Antifungal Properties of Essential Oils Derived from the Genus Cymbopogon: A Systematic Review.

Essential oils (EOs) are products of secondary metabolism with recognized organoleptic characteristics and biological properties. Recently, there has been a growing demand for EOs in the national and international market, mainly due to the recognition of their use as complementary medicine practices, and the increased use in the industries of pharmaceutics, cosmetics, well-being, veterinary and agroecology, boosting the productive sector. In this context, EOs from grasses of the Cymbopogon (Poaceae) are promising sources of bioactive compounds, due to their recognized biological properties, such as anti-inflammatory, antibacterial, antifungal, antidiabetic, repellent, and larvicide. Thus, the present study aims to carry out a review of the scientific literature of the main works related to the evaluation of the antifungal action of essential oils extracted from plants of the Cymbopogon genus, compiling the species that showed the best results and relating them to their main chemical constituents. This review covers the following species: C. citratus, C. flexuosus, C. winterianus, C. martinii, C. nardus, C. giganteus, C. schoenanthus, C. khasans, and C. proximus. Among them, C. citratus was the most assessed, being associated with the vast majority of studies (61.9 %), and it was also the species that showed the best results in terms of MIC.

Antifungal resistance on Sporothrix species: an overview.

INTRODUCTION: The treatment of human and animal sporotrichosis is often performed with antifungal agents; however, the emergence of antifungal-resistant strains of Sporothrix species has been reported. We aimed to discuss the ability of Sporothrix species in developing resistance to the conventional antifungals and mechanisms for this. METHODOLOGY: Published data on databases (PubMed, Science Direct, Google Scholar) were investigated using a combination of keywords from 2008 to 2019 by the StArt tool. RESULTS: The minimal inhibitory concentrations values based on the Clinical and Laboratory Standards Institute (CLSI) from eight references were classified according to the epidemiological cutoff values in wild-type or non-wild-type strains. In this way, non-wild-type S. schenckii and, mainly, S. brasiliensis isolates were recognized on itraconazole, amphotericin B, terbinafine, and voriconazole, which are strains that deserve more attention toward antifungal control, with a probable risk of mutation to antifungal resistance. Among the few reviewed studied on antifungal resistance, the melanin production capacity (DHN-melanin, L-DOPA melanin, and pyomelanin), the low genetic diversity due to the abnormal number of chromosomes, and the mutation in cytochrome P450 are some of the factors for developing resistance mechanism. CONCLUSIONS: The emergence of Sporothrix species with in vitro antifungal resistance was evidenced and the possible mechanisms for resistance development may be due to the melanin production capacity, genetic diversity and mutations in cytochrome P450. Further studies should be carried out targeting gene expression for the development of antifungal resistance on Sporothrix species in order to prospect new therapeutic targets for human and veterinary use.

Synergistic effect of ibuprofen with itraconazole and fluconazole against Cryptococcus neoformans

The present study investigated the association of the non-steroidal anti-inflammatory drug ibuprofen with itraconazole, fluconazole and amphotericin B against Cryptococcus neoformans isolates. The minimal inhibitory concentration (MIC) was found according to M27-A3 protocol and in vitro interactions were evaluated using checkerboard microdilution method. Synergism was demonstrated between azoles and ibuprofen for most isolates. However, no synergistic effects were seen when amphotericin B was combined with ibuprofen. Therefore, our results suggest that ibuprofen presents clinical potential when combined with azole drugs in the treatment of cryptococcosis.

Airborne fungi in the city of Porto Alegre, Rio Grande do Sul, Brazil.

Knowledge of anemophilous fungi in a given city or region is important for the ecological diagnosis and specific treatment of allergic manifestations induced by inhaled allergens. In order to diagnose the presence of anemophilous fungi, several qualitative and quantitative techniques are used depending on the study place. This study of fungal air spores was performed with a Rotorod Sampler(R), an equipment which samples the air through a plastic rod attached to an electric engine that makes it spin fast enough to collect the particles in the air. The samples were collected once a week during 24 hours using the standard cycle of the manufacturers. A total of 52 samples were obtained from April 2000 through March 2001. The results revealed prevalence of ascosporos (50.49%), Cladosporium (17.86%), Aspergillus/Penicillium (15.03%), basidiosporos (3.84%), rusts (3.82%), and Helminthosporium (2.49%), and a lesser frequency of Botrytis (1.22%), Alternaria (1.19%), smuts (0.90%), Curvularia (0.87%), Nigrospora (0.61%), and Fusarium (0.08%). Also, 1.59% of the spores detected here could not be identified by the systematic key used. More fungal spores were observed during the summer than during the autumn.

[Airborne fungi and sensitization in atopic individuals in Porto Alegre, RS, Brazil]. / Os fungos anemófilos e sensibilização em indivíduos atópicos em Porto Alegre, RS.

