Brandolt Tchana Martinez, Klafke Gabriel Baracy, Gonçalves Carla Vitola, Bitencourt Laura Riffel, Martinez Ana Maria Barral de, Mendes Josiara Furtado, Meireles Mário Carlos Araújo, Xavier Melissa Orzechowski
Universidade Federal do Rio Grande, Laboratório de Micologia, Rio Grande, RS, Brazil; Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brazil.
Universidade Federal do Rio Grande, Laboratório de Micologia, Rio Grande, RS, Brazil.
Braz J Microbiol. 2017 Jan-Mar;48(1):145-150. doi: 10.1016/j.bjm.2016.09.006. Epub 2016 Oct 4.
Vulvovaginal candidiasis (VVC) is an infection of the genital mucosa caused by different species of the genus Candida. Considering the lack of data on this topic in the south of Brazil, this study aimed to assess the prevalence of Candida spp. in the cervical-vaginal mucosa of patients treated at a university hospital in southern Rio Grande do Sul, as well as the etiology and the susceptibility of the isolates against fluconazole, itraconazole, miconazole and nystatin. Samples were collected at the gynecology clinic of the Federal Hospital of the University of Rio Grande, and the isolates were identified using phenotypic and biochemical tests. The susceptibility analysis was performed according to the CLSI M27-A2 protocol. Of the 263 patients included, Candida spp. was isolated in 27%, corresponding to a prevalence of approximately 15% for both VVC and colonization. More than 60% of the isolates were identified as Candida albicans; C. non-albicans was isolated at a rate of 8.6% in symptomatic patients and 14.3% in asymptomatic patients. The prevalence of resistance against fluconazole and itraconazole was 42% and 48%, respectively; the minimal inhibitory concentration of miconazole ranged from 0.031 to 8μg/mL, and that of nystatin ranged from 2 to >16μg/mL. The high rate of resistance to triazoles observed in our study suggests the necessity of the association of laboratory exams to clinical diagnosis to minimize the practice of empirical treatments that can contribute to the development of resistance in the isolates.
外阴阴道念珠菌病(VVC)是由念珠菌属不同菌种引起的生殖器黏膜感染。鉴于巴西南部缺乏关于该主题的数据,本研究旨在评估南里奥格兰德州一家大学医院接受治疗的患者宫颈 - 阴道黏膜中念珠菌属的患病率,以及分离株对氟康唑、伊曲康唑、咪康唑和制霉菌素的病因及敏感性。样本在里奥格兰德大学联邦医院的妇科诊所采集,分离株通过表型和生化试验进行鉴定。药敏分析按照CLSI M27 - A2协议进行。在纳入的263例患者中,27%分离出念珠菌属,VVC和定植的患病率约为15%。超过60%的分离株被鉴定为白色念珠菌;非白色念珠菌在有症状患者中的分离率为8.6%,在无症状患者中的分离率为14.3%。对氟康唑和伊曲康唑的耐药率分别为42%和48%;咪康唑的最低抑菌浓度范围为0.031至8μg/mL,制霉菌素的最低抑菌浓度范围为2至>16μg/mL。我们的研究中观察到的对三唑类药物的高耐药率表明,有必要将实验室检查与临床诊断相结合,以尽量减少可能导致分离株产生耐药性的经验性治疗做法。