Corticosteroid therapy associated with COVID-19: an ally or a risk factor for the establishment of secondary fungal co-infections?

Corticosteroid therapy to combat inflammation caused by SARS-CoV-2 seems to be a risk factor for developing secondary fungal co-infections. PubMed and ScienceDirect databases were searched, with the following word groups: [(aspergillosis OR mucormycosis OR candidiasis) AND (coronavirus disease) AND (corticoids). The selected articles present the main risk factors related to the establishment of secondary fungal co-infections in COVID-19 patients. Corticosteroid therapy used to combat inflammation caused by SARS-CoV-2 has been shown to be strongly associated with the establishment of mucormycosis and aspergillosis. Mucormycosis has been the main fungal co-infection related to corticosteroid therapy, causing a high number of deaths in COVID-19 patients. Diabetes mellitus was the most prevalent comorbidity, especially for the establishment of mucormycosis. Dexamethasone use seems to be associated with mucormycosis emergence and death. However, aspergillosis showed a greater relationship with patient recovery. Thus, risk factors such as diabetes mellitus, combined with corticosteroid use, have shown a relationship to the establishment of mucormycosis. The corticosteroids used in COVID-19 patients should be individually analyzed, considering the patient's medical history and the risk/benefit ratio of the use of these drugs.

Poloxamer-enhanced solubility of griseofulvin and its related antifungal activity against Trichophyton spp

Abstract Poorly water-soluble drugs, such as the antifungal drug griseofulvin (GF), exhibit limited bioavailability, despite their high membrane permeability. Several technological approaches have been proposed to enhance the water solubility and bioavailability of GF, including micellar solubilization. Poloxamers are amphiphilic block copolymers that increase drug solubility by forming micelles and supra-micellar structures via molecular self-association. In this regard, the aim of this study was to evaluate the water solubility increment of GF by poloxamer 407 (P407) and its effect on the antifungal activity against three Trichophyton mentagrophytes and two T. rubrum isolates. The GF water solubility profile with P407 revealed a non-linear behavior, well-fitted by the sigmoid model of Morgan-Mercer-Flodin. The polymer promoted an 8-fold increase in GF water solubility. Fourier-transform infrared (FT-IR) spectroscopy, differential scanning calorimetry (DSC), and 2D nuclear magnetic resonance (NMR Roesy) spectroscopy suggested a GF-P407 interaction, which occurs in the GF cyclohexene ring. These results were supported by an increase in the water solubility of the GF impurities with the same molecular structure. The MIC values recorded for GF ranged from 0.0028 to 0.0172 mM, except for T. Mentagrophytes TME34. Notably, the micellar solubilization of GF did not increase its antifungal activity, which could be related to the high binding constant between GF and P407.

Biological activities of essential oils from six genotypes of four Ocotea species

Abstract Essential oils from four Ocotea species collected in southern Brazil were evaluated for chemical composition using gas chromatography coupled with mass spectrometry. The primary compound identified in O. acutifolia essential oil was an unsaturated tetracyclic diterpene, phyllocladene (67.7%), followed by a sesquiterpene hydrocarbon, ß-selinene (18.0%). The sesquiterpene fraction was predominant in oils from two collections of O. puberula; ß-caryophyllene (25.2%) and globulol (22.6%) were the major compounds identified in collections 1 and 2, respectively. O. silvestris essential oil contained predominantly germacrene D and bicyclogermacrene. These compounds were also predominant in essential oil from O. indecora leaves collected from shady habitats. By contrast, essential oil extracted from O. indecora grown under direct sunlight contained mainly oxygenated sesquiterpenes, such as guaiol (30.2%), α-eudesmol (27.6%), and ß-eudesmol (12.7%). Chemotaxis assays showed that Ocotea essential oils had no significant inhibitory activity on leukocyte migration compared with a chemotactic stimulant (lipopolysaccharide from Escherichia coli). However, the oils exhibited antifungal activity against Candida parapsilosis, with a minimum inhibitory concentration of 500 µg/mL. To our knowledge, this is the first study to investigate the in vitro antifungal and antichemotactic activities of essential oils from Ocotea species native to southern Brazil

Método convencional para o diagnóstico de micoses: um estudo comparativo / Conventional method for the diagnosis of mycoses: a comparative study