OBJECTIVE: To identify and quantify the fungal spores in the atmospheric air of Porto Alegre and to assess sensitization to these allergens in atopic individuals suffering from rhinitis and asthma. METHODS: A total of 52 samples were obtained using a Rotorod Sampler from April 2000 through March 20001. Allergy skin tests with anemophilous fungus allergens as well as fluorimmunoenzymatic tests were performed in 39 atopic individuals with rhinitis and asthma in order to detect the incidence of respiratory allergies caused by these airborne fungi. RESULTS: In the 3773 fungal spores detected in this study, there was a prevalence of ascosporos (50.49%), Cladosporium (17.86%), Aspergillus/Penicillium (15.03%), basidiosporos (3.84%), rusts (3.82%), and Helminthosporium (2.49%), as well as a lesser frequency of Botrytis (1.22%), Alternaria (1.19%), smuts (0.90%), Curvularia (0.87%), Nigrospora (0.61%), and Fusarium (0.08%). Sixty spores (1.59%) detected here could not be identified by the systematic key used. Among the atopic individuals tested, 15.38% were found to be sensitized by these anemophilous fungi allergens. CONCLUSIONS: The occurrence of a great number of fungal spores emphasizes the importance of studying anemophilous fungi locally, since they are responsible for 15.38% of allergic sensitization in atopic individuals with asthma and rhinitis.

Candida blankii: um patógeno emergente de difícil diagnóstico e tratamento clínico / Candida blankii: an emerging pathogen difficult to diagnose and to treat clinically

O gênero Candida possui várias espécies conhecidas e que podem tornar-se patogênicas em determinadas situações. Candida blankii é uma espécie emergente que, na última década, foi identificada como um agente de doenças sistêmicas. Ainda não existe um protocolo de tratamento específico, apesar de que n os poucos casos registrados na literatura a terapia adotada foi efetiva. O objetivo deste estudo foi realizar uma revisão bibliográfica para coletar informações relevantes sobre este patógeno como um possível agente etiológico em infecções sistêmicas, bem como sua epidemiologia e os aspectos de sua patogenicidade. (AU)

The genus Candida has several known species and may become pathogenic in certain situations. Candida blankii is an emerging species that in the past decade has been identified as an agent of systemic diseases. There is no specific treatment protocol yet, although in the few cases reported in the literature the therapy adopted was effective. The objective of this study was to conduct a literature review to collect relevant information about this pathogen as a possible etiological agent in systemic infections, as well as its epidemiology and aspects of pathogenicity. (AU)

Candida auris: emergence and epidemiology of a highly pathogenic yeast

Candida auris is a multidrug-resistant emerging yeast, which was responsible for healthcare-associated infection outbreaks, and was cataloged as a new species in 2009, after being isolated from a patient's ear canal secretion in Japan. Since the notification of this first occurrence, numerous cases have been reported throughout the world, including Brazil. C. auris affects mainly inpatients, patients in intensive care units, exposed to broad-spectrum antifungal medications and who make use of vascular catheters. Currently, this yeast is one of the main responsible for invasive infections in hospitals and has been cause of concern by authorities and organs due to its rapid dissemination and difficult treatment caused by its low susceptibility to antifungal agents traditionally used in clinical practice. As a contributor to the severity of infections associated with C. auris, the transmission mechanism is still unknown, which implies in a lack of control of the microorganism and high mortality rates. Thus, this literature review presents relevant information in order to alert the importance of C. auris as an etiological agent of systemic infections, as well as its epidemiology and the real challenges of the treatment (AU)

Prevalência de Micoses Superficiais e Cutâneas em Pacientes Atendidos Numa Atividade de Extensão Universitária / Prevalence of Superficial and Cutaneous Mycoses in Patients Attending a University Extension Activity

Objetivo: Verificar a presença de micoses superficiais e cutâneas na comunidade e desenvolver ações preventivas para o combate das mesmas proporcionando melhor qualidade de vida na população. Material e Métodos: Tendo em vista a prevalência relativamente alta das infecções fúngicas, foram atendidos pacientes encaminhados para o diagnóstico micológico e aplicado a eles medidas preventivas de orientação verbal sobre o que é uma micose, como ocorre o contágio, suas recidivas entre outras e também a entrega de um manual explicativo com essas mesmas orientações. Todos os procedimentos foram realizados pelo acadêmico bolsista o qual participou ativamente em todas as etapas de execução do projeto, tanto na atividade prática quanto no desenvolvimento e aplicação de ações preventivas. Resultados: Durante os anos de 2013 e 2014, foram atendidos 179 pacientes e colhidas 199 amostras clínicas nos diversos sítios anatômicos. Após o diagnóstico micológico, o paciente foi encaminhado para a Unidade Básica de Saúde (UBS) para receber o tratamento. Os fungos com maior prevalência foram a levedura Candida spp e os dermatófitos Trichophyton rubrum igualmente com 24,9% seguido do Trichophyton mentagrophytes com 22,4% dos isolados. Conclusão: Os resultados dos fungos isolados no diagnóstico micológico possibilitaram confirmar a presença de micoses superficiais e cutâneas na comunidade envolvida reforçando a necessidade de desenvolver ações preventivas que possam diminuir a prevalência das mesmas. (AU)

Objective: To verify the presence of superficial and cutaneous mycoses in the community and develop preventive actions to combat them, thereby providing better quality of life to the population. Methods: In view of the relatively high prevalence of fungal infections, we included in this study patients who had been referred to mycological diagnosis. They were verbally instructed with regard to mycosis concepts, forms of contamination, recurrences, among other subjects. The patients were given an explanatory manual including these guidelines. All procedures were performed by an academic student, who actively participated in all project execution stages, both in practical activities and in the development and implementation of preventive actions. Results: During the years 2013 and 2014, a total of 179 patients were treated and 199 clinical samples were collected from various anatomical sites. After mycological diagnosis, the patient was referred to the Primary Care Unit (PCU) to receive treatment. The most prevalent fungi were the yeasts Candida spp. (24.9%) and dermatophytes Trichophyton rubrum (24.9%), followed by Trichophyton mentagrophytes (22.4%). Conclusion: The results of the mycological diagnosis confirmed the presence of superficial and cutaneous mycoses in the sample. These findings reinforce the need to develop preventive actions that might reduce the prevalence of fungal infections. (AU)

