONCLUSIONS: C. albicans is a common cause of fungal infections in RS, accounting for half of the cases; resistance to antifungals was found in non-hospitalized patients. In addition, women seem to be more susceptible to fungal infections than men, however men show more systemic mycoses than women. The nails are the most common site of infection.
Assuntos
Micoses/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Antifúngicos/uso terapêutico , Brasil/epidemiologia , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candida albicans/isolamento & purificação , Candidíase/epidemiologia , Candidíase/microbiologia , Criança , Pré-Escolar , Criptococose/epidemiologia , Criptococose/microbiologia , Cryptococcus neoformans/isolamento & purificação , Feminino , Fluconazol/uso terapêutico , Soronegatividade para HIV , Soropositividade para HIV/epidemiologia , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Micoses/microbiologia , Onicomicose/epidemiologia , Onicomicose/microbiologia , Prevalência , Estudos Retrospectivos , Distribuição por Sexo , Fatores de Tempo , Adulto JovemRESUMO
The number of new cases of emerging fungal infections has increased considerably in recent years, mainly due to the large number of immunocompromised individuals. The objective of this study was to evaluate the susceptibility of emerging fungi to fluconazole, itraconazole and amphotericin B by disk diffusion method. In 2015, 82 emerging fungi were evaluated in IPB-LACEN/RS and 13 (15.8%) were resistant: 10/52 were from superficial mycoses and 3/30 from systemic mycoses. The data from the study point to the need for permanent vigilance regarding the careful evaluation in the prescription and clinical and laboratory follow-up of patients affected by fungal infections.
Assuntos
Antifúngicos/uso terapêutico , Farmacorresistência Fúngica , Fungos/efeitos dos fármacos , Micoses/tratamento farmacológico , Adulto , Idoso , Anfotericina B/uso terapêutico , Antifúngicos/farmacologia , Feminino , Fluconazol/uso terapêutico , Fungos/isolamento & purificação , Infecções por HIV/complicações , Humanos , Itraconazol/uso terapêutico , Masculino , Testes de Sensibilidade Microbiana , Micoses/microbiologiaRESUMO
Background: The number of fungal infections has increased in recent years in Rio Grande do Sul (RS), Brazil. Epidemiological studies are important for proper control of infections. Aims: To evaluate the etiology of fungal infections in patients in RS, from 2003 to 2015. Methods: This is a retrospective and longitudinal study carried out at Mycology Department of Central Laboratory of RS; 13,707 samples were evaluated. The variables sex, age, site of infection, and etiologic agent were analyzed. Susceptibility of Candida to fluconazole was tested in samples collected in 2015from 51 outpatients. Results: Of the 13,707 samples, 840 cases (6.12%) of fungal infections were found and included in the analyses; female gender accounted for the 55.9% of the cases. The main fungus was Candida albicans (450 cases, 53.38%; p < 0.001). Onychomycosis was the most frequent infection in superficial mycoses. Systemic mycoses accounted for 54.05% of the cases, from which 68.8% occurred in males, mainly HIVpositive (33.11%), and the main etiologic agent in these cases was Cryptococcus neoformans (73.13%). Among 51 samples tested for susceptibility to fluconazole, 78.43% of Candida isolates were susceptible; 5.88% were susceptible in a dose-dependent manner, and 15.69% were resistant. Conclusions: C. albicans is a common cause of fungal infections in RS, accounting for half of the cases;resistance to antifungals was found in non-hospitalized patients. In addition, women seem to be moresusceptible to fungal infections than men, however men show more systemic mycoses than women. Thenails are the most common site of infection. (AU)
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Fungos/classificação , Micoses/epidemiologia , Brasil/epidemiologia , Fluconazol/farmacologia , Prevalência , Estudos Retrospectivos , Estudos Longitudinais , Farmacorresistência Fúngica , Fungos/efeitos dos fármacosRESUMO
Abstract: The number of new cases of emerging fungal infections has increased considerably in recent years, mainly due to the large number of immunocompromised individuals. The objective of this study was to evaluate the susceptibility of emerging fungi to fluconazole, itraconazole and amphotericin B by disk diffusion method. In 2015, 82 emerging fungi were evaluated in IPB-LACEN/RS and 13 (15.8%) were resistant: 10/52 were from superficial mycoses and 3/30 from systemic mycoses. The data from the study point to the need for permanent vigilance regarding the careful evaluation in the prescription and clinical and laboratory follow-up of patients affected by fungal infections.