Introdução: O método clássico para o diagnóstico de micoses é realizado pelo Exame Micológico Direto (EMD) e cultural, que possibilita a visualização de estruturas fúngicas vegetativas e estruturas reprodutivas, respectivamente. Essa combinação é fundamental para reduzir possíveis erros analíticos e aumentar a precisão do diagnóstico. Métodos: Com a finalidade de verificar a frequência do EMD e cultural, e comparar seus parâmetros de sensibilidade e especificidade, realizamos uma análise retrospectiva entre janeiro de 2018 e maio de 2020, de 1603 laudos micológicos oriundos de um laboratório de análises clínicas, localizado em Porto Alegre. Resultados: Após a análise dos laudos observamos que a maioria dos casos apresentaram o EMD negativo com cultura positiva (36,24%). Na sequência, 30,87% dos casos foram de amostras negativas e 25,57% dos laudos foram positivos para ambos os exames. A minoria dos casos (7,29%) apresentou o EMD positivo com cultura negativa. Conclusão: Esta análise revelou que o exame cultural é mais sensível e específico, demonstrando uma maior confiabilidade no diagnóstico. Entretanto, vale ressaltar que a realização dos exames em conjunto, além de reduzir possíveis erros analíticos, proporciona um diagnóstico melhor fundamentado. (AU)

Introduction: The classic method for the diagnosis of mycoses is performed by both direct mycological examination (DME) and culture, which allow the visualization of vegetative and reproductive fungal structures, respectively. This combination is essential to reduce possible analytical errors and increase the accuracy of the diagnosis. Methods: To assess the frequency of DME and culture, and compare their parameters of sensitivity and specificity, we performed a retrospective analysis of 1603 mycological reports produced between January 2018 and May 2020 in a clinical analysis laboratory in Porto Alegre, southern Brazil. Results: After analyzing the reports, we observed that most cases presented a negative DME and a positive culture (36.24%). Subsequently, 30.87% of the cases were negative for both tests, and 25.57% were positive for both tests. The minority of cases (7.29%) presented a positive DME and a negative culture. Conclusion: Our analysis revealed that cultural examination is more sensitive and specific, showing greater reliability in the diagnosis. However, it is noteworthy that performing the tests together, in addition to reducing possible analytical errors, provides a more consistent diagnosis. (AU)

Synergistic effect of ibuprofen with itraconazole and fluconazole against Cryptococcus neoformans

The present study investigated the association of the non-steroidal anti-inflammatory drug ibuprofen with itraconazole, fluconazole and amphotericin B against Cryptococcus neoformans isolates. The minimal inhibitory concentration (MIC) was found according to M27-A3 protocol and in vitro interactions were evaluated using checkerboard microdilution method. Synergism was demonstrated between azoles and ibuprofen for most isolates. However, no synergistic effects were seen when amphotericin B was combined with ibuprofen. Therefore, our results suggest that ibuprofen presents clinical potential when combined with azole drugs in the treatment of cryptococcosis.

Human fusariosis: An emerging infection that is difficult to treat

Abstract Fusarium spp. has been associated with a broad spectrum of emerging infections collectively termed fusariosis. This review includes articles published between 2005 and 2018 that describe the characteristics, clinical management, incidence, and emergence of these fungal infections. Fusarium solani and F. oxysporum are globally distributed and represent the most common complexes. Few therapeutic options exist due to intrinsic resistance, especially for the treatment of invasive fusariosis. Therefore, the use of drug combinations could be an important alternative for systemic antifungal resistance. Increase in the number of case reports on invasive fusariosis between 2005 and 2018 is evidence of the emergence of this fungal infection.

Anabolic-androgenic steroids cycle administration decreases anxious-like behavior but does not affect long-term memory acquisition in rats

The steroid hormones are lipids in nature, which play crucial roles in several metabolic and behavioral pathways in mammals. Drug therapy uses sterol hormones for treating some disturbances linked with its deficiency; however, the illicit use of these hormones by amateur and elite athletes to enhance performance or body appearance may lead to several health issues. In this study we evaluated the anxious-like behavior and the long-term memory acquisition of male rats undergoing sedentary life-style or physical effort, with or without anabolic-androgenic steroids (ASC) treatment. The results showed a decrease in anxious-like behavioral levels in rats that received ASC treatment associated or not with physical effort, but this treatment did not affect the acquisition of long-term memory at the dose and experimental model assessed.