Diagnóstico e orientações preventivas nas infecções cervico-vaginais e no câncer cervical / Diagnostic and preventive guidelines for cervical-vaginal infections and cervical cancer

Objetivo Avaliar o diagnóstico de câncer cervical e de infecções cervico vaginais, bem como posteriores orientações preventivas para estas doenças. Métodos Foram avaliados esfregaços vaginais de exames citológicos e cultura para a pesquisa de Candida spp. nos materiais colhidos de pacientes atendidas em Unidades Básicas de Saúde do Sistema Único de Saúde. Resultados Foi atendido um total de 78 mulheres com idades entre 15 e 81 anos, tendo como média de idade 39,8 anos e desvio-padrão de 15,6 anos. Na leitura da lâmina corada pelo método de Papanicolaou para adequação da amostra, 43 (55,1%) apresentaram presença de junção escamo-colunare 21 (26,9%) presença de metaplasia. Com relação à flora microbiana presente nas amostras, houve 27 amostras (34,6%) com flora lactobacilar, 40 (51,3%) com flora cocóide, 4 (5,1%) com presença de Candida spp. e Gardnerella vaginalis, 2 (2,6%) com Trichomonas vaginalis e em 26 casos (33,3%) outros bacilos foram observados. No laudo citológico, 32 amostras (41,0%) tiveram resultado normal, 34 (43,6%) com processo inflamatório, 6 (7,6%) apresentaram atrofia com inflamação, com 5 (6,4%) com processo inflamatório e reacional e uma (1,3%) com presença de células escamosas atípicas de significado indeterminado. Quanto à cultura para Candida spp., 55 (73,3%) amostras foram negativas e 20 (26,7%), positivas. Destas, 11 (14,1%) foram casos de Candida albicans isolada, 5 (6,7%) de Candida glabrata, 2 (2,7%) de Candida parapsilosis e outros 2 de Candida guilliermondii. Conclusão O presente estudo demonstrou que mulheres com ou sem lesões precursoras do câncer do colo do útero, apresentavam também outras infecções que, de alguma forma, comprometem sua qualidade de vida, reforçando a aplicação de medidas preventivas para melhorar essas realidade.

Objective To assess the diagnosis of cervical cancer, cervical and vaginal infections, and subsequent guidelines to prevent these diseases. Methods Cytological tests and culture of vaginal smears of patients treated at Primary Healthcare Units of the Unified Healthcare System were assessed for Candida spp. Results A total of 78 women aged 15 to 81 years were examined. Their mean age and standard deviation were 39.8±15.6 years. Slides stained with Papanicolaou stain showed that 43 (55.1%) women had squamocolumnar junction and 21 (26.9%) had metaplasia. The microbial floras found in the samples included: 27 (34.6%) with Lactobacillus flora, 40 (51.3%) with coccoid flora, 4 (5.1%) with Candida spp. and Gardnerella vaginalis, 2 (2.6%) with Trichomonas vaginalis, and 26 (33.3%) with other bacilli. According to the cytological report, 32 samples (41.0%) were normal, 34 (43.6%) had an inflammatory process, 6 (7.6%) had atrophy and inflammation, 5 (6.4%) had an inflammatory and reactional process, and one (1.3%) had atypical squamous cells with undetermined significance. Fifty-five (73.3%) samples were negative for Candida spp. culture, and 20 (26.7%) were positive. Of these, 11 (14.1%) were isolated cases of Candida albicans, 5 (6.7%), of Candida glabrata, 2 (2.7%), of Candida parapsilosis, and another two (2.7%), of Candida guilliermondii. Conclusion The study women with or without precursor lesions of cervical cancer presented other infections that somehow compromised their quality of life, reinforcing the need to implement preventive measures to improve this reality.

Identification of Malassezia yeast species isolated from patients with pityriasis versicolor.

Pityriasis versicolor (PV) is a disease with worldwide distribution. Twelve different species of Malassezia yeast have been described. The objective of this study was to determine which species of Malassezia are more prevalent in patients with pityriasis versicolor. Samples were collected by scraping the lesions of 87 patients with a clinical suspicion of pityriasis versicolor. The samples were then submitted to fungal microscopy and culture to identify the species. The species found were: Malassezia sympodialis (30%), Malassezia furfur (25.7%), Malassezia globosa (22.7%), Malassezia restricta (12.1%), Malassezia obtusa (7.6%) and Malassezia slooffiae (1.5%).

