Efeito de extratos vegetais de Hamamelis virginiana, Persea americana, Cynara scolymus L e Stryphnodendron barbatiman Msobre a expressão fenotípica dos fatores de virulência em biofilmes de Candida albicans / Effect of Hamamelis virginiana, Persea americana, Cynara scolymus L and Stryphnodendron barbatiman M plant extracts on the phenotypic expression of virulence factors in biofilms of the Candida albicans

Objetivo: Analisar a expressão fenotípica de fatores de virulência em biofilmes de Candida albicans frente a extratos glicólicos de plantas. Material e Métodos: Os biofilmes de Candida albicans (ATCC 18804) obtidos a partir de incubação de 48 horas foram expostos por 5 minutos e 24 horas a diferentes concentrações de extratos glicólicos de Hamamelis virginiana e Persea americana, Cynara scolymus L e Stryphnodendron barbatiman M, a fim de verificar a ação antifúngica da proteinase, fosfolipase e hemolisina. Resultados: Todos os extratos foram eficazes na redução do biofilme. Em contato por 5 minutos. os extratos reduziram 50% do biofilme. Após 24 horas. o extrato de Persea americana apresentou o biofilme em 90%, seguido de Cynara scolymus, que o interrompeu em 85%. Houve mudança na intensidade da proteinase após 5 minutos e 24 horas, com uma atividade enzimática média de 0,69 em comparação com o controle de 0,49. Cynara scolymus foi o extrato com maior concentração média de 100 mg/ml; a intensidade da fosfolipase foi alterada com Stryphnodendron barbatiman sendo mais efetivo em 24 horas em relação ao controle (p< 0,0001). A secreção de hemolisina foi modificada por Hamamelis virginiana (12,5 mg/ml) após 5 minutos de exposição e em 24 horas. todos os extratos foram capazes de causar alterações na secreção. Conclusão: Os extratos testados apresentam potencial antifúngico em biofilmes de Candida albicans, implicando em redução significativa dos fatores de virulência. Assim, estes podem ser indicados como uma ferramenta terapêutica alternativa para reduzir a morbidade dessas infecções, já que em ambos os tempos de exposição investigados, eles foram capazes de reduzir a secreção enzimática do fungo (AU)

Objective: Analyze the phenotypic expression of virulence factors in Candida albicans biofilms against plant glycolicextracts. Material and Methods: The biofilms of Candida albicans (ATCC 18804) obtained from incubation for 48 hours were exposed for 5 minutes and 24 hours to different concentrations of glycolic extracts of Hamamelis virginiana and Persea americana, Cynara scolymus L and Stryphnodendron barbatiman M, in order to verify the antifungal activity of the proteinase, phospholipase and hemolysin. Results: All extracts were effective in reducing biofilm. In contact for 5 minutes. the extracts reduced 50% of the biofilm. After 24 hours, the Persea americanaextract showed the biofilm at 90%, followed by Cynara scolymus, which interrupted it at 85%, There was a change in proteinase intensity after 5 minutes and 24 hours. with an average enzymatic activity of 0.69 compared to the control of 0.49. Cynara scolymus was the extract with the highest mean concentration of 100 mg/ml; the phospholipase intensity was changed with Stryphnodendron barbatiman being more effective in 24 hours compared to the control (p< 0.0001). The hemolysin secretion was modified by Hamamelis virginiana (12.5 mg/ml) after 5 minutes of exposure, and in 24 hours. all extracts were capable to cause changes in secretion. Conclusion: The tested extracts have antifungal potential in Candida albicans biofilms, implying a significant reduction in virulence factors. Thus, these can be indicated as an alternative therapeutic tool to reduce the morbidity of these infections, as in both investigated exposure times. they were able to reduce theenzymatic secretion of the fungus (AU)

In vitro sensitivity of Malassezia furfur isolates from HIV-positive and negative patients to antifungal agents / Sensibilidad in vitro a antifúngicos de aislamientos de Malassezia furfur de pacientes positivos y negativos para HIV

Introduction. Malassezia is a lipophilic and lipid-dependent yeast genus belonging to the skin microbiota of humans and other animals. However, due to dysbiosis processes or other factors in the host, this yeast can cause different pathologies, ranging from skin diseases, such as seborrheic dermatitis, to fungemia. Isolation of Malassezia furfur has been reported in HIV-positive patients with or without skin lesions. Due to its opportunistic nature and its variable resistance to antifungal compounds, it is relevant to know the Malassezia sensitivity profiles. Objective. To determine the sensitivity to different antifungal agents, of clinical isolates of M. furfur obtained from HIV-positive or negative patients, with or without seborrheic dermatitis. Materials and methods. Assessment of isolates sensitivity to itraconazole, voriconazole, fluconazole, and amphotericin B was performed by two techniques: (1) Broth microdilution using Clinical and Laboratory Standards Institute (CLSI) protocol M27-A3 with modifications; and (2) agar tests using Etest®. Results. Isolates obtained from HIV patients showed an increase in the minimum inhibitory concentration of fluconazole, voriconazole, and amphotericin B, compared with those of non-HIV patients. Itraconazole was the antifungal with the lowest minimum inhibitory concentration (MIC) in most isolates. Conclusion. We observed differences in the sensitivity profiles of M. furfur isolates according to the context of the patient. High MIC of antifungals like fluconazole, commonly used for treating pathologies caused by Malassezia, were identified.

Introducción. Malassezia es un género de levaduras lipofílicas que dependen de los lípidos y hacen parte de la microbiota de la piel de humanos y otros animales. No obstante, debido a procesos de disbiosis u otros factores en el huésped, esta levadura puede llegar a causar diferentes enfermedades: desde cutáneas (como dermatitis seborreica) hasta fungemias. Se han reportado aislamientos de Malassezia furfur en pacientes positivos para HIV, con lesiones cutáneas o sin ellas. Por su carácter oportunista y sensibilidad variable a los compuestos antifúngicos, es relevante conocer los perfiles de sensibilidad. Objetivo. Determinar la sensibilidad a diferentes antifúngicos de aislamientos clínicos de M. furfur obtenidos de pacientes positivos o negativos para HIV, con dermatitis seborreica o sin ella. Materiales y métodos. La sensibilidad de los aislamientos a itraconazol, voriconazol, fluconazol y anfotericina B, se determinó mediante dos técnicas: microdilución en caldo según el protocolo M27-A3 del Clinical & Laboratory Standards Institute (CLSI), con modificaciones, y pruebas en agar mediante Etest®. Resultados. Los aislamientos obtenidos de pacientes con HIV mostraron aumento de la concentración inhibitoria mínima a fluconazol, voriconazol y anfotericina B, en comparación con los de pacientes sin HIV. Por otro lado, al evaluar la mayoría de los aislamientos, el itraconazol fue el antifúngico con la menor concentración inhibitoria mínima. Conclusión. Se evidencian diferencias en los perfiles de sensibilidad de los aislamientos de M. furfur, según el contexto del paciente, y elevadas concentraciones inhibitorias mínimas de antifúngicos como el fluconazol, usados comúnmente para el tratamiento de las enfermedades causadas por Malassezia spp.

