Prevalence and Fluconazole Susceptibility Profile of Candida spp. Clinical Isolates in a Brazilian Tertiary Hospital in Minas Gerais, Brazil

Abstract

Candidiasis has become an important concern for clinical practice, especially with the increasing incidence of immunocompromised patients. In this scenario, the development resistance to fluconazole presents a challenge for treating these opportunistic infections. The aim of this study was to evaluate some epidemiology features of Candida infections in a Brazilian University Hospital using data, previously unavailable. We observed that 44% of the 93 clinical isolates tested, belonged to Candida albicans species and 56% belonged to non-Candida albicans species (mainly Candida tropicalis and Candida glabrata). Most strains were isolated from urine samples where C. albicans was predominantly detected. 29 strains presented a fluconazole resistance phenotype and of these, 22 were chemosensitised by FK506, a classical inhibitor of ABC transporters related to azoles resistance. These data suggest the probable role of efflux pumps in this resistance phenotype. Our study highlights the need for developing effective control measures for fungal infections, rational use of antifungal drugs and development of new molecules able to abrogate the active transport of antifungals.

Antibacterial effects of extracts obtained from plants of Argentina: Bioguided isolation of compounds from the anti-infectious medicinal plant Lepechinia meyenii

“…The fractional inhibitory concentration index (FICI) is defined as the sum of the MIC of each compound when used in combination divided by the MIC of each compound alone, obtained in parallel in the same assay. FICI at 0.5 indicated potentiation or over-additive effect for the combination (Joray et al, 2011b;Neves-Junior et al, 2015) . When it fell between 0.5 and 1, it was defined as an additive effect, between 1.0 and 4.0 it was classified as "no interaction", while at > 4.0 indicated antagonism (Joray et al, 2011b).…”

Characterisation of an ABC transporter of a resistant Candida glabrata clinical isolate

“…Clinical source and species identification - After a screening of 93 Candida spp. clinical isolates provided by the University Hospital of the Federal University of Juiz de Fora, MG, Brazil, between 2012 and 2014 ( Neves-Junior et al 2015 ), four strains were selected: three R strains (codes 107, 109 and 211i) and one S (code 227i) to antifungal FCZ. All clinical isolates were identified as C. glabrata specie by MALDI-TOF mass spectrometry analysis.…”

“…Azole susceptibility - Selected C. glabrata strains were previously classified as S, susceptible-dependent dose (SDD) and R to FCZ according to the CLSI M27-A3 protocol ( CLSI 2008 , Neves-Junior et al 2015 ). In the present study, other azoles such as ITZ, PSZ and VRZ, in different concentrations, were also tested.…”

“…In the present study, other azoles such as ITZ, PSZ and VRZ, in different concentrations, were also tested. We selected three C. glabrata fluconazole resistant strains that had been previously chemosensitised by FK506, a classic ABC transporter inhibitor ( Neves-Junior et al 2015 ). As observed in Table I , only C. glabrata presented a high resistant phenotype to all azoles tested: MIC 50 breakpoints were higher than the last concentration tested in this study.…”

“…Clinical isolates and control strains - Three resistant and one susceptible C. glabrata clinical isolate were selected from ninety-three Candida strains due to their high/low fluconazole (FCZ) resistance ( Neves-Junior et al 2015 ). These clinical isolates were obtained from patients attended at the University Hospital of the Federal University of Juiz de Fora, MG, Brazil, between 2012 and 2014.…”