Alterações citológicas cervicovaginais no Alto Uruguai Gaúcho, Rio Grande do Sul / Cytological cervico-vaginal changes in Alto Uruguai Gaúcho, Rio Grande do Sul

Objetivo: Avaliar a frequência de alterações cervicovaginais que acometem mulheres da região do Alto Uruguai. Métodos: Foram avaliados dados de exames citopatológicos obtidos a partir de um sistema de programa personalizado conhecido como Laudo & Imagem, propriedade de um laboratório de referência da cidade de Erechim, Rio Grande do Sul, no período de 2007 a 2011. Resultados: Dos 62.280 casos avaliados, 2.049 (3,3%) apresentaram alguma alteração citológica; destes, 1.094 (53,4%) corresponderam à lesão escamosa de baixo grau, 179 (8,8%) à lesão escamosa de alto grau, 13 (0,7%) à carcinoma escamoso, 5 (0,2%) à adenocarcinoma e 758 (37%) a atipias de significado indeterminado, que, no seguimento, 360 (47,5%) corresponderam a lesões benignas, 225 (29,7%) a lesões malignas; destas, 220 casos (29,02%) de lesão escamosa intraepitelial de baixo grau, 4 casos (0,53%) de lesão escamosa intraepitelial de alto grau e 1 (0,13%) de carcinoma escamoso. Não tiveram seguimento citopatológico 173 (22,8%) casos. Conclusão: O estudo verificou que os dados encontrados nessa região assemelham-se aos encontrados nacionalmente, o que justifica a importância de incentivo ao rastreamento e à prevenção através dos programas de rastreamento do exame citológico para a detecção precoce do câncer de colo uterino.

Objective: To evaluate the frequency of cervical changes that affects women in Alto Uruguai, Rio Grande do Sul. Methods: We evaluated cytology findings of the National Health System, in a reference laboratory in Erechim, Rio Grande do Sul at the period of 2007 to 2011. Results: From 62,280 cases evaluated, 2,049 (3.2%) showed cytological changes, which in 1,094 (53.4%) corresponded to low-grade squamous intraepithelial lesions, 179 (8.8%) and high grade squamous intraepithelial lesion, 13 (0.7%) squamous carcinomas, 5 (0.2%) adenocarcinomas and the 758 (37%) of atypical squamous cell underteminated significance Of atypical squamous cell underteminated significance, 360 (47.5%) lesions were benign, 225 (29.7%) malignant lesions and of this cases, 220 (29.02%) cases of low-grade squamous intraepithelial lesions, 4 (0.53%) cases of high grade squamous intraepithelial lesion and 1 (0.13%) cases of squamous cell carcinoma. But, 173 patients (22.8%) did not follow the cytopathologic screening. Conclusion: In conclusion the study and found that the data found in this region are similar to those found at the national level, justifying the importance of encouraging screening and prevention through screening programs of cytological cervical early detection of cervical cancer .

O uso do Moodle como reforço ao ensino presencial de parasitologia e micologia no curso de graduação em medicina / The Moodle as a reinforcement to classroom teaching of course parasitology and mycology in undergraduate medical course

O ensino presencial nos cursos de graduação continua sendo o foco do ensino e da aprendizagem. Com o advento de novas tecnologias de ensino, algumas ferramentas têm sido utilizadas como reforço ao ensino presencial. A plataforma Moodle (Modular Object Oriented Distance Learning) tem sido uma das mais empregadas nas instituições de ensino. Este estudo avaliou a relação do ensino presencial com o uso do Moodle institucional na disciplina de Parasitologia e Micologia Médica do curso de Medicina da Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA). Como reforço a esta atividade, a página da disciplina cadastrada no sistema Moodle disponibilizou casos clínicos para que os alunos realizassem o diagnóstico. Além disso, foram apresentadas outras informações complementares para o ensino presencial. A metodologia buscou exercitar os instrumentos de aprendizagem que o sistema Moodle oferece, como o link a um arquivo ou site, os fóruns de discussão, a ferramenta questionário e o chat. Como o Moodle é institucional, nele está disponível a página da disciplina, onde passaram a constar todas as informações referentes à mesma, bem como as atividades extraclasse.

The classroom teaching in undergraduate courses remain the focus of teaching and learning. With the advent of new technologies for learning, some tools have been used to reinforce classroom teaching. The platform Moodle (Modular Object Oriented Distance Learning) has been one of the most used in educational institutions. This study assessed the relationship of classroom learning using institutional Moodle in the discipline of Medical Parasitology and Mycology of the School of Medicine, Federal University of Health Sciences of Porto Alegre (UFCSPA). As a support to this activity, on the course page registered in the Moodle system were provided clinical cases for students to perform the diagnosis. Furthermore, additional information was made available for classroom teaching. The methodology sought to exercise the learning tools that Moodle offers, such as links to a file or website, the discussion forums, the questionnaire and chat tools. As Moodle is institutional, in it is available the discipline's page, which now contains all information concerning the same, as well as the extra class activities.