Consensus document on the management of febrile neutropenia in paediatric haematology and oncology patients of the Spanish Society of Pediatric Infectious Diseases (SEIP) and the Spanish Society of Pediatric Hematology and Oncology (SEHOP).

Febrile neutropenia is one of the main infectious complications experienced by paediatric patients with blood or solid tumours, which, despite the advances in diagnosis and treatment, are still associated with a significant morbidity and mortality. These patients have several risk factors for infection, chief of which are chemotherapy-induced neutropenia, the disruption of cutaneous and mucosal barriers and the use of intravascular devices. Early diagnosis and treatment of febrile neutropenia episodes based on the patient's characteristics is essential in patients with blood and solid tumours to improve their outcomes. Therefore, it is important to develop protocols in order to optimise and standardise its management. In addition, the rational use of antibiotics, with careful adjustment of the duration of treatment and antimicrobial spectrum, is crucial to address the increase in antimicrobial drug resistance. The aim of this document, developed jointly by the Spanish Society of Pediatric Infectious Diseases and the Spanish Society of Pediatric Hematology and Oncology, is to provide consensus recommendations for the management of febrile neutropenia in paediatric oncology and haematology patients, including the initial evaluation, the stepwise approach to its treatment, supportive care and invasive fungal infection, which each facility then needs to adapt to the characteristics of its patients and local epidemiological trends.

Documento de consenso de manejo de neutropenia febril en el paciente pediátrico oncohematológico de la Sociedad Española de Infectología Pediátrica (SEIP) y la Sociedad Española de Hematología y Oncología Pediátrica (SEHOP) / Consensus document on the management of febrile neutropenia in paediatric haematology and oncology patients of the Spanish Society of Pediatric Infectious Diseases (SEIP) and the Spanish Society of Pediatric Hematology and Oncology (SEHOP)

La neutropenia febril es una de las principales complicaciones infecciosas que sufren los pacientes pediátricos oncohematológicos, y a pesar los avances en diagnóstico y tratamiento, siguen condicionando una mortalidad y morbilidad significativa. Estos pacientes agrupan una serie de factores de riesgo de infección, donde destaca la neutropenia asociada a quimioterapia, la disrupción de barreras cutáneo-mucosas y el uso de dispositivos intravasculares. El abordaje diagnóstico y terapéutico precoz de los episodios de neutropenia febril en los pacientes oncohematológicos, ajustado a las características individuales de cada paciente, es fundamental para mejorar su pronóstico. Por ello, diseñar protocolos de abordaje, que sistematicen su atención, permite optimizar y homogeneizar su abordaje. Además, racionalizar el uso de los antimicrobianos, ajustando la duración y el espectro de los mismos, es crucial para hacer frente al incremento de resistencias a antimicrobianos. El objetivo de este documento, elaborado entre la Sociedad Española de Infectología Pediátrica y la Sociedad Española de Hematología y Oncología Pediátrica, es dar recomendaciones de consenso sobre el manejo de la neutropenia febril en el paciente oncohematológico, respecto al abordaje inicial, terapia secuencial y de soporte e infección fúngica invasiva, que cada centro debe adaptar a las características de sus pacientes y epidemiología local. (AU)

Febrile neutropenia is one of the main infectious complications experienced by paediatric patients with blood or solid tumours, which, despite the advances in diagnosis and treatment, are still associated with a significant morbidity and mortality. These patients have several risk factors for infection, chief of which are chemotherapy-induced neutropenia, the disruption of cutaneous and mucosal barriers and the use of intravascular devices. Early diagnosis and treatment of febrile neutropenia episodes based on the patient's characteristics is essential in patients with blood and solid tumours to improve their outcomes. Therefore, it is important to develop protocols in order to optimise and standardise its management. In addition, the rational use of antibiotics, with careful adjustment of the duration of treatment and antimicrobial spectrum, is crucial to address the increase in antimicrobial drug resistance. The aim of this document, developed jointly by the Spanish Society of Pediatric Infectious Diseases and the Spanish Society of Pediatric Hematology and Oncology, is to provide consensus recommendations for the management of febrile neutropenia in paediatric oncology and haematology patients, including the initial evaluation, the stepwise approach to its treatment, supportive care and invasive fungal infection, which each facility then needs to adapt to the characteristics of its patients and local epidemiological trends. (AU)

Aspergilosis invasiva: definiciones, diagnóstico y tratamiento / Invasive aspergillosis: definitions, diagnosis, and treatment

Resumen La aspergilosis invasiva (AI) es una enfermedad grave y con alta mortalidad. Existen factores de riesgo y se describen brotes intrahospitalarios relacionados con construcciones. También se des cribe una entidad relacionada con la infección por COVID-19, conocida como aspergilosis pulmonar asociada a COVID-19 (APAC). Es de vital importancia implementar un tratamiento adecuado y precoz, especialmente en pacientes inmunocomprometidos y críticamente enfermos. El diagnóstico se basa en reconocer los factores predisponentes, la clínica, la obtención de imágenes, exámenes directos, cultivos, histopatología y biomarca dores como el galactomanano. La droga de elección es el voriconazol, pero se deben conocer las alternativas terapéuticas dada la creciente presencia de aislamientos resistentes.

Abstract Invasive aspergillosis (IA) is a serious disease with high mortality. There are several risk factors and in-hospital outbreaks related with construction have been described. An entity related to COVID-19 infection, known as COVID-19 associated pulmonary aspergillosis (CAPA), has recently appeared. Early and appropriate treatment is of paramount importance, especially in immunocompromised and critically ill patients. Diagnosis is based on recognition of predisposing factors, clinical signs, imaging, direct examination, culture, histopathology, and biomarkers such as galactomannan. The drug of choice is voriconazole, but alternative therapies must be taken into account given the increasing presence of resistant isolates.

