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1.
Braz. j. oral sci ; 20: e210219, jan.-dez. 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1253954

ABSTRACT

Aim: This study evaluated the chemical composition of Lippia thymoides (Lt) essential oil and its antimicrobial activity against fungal strains of Candida albicans (Ca) and Gram-negative bacteria Prevotella intermedia (Pi) and Fusobacterium nucleatum (Fn). Methods: Lt essential oil was obtained by hydrodistillation apparatus with a modified Clevenger extension. The chemical analysis was analyzed by gas phase chromatography and mass spectrometry on Shimadzu QP 2010 plus. Sample sensitivity evaluation was performed by ABHb-inoculum and culture plates were developed with triphenyltetrazolium chloride, also Fn and Pi samples analysis were in anaerobic environment and Ca sample analysis was performed in aerobic environment. The minimum inhibitory concentration (CIM) was determinated by microdilution in eppendorfs tubes. Results: The chemical analysis showed that Thymol (59,91%) is the main compound found in Lt essential oil, also other antifungal and antimicrobial agents were present γ-terpinene (8.16%), p-cymene (7.29%) and ß-caryophyllene (4.49%), Thymol is a central ingredient of many medicinal plants and has a potent fungicidal, bactericidal and antioxidant activity, it has been previously shown to have anti-inflammatory activity against Periodontal Disease (PD) cause can reduces prostanoids, interleukins, leukotrienes levels in periodontium. CIM result Pi was 6.5 µg/mL, Fn was 1.5 µg/mL and Ca was 0.19 µg/mL. Conclusion: The antimicrobial activity of L. thymoides, through the compound Thymol, has been shown promising potential against gram-negative periodontopathogenic bacteria and fungi whose therapeutic arsenal is still very restricted


Subject(s)
Periodontitis , Oils, Volatile , Plant Extracts , Lippia , Microbiota , Antifungal Agents
2.
Medicina (B.Aires) ; 81(5): 780-785, oct. 2021. graf
Article in Spanish | LILACS | ID: biblio-1351051

ABSTRACT

Resumen Se realizó un estudio retrospectivo de las infecciones fúngicas atendidas en un centro de quemados de alta complejidad situado en Buenos Aires, entre 2011 y 2014, mediante el análisis de las histo rias clínicas (n = 36). Las edades de los pacientes estuvieron entre 18 y 87 años, y 23 (63.9%) fueron mujeres. La extensión de la superficie corporal afectada más prevalente varió entre 30 y 50% (p = 0.03), y entre 71% y 100% en pacientes de menor edad, relacionándose con intentos de femicidio. En el 69.4% la profundidad de la quemadura fue grado 4, y en el 50% de los casos se observaron lesiones por inhalación, con una alta mortali dad (p = 0.04). El Candida score resultó de 3 en el 77.7% de los casos. Se usaron vías centrales y ventilación mecánica. Todos los pacientes recibieron tratamiento antibiótico y en 33 (91.7%) antifúngicos. La escisión qui rúrgica de la quemadura se practicó en 33 (91.7%) y los autoinjertos de piel en 29 (80.6%). La infección fúngica se desarrolló en una media de 21.4 días del ingreso en UCI. Se estudiaron 52 muestras de levaduras que se aislaron de urocultivo (42.3%), hemocultivo (26.9%), biopsia cutánea (9.6%), punta de catéter (15.4%) y aspirado traqueal (5.8%). Por cultivo microbiológico y métodos moleculares se identificaron a Candida albicans (53.8%), C. tropicalis (23.1%), C. parapsilosis sensu stricto (13.5%), C. krusei (5.8%), C. glabrata (1.9%) y C. dubliniensis (1.9%). Las infecciones fúngicas representan severas complicaciones en quemados con factores de riesgo.


Abstract A retrospective analysis of fungal infections was carried out in a health-care burn center between 2011 and 2014 using the patients' medical records (n = 36). Patients ranged from 18 to 87 years of age, with 23 (63.9%) being women. The most prevalent widespread total body surface area affected (TBSA) was 30-50% (p = 0.03), and 71-100% in younger patients, mainly associated with femicide. Fourth degree burns were revealed in 69.4% of the patients while in 50%, inhalation injuries were observed to represent a higher mortality rate (p = 0.04). The Candida score was 3 in 77.7% of cases respectively. Central venous catheter and mechanical ventilation were used. All patients received antibiotic treatment and 91.7% antifungal treatment. Surgical excision of the burn was performed in 33 (91.7%) patients, and skin autografting in 29 (80.6%). The median of the fungal infection devel oped was 21.4 days after admission to the ICU. The specimens analyzed involved 52 yeast samples isolated from different cultures: urine (42.3%), blood (26.9%), skin biopsy (9.6%), catheter tip (15.4%) and tracheal aspirate (5.8%). The use of microbiological culture and molecular methods allowed for the identification of Candida albicans (53.8%), C. tropicalis (23.1%), C. parapsilosis sensu stricto (13.5%), C. krusei (5.8%), C. glabrata (1.9%) and C. dubliniensis (1.9%). Fungal infections observed in skin burns lead to severe complications in at-risk patients.