In Vitro additive effect on griseofulvin and terbinafine combinations against multidrug-resistant dermatophytes

ABSTRACT Griseofulvin (GF) and terbinafine (TF) are commonly used drugs to treat dermatophytosis, a fungal infection of the skin. Today there is an increase in drug resistance to these antifungals which highlight the need for alternative synergistic therapies. Minimum Inhibitory Concentration (MIC) of GF and TF were determined against fungi clinical isolates from local hospitals with values ranging 0.03-2.0 µg mL-1 and 0.24-4.0 µg mL-1, respectively. A checkboard test was used to determine the combination of GF:TF which could induce an additive effect against the fungi isolates Multidrug-resistant isolates showed susceptibility after treatment with 16:2 µg mL-1 GF:TF. An MTT assay further verified that GF and TF combinations have greater additive effect against pathological and multidrug-resistant isolates than antifungals alone. Herein we disclose GF:TF combinations that could constitute as a possible new anti-dermatophyte therapy.

Synergistic antifungal activity of the lipophilic fraction of Hypericum carinatum and fluconazole

ABSTRACT Hypericum species, Hypericaceae, are recognized as a source of therapeutical agents. Purified fractions and isolated compounds have been shown antimicrobial activity. As the indiscriminate use of antifungals and the increase of infections caused by emerging species are leading to the search of new alternative treatments, the aim of this study was to continue the study with Hypericum carinatum Griseb. lipophilic fraction, rich in phloroglucinol derivatives, investigating the effect of its association with fluconazole against emerging yeasts (Candida krusei, C. famata, C. parapsilosis and Cryptococcus neoformans). The synergistic activity between H. carinatum lipophilic fraction and fluconazole was assessed by two methodologies for multiple dose–response analysis: checkerboard and isobologram. Regarding synergistic experiments, the effect of the association was higher than the effect of fluconazole alone against Candida krusei and C. famata isolates (MIC fluconazole decreased about eight and four folds, respectively), suggesting that, somehow, H. carinatum lipophilic fraction compounds are facilitating the action of this drug. On the other hand, when tested against Cryptococcus neoformans and C. parapsilosis, fluconazole showed better results than the association. Thus, against Candida krusei and C. famata, the lipophilic fraction of H. carinatum was able to reduce the MIC values of fluconazole and could be considered as a potential alternative to be used against emerging yeast species.

Is the emergence of fungal resistance to medical triazoles related to their use in the agroecosystems? A mini review

Abstract Triazole fungicides are used broadly for the control of infectious diseases of both humans and plants. The surge in resistance to triazoles among pathogenic populations is an emergent issue both in agriculture and medicine. The non-rational use of fungicides with site-specific modes of action, such as the triazoles, may increase the risk of antifungal resistance development. In the medical field, the surge of resistant fungal isolates has been related to the intensive and recurrent therapeutic use of a limited number of triazoles for the treatment and prophylaxis of many mycoses. Similarities in the mode of action of triazole fungicides used in these two fields may lead to cross-resistance, thus expanding the spectrum of resistance to multiple fungicides and contributing to the perpetuation of resistant strains in the environment. The emergence of fungicide-resistant isolates of human pathogens has been related to the exposure to fungicides used in agroecosystems. Examples include species of cosmopolitan occurrence, such as Fusarium and Aspergillus, which cause diseases in both plants and humans. This review summarizes the information about the most important triazole fungicides that are largely used in human clinical therapy and agriculture. We aim to discuss the issues related to fungicide resistance and the recommended strategies for preventing the emergence of triazole-resistant fungal populations capable of spreading across environments.