Candida bloodstream infection in patients with cancer: A retrospective analysis of an 11-year period.

BACKGROUND: Candida bloodstream infection (CBSI) is a growing problem among patients with cancer. AIM: To describe the main clinical and microbiological characteristics in patients with cancer who suffer CBSI. METHODS: We reviewed the clinical and microbiological characteristics of all patients with CBSI diagnosed between January 2010 and December 2020, at a tertiary-care oncological hospital. Analysis was done according to the Candida species found. Multivariate logistic regression analysis was used to determine the risk factors associated with 30-day mortality. RESULTS: There were 147 CBSIs diagnosed, 78 (53%) in patients with hematologic malignancies. The main Candida species identified were Candida albicans (n=54), Candida glabrata (n=40) and Candida tropicalis (n=29). C. tropicalis had been mainly isolated from patients with hematologic malignancies (79.3%) who had received chemotherapy recently (82.8%), and in patients with severe neutropenia (79.3%). Seventy-five (51%) patients died within the first 30 days, and the multivariate analysis showed the following risk factors: severe neutropenia, a Karnofsky Performance Scale score under 70, septic shock, and not receiving appropriate antifungal treatment. CONCLUSIONS: Patients with cancer who develop CBSI had a high mortality related with factors associated with their malignancy. Starting an empirical antifungal therapy the soonest is essential to increase the survival in these patients.

Antifungal effect of Arnica montana and Hamamelis virginiana against Candida species

Objetivo ­ Avaliar a atividade antifúngica dos extratos glicólicos de Arnica montana e Hamamelis virginiana contra cepas de Candida spp. A candidíase é uma infecção fúngica comum, portanto, a pesquisa de novos agentes antifúngicos tem sido um alvo interessante. Várias plantas apresentaram atividades biológicas e, portanto, podem ser fontes promissoras de produtos naturais com atividades an-tifúngicas. Métodos ­ As atividades antifúngicas dos extratos glicólicos foram avaliadas por meio da determinação da concentração inibitória mínima (CIM) de acordo com o protocolo M27-S3 do Clinical and Laboratory Standards Institute (2008). Resultados ­ O ex-trato glicólico de A. montana apresentou a atividade antifúngica mais forte contra C. tropicalis, com concentração inibitória mínima (CIM) de 10% v/v e concentração fungicida mínima (MFC) de 80% v/v, seguido por C. krusei e C. glabrata, com valores de MIC e MFC de 20% v/v. Além disso, avaliamos a toxicidade dos dois extratos glicólicos no modelo Galleria mellonella usando as curvas de sobre-vivência de larvas tratadas com os extratos. Nossos resultados demonstraram que os extratos glicólicos de A. montana e H. virginiana não exibiram toxicidade contra larvas de G. mellonella e demonstraram atividade antifúngica contra espécies de Candida spp. Con-clusão ­ Assim, ambos os extratos são candidatos promissores para o desenvolvimento de novos agentes antifúngicos.

Objective ­ To evaluate the antifungal activity of Arnica montana and Hamamelis virginiana glycolic extracts against Candida strains. Methods ­ The antifungal activities of glycolic extracts were investigated by determination of the minimum inhibitory concentration (MIC) according to protocol M27-S3 of Clinical and Laboratory Standards Institute (2008). Results ­ A. montana glycolic extract showed the strongest antifungal activity against C. tropicalis, with a minimum inhibitory concentration (MIC) of 10% v/v and a minimum fungicidal concentration (MFC) of 80% v/v, then C. krusei and C. glabrata, with MIC and MFC values of 20% v/v. H. virginiana glycolic extract ex-hibited stronger activity against C. albicans and C. tropicalis, with MIC and MFC values of 10% v/v, than against C. glabrata, C. krusei, and C. parapsilosis, with MIC and MFC values of 20% v/v. Moreover, we evaluated the toxicity of the two glycolic extracts in the Galleria mellonella model using the survival curves of larvae treated with the two extracts. Our results demonstrated that the glycolic extracts of A. montana and H. virginiana exhibited no toxicity against G. mellonella larvae and demonstrated antifungal activity against Candida spe-cies. Conclusion ­ Thus, both extracts are promising candidates for the development of novel antifungal agents.

Candida bloodstream infection in patients with cancer: A retrospective analysis of an 11-year period / Candidemia en pacientes con cáncer: estudio retrospectivo de un periodo de 11 años

Background: Candida bloodstream infection (CBSI) is a growing problem among patients with cancer. Aim: To describe the main clinical and microbiological characteristics in patients with cancer who suffer CBSI. Methods: We reviewed the clinical and microbiological characteristics of all patients with CBSI diagnosed between January 2010 and December 2020, at a tertiary-care oncological hospital. Analysis was done according to the Candida species found. Multivariate logistic regression analysis was used to determine the risk factors associated with 30-day mortality. Results: There were 147 CBSIs diagnosed, 78 (53%) in patients with hematologic malignancies. The main Candida species identified were Candida albicans (n=54), Candida glabrata (n=40) and Candida tropicalis (n=29). C. tropicalis had been mainly isolated from patients with hematologic malignancies (79.3%) who had received chemotherapy recently (82.8%), and in patients with severe neutropenia (79.3%). Seventy-five (51%) patients died within the first 30 days, and the multivariate analysis showed the following risk factors: severe neutropenia, a Karnofsky Performance Scale score under 70, septic shock, and not receiving appropriate antifungal treatment. Conclusions: Patients with cancer who develop CBSI had a high mortality related with factors associated with their malignancy. Starting an empirical antifungal therapy the soonest is essential to increase the survival in these patients.(AU)

Antecedentes: Los episodios de candidemia son un problema creciente en los pacientes con cáncer. Objetivos: Describir las principales características, clínicas y microbiológicas, en pacientes con cáncer que padecen candidemia. Métodos: Se revisaron todos los episodios de candidemia diagnosticados entre enero de 2010 y diciembre de 2020 en un hospital oncológico. El análisis se realizó comparando las principales especies de Candida identificadas. Se realizó análisis de regresión logística para identificar los factores de riesgo relacionados con la mortalidad a los 30 días. Resultados: Se identificaron 147 episodios de candidemia, 78 (53%) en pacientes con neoplasias hematológicas. Las principales especies de Candida identificadas fueron Candida albicans (n=54), Candida glabrata (n=40) y Candida tropicalis (n=29). C. tropicalis fue aislada principalmente de pacientes con neoplasias hematológicas (79,3%), en aquellos que habían recibido quimioterapia de forma reciente (82,8%) y en pacientes con neutropenia grave (79,3%). Setenta y cinco pacientes (51%) fallecieron en los primeros 30días; los factores de riesgo asociados fueron la neutropenia grave, un valor inferior a 70 en la escala de Karnofsky, presencia de choque séptico y no recibir los antifúngicos apropiados. Conclusiones: Los pacientes con cáncer que cursan con candidemia presentan una alta mortalidad relacionada con factores asociados a la neoplasia. Iniciar un tratamiento antifúngico lo antes posible incrementa la supervivencia de estos pacientes.(AU)