Subject(s)
Humans , Female , Candida , Mycoses/drug therapy , Retrospective Studies , Risk Factors , Antifungal Agents
3.
Con-ciencia (La Paz) ; 9(1): 1-17, jun. 2021. ilus., tab
Article in Spanish | LILACS | ID: biblio-1284388

ABSTRACT

INTRODUCCIÓN: el aumento de la incidencia de las micosis ha generado la necesidad de desarrollar técnicas in vitro para el estudio de la susceptibilidad a los antifùngicos; El documento CLSI M27-A2 es el método de referencia para estudios de sensibilidad en levaduras. No obstante, este no subsana las necesidades de rutina de los laboratorios, principalmente por ser laboriosos; en consecuencia, métodos alternativos surgen ante la necesidad de contar con técnicas más sencillas, una de ellos es el ATB FUNGUS 3 que permite determinar la sensibilidad de Candida frente a diferentes antifùngicos. OBJETIVO: validar el método comercial ATB FUNGUS 3, frente al método de referencia M27-A2, con el fin de conocer su valor diagnóstico. MATERIAL Y MÉTODOS: se determinó la eficacia del método a través de parámetros de test diagnóstico; además, se evaluó la sensibilidad de 50 cepas de Candida albicans frente a Fluconazol (FLZ) e Itraconazol (ITZ) mediante el método comercial y el de referencia. RESULTADOS: se encontró que el ATB - FUNGUS 3 presenta una especificidad para FLZ de 100%, sensibilidad de 91%, valor predictivo positivo (VPP) de 56%, valor predictivo negativo (VPN) de 100%, con una eficacia diagnóstica de 92%, calculados para un intervalo de confianza (IC) de 95%; para ITZ la especificidad y sensibilidad fue de 88 % y 90% respectivamente, con un VPP de 64%, un VPN de 97%, eficacia diagnóstica de 90%, IC 95%. Para las pruebas de concordancia, el índice Kappa para FLZ e ITZ fue de 0,67 y 0,68 respectivamente. La prueba de Likelihood ratio para el FLZ fue (LR+) de 11,25 mientras que el (LR-) fue 0; para el ITZ (LR+) de 9,19 y el (LR-) fue 0,14. Reproducibilidad de 90 % (FLZ) y 85% (ITZ). CONCLUSIONES: el ATB FUNGUS 3, es una técnica rápida, de fácil realización y reproducible; pero el desempeño global de la técnica, sugiere que aún no es confiable para el diagnóstico en laboratorios, debido a los valores bajos obtenidos en los VPP, que indican que se podría derivar en errores al momento de determinar una cepa como sensible o resistente, punto importante al momento de decidir la conducta terapéutica.


INTRODUCTION: the higher incidence of mycoses has generated the need to develop in vitro techniques for susceptibility study to antifungal agents. CLSI M27-A2 is a reference method for yeast susceptibility studies. However, this method does not meet the needs of routine laboratories because it is difficult to follow all the processes. Consequently, alternative methods arise due to the need for simpler techniques. Then, one of them is ATB FUNGUS 3 which allows determining Candida's sensitivity to different antifungal agents. OBJECTIVE: validate the commercial method ATB FUNGUS 3 compared with the reference method M27-A2 in order to know its diagnostic value. MATERIAL AND METHODS: efficacy was determined by diagnostic test parameters. Moreover, sensitivity of 50 strains of Candida albicans at Fluconazole (FLZ) and Itraconazole (ITZ) was evaluated by the commercial and reference methods. RESULTS: ATB - FUNGUS 3 presents a specificity for FLZ of 100%, sensitivity of 91%, positive predictive value (PPV) 56%, negative predictive value (NPV) 100% with a diagnostic efficacy of 92%, calculated for a 95% confidence interval (CI). For ITZ, the specificity and sensitivity were 88% and 90% respectively, with a PPV 64%, a NPV 97% with a diagnostic efficacy of 90%, 95% CI. For the concordance tests, the Kappa index for FLZ and ITZ was 0.67 and 0.68 respectively. The Likelihood ratio test for FLZ was (LR +) of 11.25 while the (LR-) was 0; for ITZ (LR +) of 9.19 and the (LR-) was 0.14. Reproducibility of 90% (FLZ) and 85% (ITZ). CONCLUSIONS: the ATB FUNGUS 3 is a fast, easy and reproducible technique. However, the overall performance of the technique suggests that this method hasn't been reliable for diagnostic laboratory yet, because PPVS obtained low values. These PPVS indicate that it could lead to errors when determining a strain as sensitive or resistant. This is an important point when deciding the therapeutic conduct.