Dermatofitoses: agentes etiológicos, formas clínicas, terapêutica e novas perspectivas de tratamento / Dermatophytoses: etiologic agents, clinical forms, therapy and new perspectives of treatment

As dermatofitoses têm ocorrência mundial, sendo mais prevalentes em países de clima tropical e subtropical. Dados epidemiológicos indicam que essas micoses estão entre as infecções fúngicas de maior ocorrência. O quadro clínico mais comum de dermatofitose inclui despigmentação, placas anulares, prurido e perda de cabelo, com lesões tipicamente conhecidas como tineas, ocasionadas por fungos filamentosos dermatofíticos de três gêneros anamórficos: Microsporum, Trichophyton e Epidermophyton. O tratamento das dermatofitoses, em geral, está relacionado ao uso de antifúngicos tópicos e/ou sistêmicos, apresentando como problemática o surgimento de espécies multirresistentes. Esta revisão aborda as dermatofitoses e seus agentes etiológicos de forma aprofundada em aspectos epidemiológicos, apresentando a importância clínica do tema, com ênfase na causa, prevenção, tratamento e prognóstico dessa micose cutânea (AU)

Dermatophytoses have worldwide occurrence with higher prevalence in tropical and subtropical countries. Epidemiological data show that these mycoses are among the most frequent fungal infections. The most common symptoms of dermatophytoses include depigmentation, annular plaques, itching and hair loss, with lesions such as tinea, caused by dermatophytic filamentous fungi of three anamorphic genera: Microsporum, Trichophyton and Epidermophyton. Topical and/or systemic antifungalmedications are used in the treatment of dermatophytoses in general, resulting in problems such as the emergence of multidrug-resistant species. This review discusses dermatophytoses and their etiological agents with a focus on epidemiological aspects, presenting the clinical importance of the issue, with emphasis on cause, prevention, treatment and prognosis of this skin mycosis (AU)

Analysis of flavonoids in Rubus erythrocladus and Morus nigra leaves extracts by liquid chromatography and capillary electrophoresis

AbstractThis study uses high performance liquid chromatography and capillary electrophoresis as analytical tools to evaluate flavonoids in hydrolyzed leaves extracts of Rubus erythrocladus Mart., Rosaceae, and Morus nigra L., Moraceae. For phytochemical analysis, the extracts were prepared by acid hydrolysis and ultrasonic bath and analyzed by high performance liquid chromatography using an ultraviolet detector and by capillary electrophoresis equipped with a diode-array detector. Quercetin and kaempferol were identified in these extracts. The analytical methods developed were validated and applied. Quercetin and kaempferol were quantified in R. erythrocladus, with 848.43 ± 66.68 μg g-1 and 304.35 ± 17.29 μg g-1, respectively, by HPLC-UV and quercetin, 836.37 ± 149.43 μg g-1, by CE-DAD. In M. nigra the quantifications of quercetin and kaempferol were 2323.90 ± 145.35 μg g-1 and 1446.36 ± 59.00 μg g-1, respectively, by HPLC-UV and, 2552.82 ± 275.30 μg g-1 and 1188.67 ± 99.21 μg g-1, respectively, by CE-DAD. The extracts were also analyzed by ultra-performance liquid chromatography coupled with a diode-array detector and mass spectrometer (MS), UPLC-DAD/MS.

Perfil de inaptidão na triagem clínica e sorológica de candidatos à doação de sangue / Profile of inability in the clinic and serological screening of candidates for blood donation

Objetivo: Caracterizar os candidatos quanto ao gênero e analisar a prevalência dos critérios de inaptidão adotados às doações de sangue, realizadas no Banco de Sangue Santa Maria, em Santa Maria, RS. Métodos: Dados retrospectivos arquivados foram avaliados, analisando-se os critérios de exclusão na triagem clínica e sorológica, no período de janeiro de 2005 até dezembro de 2010. Foram analisados 20.264 doadores. O estudo foi aprovado pelo Comitê de Ética e Pesquisa da Universidade Federal do Rio Grande do Sul-UFRGS, sob número de protocolo 18147. Resultados: Novecentos e setenta e seis (5%) candidatos foram considerados inaptos pela triagem clínica e 19.288 (95%) foram considerados aptos para prosseguirem com os testes laboratoriais. Dos doadores aptos, 941 (5%) foram excluídos na triagem sorológica, totalizando 18.347 bolsas de sangue disponíveis para uso. Predominaram os doadores do sexo masculino (62%) e a principal causa de exclusão, na triagem clínica, foi hipertensão (0,7%). Para a triagem sorológica, a principal causa de exclusão foi a Doença de Chagas (1,5%). Conclusão: Ressaltou-se a importância da triagem clínica, tendo em vista que ela excluiu 5% dos candidatos à doação e a relevância da triagem sorológica ser feita corretamente, evitando que resultados falso-negativos sejam liberados.

