Drug susceptibility in emerging fungal infections: tests with fluconazole, itraconazole, and amphotericin B

Fay, Vanessa da Silva; Rodrigues, Diana Mara Garcia; Gonçalves, Stela Maris Bottin; Gregianini, Tatiana Schaffer; Bonamigo, Renan Rangel

doi:10.1590/abd1806-4841.20187364

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Communication • An. Bras. Dermatol. 93 (3) • May-Jun 2018 • https://doi.org/10.1590/abd1806-4841.20187364 copy

Drug susceptibility in emerging fungal infections: tests with fluconazole, itraconazole, and amphotericin B^* * Work conducted at the Instituto de Pesquisas Biológicas/Laboratório Central (IPB-Lacen) da Secretaria de Saúde do Estado do Rio Grande do Sul, Porto Alegre (RS), Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

The number of new cases of emerging fungal infections has increased considerably in recent years, mainly due to the large number of immunocompromised individuals. The objective of this study was to evaluate the susceptibility of emerging fungi to fluconazole, itraconazole and amphotericin B by disk diffusion method. In 2015, 82 emerging fungi were evaluated in IPB-LACEN/RS and 13 (15.8%) were resistant: 10/52 were from superficial mycoses and 3/30 from systemic mycoses. The data from the study point to the need for permanent vigilance regarding the careful evaluation in the prescription and clinical and laboratory follow-up of patients affected by fungal infections.

Keywords:
Antifungal agents; Drug resistance; Mycology

	Fluconazole		Itraconazole		Amphotericin B
	S (n)	R (n)	S^* * Skin, nails (n)	R^* * Skin, nails (n)	S^* * Skin, nails (n)	R^* * Skin, nails (n)
*Superficial mycosis ^ * Skin, nails**	45	6	42	3	50	1
Systemic mycosis ^ Mucous membranes (except if isolated only on the oral, genital, anal mucosa), cerebrospinal fluid, bronchoalveolar fluid, pleural fluid, sputum, blood, liver, lymph node, bone.	24	3	22	0	30	0
Malegender	20	2	21	0	25	0
Femalegender	49	7	43	3	55	1
HIV -	66	8	60	3	76	1
HIV +	31	1	4	0	4	0

Species	Antifungal	Resistance (n)
	Amphotericin B	0
Candida albicans (n = 25)	Fluconazole	3
	Itraconazole	2
	Amphotericin B	0
Candida spp.^* * The identification was not possible in 5 cases. (n = 5)	Fluconazole	1
	Itraconazole	0
Candida parapsilosis (n = 18)	Amphotericin B	0
	Fluconazole	1
	Itraconazole	1
Candida guillermondii (n = 2)	Amphotericin B	0
	Fluconazole	0
	Itraconazole	0
	Amphotericin B	0
Candida tropicalis (n = 2)	Fluconazole	1
	Itraconazole	0
Candida colliculosa (n = 1)	Amphotericin B	0
	Fluconazole	0
	Itraconazole	0
	Amphotericin B	1
Candida famata (n = 1)	Fluconazole	0
	Itraconazole	0
	Amphotericin B	0
Candida lipolytica (n = 1)	Fluconazole	0
	Itraconazole	0
	Amphotericin B	0
Candida kefyr (n = 1)	Fluconazole	0
	Itraconazole	0
Cryptococcus neoformans (n = 26)	Amphotericin B	0
	Fluconazole	3
	Itraconazole	0

Sociedade Brasileira de Dermatologia Av. Rio Branco, 39 18. and., 20090-003 Rio de Janeiro RJ, Tel./Fax: +55 21 2253-6747 - Rio de Janeiro - RJ - Brazil
E-mail: revista@sbd.org.br

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[1] Mailing address: Vanessa da Silva Fay. E-mail: nessabiosinos@yahoo.com.br

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Drug susceptibility in emerging fungal infections: tests with fluconazole, itraconazole, and amphotericin B* * Work conducted at the Instituto de Pesquisas Biológicas/Laboratório Central (IPB-Lacen) da Secretaria de Saúde do Estado do Rio Grande do Sul, Porto Alegre (RS), Brazil.

Abstract:

Drug susceptibility in emerging fungal infections: tests with fluconazole, itraconazole, and amphotericin B^* * Work conducted at the Instituto de Pesquisas Biológicas/Laboratório Central (IPB-Lacen) da Secretaria de Saúde do Estado do Rio Grande do Sul, Porto Alegre (RS), Brazil.