Subject(s)
Candida albicans , Antifungal Agents , Confidence Intervals , Diagnosis
4.
Medicina (B.Aires) ; 81(3): 438-451, jun. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346482

ABSTRACT

Resumen Las infecciones fúngicas invasoras (IFI) constituyen una de las principales complicaciones infecciosas en pacientes oncohematológicos y con trasplante de células progenitoras hematopoyéticas (TCPH), ocasionando alta morbimortalidad e incrementando significativamente los costos de atención y la estadía hos pitalaria. La epidemiología de las IFI ha cambiado en las últimas décadas, siendo los hongos filamentosos, particularmente Aspergillus spp., los principales agentes etiológicos. Existen múltiples factores de riesgo para una IFI; pero la neutropenia profunda y prolongada, y la inmunodeficiencia celular severa siguen siendo los más importantes. Por este motivo, la población de mayor riesgo la constituyen los pacientes con leucemias agudas, mielodisplasias y TCPH alogénicos con enfermedad injerto contra huésped (EICH), en tratamiento con corticoides. Numerosos ensayos clínicos aleatorizados y metaanálisis han demostrado que la profilaxis antifúngica primaria (PAF) reduce significativamente la incidencia de IFI, tanto de aquellas causadas por Candida spp. como por Aspergillus spp., la mortalidad relacionada a IFI y la mortalidad global en algunos grupos de pacientes. Asimismo, en enfermos de alto riesgo, en donde se espera una incidencia de IFI elevada, es una estrategia costo-efectiva. Varios antifúngicos han demostrado beneficio clínico y pueden utilizarse como estrategia de PAF en diferentes escenarios, presentando ventajas y desventajas que deben ser tenidas en cuenta al momento de indicar una PAF. Para esto, sociedades científicas nacionales e internacionales, han emitido recomendaciones de indicación de PAF. Se analizan los aspectos relacionados con la eficacia clínica de los diferentes antifúngicos según la población de riesgo, las potenciales desventajas, momento y forma de administración.


Abstract Invasive fungal infections (IFI) are among the main infectious complications in patients with hema tological malignancies and with hematopoietic stem cell transplant (HSCT), causing high morbidity and mortality and significantly increasing the healthcare cost and hospital stay. The epidemiology of IFIs has changed in recent decades, with filamentous fungi, particularly Aspergillus spp., being the main etiological agents. There are multiple risk factors for having an IFI; however, the most important are profound and prolonged neutropenia and severe cellular immunodeficiency. For this reason, the population at greatest risk is made up of patients with acute leukemias, myelodysplasias and allogeneic HSCT with graft-versus-host disease (GVHD) treated with cortico steroids. Numerous randomized clinical trials and meta-analyses have shown that primary antifungal prophylaxis (AFP) significantly reduces the incidence of IFI, particularly those caused by Candida spp. and Aspergillus spp., IFI-related mortality, and overall mortality in some group of patients. Likewise, in high-risk patients, where a high incidence of IFI is expected, it is a cost-effective strategy. Several antifungals have demonstrated clinical benefit. They can be used as a AFP strategy in different settings, presenting advantages and disadvantages that must be taken into account in each case. For this, national and international scientific societies have issued recom mendations for the indication of AFP. Aspects related to the different antifungals' clinical efficacy are analyzed considering the population at risk, the potential disadvantages, timing, and form of administration.


Subject(s)
Humans , Myelodysplastic Syndromes , Hematopoietic Stem Cell Transplantation/adverse effects , Graft vs Host Disease , Neutropenia/drug therapy , Antifungal Agents/therapeutic use
5.
Rev. Asoc. Odontol. Argent ; 109(1): 59-63, ene.-abr. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1281778

ABSTRACT

Objetivo: Describir el diagnóstico y el tratamiento interdisciplinario de un caso clínico de histoplasmosis. Caso clínico: Un paciente masculino de 39 años, con antecedentes de consumo de drogas, alcohol, tabaquismo crónico y VIH+ sin adherencia al tratamiento, acudió al Servicio de Odontología por una interconsulta del Servicio de Clínica Médica para la evaluación de lesiones erosivas en paladar duro y blando, reborde alveolar anterior, dorso lingual y lesión tumoral en encía anterosuperior. El diagnóstico definitivo se obtuvo por medio del análisis de muestras de biopsia transbronquial, lavado broncoalveolar y biopsia de lesión en piel. El paciente recibió tratamiento sistémico con antimicóticos (anfotericina B e itraconazol según esquema) y tratamiento local con colutorio de clorhexidina al 0,12% y 100.000 UI de nistatina en suspensión. Al momento del alta, presentaba una considerable mejoría de su estado general y de las lesiones orales, con disminución de sintomatología dolorosa. Se indicó turno para control a los 7 días de forma ambulatoria, al cual el paciente no asistió. El abordaje interdisciplinario y el análisis de los diferentes aspectos socioeconómicos, culturales, ambientales y sistémicos del paciente facilitaron el diagnóstico temprano de la enfermedad (AU)