Puntos farmacéuticos clave de la terapia antimicrobiana parenteral domiciliaria: revisión narrativa / Pharmaceutical key points in domiciliar prenteral antimicrobian therapy: narrative review

Introducción: Los buenos resultados de la terapia intravenosa domiciliaria, la mayor complejidad de los pacientes y el aumento de presión hospitalaria provocan que cada vez que los requerimientos técnicos sobre la misma sean más exigentes. Método: De todos los principios activos se realizó una búsqueda ordenada mediante términos MESH buscando: [“principio activo” and stability], [“principio activo” and storage], [“principio activo” and solvent]. Resultados: En este artículo se detallan los aspectos técnicos críticos a la hora de plantear una estrategia de antibioterapia intravenosa a domicilio: se revisan los antimicrobianos (antibióticos, antifúngicos y antivirales) candidatos a ser administrados en el domicilio por vía intravenosa en un paciente ingresado cargo de un servicio de hospitalización a domicilio: se revisan los principios activos candidatos, la concentración a la que se debe administrar, los tiempos de infusión mínimos, las condiciones de conservación, las estabilidades máximas, los solventes compatibles más frecuentes tipo de vía en la que deberíamos administrar según las propiedades fisicoquímicas del fármaco, el dispositivo de administración y la duración prevista del tratamiento. Conclusiones: Es fundamental a la hora de plantear una terapia intravenosa antibiótica domiciliaria que los fármacos se encuentren correctamente acondicionados y seleccionados.(AU)

Introduction: The good results of home intrave-nous therapy, the greater complexity of patients and the increase in hospital pressure cause that every time the technical requirements on it are more demanding. Method: Of all drugs, a search was carried out in order using MESH terms searching: [“drug” and stability], [“drug” and storage], [“drug” and solvent]. Results: This article details the critical technical aspects when considering a home intravenous antibiotic therapy strategy: antimicrobials (an-tibiotics, antifungals and antivirals) candidates to be administered at home intravenously in an inpatient in charge of a home hospitalization service are reviewed: the candidate drugs, the concentration to be administered, the minimum infusion times, storage conditions, maximum stability, the most frequent compatible solvents and the vascular access in which we should ad-minister according to the physicochemical prop-erties of the drug, the delivery device and the expected duration of treatment. Conclusions: It is essential when considering a home antibiotic intravenous therapy that the drugs are correctly conditioned and selected.(AU)

A survey to describe common practices on antifungal monitoring among Spanish clinicians.

INTRODUCTION: We developed a survey to obtain information on the monitoring practices of major systemic antifungals for treatment and prevention of serious fungal infection. METHODS: The survey included questions relating to methodology and practice and was distributed among 137 colleagues of the Study Group of Medical Mycology (GEMICOMED) from July to December 2019. RESULTS: Monitoring was routinely carried out by most respondents, mainly for voriconazole, and was more likely used to determine the efficacy of the dose administered and less for minimizing drug toxicity. Most responders did not follow the strategies of voriconazole dosage based on CYP2C19 genotyping. Monitoring of posaconazole, itraconazole, or other azole metabolites was not carried out or scarcely demanded. Most responders rarely used flucytosine in their clinical practice nor did they monitor it. According to the answers given by some responders, monitoring isavuconazole, amphotericin B, caspofungin and fluconazole exposure would be also interesting in daily clinical practice in selected patient populations. CONCLUSIONS: The survey reveals common practices and attitudes towards antifungal monitoring, sometimes not performed as per best recommendations, offering an opportunity for education and research. Appropriate use of therapeutic drug monitoring may be an objective of antifungal stewardship programmes.

A survey to describe common practices on antifungal monitoring among Spanish clinicians / Monitorización de antifúngicos sistémicos: resultados de una encuesta distribuida en España

Introduction: We developed a survey to obtain information on the monitoring practices of major systemic antifungals for treatment and prevention of serious fungal infection. Methods: The survey included questions relating to methodology and practice and was distributed among 137 colleagues of the Study Group of Medical Mycology (GEMICOMED) from July to December 2019. Results: Monitoring was routinely carried out by most respondents, mainly for voriconazole, and was more likely used to determine the efficacy of the dose administered and less for minimizing drug toxicity. Most responders did not follow the strategies of voriconazole dosage based on CYP2C19 genotyping. Monitoring of posaconazole, itraconazole, or other azole metabolites was not carried out or scarcely demanded. Most responders rarely used flucytosine in their clinical practice nor did they monitor it. According to the answers given by some responders, monitoring isavuconazole, amphotericin B, caspofungin and fluconazole exposure would be also interesting in daily clinical practice in selected patient populations. Conclusions: The survey reveals common practices and attitudes towards antifungal monitoring, sometimes not performed as per best recommendations, offering an opportunity for education and research. Appropriate use of therapeutic drug monitoring may be an objective of antifungal stewardship programmes.(AU)

Introducción: Describimos los resultados de una encuesta diseñada para obtener información sobre prácticas de monitorización de los principales antifúngicos sistémicos utilizados en el tratamiento y la prevención de la infección fúngica grave en España. Métodos: La encuesta, que incluye preguntas relacionadas tanto con metodología como con su uso práctico, se distribuyó entre 137 compañeros del Grupo de Estudio de Micología Médica (GEMICOMED), de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Resultados: La mayoría de los encuestados respondieron utilizar la monitorización de antifúngicos de forma rutinaria, principalmente para voriconazol, y en especial para evaluar la eficacia de la dosis administrada y menos para minimizar su toxicidad. La mayoría de ellos no siguieron las estrategias de dosificación de voriconazol basadas en el conocimiento previo del genotipo CYP2C19, relacionado con su metabolización. Por el contrario, la monitorización de posaconazol, itraconazol o de algunos de sus metabolitos no se realizó o apenas se solicitó. La mayoría de los encuestados rara vez usan 5-fluocitosina en su práctica clínica y por tanto tampoco monitorizan su exposición. Un alto porcentaje consideraría de utilidad poder evaluar la exposición a isavuconazol, anfotericina B, caspofungina y fluconazol en determinadas situaciones en la práctica clínica. Conclusiones: La encuesta revela prácticas y actitudes hacia la monitorización de antifúngicos que en ocasiones no se realizan según las principales recomendaciones, lo que ofrece una oportunidad para la educación y la investigación. Abordar esta formación podría convertirse en objetivo de los programas racionales del uso de antimicrobianos a nivel nacional.(AU)

