Laboratorial analyses of fungal keratitis in a University Service

Andrade, Alfredo José Muniz de; Vieira, Luis Antonio; Hofling-Lima, Ana Luísa; Yu, Maria Cecília Zorat; Gompertz, Olga Fischman; Freitas, Denise de

doi:10.1590/s0004-27492000000100012

Cited by 10 publications

(19 citation statements)

References 4 publications

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Section: Discussionunclassified

“…Este fato pode ser atribuído à maior exposição do homem aos fatores predisponentes (6)(7)(10)(11)18,(23)(24) . A idade média foi de 35,7 anos, caracterizando o acometimento na faixa etária de maior atividade (6,7,11,23) . Verificou-se que a procedência de 100% dos casos era do meio rural e 60% eram lavradores, demonstrando a importância na etiologia da úlcera fúngica do contato com o meio agrário e a suscetibilidade ao trauma ocular com vegetais (3,5,7,9,(11)(12)(13)(17)(18)23,(25)(26) .…”

Section: Discussionunclassified

“…Este fato pode ser atribuído ao desenvolvimento e ao uso indiscriminado de antibióticos de amplo espectro e de corticóides, uso de lentes de contato, aumento do número de cirurgias corneanas e aos avanços nas técnicas de diagnóstico (2)(3)(4)(5)(6)(7)(8)(9) . A epidemiologia da ceratomicose depende de fatores climáticos (2,(8)(9)(10)(11)(12) . Em climas temperados (Europa Central, Inglaterra, norte dos EUA), Candida sp é o fungo isolado com mais freqüência, seguido pelo Aspergillus sp (2,(5)(6)(8)(9)(13)(14) .…”

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“…Em climas temperados (Europa Central, Inglaterra, norte dos EUA), Candida sp é o fungo isolado com mais freqüência, seguido pelo Aspergillus sp (2,(5)(6)(8)(9)(13)(14) . Já em regiões tropicais (Sul da Flórida, América do Sul, Japão, Nigéria, África do Sul), o fungo mais freqüentemente encontrado é o Fusarium sp (2)(3)(5)(6)(8)(9)11,(13)(14) . O fungo mais isolado em todo mundo é o Aspergillus sp (2-3, 6,14) .…”

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“…O fungo mais isolado em todo mundo é o Aspergillus sp (2-3, 6,14) . Os fungos filamentosos estão associados ao trauma com vegetal, enquanto os fungos leveduriformes são tipicamente encontrados em pacientes com doença ocular ou sistêmica prévia (3)(4)(7)(8)(9)(11)(12)14) . Com relação à biota conjuntival, é relatado que os fungos são isolados do saco conjuntival de olhos saudáveis em uma incidência que varia de 2,9% a 72% (7- (6,20) .…”

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Perfil das ceratites fúngicas no Hospital São Geraldo Belo Horizonte - MG

Salera¹,

Tanure²,

Lima³

et al. 2002

Arq. Bras. Oftalmol.

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Section: Discussionunclassified

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Perfil das ceratites fúngicas no Hospital São Geraldo Belo Horizonte - MG

Salera¹,

Tanure²,

Lima³

et al. 2002

Arq. Bras. Oftalmol.

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Antifungal susceptibility testing of yeast isolated from corneal infections

Mascaro¹,

Hofling-Lima²,

Gompertz³

et al. 2003

Arq. Bras. Oftalmol.

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Antifungal susceptibility testing of yeast isolated from corneal infections INTRODUTIONFungi are opportunistic agents which rarely infect healthy corneas of immunocompetent individuals. Systemic and local underlying diseases may render the corneal tissues susceptible to infections with these organisms (1) . Trauma, specially related to organic materials, topical use of steroids and antibiotics (2)(3) , contact lens wear, surgical procedures, contamination of eye solutions, inappropriate maintenance of contact lenses (4) , systemic infections as well as any disease associated with immunodeficiency are considered risk factors for fungal eye infections (5) . In Brazil, the incidence of fungal eye infections ranges from 3.8 to 10%, depending on the site of the infection, the diagnostic tools available for fungal infections in the medical center and the seasons related to the studied period (6)(7)(8)(9) . The occurrence of keratomycosis is of great importance, not only because of diagnostic problems but also due to the severity of clinical manifestations and poor outcome despite antifungal treatment. The severity and progression of the fungal infection usually depend on the existence of Purpose: To report the antifungal susceptibility profile of yeast isolates obtained from cases of keratitis. Methods: Susceptibility testing of 15 yeast strains isolated from corneal infections to amphotericin B, fluconazole, itraconazole and ketoconazole was performed using the NCCLS broth microdilution assay. Results: Most episodes of eye infections were caused by Candida albicans. The antifungal drugs tested showed the following minimal inhibitory concentration values against yeast isolates: 0.125-0.5 µg/ml for amphotericin B; 0.125->64.0 µg/ml for fluconazole; 0.015-1.0 µg/ml for itraconazole and 0.015-0.125 µg/ml for ketoconazole. Despite the fact that all Candida isolates were judged to be susceptible to azoles, one isolate showed a minimal inhibitory concentration value significantly higher than a 90% minimal inhibitory concentration of all tested isolates. Rhodotorula rubra was resistant to fluconazole and itraconazole. Conclusions: Despite the fact that most yeast isolates from corneal infections are usually susceptible to amphotericin B and azoles, they exhibit a wide range of minimal inhibitory concentration values for antifungal drugs. The identification of strains at species level and their susceptibility pattern to antifungal drugs should be considered before determining the concentration to be used in topical antifungal formulations in order to optimize therapeutic response in eye infections.ABSTRACT

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