Aim: To describe the diagnosis and interdisciplinary treatment of a clinical case of histoplasmosis. Clinical case: 39-year-old male patient with a history of drug abuse, alcohol, and chronic smoking, HIV+ without treatment compliance, attends the dental department referred by the medical department for the diagnosis of erosive lesions in the hard and soft palate, anterior alveolar ridge, lingual dorsum and tumor lesion in the anterosuperior gingiva. The definitive diagnosis was obtained by the analysis of transbronchial biopsy, bronchoalveolar lavage and skin lesion biopsy. The patient received systemic treatment with antifungals (amphotericin b, itraconazole according to protocol), and local treatment with 0.12% chlorhexidine mouthwash and 100,000 IU nystatin suspension. At the time of medical discharge, the patient presented a considerable improvement in his general condition and of the oral lesions with a reduced pain. A 7 days recall was prescribed, however the patient failed to attend. The interdisciplinary approach to the patient and the analysis of the different socio-economic, cultural, environmental and systemic aspects of the patient facilitates the early diagnosis of the disease (AU)


Subject(s)
Humans , Male , Adult , Oral Manifestations , HIV , Dental Care for Chronically Ill , Histoplasmosis , Argentina , Biopsy , Amphotericin B , Nystatin , Immunosuppression/adverse effects , Itraconazole , Bronchoalveolar Lavage , Dental Service, Hospital , Early Diagnosis , Mouth Mucosa/injuries , Antifungal Agents
6.
ABCS health sci ; 46: e021203, 09 fev. 2021. tab
Article in English | LILACS | ID: biblio-1147180

ABSTRACT

INTRODUCTION: The resistance of fungal species to drugs usually used in clinics is of great interest in the medical field. OBJECTIVE: To evaluate susceptibility and in vitro response of species of Trichophyton spp. to antifungal drugs of interest in clinical medicine. METHODS: 12 samples of clinical isolates from humans were used, nine of T. mentagrophytes and three of T. tonsurans. Susceptibility tests were performed according to the agar diffusion (AD) and broth microdilution (BM) methods. RESULTS: In the AD method, the species T. tonsurans presented a percentage of sensitivity of 33% in relation to amphotericin B and 66% to itraconazole, with 100% resistance to ketoconazole and fluconazole. T. mentagrophytes also showed 100% resistance to ketoconazole in this technique, with 11% sensitivity to ketoconazole, 22% to itraconazole and 22% of samples classified as sensitive dose dependent. In the MC method, the species T. tonsurans presented a sensitivity percentage of 66%, 55% and 33% in relation to ketoconazole, fluconazole and itraconazole, respectively. The T. mentagrophytes species presented sensitivity percentages of 11%, 11%, 33% and 55% for amphotericin B, itraconazole, ketoconazole and fluconazole, respectively. CONCLUSION: There was resistance in vitro of the species of T. mentagrophytes and T. tonsurans against the antifungal fluconazole and relative resistance against ketoconazole in the AD method. In BM, however, important percentages of sensitivity were observed for the two species analyzed in relation to the antifungals fluconazole and ketoconazole when compared to itraconazole and amphotericin B.


INTRODUÇÃO: A resistência de espécies fúngicas às drogas usualmente empregadas no meio clínico é motivo de grande interesse na área médica. OBJETIVO: Avaliar susceptibilidade e resposta in vitro de espécies de Trichophyton spp. a drogas antifúngicas de interesse em clínica médica. MÉTODOS: Foram utilizadas 12 amostras de isolados clínicos de humanos, sendo nove de T. mentagrophytes e três de T. tonsurans. Foram realizados testes de susceptibilidade segundo os métodos de difusão em ágar (DA) e microdiluição em caldo (MC). RESULTADOS: No método de DA, a espécie T. tonsurans apresentou percentual de sensibilidade de 33% em relação à anfotericina B e de 66% ao itraconazol, com 100% de resistência frente ao cetoconazol e ao fluconazol. A espécie T. mentagrophytes também apresentou 100% de resistência frente ao cetoconazol nesta técnica, com 11% de sensibilidade ao cetoconazol, 22% ao itraconazol e 22% das amostras classificadas como sensível dose dependente. No método de MC, a espécie T. tonsurans apresentou percentual de sensibilidade de 66%, 55% e 33% em relação ao cetoconazol, fluconazol e itraconazol, respectivamente. A espécie T. mentagrophytes apresentou percentuais de sensibilidade de 11%, 11%, 33% e 55% para anfotericina B, itraconazol, cetoconazol e fluconazol, respectivamente. CONCLUSÃO: Houve resistência in vitro das espécies do T. mentagrophytes e T. tonsurans frente ao antifúngico fluconazol e resistência relativa frente ao cetoconazol no método de DA. Na MC, no entanto, foram observados importantes percentuais de sensibilidade das duas espécies analisadas frente aos antifúngicos fluconazol e cetoconazol quando comparadas ao itraconazol e à anfotericina B.