Avaliação dos efeitos antifúngicos de fármacos inibidores seletivos da recaptação de serotonina em Cryptococcus gattii / Evaluation of the antifungal effects of selective serotonin reuptake inhibitors in Cryptococcus gattii

A criptococose é uma infecção fúngica que acomete tanto indivíduos imunocomprometidos como imunocompetentes. O arsenal antifúngico é limitado, existem relatos de desenvolvimento de resistência fúngica a esses compostos e também alta toxicidade ao paciente. O reposicionamento de fármacos dos inibidores seletivos da recaptação de serotonina (ISRS) tem mostrado ação contra espécies fúngicas, tornando estes compostos alternativas a serem estudadas para o tratamento das infecções criptocócicas. Assim, o objetivo deste estudo foi avaliar os efeitos antifúngicos em cápsula, biofilme e células planctônicas de Cryptococcus gattii (cepa ATCC 56990 e isolado clínico 5) dos fármacos ISRS, cloridrato de fluoxetina (CF) e cloridrato de paroxetina (CP). Para isso, foi utilizada a técnica de microdiluição em caldo de acordo com European Committee on Antimicrobial Susceptibility Testing (EUCAST) para determinar a Concentração Inibitória Mínima (CIM), sendo a CIM de 31,25 µg/mL determinada para os fármacos CF e CP e ambos os fármacos demonstraram ação fungicida (CIM/CFM = 1). Em seguida foi verificado atividade sinérgica dos fármacos CF e CP combinados com anfotericina B (AmB), como resultado encontramos três concentrações sinérgicas, para CF reduzindo 8 e 4x em relação ao valor de CIM, para CP reduzindo 4x em relação ao valor de CIM e para AmB houve redução de 4x em relação ao valor de CIM. Posteriormente, o efeito dos fármacos mencionados foi avaliado na redução da biomassa do biofilme, por meio da técnica de cristal violeta. Nas concentrações 10x (312,5 µg/mL) e 20x (625 µg/mL) CIM de observou-se a redução da biomassa do biofilme de C. gattii em 57,72% a 76,66% para CF e redução entre 42,69 a 68,03% para CP. Além disso, em concentrações sub- inibitórias, ambos fármacos reduziram o tamanho da cápsula da levedura em até 62,46% para CF e 58,94% para CP. Também foi analisada a viabilidade do biofilme pela contagem de unidades formadoras de colônia/mL, após tratamento com CF e CP 20x valor de CIM e foi observada redução entre 1,21 a 1,446 log na viabilidade do biofilme (p< 0,0001). Ainda, o efeito dos fármacos em biofilme foi avaliado quanto ao efeito na atividade metabólica pelo ensaio XTT nas concentrações 10x e 20x CIM de ambos os fármacos foi possível observar redução entre 39,05% a 84,62% para CF e redução entre 56,99% a 67,64% para CP. Assim, os fármacos avaliados apresentaram potencial antifúngico frente C. gattii em todos os ensaios in vitro, podendo ser considerados novas alternativas para o tratamento deste patógeno (AU)

Cryptococcosis is a fungal infection that affects both immunocompromised and immunocompetent individuals. The antifungal arsenal is limited, there are reports of the development of fungal resistance to these compounds and also high toxicity to the patient. The drug repositioning of selective serotonin reuptake inhibitors (SSRIs) has shown action against fungal species, making these compounds alternatives to be studied for the treatment of cryptococcal infections. Thus, the aim of this study was to evaluate the antifungal effects on capsule, biofilm and planktonic cells of Cryptococcus gattii (ATCC strain 56990 and clinical isolate 5) of the SSRI drugs, fluoxetine hydrochloride (FLH) and paroxetine hydrochloride (PAH). For this, the broth microdilution technique was used according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) to determine the Minimum Inhibitory Concentration (MIC), and the MIC of 31.25 µg/mL was determined for the drugs (FLH) and PAH and both drugs demonstrated fungicidal action (MIC/CFM = 1).Then it was verified synergistic activity of the drugs FLH and PAH combined with amphotericin B (AmB), as a result we found three synergistic concentrations, for FLH reducing 8 and 4x compared to the MIC value, for PAH reducing 4x compared to the MIC value and for AmB there was 4x reduction compared to the MIC value. Subsequently, the effect of the mentioned drugs was evaluated in the reduction of biofilm biomass by means of the crystal violet technique. At 10x (312.5 µg/mL) and 20x (625 µg/mL) MIC concentrations of it was observed the reduction of C. gattii biofilm biomass by 57.72% to 76.66% for FLH and reduction between 42.69 to 68.03% for PAH. Furthermore, at sub-inhibitory concentrations, both drugs reduced the yeast capsule size by up to 62.46% for FLH and 58.94% for PAH. The biofilm viability was also analyzed by counting colony forming units/mL, after treatment with FC and CP 20x the MIC value and a reduction between 1.21 to 1.446 log in biofilm viability was observed (p< 0.0001). Also, the effect of the drugs in biofilm was evaluated as the effect on the metabolic activity by the XTT assay in concentrations 10x and 20x MIC of both drugs was possible to observe reduction between 39.05% to 84.62% for FC and reduction between 56.99% to 67.64% for CP. Thus, the drugs evaluated showed antifungal potential against C. gattii in all in vitro assays, and may be considered new alternatives for the treatment of this pathogen.(AU)

Reposicionamento de fármacos para cryptococose: avaliação experimental do cloridrato de duloxetina em Cryptococcus neoformans e Cryptococcus gattii / Repositioning of drugs for cryptococcosis: experimental evaluation of duloxetine hydrochloride in Cryptococcus neoformans and Cryptococcus gatti

