Relação entre a suscetibilidade de Candida spp a anfotericina B, com óbito ou sobrevivência dos pacientes em episódios de candidemia

Abstract

Among fungal infections, those caused by Candida spp are the most recurrent. Candidaemias are the most emergent and amphotericin B has been the mainstay of therapy in spite of its therapeutic failures. Because of these limitations, susceptibility testing of fungi against antifungal agents has been evidencing a great importance in order to confirm susceptibility to the used antifungal agents. In this study, 144 Candida spp isolates from immunocompromised patients, that either evolved into death (Group 1) or survived to candidaemia episodes (Group 2), were assessed. Tests were made according to proceedings and culture media described on M27-A2 document currently provided by Clinical and Laboratory Standards Institute (CLSI). Media such as Yeast Nitrogen Base- dextrose (YNBd) and Antibiotic Medium were also tested, being used a higher number of Amphotericin B concentrations. Susceptibility values of strains from Group 1 were significantly higher than Group 2 when Antibiotic Medium 3 (AM3) and YNBd were used. The Minimal Inhibitory Concentration (MIC) and Minimal Fungicidal Concentration (MFC) media values for strains from patients that survived to candidaemia were, respectively, 0.5 μg/dL and 0.7 μg/dL; whereas MIC and MFC media values for strains from patients that evolved into death were, respectively, 0.6 μg/dL and 0.9 μg/dL. Significant differences were not observed between the two groups of strains when using RPMI 1640 medium.