Subject(s)
Trichophyton/drug effects , Microbial Sensitivity Tests , Drug Resistance, Fungal , Disease Susceptibility/microbiology , Antifungal Agents/pharmacology , Tinea/microbiology , Tinea/drug therapy , Colony Count, Microbial , Fluconazole/pharmacology , Amphotericin B/pharmacology , Itraconazole/pharmacology , Ketoconazole/pharmacology
7.
São Paulo; s.n; 20210219. 78 p.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1147715

ABSTRACT

A resina acrílica é usada em larga escala nos mais diversos setores inclusive na odontologia. Apesar dessa difusão, esse material sofre um problema sério frente a adesão de microrganismos em sua superfície. Visando isso, o presente trabalho elaborou um biomaterial baseado na incorporação do biocida Poli (cloreto de dialildimetilamônio) (PDADMAC) na massa de resinas acrílicas auto e termopolimerizável, avaliou suas propriedades antifúngicas e citotoxicidade. O PDADMAC foi incorporado nas resinas acrílicas e sua atividade antifúngica foi testada frente aos fungos Candida albicans (ATCC 10231) e Aspergillus niger (ATCC 16404) seguindo os protocolos padrão G21-15 e E2149-13. Além disso, cepas isoladas da mucosa oral de pacientes sem doenças sistêmicas foram identificadas e a partir disso foram realizados os estudos de protease e de potencial antifúngico frente a essas cepas. Foram realizados também os testes de citotoxidade utilizando o ensaio de redução de MTT em células-tronco de polpa dentária cultivadas em contato com meio de cultura condicionado pelas resinas. Os resultados demostraram que ambas as resinas com PDADMAC exibiram eficácia significativa contra Candida albicans. Já com relação ao fungo Aspergillus niger, ficou evidente que esse material possui apenas eficácia fungistática. Com relação às cepas isoladas da mucosa oral de pacientes sem doenças sistêmicas, foi observado que a Candida albicans foi a mais prevalente e que independente da produção de protease produzidas por essas cepas as resinas acrescidas de PDADMAC são eficazes. Nos exames de citotoxidade a adição do biocida nas resinas não afetou a viabilidade celular quando comparada às células cultivadas em condições ideais. Portanto, conclui-se que a incorporação de PDADMAC nas resinas acrílicas foi determinante para alcançar o efeito antifúngico desejado, mantendo a biocompatibilidade. Este estudo encontrou resultados promissores para o uso futuro deste biocida em materiais odontológicos.


Subject(s)
Acrylic Resins , Dental Materials , Antifungal Agents
8.
Article in Chinese | WPRIM | ID: wpr-878924

ABSTRACT

The aim of this paper was to investigate the effect of berberine hydrochloride on the cell wall integrity of Candida albicans hypha. The minimal inhibitory concentration(MIC) of berberine hydrochloride against clinical and standard C. albicans strains was detected by micro liquid-based dilution method; the effect of berberine hydrochloride on the colony formation of C. albicans SC5314 was investigated by spot assay; the effect of berberine hydrochloride on the metabolism of C. albicans SC5314 hypha was checked by XTT reduction assay, and the viability of C. albicans SC5314 hypha was tested by fluorescent staining assay. The effect of berberine hydrochloride on the morphology of C. albicans SC5314 hypha was examined by scanning electron microscope. The changes in the cell wall of C. albicans SC5314 hypha after berberine hydrochloride treatment were detected by transmission electron microscopy. The effect of berberine hydrochloride on β-glucan from C. albicans SC5314 was detected by flow cytometry. The effect of berberine hydrochloride on hypha-specific gene ECE1 and β-glucan synthase genes FKS1 and FKS2 in C. albicans was examined by qRT-PCR. The results showed that berberine hydrochloride showed a strong inhibitory effect on both clinical and standard strains of C. albicans, and the MIC was 64-128 μg·mL~(-1). Spot assay, XTT redunction assay and fluorescent staining assay showed that with the increase of berberine hydrochloride concentration, the viability of C. albicans SC5314 gradually decreased. The transmission electron microscopy scanning assay showed that this compound could cause cell wall damage of C. albicans. The flow cytometry analysis showed the exposure degree of C. albicans β-glucan. The qRT-PCR further showed that berberine hydrochloride could significantly down-regulate hypha-specific gene ECE1 and β-glucan synthase-related gene FKS1 and FKS2. In conclusion, this compound can down-regulate C. albicans and β-glucan synthase-related gene expressions, so as to destroy the cell wall structure of C. albicans, expose β-glucan and damage the integrity of the wall.


Subject(s)
Antifungal Agents/pharmacology , Berberine/pharmacology , Candida albicans/genetics , Cell Wall , Hyphae , Microbial Sensitivity Tests
9.
Chinese Journal of Biotechnology ; (12): 1107-1119, 2021.
Article in Chinese | WPRIM | ID: wpr-878617

ABSTRACT

Natamycin is a polyene macrolide antibiotics with strong and broad spectrum antifungal activity. It not only effectively inhibits the growth and reproduction of fungi, but also prevents the formation of some mycotoxins. Consequently, it has been approved for use as an antifungal food preservative in most countries, and is also widely used in agriculture and healthcare. Streptomyces natalensis and Streptomyces chatanoogensis are the main producers of natamycin. This review summarizes the biosynthesis and regulatory mechanism of natamycin, as well as the strategies for improving natamycin production. Moreover, the future perspectives on natamycin research are discussed.