Objective: Characterize donors by gender and analyze theprevalence of the inability criteria of donations made at the SantaMaria Blood Bank, located at Santa Maria, Brazil. Methods: First,we searched historical data for exclusion criteria used in clinicaland serological screenings during the period from January, 2005 toJuly, 2010. We evaluated 20,264 blood donors' data for this study.The Ethical Committee of Rio Grande do Sul Federal UniversityUFRGSapproved this study under the protocol number 18147.Results: Nine hundred and seventy-six (5%) candidates wereconsidered unfit by the clinical screening and 19,288 (95%) wereconsidered fit. From the resulting fit population of the clinicalscreening, 941 (5%) were excluded from donating by the serologicalscreening, totaling 18.347 blood donations fit for use. The resultsshows that majority of the donors were male (62%) and the leadingcause of exclusion from donating in the clinical screening washypertension (0.7%). As for the serological screening, the leadingcause for exclusion was Chagas disease (1.5%). Conclusion: Thestudy stress the importance of the clinical screening process, giventhat it excluded 5% of blood donations, which were unfit for use. Wealso notice the relevance of a correctly done serological screening,thus avoiding that false-negative results are released.

Antifungal activity against Cryptococcus neoformans strains and genotoxicity assessment in human leukocyte cells of Euphorbia tirucalli L.

In the last times, focus on plant research has increased all over the world. Euphorbia tirucalli L., a plant known popularly as Aveloz, and originally used in Africa, has been drawing attention for its use in the United States and Latin America, both for use as an ornamental plant and as a medicinal plant. E. tirucalli L. is a member of the family Euphorbiaceae and contains many diterpenoids and triterpenoids, in particular phorbol esters, apparently the main constituent of this plant, which are assumed to be responsible for their activities in vivo and in vitro. The in vitro antifungal activities of Euphorbia tirucalli (L.) against opportunistic yeasts were studied using microbroth dilution assay. The results showed that aqueous extract and latex preparation were effective against ten clinical strains of Cryptococcus neoformans in vitro (Latex and extract MIC range of 3.2 - > 411 µg/mL). Aiming the safe use in humans, the genotoxic effects of E. tirucalli were evaluated in human leukocytes cells. Our data show that both aqueous extract and latex preparation have no genotoxic effect in human leukocytes cells in vitro. Although the results cannot be extrapolated by itself for use in vivo, they suggest a good perspective for a therapeutic application in future. In conclusion, our results show that the aqueous extract and latex preparation from E. tirucalli L. are antifungal agents effectives against several strains of C. neoformans and do not provoke DNA damage in human leukocyte cells, considering the concentrations tested.

Antifungal activity and mechanism of action of monoterpenes against dermatophytes and yeasts

Dermatomycosis causes highly frequent dermal lesions, and volatile oils have been proven to be promising as antifungal agents. The antifungal activity of geraniol, nerol, citral, neral and geranial (monoterpenes), and terbinafine and anidulafungin (control drugs) against seven opportunistic pathogenic yeasts and four dermatophyte species was evaluated by the Clinical and Laboratory Standards Institute microdilution tests. Monoterpenes were more active against dermatophytes than yeasts (geometric mean of minimal inhibitory concentration (GMIC) of 34.5 and 100.4 µg.ml-1, respectively). Trichophyton rubrum was the fungal species most sensitive to monoterpenes (GMIC of 22.9 µg.ml-1). The trans isomers showed higher antifungal activity than the cis. The mechanism of action was investigated evaluating damage in the fungal cell wall (Sorbitol Protection Assay) and in the cell membrane (Ergosterol Affinity Assay). No changes were observed in the MIC of monoterpenes in the sorbitol protection assay.The MIC of citral and geraniol was increased from 32 to 160 µg.ml-1 when the exogenous ergosterol concentrations was zero and 250 µg.ml-1, respectively. The monoterpenes showed an affinity for ergosterol relating their mechanism of action to cell membrane destabilization.