Infecções fúngicas como as causadas por Cryptococcus spp. são de alta mortalidade e morbidade. O reposicionamento de fármaco, ou seja, a utilização de compostos para finalidade diferente da qual esse foi desenvolvido, pode ser uma alternativa para identificar fármacos mais eficazes. Assim, este estudo tem como propósito avaliar a atividade antifúngica, in vitro e in vivo, do fármaco cloridrato de duloxetina (CD), antidepressivo pertencente a classe dos Inibidores Seletivos da Recaptação da Serotonina e Norepinefrina frente a cepas padrões e clínicas de Cryptococcus neoformans e C. gattii. Foi utilizada a técnica de microdiluição de acordo com o European Committee on Antimicrobial Susceptibility Testing (EUCAST) para determinar a Concentração Inibitória Mínima (MIC), e a técnica do "tabuleiro de xadrez" para avaliar o efeito sinérgico de anfotericina B (AmB) em associação com CD. Além disso, foi avaliado o efeito de CD na quantidade do ergosterol. O efeito do CD também foi avaliado em biofilmes de C. neoformans e C. gattii, analisando a biomassa por cristal violeta, a viabilidade celular por XTT e morfologia através das imagens de Microscopia Eletrônica de Varredura (MEV). In vivo, a eficácia de CD foi avaliada por curvas de sobrevivência no modelo invertebrado Galleria mellonella. CD foi ativo frente a todas as cepas clínicas e padrões de C. neoformans e C. gattii, apresentando valores de CIM e CFM na faixa de 15,62 ­ 62,5 µg/mL. A combinação de CD com AmB apresentou uma combinação sinérgica, reduzindo o valor da CIM em 4 vezes tanto para CD quanto para AmB. CD não produziu redução na quantidade de ergosterol presente na membrana de C. gattii ATCC e C. neoformans ATCC. Em biofilmes, foi observada a redução da biomassa do biofilme em até 82,16% e redução de 99,6% na viabilidade celular de C. gattii. Em biofilmes de C. neoformans a redução foi de 81,13% e 99,5% respectivamente para a análise de biomassa e viabilidade. As imagens de MEV corroboraram com os achados dos ensaios realizados para análise do efeito de CD em biofilmes. Em G. mellonella aumentou a sobrevivência da larva quando utilizado na concentração de 3,125 mg/larva. Assim, os ensaios validaram a hipótese de que o cloridrato de duloxetina tem ação antifúngica e antibiofilme in vitro frente a cepas clínicas e cepas padrões de C. neoformans e C. gattii. (AU)

Fungal infections such as those caused by Cryptococcus spp. are of high mortality and morbidity. Drug repositioning, that is, the use of compounds for a purpose different from the one for which it was developed, can be an alternative to identify more effective drugs. Thus, this study aims to evaluate the antifungal activity, in vitro and in vivo, of the drug duloxetine hydrochloride (CD), an antidepressant belonging to the class of Selective Serotonin and Norepinephrine Reuptake Inhibitors against standard and clinical strains of Cryptococcus neoformans and C. gattii. The microdilution technique according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) was used to determine the Minimum Inhibitory Concentration (MIC), and the "chessboard" technique was used to evaluate the synergistic effect of amphotericin B (AmB) on association with CD. In addition, the effect of CD on the amount of ergosterol was evaluated. The effect of CD was also evaluated in C. neoformans and C. gattii biofilms, analyzing the biomass by crystal violet, cell viability by XTT and morphology through Scanning Electron Microscopy (SEM) images. In vivo, the effectiveness of CD was evaluated by survival curves in the Galleria mellonella invertebrate model. CD was active against all clinical strains and patterns of C. neoformans and C. gattii, with MIC and CFM values in the range of 15.62 ­ 62.5 µg/mL. The combination of CD with AmB showed a synergistic combination, reducing the MIC value by 4 times for both CD and AmB. CD did not produce a reduction in the amount of ergosterol present in the membrane of C. gattii ATCC and C. neoformans ATCC. In biofilms, a reduction in biofilm biomass of up to 82.16% and a 99.6% reduction in cell viability of C. gattii were observed. In C. neoformans biofilms the reduction was 81.13% and 99.5% respectively for biomass and viability analysis. The SEM images corroborated the findings of the tests carried out to analyze the effect of CD on biofilms. In G. mellonella, larval survival increased when used at a concentration of 3.125 mg/larvae. Thus, the tests validated the hypothesis that duloxetine hydrochloride has antifungal and antibiofilm action in vitro against clinical strains and standard strains of C. neoformans and C. gattii.(AU)

Una experiencia de siete años en el laboratorio de Micología del Hospital de Pediatría Juan P. Garrahan / A seven-year experience in the Mycology Laboratory of Hospital de Pediatría Juan P. Garrahan

En noviembre del año 2015 nos incorporamos al Laboratorio de Micología del Servicio de Microbiología del Hospital Garrahan. En este breve resumen queremos compartir los avances logrados a través de nuestra experiencia durante siete años de trabajo profesional. Debido a los diagnósticos realizados y su complejidad, consideramos que el Hospital Garrahan, sus pacientes y la comunidad toda necesitan contar con un laboratorio de Micología que responda a sus necesidades. Creemos haber iniciado un camino que esperamos continúe y culmine con la creación de la Unidad de Micología (AU)

In November 2015 we joined the Mycology Laboratory of the Microbiology Service of the Hospital Garrahan. In this brief summary we want to share the advances achieved through our experience during seven years of professional work. Due to the diagnosis made and their complexity, we believe that the Hospital Garrahan, its patients and the entire community, need to have a Mycology laboratory that responds to their requirements. We believe we have started a path that we hope will continue and culminate with the creation of the Mycology Unit (AU)

Scedosporiosis pulmonar post COVID-19 en paciente diabético: a propósito de un caso

Las especies de Scedosporium son consideradas patógenos oportunistas emergentes, que afectan a pacientes inmunocomprometidos o con respuesta inmunológica normal. La enfermedad invasiva grave supera tasas de mortalidad del 80 %. Se describe caso con afectación pulmonar causada por el complejo de especies de Scedosporium en un paciente masculino de 75 años de edad, procedente de Caracas, Venezuela, con diabetes mellitus tipo 2, infección respiratoria baja, dos infecciones previas por enfermedad por coronavirus 2019 (COVID-19) e imagen radiológica de lesión de ocupación de espacio pulmonar basal izquierdo. Se envió al laboratorio de microbiología porción de aproximadamente 1 cm2 de tejido pulmonar, solicitando estudios micológicos y para micobacterias. Al examen directo con KOH al 20 % se observó un fragmento de hifa hialina tabicada. A los 12 días de incubación hubo crecimiento en agar Sabouraud dextrosa más gentamicina de colonias vellosas con pigmentado difusible color amarillo pálido a mostaza. Se realizó examen directo a las colonias con azul de algodón, observándose estructuras compatibles con el complejo de especies de Scedosporium. Scedosporium spp., es el segundo hongo filamentoso, después de Aspergillus spp., causante de infecciones respiratorias bajas. El paciente fue tratado con voriconazol después del diagnóstico micológico con una evolución satisfactoria. Las infecciones por especies de Scedosporium afectan órganos internos como los pulmones, similar al caso descrito. La infección por COVID-19 es un factor predisponente para adquirir infecciones fúngicas poco frecuentes. El laboratorio de microbiología cumple un rol importante en el diagnóstico de micosis causadas por hongos inusuales.