Subject(s)
Antifungal Agents/pharmacology , Fungi , Natamycin , Streptomyces
10.
Artemisa; I Jornada Científica de Farmacología y Salud. Fármaco Salud Artemisa 2021; 2021. [1-13] p. tab.
Non-conventional in Spanish | LILACS, MTYCI | ID: biblio-1283644

ABSTRACT

Introducción: La onicomicosis constituye una afección muy frecuente de las uñas, que afecta gran parte de la población mundial, predominando en adultos y que repercute de manera negativa. Métodos: Se realizó una intervención terapéutica con 118 pacientes que asistieron a consulta de Dermatología del policlínico Turcios Lima, de Pinar del Río, entre enero y diciembre del 2019. Fueron incluidos aquellos pacientes entre 18 y 70 años de edad, con diagnóstico clínico de Onicomicosis y que no tuvieran enfermedades crónicas asociadas, previa autorización mediante consentimiento informado. Resultados: Predominó los pacientes comprendidos entre 41 y 60 años de edad, con 42.3%, con mayor número de masculinos, representados por el 55.0%; la mayoría de los pacientes tenían más de tres uñas afectadas, con un 37.2% en las mujeres predomino la onicomicosis en las uñas de las manos(24.5%) y en los hombres en las uñas de los pies, con 36.4%; el mayor porciento resultó curado ,de ellos un número importante los que tenían afectadas entre dos y tres uñas, para un 72.8% con relación a la curación de uñas afectadas, resultó mayor en los que tenían onicomicosis en las uñas de los pies con un 33.0%.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Onychomycosis/therapy , Antifungal Agents , Patients , Cuba , Dermatology
11.
Rev. biol. trop ; 69(1): 36-44, 2021. tab, graf
Article in Spanish | LILACS, MTYCI | ID: biblio-1290965

ABSTRACT

Introduction: In recent decades, studies related to the search and characterization of bioactive molecules in marine organisms have increased exponentially, demonstrating the enormous wealth of secondary metabolites of diverse structural composition that cannot be found in organisms present in the terrestrial environment. A significant number of the new marine natural compounds discovered have contributed to solving some of the problems of humanity, mainly those related to human health. Objective: The purpose of this research is to evaluate the bactericidal and fungicidal activities of the methanolic extract of sea cucumber Holothuria princeps collect from the bay of Cispatá in the Colombian Caribbean, in addition to chemically identifying its fatty acids. Methods: A methanolic extraction was performed from the collected biological material, by the cold maceration method. The extract obtained was fractionated using chromatographic techniques and the fatty acids were obtained, which were derivatized and identified by means of gas chromatography in coupling with mass spectrometry. The antibacterial and antifungal activities of the methanolic extract of Holothuria princeps was performed through the microdilution method against reference strains and clinical isolates. Results: We found 16 fatty acids present in Holothuria princeps according to the analysis of their mass spectra. Antibacterial activity showed that Enterococcus faecalis was the most susceptible to the extract at low concentrations, while Pseudomonas aeruginosa was the highest at the higher concentrations. In antifungal treatment, the fungus with the highest inhibition was the clinical isolate of Candida albicans (blood sample). Conclusions: Taking into account previous studies in the genus Holothuria, it is considered that the environment plays a fundamental role in the presence and diversity of fatty acids. The evaluation of the antibacterial activity against reference strains of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae and Enterococcus faecalis demonstrated the existence of a considerable effect in the reduction of bacterial growth by the extracts applied, mainly at low concentrations (less than 1 000 ppm). On the other hand, the antifungal activity against the reference strain of Candida albicans and the clinical isolates of Candida albicans (blood sample) and Candida krusei (catheter sample), the extract showed that the best results were presented at higher concentrations (above 1 500 ppm).


Introducción: En las últimas décadas los estudios relacionados con la búsqueda y caracterización de moléculas bioactivas en organismos marinos han aumentado de una manera exponencial, lo que demuestra la enorme riqueza de metabolitos secundarios de diversa composición estructural que no pueden ser encontrados en organismos presentes en el medio terrestre. Estas nuevas moléculas halladas poseen numerosas actividades biológicas que ayudan a resolver muchos problemas que ha tenido el hombre a lo largo de su existencia, lo que las convierte en productos de gran importancia para la humanidad. Objetivo: El propósito de este estudio es la identificación de los ácidos grasos presentes en el pepino de mar Holothuria princeps recolectado en costas del Caribe colombiano, además del análisis de las actividades antibacterianas y antifúngicas de su extracto metanólico frente a cepas de referencia y aislados clínicos. Métodos: Del material biológico recolectado se realizó una extracción metanólica usando el método de maceración en frío. El extracto obtenido se fraccionó usando cromatografía en columna y se lograron obtener los ácidos grasos, los cuales fueron derivatizados e identificados por medio de cromatografía de gases en acople con espectrometría de masas. La actividad antibacteriana y antifúngica del extracto metanólico de Holothuria princeps se realizó a través del método de microdilución. Resultados: Los resultados arrojaron la identificación de 16 ácidos grasos presentes en Holothuria princeps de acuerdo con el análisis de sus espectros de masas. La actividad antibacteriana mostró que Enterococcus faecalis fue la bacteria más susceptible al efecto del extracto a bajas concentraciones, mientras que a las más altas lo fue Pseudomonas aeruginosa. A nivel general en el tratamiento antifúngico, el hongo que presentó una mayor inhibición fue el aislado clínico de Candida albicans (muestra de sangre). Conclusiones: Teniendo en cuenta estudios previos en organismos del mismo género, se puede considerar en cuanto a los ácidos grasos identificados, que el entorno juega un papel fundamental en la presencia y composición de estos compuestos. La evaluación de la actividad antibacteriana contra cepas de referencia de Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae y Enterococcus faecalis, demostró la existencia de un efecto considerable en la reducción del crecimiento bacteriano por parte de los extractos utilizados, principalmente a bajas concentraciones (menos de 1 000 ppm). En cuanto