Contributing factors for farm workers' exposure to pesticides in the west of the state of Santa Catarina, Brazil / Fatores contribuintes para a exposição de trabalhadores rurais a pesticidas no Oeste de Santa Catarina, Brazil

Pesticide overuse is highly harmful to human health and has become a serious public health issue in developing countries, Brazil included. Current study collects and evaluates data on toxicity risk to farmers exposed to pesticides in Marema, a municipality in the west of the Brazilian southern state of Santa Catarina. The sectional, descriptive and observational study comprises a questionnaire with open and closed questions. Retrieved data showed that farmers with low educational level need understandable information to raise their awareness on the use of pesticides, starting from an effective assistance at purchase and in management till the disposal of empty containers. Data show that farmers undergo regular exposure risks to pesticides and traditional practices corroborate for the increase in the environmental damage and health problems.

Nos países em desenvolvimento como o Brasil, o uso excessivo de pesticidas tem resultado em prejuízos à saúde humana, o que reflete em sério problema de saúde pública. O objetivo deste estudo foi coletar e avaliar dados sobre o risco de toxicidade em agricultores expostos a agrotóxicos no município de Marema, localizado no Oeste de Santa Catarina, região Sul do Brasil. A pesquisa foi conduzida por um estudo descritivo, transversal e observacional por meio de questionário com perguntas abertas e fechadas, com o total de 100 amostras no município. Os dados obtidos demonstram que os agricultores, que possuem baixo nível de educação formal, necessitam de informações compreensíveis e conscientizadoras sobre o uso de agrotóxicos, incoando por uma efetiva assistência, desde sua aquisição e manejo até o destino final das embalagens vazias. Todos os dados nos levam a sugerir a presença de constante risco de intoxicação por agrotóxicos junto aos agricultores, uma vez que suas práticas corroboram para a instalação de danos ambientais e problemas de saúde.

Evaluation of toxicity risks in farmers exposed to pesticides in an agricultural community in Concórdia, Santa Catarina State, Brazil / Avaliação do risco de toxicidade em agricultores expostos a agrotóxicos em uma comunidade agrícola de Concórdia, Estado de Santa Catarina, Brasil

A utilização de agrotóxicos nas atividades rurais tem crescido ao longo dos anos com o intuito de aumentar a produtividade das lavouras e reduzir a mão-de-obra empregada. Em contrapartida, o uso excessivo ou sem medidas adequadas de biossegurança podem causar sérios danos à saúde humana. Este trabalho tem por objetivo avaliar o risco de toxicidade de 50 agricultores da comunidade da Linha São Paulo, município de Concórdia, Estado de Santa Catarina, expostos a produtos agrotóxicos pela aplicação de questionário com perguntas abertas e fechadas. Foi possível observar que estão presentes várias situações e procedimentos que expõem boa parte dos agricultores envolvidos nesta pesquisa a riscos de intoxicação, pois não possuem uma ideia clara a respeito das medidas de biossegurança, como também não há entendimento adequado sobre os produtos que utilizam, sugerindo carência na veiculação de informações acerca dos produtos. Estes dados corroboram para o aumento do risco à saúde dos agricultores entrevistados em sua rotina de trabalho. Dessa forma, fica fortemente destacada a necessidade de medidas voltadas à informação e sensibilização, que conscientizem e conduzam ao autocuidado no manejo de agrotóxicos.

There has been an increase during recent years in the use of pesticides in agricultural activities to improve productivity, reduce labor costs and increase profits. On the other hand, the use of pesticides in excess or without adequate biosafety practices could lead to serious harm to human health. Current research evaluated toxicity risks in the case of 50 agricultural workers from the São Paulo Rural Community in the municipality of Concordia, Santa Catarina State, Brazil, who were exposed to pesticides. The questionnaire with open- and closed-ended questions revealed that there are several situations and procedures that expose most farm workers to toxicity risks since they do not have a clear understanding of biosafety measures or suitable knowledge on the products they use. Since a lack of information on pesticides exists, there is strong evidence for measures to inform and raise consciousness so that agricultural workers may exercise self-care in handling pesticides.

