Perfil de suscetibilidade a antifúngicos de dermatófitos isolados de pacientes com insuficiência renal crônica

Abstract

BACKGROUND: The pre va len ce of der ma tophy to sis in the gene ral popu la tion is high, par ti cu larly in patients with chronic renal fai lu re. Treatment requi res the use of topi cal and/or syste mic anti fun gal drugs. The effi cacy of anti fun gal agents for the treat ment of der ma tophy to sis has yet to be eva lua ted. Studies eva lua ting the in vitro acti vity of anti fun gal agents are rare, par ti cu larly in fila men tous fungi. OBJECTIVE: To eva lua te the sus cep ti bi lity pro fi le of dif fe rent spe cies of der ma tophy tes iso la ted from patients with chro nic renal fai lu re to nine anti fun gal drugs avai la ble on the mar ket for the treat ment of der ma tophy to sis. METHODS: Twenty-six iso la tes of der ma tophy tes obtai ned from patients with chro nic renal fai lu re were analy zed with res pect to their sus cep ti bi lity to nine anti fun gal agents (keto co na zo le, ciclo pi rox ola mi ne, flu co na zo le, gri seo ful vin, itra co na zo le, mico nazo le, piroc to ne ola mi ne, ter bi na fi ne and tio co na zo le), using the broth micro di lu tion method pro po sed by the Clinical and Laboratory Standards Institute (CLSI) and adap ted for der ma tophy tes. RESULTS: Of the anti fun gal agents tes ted, the best results in terms of sen si ti vity were found with ter bi na fi ne and tio co na zo le, while the anti fun gal acti vity of flu co na zo le was found to be weak, par ti cu larly against strains of M. gypseum. Ciclopirox ola mine, although less effec ti ve than ter bi na fi ne, also yiel ded satis fac tory results. CONCLUSIONS: In gene ral, the sen si ti vity pro fi le of the anti fun gal agents tes ted in this study was simi lar to results obtai ned in previous stu dies, con fir ming the need to deter mi ne which spe cies is cau sing the der ma tophy to sis given that anti fun gal sus cep ti bility varies from one spe cies to ano ther. Furthermore, the pre sent fin dings show the impor tan ce of con duc ting in vitro sen si tivity tests, since the sen si ti vity pro fi le may dif fer among iso la tes of the same spe cies. Keywords: Antifungal agents; Arthrodermataceae; Kid ney fai lu re chronic; Mycoses Resumo: FUNDAMENTOS: As der ma to fi to ses apre sen tam alta pre va lên cia na popu la ção em geral e, prin ci pal men te, em pacien tes com insu fi ciên cia renal crô ni ca, neces si tan do tra ta men to com anti fún gi cos tópi cos e/ou sis tê mi cos, cuja efi cá cia pre ci sa ser avalia da. Estudos in vitro para ava liar a ação de anti fún gi cos são raros, espe cial men te, em fun gos fila men to sos. OBJETIVO: Avaliar o per fil de sus ce ti bi li da de de dife ren tes espé cies de der ma tó fi tos, iso la dos de pacien tes com insu fi ciên cia renal crô ni ca, em rela ção a nove anti fún gi cos dis po ní veis comer cial men te para o tra ta men to de der ma to fi to ses. MÉTODO: Analisaram-se 26 iso la dos de der ma tó fi tos de pacien tes com insu fi ciên cia renal crô ni ca em rela ção a nove anti fún gi cos (cetoco na zol, ciclo pi rox ola mi na, flu co na z...

Onychomycosis: clinical, mycological and in vitro susceptibility testing of isolates of Trichophyton rubrum

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“…The plate was incubated for 15 days at 30 °C and growth was visually observed. MFC was defined as the minimum concentration in which no fungal growth occurred [12]. This assay was performed in duplicate.…”