Etiología de la candidiasis vulvovaginal recidivante en la Atención Primaria de Salud en Santa Catarina, Brasil / Etiology of recurrent vulvovaginal candidiasis in the National Health System in Santa Catarina, Brazil / Etiologia da candidíase vulvovaginal recorrente na AtenþÒo Primária O Saúde em Santa Catarina, Brasil

El objetivo del presente trabajo fue destacar las características epidemiológicas que puedan subsidiar la Atención Primaria de Salud (APS) en mujeres portadoras de candidiasis vulvovaginal (CVV) y candidiasis vulvovaginal recidivante (CVVR), a partir de estudios realizados en tres municipios del sur de Brasil. A través del examen micológico de la secreción vaginal de 300 mujeres con sospecha clínica de CVV o CVVR se identificaron las especies prevalentes de Candida, correlacionándose los hallazgos con los principales factores de riesgo mencionados en la literatura. Fueron confirmadas levaduras en 90 (30%) casos, resultando las especies más frecuentes C. albicans (61,1%), C. krusei (16,7%), C. tropicalis (6,7%), C. glabrata (4,4%) y Candida spp. (11,1%). En los casos de CVVR, C. albicans fue la especie más encontrada, con una prevalencia superior a la observada en la CVV. C. krusei apareció como la segunda especie más prevalente en todas las muestras, resaltando la importancia del diagnóstico a nivel de especie, dada la resistencia intrínseca al fluconazol. Las informaciones epidemiológicas del estudio son útiles para que los gestores de la Atención Primaria de Salud (APS) y los profesionales de la Salud puedan tener subsidios adicionales para actuar preventivamente en el caso de candidiasis vulvovaginales.(AU)

The main purpose of this work was to highlight epidemiological characteristics serving as subsidies to health promotion activities for vulvovaginal candidiasis (VVC) and recurrent vulvovaginal candidiasis (RVVC) by the national health system, in three cities in southern Brazil. Through the mycological examination of vaginal secretions of 300 women with clinical suspicion of VVC or RVVC, Candida-prevalent species were identified and they were correlated with the main risk factors mentioned in the literature. Yeasts were confirmed in 90 (30%) cases, resulting in C. albicans 61.1%, C. krusei 16.7%, C. tropicalis 6.7%, C. glabrata 4.4% and others 11.1%. C. albicans was the species most commonly found in cases of RVVC, with levels higher than the prevalence of the species in the VVC. C. krusei prevailed as the second most prevalent species in both samples, emphasizing the importance of diagnosing the species level, due to its intrinsic resistance to fluconazole. The epidemiological information of the study is useful for managers of the National Health Care System, as well as direct health professionals, who can have new subsidies to act preventively against vulvovaginal candidiasis.(AU)

O objetivo do presente trabalho foi destacar as características epidemiológicas que possam subsidiar a AtenþÒo Primária O Saúde (APS) em mulheres portadoras de candidíase vulvovaginal (CVV) e candidíase vulvovaginal recorrente (CVVR), a partir de estudos realizados em trÛs municípios do sul do Brasil. Através do exame micológico da secreþÒo vaginal de 300 mulheres com suspeita clínica de CVV ou CVVR foram identificadas as espécies prevalentes de Candida, correlacionando os achados com os principais fatores de risco mencionados na literatura. Foram detectadas leveduras em 90 (30%) dos casos, resultando as espécies mais frequentes C. albicans (61,1%), C. krusei (16,7%), C. tropicalis (6,7%), C. glabrata (4,4%) e Candida spp. (11,1%). Nos casos de CVVR, C. albicans foi a espécie mais encontrada, com uma prevalÛncia superior O observada nos casos de CVV. C. krusei apareceu como a segunda espécie mais prevalente em todas as amostras, ressaltando a importÔncia do diagnóstico em nível de espécie, devido O resistÛncia intrínseca ao fluconazol. As informaþ§es epidemiológicas deste estudo sÒo úteis para que os gestores da AtenþÒo Primária O Saúde (APS) e os profissionais da Saúde Pública possam ter subsídios adicionais para atuar preventivamente nos casos de candidíases vulvovaginais.(AU)

Etiología de la candidiasis vulvovaginal recidivante en la Atención Primaria de Salud en Santa Catarina, Brasil / Etiology of recurrent vulvovaginal candidiasis in the National Health System in Santa Catarina, Brazil / Etiologia da candidíase vulvovaginal recorrente na Atenção Primária à Saúde em Santa Catarina, Brasil

El objetivo del presente trabajo fue destacar las características epidemiológicas que puedan subsidiar la Atención Primaria de Salud (APS) en mujeres portadoras de candidiasis vulvovaginal (CVV) y candidiasis vulvovaginal recidivante (CVVR), a partir de estudios realizados en tres municipios del sur de Brasil. A través del examen micológico de la secreción vaginal de 300 mujeres con sospecha clínica de CVV o CVVR se identificaron las especies prevalentes de Candida, correlacionándose los hallazgos con los principales factores de riesgo mencionados en la literatura. Fueron confirmadas levaduras en 90 (30%) casos, resultando las especies más frecuentes C. albicans (61,1%), C. krusei (16,7%), C. tropicalis (6,7%), C. glabrata (4,4%) y Candida spp. (11,1%). En los casos de CVVR, C. albicans fue la especie más encontrada, con una prevalencia superior a la observada en la CVV. C. krusei apareció como la segunda especie más prevalente en todas las muestras, resaltando la importancia del diagnóstico a nivel de especie, dada la resistencia intrínseca al fluconazol. Las informaciones epidemiológicas del estudio son útiles para que los gestores de la Atención Primaria de Salud (APS) y los profesionales de la Salud puedan tener subsidios adicionales para actuar preventivamente en el caso de candidiasis vulvovaginales.