Subject(s)
Holothuria , Anti-Bacterial Agents , Antifungal Agents , Mass Spectrometry , Candida albicans , Chromatography
12.
Rev. patol. trop ; 50(3)2021. ilus
Article in English | LILACS | ID: biblio-1292499

ABSTRACT

This study characterized and related yeasts of the genus Candida isolated from vaginal mucous membranes of women with lesions caused by high-risk HPV for cervical cancer. Forty-two women treated at the Lower Genital Tract Pathology Clinic of the University of São Paulo Medical School Hospital of Clinics were examined, with 30 high-grade (G1) uterine lesions with a mean age of 36.5 years ± 11. 1 and 12 with low grade (G2) uterine lesions with a mean age of 34.7 years ± 15.5. Clinical conditions and laboratory data on HPV were collected from patients' medical records; the socio-demographic data obtained from an appropriate questionnaire. For the study of association between the variables, Odds Ratio analysis was used from the STATA 13.1 program. Patients G1 had a higher prevalence for diabetes and the results indicated 27% prevalence of Candida spp. in vaginal mucosa, in G2 this was 33% in vaginal mucosa. Among the species found in vaginal mucosa of patients, Candida albicans was the most isolated with 88%, followed by C. tropicalis (8%) and C. glabrata (4%). The strains of C. albicans isolated from mucosa presented sensitivity to all antifungal agents tested, unlike the C. tropicalis strain isolated in G2 in vaginal mucosa, which presented a resistance profile to fluconazole. Thus, monitoring and supervision through clinical and laboratory testing of HPV patients is important, reinforcing the need for care, treatment and prevention of HPV-related infections and Candida spp.


Subject(s)
Humans , Female , Papillomaviridae , Candida albicans , Uterine Cervical Neoplasms , Mucous Membrane , Antifungal Agents
13.
Arq. odontol ; 57: 141-148, jan.-dez. 2021. ilus, tab
Article in English | LILACS, BBO | ID: biblio-1343550

ABSTRACT

Aim: To evaluate the effect of three natural antifungal agents combined with routine denture care on the treatment of DS, using a quantitative mycological culture analysis. Methods: Thirty denture wearers with denture stomatitis DS were treated using five substances: sterile distilled water (G1), nystatin oral suspension (G2), 20% alcoholic extract propolis (G3), Punica granatumLinné gel (G4), and Uncaria tomentosa gel (G5). The substances were used 3 times a day for 14 days. Quantitative mycological culture analysis of samples collected from the palatal mucosa was performed at three stages: before treatment (T0), after 14 days of treatment (T1), and 30 days after treatment completion (T2). Data were evaluated using Kruskal-Wallis and Friedman tests (p < 0.05). Results: Palatal mucosa intragroup analysis showed a significant reduction of Candida CFU/mL values for all groups at T1 compared to T0 (p < 0.05). However, they did not present statistical differences when comparing T1 and T2 (p > 0.05). The intergroup analysis demonstrated that there are no statistical differences, regardless of the evaluation time (p > 0.05). Conclusion:The natural products tested showed a satisfactory result on DS treatment, which proved to be equivalent to conventional topical therapy with nystatin and to treatment using only regular oral hygiene procedures.


Objetivo: Avaliar o efeito de três antifúngicos naturais combinados com o cuidado rotineiro com próteses dentárias no tratamento da EP, por meio de uma análise quantitativa de cultura micológica. Métodos: Trinta usuários de próteses dentárias com EP foram tratados com cinco substâncias: água destilada estéril (G1), suspensão oral de nistatina (G2), extrato alcoólico de própolis 20% (G3), gel Punica granatum L. (G4) e gel Uncaria tomentosa (G5). As substâncias foram utilizadas 3 vezes ao dia durante 14 dias. A análise micológica quantitativa das amostras coletadas da mucosa palatina foi realizada em três etapas: antes do tratamento (T0), após 14 dias do tratamento (T1) e 30 dias após o término do tratamento (T2). Os dados foram avaliados pelos testes de Kruskal-Wallis e Friedman (p < 0,05). Resultados: A análise intragrupo da mucosa palatina mostrou uma redução significativa dos valores de Candida UFC/mL para todos os grupos em T1 em comparação com T0 (p < 0,05). No entanto, não apresentaram diferenças estatísticas na comparação de T1 e T2 (p > 0,05). A análise intergrupos demonstrou que não há diferenças estatísticas, independentemente do tempo de avaliação (p > 0,05). Conclusão: Os produtos naturais testados apresentaram resultado satisfatório no tratamento da EP, sendo equivalente à terapia tópica convencional com nistatina e ao tratamento apenas com procedimentos rotineiros de higiene bucal.


