Avaliação comparativa de testes de suscetibilidade a antifungicos pelos metodos NCCLS e EUCAST de leveduras do genero Candida

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

Considering the tertiary characteristics of the Clinical Hospital of the State University of Campinas, with a large number of immunocompromised patients, it would be very important to know the susceptibility pattem from the fungal pathogens. From anuary 1999 to December 2003,3926 Candida strains were isolated from3297 patients. C.albicans was the most frequent species with 64, 4%, followed by C. tropicalis (11, 8%), C.glabrata (10, 8%) and C.parapsilosis (6,5%). C. albicans strains were mosdy isolated Itomsputum (34,8%), urine (20,5%), bronchoalveolar lavage (11,6%) and perinea swab (8,3%). C. parapsilosis was more related to catheters (10,0%) and blood cultures (24,1%), while C.tropicalis (35,0%) and C.glabrata (50,0%) were frequent in urine. This data showed the most prevalent species and the necessity to know their susceptibility pattem to current in use antifungal drugs. In this work, 175 Candida strains isolated from blood, catheter and urine were submitted to antifungal susceptibility tests to amphotericin B, fluconazole, ketoconazole and itraconazole by NCCLS and EUCAST methodologies, for statistical comparison of MICs. Exact agreement of the two methodologies was obtained for 88,57% of C. parapsilosis strains when testing itraconazole and ketoconazole (85,71%). Until 1 dilution and results over 90% of agreement were obtained for C.krusei when testing amphotericin B (97,14%) and fluconazole (94,2%), C.glabrata tested with itraconazole (97,14%) and C.parapsilosis with itraconazole (100,0%) and ketoconazole (91,4%). With until 2 dilutions difference 100% agreement was obtained for all evaluated strains with amphotericin B, C.glabrata, C.krusei and C.tropicalis with itraconzole, C.parapsilosis and C.krusei with ketoconazole; C.tropicalis, C.krusei and C.glabrata for fluconazole For the most drugs evaluated, higher MICs were observed with NCCLS methodology. C.parapsilosis strains showed, in general the best results. According to the NCCLS M27 A2 document all strains, testes by the two methodologies, were classified by their susceptibility. Results shoed good agreement for fluconazole, except for C.krusei strains, pointed as more resistant by NCCLS. The same happened with all strains when testing itraconazole. Also for amphotericin B less sensible strains were pointed by NCCLS with exception to C.albicans. So, in our institution, in the evaluated period, the resistance tax for fluconazole was 6,8% by NCCLS and 5,1% by EUCAST; for itraconazole was 32,6% by NCCLS and 31,4% by EUCAST and for amphotericin B 23,4% by NCCLS and 9,1% by EUCAST. In general, this data of susceptibility are compatible with literature relates. And finally, a routine performing test would be very good if utilize spectrophotometric lectures after 24 and 48h incubation, in flat microtitulation plates of NCCLS methodology tests

ASSUNTO(S)

estatistica - analise infecções oportunistas epidemiologia imunossupressão espectrofotometria

ACESSO AO ARTIGO

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