The main purpose of this work was to highlight epidemiological characteristics serving as subsidies to health promotion activities for vulvovaginal candidiasis (VVC) and recurrent vulvovaginal candidiasis (RVVC) by the national health system, in three cities in southern Brazil. Through the mycological examination of vaginal secretions of 300 women with clinical suspicion of VVC or RVVC, Candida-prevalent species were identified and they were correlated with the main risk factors mentioned in the literature. Yeasts were confirmed in 90 (30%) cases, resulting in C. albicans 61.1%, C. krusei 16.7%, C. tropicalis 6.7%, C. glabrata 4.4% and others 11.1%. C. albicans was the species most commonly found in cases of RVVC, with levels higher than the prevalence of the species in the VVC. C. krusei prevailed as the second most prevalent species in both samples, emphasizing the importance of diagnosing the species level, due to its intrinsic resistance to fluconazole. The epidemiological information of the study is useful for managers of the National Health Care System, as well as direct health professionals, who can have new subsidies to act preventively against vulvovaginal candidiasis.

O objetivo do presente trabalho foi destacar as características epidemiológicas que possam subsidiar a Atenção Primária à Saúde (APS) em mulheres portadoras de candidíase vulvovaginal (CVV) e candidíase vulvovaginal recorrente (CVVR), a partir de estudos realizados em três municípios do sul do Brasil. Através do exame micológico da secreção vaginal de 300 mulheres com suspeita clínica de CVV ou CVVR foram identificadas as espécies prevalentes de Candida, correlacionando os achados com os principais fatores de risco mencionados na literatura. Foram detectadas leveduras em 90 (30%) dos casos, resultando as espécies mais frequentes C. albicans (61,1%), C. krusei (16,7%), C. tropicalis (6,7%), C. glabrata (4,4%) e Candida spp. (11,1%). Nos casos de CVVR, C. albicans foi a espécie mais encontrada, com uma prevalência superior à observada nos casos de CVV. C. krusei apareceu como a segunda espécie mais prevalente em todas as amostras, ressaltando a importância do diagnóstico em nível de espécie, devido à resistência intrínseca ao fluconazol. As informações epidemiológicas deste estudo são úteis para que os gestores da Atenção Primária à Saúde (APS) e os profissionais da Saúde Pública possam ter subsídios adicionais para atuar preventivamente nos casos de candidíases vulvovaginais.

Prevalência de Candida spp. em biofilme dentário de usuários de aparelhos ortodônticos fixos / Prevalence of Candida spp. in the dental biofilm of fixed orthodontic appliances users

OBJETIVOS: O presente estudo tem como objetivo avaliar a prevalência de Candida spp. em biofilme dentário de usuários de aparelhos ortodônticos fixos (AOF) e relacionar com seus hábitos e características.MATERIAIS E MÉTODOS: Foram isolados e identificados cepas de Candida em amostras de saliva em indivíduos usuários de AOF com presença de biofilme microbiano e indivíduos usuários de AOF mas sem presença de biofilme (grupo controle), a partir do cultivo em laboratório.RESULTADOS: Neste estudo foram analisadas 108 amostras de indivíduos com biofilme, e 51 indivíduos no grupo controle. Das 108 amostras analisadas, 52 (48,1%) foram negativas para o gênero Candida e 56 (55,2%) foram positivas, sendo que em oito pacientes foram isolados duas espécies de Candida, quatro pacientes com C. albicans e C. krusei, um com C. albicans e C. tropicalis, um com C. albicans e C. glabrata, um com C. tropicalis e C. glabrata e um com C. tropicalis e C. krusei. No grupo controle 33,3% apresentaram isolamento de Candida, mesmo não apresentando biofilme.CONCLUSÃO: Foram detectadas espécies de Candida patogênicas e intrinsicamente resistentes aos convencionais antifúngicos, ressaltando a importância do diagnóstico micológico para um tratamento adequado das infecções causadas por este grupo de fungos presentes na cavidade oral dos indivíduos.

OBJECTIVES: This study aims to evaluate the prevalence of Candida spp. in dental plaque of users of fixed orthodontic appliances (FOA) and relate to their habits and characteristics.MATERIALS AND METHODS: We isolated and identified strains of Candida in saliva samples from individuals using FOA with the presence of microbial biofilm and individuals without the presence of biofilm (control group) in the laboratory cultivation.RESULTS: We analyzed 108 samples from individuals with biofilm and 51 individuals in the control group. Of the 108 samples analyzed, 52 (48.1%) were negative for Candida and 56 (55.2%) were positive, with eight patients were isolated two species of Candida, four patients with C. albicans and C. krusei, with one C. albicans and C. tropicalis, with one C. albicans and C. glabrata, with one C. tropicalis and C. glabrata and with one C. tropicalis and C. krusei. In the control group 33.3% had isolated Candida, even showing no biofilm.CONCLUSION: Were detected and pathogenic Candida species intrinsically resistant to conventional antifungal agents, emphasizing the importance of mycological diagnosis for appropriate treatment of infections caused by this group of fungi present in the oral cavity of individuals.