Scedosporium species are considered emerging opportunistic pathogens affecting immunocompromised patients or patients with normal immune response. Mortality rates exceed 80 % in severe invasive disease. We describe a case of lung involvement caused by Scedosporium species complex in a 75-year-old male patient from Caracas, Venezuela, with type 2 diabetes mellitus, lower respiratory tract infection, two previous coronavirus disease infections 2019 (COVID-19) and radiological findings of a left basal lung space-occupying lesion. A piece of lung tissue measuring approximately one cm2 was sent to the microbiology laboratory, requesting mycology and mycobacteria studies. Direct examination with 20 % KOH revealed a hyaline septate hyphal fragment. Growth of hairy colonies with diffusible pale yellow to mustard pigment was observed on Sabouraud dextrose plus gentamicin agar after 12 days of incubation. Structures compatible with the Scedosporium species complex were observed on direct examination of the colonies with cotton blue. Scedosporium spp. is the second most common filamentous fungus causing infections of the lower respiratory tract after Aspergillus spp. The patient was treated with voriconazole after mycological diagnosis with satisfactory outcome. Infections with Scedosporium spp. affect internal organs such as the lungs, similar to the case described. COVID-19 infection predisposes to the acquisition of uncommon fungal infections. The microbiology laboratory plays an important role in the diagnosis of mycoses caused by unusual fungi.

Avaliação da interação farmacológica de antifúngicos e quimioterápicos: uma revisão sistemática / Evaluation of pharmacological interaction of antifungals and chemotherapy: a systematic review

Objetivo: avaliar, por meio da literatura existente, a interação farmacológica de antifúngicos e quimioterápicos. Métodos: foi realizado um estudo de revisão sistemática de acordo com o diagrama de fluxo do processo de pesquisa PRISMA. Os descritores escolhidos foram: drug interactions, CYP inhibitors, antifungal e antineoplastic, mediante análise realizada no MESH. As bases de dados escolhidas foram: Pubmed, Lilacs e Scielo. O período considerado para busca de artigos publicados foi de 2015 a 2020. Resultados: no banco de dados PubMed, foram encontrados 54 artigos, enquanto, nas bases Lilacs e Scielo, não foram encontrados artigos de acordo com os critérios estabelecidos. Dos 54 artigos, 7 foram selecionados para esta revisão. O intervalo com maior número de publicações foi de 2015-2016. Os antifúngicos mais citados nos resultados foram os inibidores fortes da CYP (Cetoconazol, Itraconazol e Voriconazol). Conclusão: a revisão sistemática da literatura mostrou que não existe uma correlação exata entre a interação farmacológica dos antifúngicos com os antineoplásicos, quando administrados de forma simultânea. São necessários mais estudos atuais que possam monitorar e estabelecer, de forma precisa, a relação dessas interações.

Objective: to evaluate, through the existing literature, the pharmacological interaction of antifungals and chemotherapeutics. Methods: a systematic review study was conducted according to the PRISMA research process flow diagram. The descriptors were chosen by analysis performed in MESH. The descriptors chosen were: drug interactions, CYP inhibitors, antifungal and antineoplastic. The databases chosen were: Pubmed, Lilacs, and Scielo. The period considered for the search of published articles was from 2015 to 2020. Results: in the PubMed database, 54 articles were found, while in the Lilacs and Scielo databases, no articles were found according to the established criteria. Of the 54 articles, 8 were selected for this review. The interval that had the highest number of publications was 2015-2016. The most cited antifungal drugs in the results were the strong CYP inhibitors. Conclusion: the systematic review of the literature showed that there is no exact correlation between the pharmacological interaction of antifungals with antineoplastic drugs when administered simultaneously. More current studies are needed that can accurately monitor and establish the relationship between these interactions.

Análisis fitoquímico preliminar y actividad antifúngica In vitro del extracto etanólico de las hojas de Solanum hispidum pers. Colectadas en la localidad Obraje - Perú / Preliminary phytochemical analysis and in vitro antifungal activity of the ethanolic extract of the leaves of Solanum hispidum pers. collected in the locality in Obraje - Peru

RESUMEN Objetivo . Analizar y determinar la actividad antifúngica in vitro del extracto etanólico de las hojas de Solanum hispidum Pers. Materiales y métodos . Se realizó el análisis fitoquímico preliminar cualitativo mediante reacciones de color y precipitación. Se investigó la actividad antifúngica in vitro frente a Candida albicans, Aspergillus brasilensis y Trichophyton mentagrophytes usando el método de difusión en pozo de agar y el ensayo de la concentración mínima inhibitoria (CMI). Resultados . El análisis fitoquímico preliminar cualitativo mostró la presencia de compuestos fenólicos, taninos, flavonoides, esteroides, alcaloides y saponinas. La actividad antifúngica in vitro fue demostrada para todos cultivos fúngicos con halos de inhibición entre 23 a 26 mm. Los valores de la CMI fueron de 125, 250 y 125 µg/mL para C. albicans, A. brasilensis y T. mentagrophytes, respectivamente. Conclusiones. El extracto etanólico de las hojas de Solanum hispidum Pers contiene importantes metabolitos secundarios y tiene moderada actividad antifúngica.