Etiología de la candidiasis vulvovaginal recidivante en la Atención Primaria de Salud en Santa Catarina, Brasil / Etiology of recurrent vulvovaginal candidiasis in the National Health System in Santa Catarina, Brazil / Etiologia da candidíase vulvovaginal recorrente na Atenção Primária à Saúde em Santa Catarina, Brasil

El objetivo del presente trabajo fue destacar las características epidemiológicas que puedan subsidiar la Atención Primaria de Salud (APS) en mujeres portadoras de candidiasis vulvovaginal (CVV) y candidiasis vulvovaginal recidivante (CVVR), a partir de estudios realizados en tres municipios del sur de Brasil. A través del examen micológico de la secreción vaginal de 300 mujeres con sospecha clínica de CVV o CVVR se identificaron las especies prevalentes de Candida, correlacionándose los hallazgos con los principales factores de riesgo mencionados en la literatura. Fueron confirmadas levaduras en 90 (30%) casos, resultando las especies más frecuentes C. albicans (61,1%), C. krusei (16,7%), C. tropicalis (6,7%), C. glabrata (4,4%) y Candida spp. (11,1%). En los casos de CVVR, C. albicans fue la especie más encontrada, con una prevalencia superior a la observada en la CVV. C. krusei apareció como la segunda especie más prevalente en todas las muestras, resaltando la importancia del diagnóstico a nivel de especie, dada la resistencia intrínseca al fluconazol. Las informaciones epidemiológicas del estudio son útiles para que los gestores de la Atención Primaria de Salud (APS) y los profesionales de la Salud puedan tener subsidios adicionales para actuar preventivamente en el caso de candidiasis vulvovaginales.

The main purpose of this work was to highlight epidemiological characteristics serving as subsidies to health promotion activities for vulvovaginal candidiasis (VVC) and recurrent vulvovaginal candidiasis (RVVC) by the national health system, in three cities in southern Brazil. Through the mycological examination of vaginal secretions of 300 women with clinical suspicion of VVC or RVVC, Candida-prevalent species were identified and they were correlated with the main risk factors mentioned in the literature. Yeasts were confirmed in 90 (30%) cases, resulting in C. albicans 61.1%, C. krusei 16.7%, C. tropicalis 6.7%, C. glabrata 4.4% and others 11.1%. C. albicans was the species most commonly found in cases of RVVC, with levels higher than the prevalence of the species in the VVC. C. krusei prevailed as the second most prevalent species in both samples, emphasizing the importance of diagnosing the species level, due to its intrinsic resistance to fluconazole. The epidemiological information of the study is useful for managers of the National Health Care System, as well as direct health professionals, who can have new subsidies to act preventively against vulvovaginal candidiasis.

O objetivo do presente trabalho foi destacar as características epidemiológicas que possam subsidiar a Atenção Primária à Saúde (APS) em mulheres portadoras de candidíase vulvovaginal (CVV) e candidíase vulvovaginal recorrente (CVVR), a partir de estudos realizados em três municípios do sul do Brasil. Através do exame micológico da secreção vaginal de 300 mulheres com suspeita clínica de CVV ou CVVR foram identificadas as espécies prevalentes de Candida, correlacionando os achados com os principais fatores de risco mencionados na literatura. Foram detectadas leveduras em 90 (30%) dos casos, resultando as espécies mais frequentes C. albicans (61,1%), C. krusei (16,7%), C. tropicalis (6,7%), C. glabrata (4,4%) e Candida spp. (11,1%). Nos casos de CVVR, C. albicans foi a espécie mais encontrada, com uma prevalência superior à observada nos casos de CVV. C. krusei apareceu como a segunda espécie mais prevalente em todas as amostras, ressaltando a importância do diagnóstico em nível de espécie, devido à resistência intrínseca ao fluconazol. As informações epidemiológicas deste estudo são úteis para que os gestores da Atenção Primária à Saúde (APS) e os profissionais da Saúde Pública possam ter subsídios adicionais para atuar preventivamente nos casos de candidíases vulvovaginais.

Occurrence and identification of yeasts in dogs external ear canal with and without otitis / Ocurrencia y detección de levaduras en el conducto auditivo de los perros con y sin otitis

Objective. To analyze the presence of yeast in the external ear canal of 116 dogs with and without a diagnosis of otitis from veterinary clinic in the Chapecó city, Santa Catarina, Brazil, and to examine the secretion of the proteinase in isolates. Materials and methods. Were collected cerumen of conduct hearing of dogs of 16 different races 71% with pendular ear type, 5% of semi-pendular and 24% of the erect type. All dogs were previously evaluated by otoscopy and grouped in dogs with and without otitis. Results. Yeasts were isolated in 44 samples (approximately 36%), where Malassezia pachydermatis was identified in 95% of samples where were observed growth of yeasts. On 20 samples the proteinase enzyme showed strong activity in 31% isolates, were 21% of the dogs with otitis tested showed high proteolytic activity. Conclusions. We observed a variation of strains of M. pachydermatis-producing enzymes. The variation in production of these enzymes is probably more associated with different response to the action of the immune system of the animal in the tissue injury.