Prevalência de parasitoses em crianças de 12 a 16 meses atendidas em unidades de saúde de Porto Alegre, Rio Grande do Sul / Prevalence of parasitic infections in 12-to 16-month-old children using primary care services of Porto Alegre, Brazil

Objetivo: Neste estudo, objetivou-se investigar a prevalência de infecções parasitárias entre crianças de 12 a 16 meses atendidas em Unidades de Saúde de Porto Alegre, Rio Grande do Sul. Métodos O estudo consistiu na análise de dados socioambientais e inquérito parasitológico de crianças que participaram de um ensaio de campo randomizado por con­glomerados. A renda familiar total mensal encontrada era menor que três salários-mínimos em 79,0% dos casos. Um total de 43,7% das mães e 47,5% dos pais relatou tem­po de estudo menor que 8 anos. Em 4,4% dos domicílios não havia serviço de esgoto e em 5,5% o banheiro era localizado na área externa. Apesar da baixa condição socioeconômica encontrada na população do estudo, a prevalência de parasitose foi de 6,8% do total da amostra. Conclusão Os resultados permitem concluir que as crianças na faixa etária estudada não constituem grupo de risco para infestação parasitária

Objective: This study investigated the prevalence of parasitic infections in children aged 12 to 16 months using the primary care services of Porto Alegre, Rio Grande do Sul. Methods The study included analysis of socio-environmental data and parasitic survey of children selected through geographical cluster sampling. Results The total monthly income of 79.0% of the households was less than three minimum salaries. Almost half the mothers (43.7%) and fathers (47.5%) had less than 8 years of formal education. A few homes (4.4%) were not connected to the sewage system and in 5.5% of the homes, the bathroom was located outside. Despite the low socioeconomic status of the study sample, the total prevalence of parasitic infections was 6.8%.Conclusion: The results show that children of the study age group are not at risk of parasitic infestation

O uso da Aprendizagem Baseada em Problemas (ABP) como reforço ao ensino presencial utilizando o ambiente de aprendizagem Moodle / The use of Problem-Based Learning (PBL) as reinforcement for students using the moodle learning environment

Este estudo teve por objetivo implementar mudanças na disciplina de Parasitologia e Micologia Médica do curso de Medicina da Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), que sempre foi oferecida na modalidade presencial. O estudo foi realizado de março a julho de 2009 com os alunos do primeiro semestre do primeiro ano do curso de Medicina. A mudança consistiu em utilizar parte do ensino a distância (EAD) com aplicação do método de ensino ABP, no ambiente virtual Moodle, disponível na instituição. Os resultados deste estudo apontam que a utilização do EAD e os recursos de ABP como complemento do ensino presencial de graduação nos cursos da área da saúde podem se tornar efetivos para a formação profissional.

This study aimed to implement changes in the course on Parasitology and Medical Mycology at the School of Medicine of the Federal University of Health Sciences in Porto Alegre (UFCSPA), Brazil, which had traditionally been offered with a classroom format. The study was conducted from March to July 2009 with students enrolled in the first semester at the medical school. The change consisted of using part of distance learning with application of the problem-based learning (PBL) method in the Moodle virtual environment, available at the institution. The results of the study indicate that the use of distance learning and PBL resources to complement classroom teaching in undergraduate health courses can become an effective part of professional training.

Candidúria: revisão atual / Candiduria: up-to-date review

Objetivo: Sumarizar o atual conhecimento sobre a candidúria no Brasil e no mundo, descrevendo sua epidemiologia, patogênese, metodologia de detecção laboratorial e terapêutica medicamentosa. Síntese dos Dados: Revisão não sistemática realizada nas bases de dados Pubmed, Scielo e Cochrane, em artigos científicos relacionados com o tema candidúria e publicados nos últimos vinte anos. Os descritores utilizados foram “Candidúria”, “Cândida” e “Infecções Hospitalares” individualmente ou em associação. Os artigos que abordavam outros tipos de infecções por Candida ou que não se adequavam ao objetivo do estudo foram excluídos. Os artigos pesquisados evidenciam que as espécies mais prevalentes no Brasil e no mundo são em ordem decrescente Candida albicans, C. parasilosis, C. tropicalis, C. glabrata, C. krusei, C. guilliermondii, C. lusitaniae, C. dubliniensis, C. kefyr e C. rugosa. Quando o tratamento é indicado, a droga de escolha é o fluconazol, desde que os isolados não possuam resistência intrínseca. Conclusão: Apesar da alta incidência e relevância clínica, as candidúrias não estão ainda completamente elucidadas, permanecendo a necessidade de esclarecer sua epidemiologia e patogênese em espécies emergentes e alcançar consenso nos protocolos de tratamento.

Objective: To summarize the current knowledge about candiduria, describing the epidemiology in Brazil and worldwide, pathogenesis, laboratorial diagnosis and prescribed therapy. Data Synthesis: A non-systematic review carried out from the databases: Pubmed, Cochrane and Scielo in scientific articles related to the theme candiduria and published in the last twenty years. The terms “candiduria”, “Cândida” and “hospital infection” were used as descriptors, individually or in association. Articles that addressed other types of Candida infection or were not suitable for the aim of the study were excluded. The studies reviewed indicate that the most prevalent species are in descending order Candida albicans, C. parasilosis, C. tropic alis, C. glabrata, C. krusei, C. guilliermondii, C. lusitaniae, C. dubliniensis, C. kefyr and C. rugosa. When treatment is indicated, the drug of choice is fluconazole, provided that the isolates do not possess intrinsic resistance. Conclusion: Despite its high incidence and clinical relevance, the candiduria is not yet been fully elucidated, remaining the need to clarify its epidemiology and pathogenesis in emerging species and reach consensus on treatment protocols.