ABSTRACT Objective. To analyze and determine the in vitro antifungical activity of the ethanolic extract of the leaves of Solanum hispidum Pers. Materials and methods. We carried out a preliminary qualitative phytochemical analysis by color and precipitation reactions. We evaluated the in vitro antifungical activity against Candida albicans, Aspergillus brasilensis and Trichophyton mentagrophytes by using the agar well diffusion method and the minimum inhibitory concentration (MIC) assay. Results. Preliminary qualitative phytochemical analysis showed the presence of phenolic compounds, tannins, flavonoids, steroids, alkaloids and saponins. In vitro antifungal activity was demonstrated for all fungal cultures with inhibition halos between 23 to 26 mm. The MIC values were 125, 250, and 125 μg/mL for C. albicans, A. brasilensis, and T. mentagrophytes, respectively. Conclusions. The ethanolic extract of the leaves of Solanum hispidum Pers. contains important secondary metabolites and has moderate antifungical activity.

Infección fúngica invasiva por Saprochaete capitata en un niño con aplasia medular / Invasive fungal infection by Saprochaete capitata in a child with bone marrow aplasia

RESUMEN Saprochaete capitata es una causa rara de infección fúngica invasiva en pacientes inmunocomprometidos con alta mortalidad y resistencia antifúngica. Presentamos el caso de un niño de cinco años con diagnóstico de aplasia medular, sometido a trasplante de progenitores hematopoyéticos (TPH), que cursó con neutropenia febril persistente, dolor abdominal intenso, aparición de lesiones maculopapulares en piel y deterioro de la función renal. Se identificó la presencia de S. capitata, en hemocultivos transcatéter venoso central. Esta infección fúngica invasiva resulta ser rara, pero emergente y potencialmente mortal, en pacientes con neutropenia febril persistente y uso prolongado de dispositivos invasivos intravasculares como catéter venoso central.

ABSTRACT Saprochaete capitata is a rare cause of invasive fungal infection in immunocompromised patients with high mortality and antifungal resistance. We present the case of a 5-year-old boy with bone marrow aplasia, who underwent hematopoietic stem cell transplantation (HSCT) and presented persistent febrile neutropenia, abdominal pain, appearance of maculopapular lesions on the skin, and impaired renal function. The presence of S. capitata was identified by blood culture from a central venous catheter. This invasive fungal infection is rare but emergent and life-threatening, especially in immunocompromised patients with persistent febrile neutropenia and prolonged use of invasive devices such as central venous catheters.

Incidencia de hipopotasemia en pacientes con neutropenia febril que reciben tratamiento con anfotericina B liposomal / Incidence of hypokalemia in patients with febrile neutropenia receiving treatment with liposomal amphotericin B

Objetivos: Describir la incidencia, la gravedad y los factores asociados a la aparición de hipopotasemia en pacientes con neutropenia febril en tratamiento con anfotericina B liposomal.Métodos: Estudio unicéntrico retrospectivo (enero 2010- mayo 2020), que incluyó a aquellos pacientes hematológicos con neutropenia febril que recibieron tratamiento con anfotericina B liposomal durante al menos 72 h. Se evaluó la incidencia de aparición de hipokalemia asociada al empleo del fármaco, la gravedad de la misma, así como el impacto del empleo de una suplementación de potasio sobre la aparición de hipokalemia en este grupo de pacientes.Resultados: Se incluyeron 89 pacientes (50,6% mujeres [n=45]; edad media 63,5 años [20-90]). El 59,6% (n=53) de los pacientes desarrolló hipopotasemia durante el tratamiento con anfotericina B liposomal: leve (52,8%, n=28), moderada (35,8%, n=19) y grave (11,3%, n=6). El empleo de una suplementación de inicio precoz a base de potasio disminuyó la tasa de aparición de hipokalemia en estos pacientes (p=0,001). El periodo entre el inicio del fármaco y el aporte de potasio fue menor en pacientes que no desarrollaron hipokalemia (p<0,001). Asimismo, este grupo de pacientes se benefició de periodos más prolongados de suplementación (p=0,002) y terapia antifúngica (p=0,039).Conclusiones: La hipopotasemia es un efecto adverso muy frecuente en pacientes con neutropenia febril que reciben tratamiento con anfotericina B liposomal, siendo necesario el establecimiento de protocolos de suplementación de potasio que disminuyan el riesgo de aparición de esta reacción adversa. (AU)

Objectives: To describe the incidence, severity and factors associated with the appearance of hypokalemia in patients with febrile neutropenia in treatment with liposomal amphotericin B. Methods: Retrospective unicenter study (January 2010-May 2020), which included those hematological patients with febrile neutropenia who were treated with liposomal amphotericin B for at least 72 h. The incidence of hypokalemia associated with the use of the drug, its severity, and the influence of potassium supplementation on the occurrence of hypokalemia in this group of patients were evaluated. Results: 89 patients were included (50.6% women [n=45]; mean age 63.5 years [20-90]). 59.6% (n=53) of patients developed hypokalemia during treatment with liposomal amphotericin B: mild (52.8%, n=28), moderate (35.8%, n=19) and severe (11.3%, n=6). The use of early-onset potassium-based supplementation decreased the rate of occurrence of hypokalemia in these patients (p=0.001). The period between drug initiation and potassium intake was lower in patients who did not develop hypokalemia (p<0.001). Likewise, this group of patients benefited from longer periods of supplementation (p=0.002) and antifungal therapy (p=0.039).Conclusions: Hypokalemia is a very frequent adverse effect in patients with febrile neutropenia who are treated with liposomal amphotericin B. It is necessary to establish protocols for potassium supplementation to reduce the risk of this adverse reaction. (AU)

[Usefulness of the Sensititre YeastOne® panel to detect Candida species resistant to antifungal drugs]. / Utilidad del panel Sensititre YeastOne® para detectar especies de Candida resistentes a los antifúngicos.

We evaluated the interlaboratory agreement, the essential agreement, and the categorical agreement between the Sensititre YeastOneTM panel and the reference methods M27 4th Edition of the Clinical and Laboratory Standards Institute (CLSI), and the EDef 7.3.1 of the European Committee on Antifungal Susceptibility Testing (EUCAST). We studied 67 Candida strains isolated from different clinical samples and 9 Candida strains with resistance to fluconazole and echinocandins. The highest percentage of interlaboratory agreement was observed with amphotericin B (96.8%), and the lowest percentage with voriconazole (77.2%). Caspofungin showed 5.8% of very major errors when compared with the CLSI reference method. For EUCAST, itraconazole, posaconazole, and anidulafungin showed high percentages of major errors: 17.6%, 18.1%, and 19.6%, respectively. Sensititre YeastOneTM is a reliable alternative, and easy to perform for detecting Candida species resistant to antifungal drugs, with some limitations for echinocandins. Results are comparable to those of the reference methods.