Objetivo. Se investigó la presencia de levaduras en el canal externo del oído de 116 perros de la clínica veterinaria en la ciudad de Chapecó, Santa Catarina,Brasil, en perros sanos y perros con otitis y se examinó la secreción de la proteinasa en las muestra aisladas. Materiales y métodos. Se recogieron cerumen del oído de perros de 16 razas diferentes, dónde 71% fue de oído de tipo pendular, 5% de semi-pendular y 24% del tipo erecto. Todos los perros fueron evaluados previamente por otoscopia y agrupados en perros con y sin otitis externa. Resultados. Las levaduras se aislaron en 44 muestras (aproximadamente 36%), donde Malassezia pachydermatis se identificó en el 95% de las muestras donde se observó el crecimiento de las levaduras. El 20 muestras la secreción de proteinasa mostró fuerte actividad en el 31% de los aislados y en 21% de los perros con otitis mostró alta actividad proteolítica. Conclusiones. Hemos observado una variación de cepas de M. pachydermatis productoras de enzimas. La variación en la producción de estas enzimas es probablemente más asociados con la respuesta diferente a la acción del sistema inmunológico del animal en la lesión tisular.

Prevalência de Candida spp. em biofilme dentário de usuários de aparelhos ortodônticos fixos / Prevalence of Candida spp. in the dental biofilm of fixed orthodontic appliances users

OBJETIVOS: O presente estudo tem como objetivo avaliar a prevalência de Candida spp. em biofilme dentário de usuários de aparelhos ortodônticos fixos (AOF) e relacionar com seus hábitos e características.MATERIAIS E MÉTODOS: Foram isolados e identificados cepas de Candida em amostras de saliva em indivíduos usuários de AOF com presença de biofilme microbiano e indivíduos usuários de AOF mas sem presença de biofilme (grupo controle), a partir do cultivo em laboratório.RESULTADOS: Neste estudo foram analisadas 108 amostras de indivíduos com biofilme, e 51 indivíduos no grupo controle. Das 108 amostras analisadas, 52 (48,1%) foram negativas para o gênero Candida e 56 (55,2%) foram positivas, sendo que em oito pacientes foram isolados duas espécies de Candida, quatro pacientes com C. albicans e C. krusei, um com C. albicans e C. tropicalis, um com C. albicans e C. glabrata, um com C. tropicalis e C. glabrata e um com C. tropicalis e C. krusei. No grupo controle 33,3% apresentaram isolamento de Candida, mesmo não apresentando biofilme.CONCLUSÃO: Foram detectadas espécies de Candida patogênicas e intrinsicamente resistentes aos convencionais antifúngicos, ressaltando a importância do diagnóstico micológico para um tratamento adequado das infecções causadas por este grupo de fungos presentes na cavidade oral dos indivíduos.

OBJECTIVES: This study aims to evaluate the prevalence of Candida spp. in dental plaque of users of fixed orthodontic appliances (FOA) and relate to their habits and characteristics.MATERIALS AND METHODS: We isolated and identified strains of Candida in saliva samples from individuals using FOA with the presence of microbial biofilm and individuals without the presence of biofilm (control group) in the laboratory cultivation.RESULTS: We analyzed 108 samples from individuals with biofilm and 51 individuals in the control group. Of the 108 samples analyzed, 52 (48.1%) were negative for Candida and 56 (55.2%) were positive, with eight patients were isolated two species of Candida, four patients with C. albicans and C. krusei, with one C. albicans and C. tropicalis, with one C. albicans and C. glabrata, with one C. tropicalis and C. glabrata and with one C. tropicalis and C. krusei. In the control group 33.3% had isolated Candida, even showing no biofilm.CONCLUSION: Were detected and pathogenic Candida species intrinsically resistant to conventional antifungal agents, emphasizing the importance of mycological diagnosis for appropriate treatment of infections caused by this group of fungi present in the oral cavity of individuals.