Identificação de espécies de malassésia na pitiríase versicolor em um serviço de dermatologia do sul do Brasil / Identification of Malassezia yeast species isolated from patients with pityriasis versicolor

A pitiríase versicolor é uma doença de distribuição universal. Existe a descrição de 12 espécies de malassezia. O objetivo deste estudo foi determinar quais as espécies de malassezia mais prevalentes nos pacientes com pitiríase versicolor. Foram realizadas as coletas através de raspado das lesões nos pacientes com suspeita clínica de pitiríase versicolor e posterior exame micológico e cultural para identificação final da espécie. Foram coletadas amostras de 87 pacientes. Quanto às culturas, 30 percent foram de Malassezia sympodialis, 25,7 percent de Malassezia furfur, 22,7 percent de Malassezia globosa, 12,1 percent de Malassezia retrita, 7,6 percent de Malassezia obtusa e 1,5 percent de Malassezia sloofiae.

Pityriasis versicolor (PV) is a disease with worldwide distribution. Twelve different species of Malassezia yeast have been described. The objective of this study was to determine which species of Malassezia are more prevalent in patients with pityriasis versicolor. Samples were collected by scraping the lesions of 87 patients with a clinical suspicion of pityriasis versicolor. The samples were then submitted to fungal microscopy and culture to identify the species. The species found were: Malassezia sympodialis (30 percent), Malassezia furfur (25.7 percent), Malassezia globosa (22.7 percent), Malassezia restricta (12.1 percent), Malassezia obtusa (7.6 percent) and Malassezia slooffiae (1.5 percent).

Presença e susceptibilidade aos antifúngicos do Cryptococcus spp. em excretas de pombos nos arredores dos grandes hospitais de Porto Alegre / Presence and susceptibility to antifungal agents of Cryptococcus spp. in the excreta of pigeons on the outskirts of large hospitals in Porto Alegre

Introdução: Os fungos do gênero Cryptococcus, principalmente as espécies C. neoformans e C. gattii, são patógenos que causam a meningoencefalite, principalmente em indivíduos imunocomprometidos. O fungo é inalado, sendo as excretas de aves o nicho mais evidente do C. neoformans e as árvores do C. gattii. O presente estudo visa pesquisar o fungo Cryptococcus spp. nos arredores de grandes hospitais de Porto Alegre e verificar a susceptibilidade destes isolados ambientais aos antifúngicos. Métodos: Foram coletadas 87 amostras de excretas de pombos no entorno de seis hospitais de Porto Alegre e semeadas. As colônias leveduriformes foram analisadas macro e microscopicamente e submetidas a provas bioquímicas e moleculares. Posteriormente, estes isolados foram submetidos aos testes de susceptibilidade aos antifúngicos Etest® (Biomérieux) e MIC Strip Test® (Leofilchem). Resultados: Os fungos do gênero Cryptococcus foram isolados em seis amostras, sendo que cinco foram identificados, pelas provas convencionais, como o C. neoformans e uma o C. gattii, porém estas espécies não foram confirmadas pelas provas moleculares. No antifungigrama se encontraram entre os isolados de C. neoformans faixas de valores de concentração inibitória mínima (CIM) de 0,25-8 μg/ml para anfotericina B, 0,125->32 μg/ml para cetoconazol, 0,75->256 μg/ml para fluconazol, 0,125->32 μg/ml para voriconazol, e todas apresentaram CIM >32 μg/ml para itraconazol. Conclusões: A presença deste fungo em áreas hospitalares pode configurar um risco biológico, já que nestas áreas circulam muitos indivíduos imunocomprometidos, e a presença de cepas resistentes aos antifúngicos pode levar a uma diferente forma de conduzir o tratamento das patologias provocadas por esta levedura.

Introduction: Fungi of the Cryptococcus genus, mainly the species C. neoformans and C. gattii, are pathogens that cause meningoencephalitis, especially in immunocompromised individuals. The fungus is inhaled, with the excreta of birds being the most obvious niche of C. neoformans and trees of C. gattii. This study aims to fi nd the Cryptococcus spp. fungus on the outskirts of large hospitals in Porto Alegre and check the susceptibility of these environmental isolates to antifungal agents. Methods: We collected 87 samples of pigeon feces in the surroundings of six hospitals in Porto Alegre and cultured them. The yeast colonies were analyzed macroscopically and microscopically and subjected to biochemical and molecular tests. Subsequently these isolates were submitted to susceptibility tests to antifungals Etest® (Biomerieux) and MIC Strip Test® (Leofi lchem). Results: Fungi of the Cryptococcus genus were isolated in 6 samples, of which 5 were identifi ed by conventional tests, such as C. neoformans and C. gattii, but these species were not confi rmed by molecular tests. On antifungal susceptibility tests in C. neoformans isolates showed minimum inhibitory concentration values (MIC) ranging from 0.25 to 8 g/ml for amphotericin B, 0.125-> 32 ug/ml for ketoconazole, 0,75-> 256/ml for fl uconazole, and 0.125->32 ug/ml for voriconazole, and all showed MIC>32 mg/ml for itraconazole. Conclusion: The presence of this fungus in hospital areas may pose a biohazard, as many immunocompromised individuals circulate in these areas, and the presence of antifungal resistant strains can lead to a different way of conducting the treatment of disorders caused by this yeast.