Subject(s)
Stomatitis, Denture , Biological Products , Candida albicans , Colony Count, Microbial , Antifungal Agents , Propolis , Distilled Water , Nystatin
14.
Mem. Inst. Oswaldo Cruz ; 116: e210207, 2021. tab, graf
Article in English | LILACS | ID: biblio-1346578

ABSTRACT

BACKGROUND Treatment of mycoses is often ineffective, usually prolonged, and has some side effects. These facts highlight the importance of discovering new molecules to treat fungal infections. OBJECTIVES To search the Medicines for Malaria Venture COVID Box for drugs with antifungal activity. METHODS Fourteen human pathogenic fungi were tested against the 160 drugs of this collection at 1.0 µM concentration. We evaluated the ability of the drugs to impair fungal growth, their fungicidal nature, and morphological changes caused to cells. FINDINGS Thirty-four molecules (21.25%) presented antifungal activity. Seven are antifungal drugs and one is the agricultural fungicide cycloheximide. The other drugs with antifungal activity included antibiotics (n = 3), antimalarials (n = 4), antivirals (n = 2), antiparasitcs (n = 3), antitumor agents (n = 5), nervous system agents (n = 3), immunosuppressants (n = 3), antivomiting (n = 1), antiasthmatic (n = 1), and a genetic disorder agent (n = 1). Several of these drugs inhibited Histoplasma capsulatum and Paracoccidioides brasiliensis growth (15 and 20, respectively), while Fusarium solani was not affected by the drugs tested. Most drugs were fungistatic, but niclosamide presented fungicidal activity against the three dimorphic fungi tested. Cyclosporine affected morphology of Cryptococcus neoformans. MAIN CONCLUSIONS These drugs represent new alternatives to the development of more accessible and effective therapies to treat human fungal infections.


Subject(s)
Humans , Pharmaceutical Preparations , Cryptococcus neoformans , COVID-19 , Malaria/drug therapy , Microbial Sensitivity Tests , Drug Repositioning , SARS-CoV-2 , Antifungal Agents/therapeutic use , Antifungal Agents/pharmacology
15.
Neumol. pediátr. (En línea) ; 16(2): 81-84, 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1293292

ABSTRACT

La aspergilosis broncopulmonar alérgica (ABPA) es una reacción de hipersensibilidad secundaria al Aspergillus fumigatus (Af) que complica la evolución en fibrosis quística (FQ). Existen pocos estudios pediátricos de su prevalencia publicados en el mundo y en Chile se desconoce. El objetivo de este trabajo fue estimar la prevalencia de ABPA en niños con FQ en un hospital de referencia, explorar factores de riesgo y describir los criterios diagnósticos, tratamiento y evolución. Se incluyeron retrospectivamente los niños con FQ atendidos en un hospital terciario en Santiago de Chile (Hospital Roberto del Río) entre los años 2011 a 2019, se identificaron aquellos con diagnóstico de ABPA. Se registraron criterios diagnósticos según la Cystic Fibrosis Foundation, presencia de factores de riesgo, tratamientos recibidos y efectos adversos. De 65 pacientes con FQ atendidos en este período, la prevalencia de ABPA fue del 12%. El promedio de edad al diagnóstico fue ± 11 años (5-17 años), predominando la edad adolescente y el género masculino. El 50% cumplieron con los criterios clásicos, el 87,5% usaron antibióticos y el 62,5% corticoides inhalados. La respuesta favorable al tratamiento inicial con corticoides y antifúngico vía oral fue 62,5%, con una exacerbación al momento del estudio. El 25% se comportaron como refractario y el 12,5% respondieron a tratamiento con pulsos de metilprednisolona. El 37,5% presentaron eventos adversos relacionados a corticoides. La prevalencia de ABPA observada es comparable a las series publicadas. Se necesitan trabajos prospectivos para conocer la prevalencia nacional y su tendencia a lo largo de los años, identificando factores de riesgo.


Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity response to Aspergillus fumigatus (Af) and worsens outcome in children with cystic fibrosis (CF). Its prevalence varies in the literature, but we do not know it in Chile. The aim of the study was to know the prevalence of ABPA in children with CF and to describe risk factors, diagnostic criteria, treatment and outcome. We included all patients with CF seen in a tertiary hospital in Santiago, Chile (Hospital Roberto del Río), between 2011 and 2019; ABPA cases (CF Foundation diagnostic criteria) were identified for the estimation of the prevalence. Risk factors, diagnostic criteria and treatment were recorded, as proposed by the Cystic Fibrosis Foundation. A total of 65 patients with CF were identified in the study period, with a prevalence of 12% (8 cases). Mean age at diagnosis ± 11 years (5-17), more frequent in adolescence and male. CF Foundation criteria diagnostic were identified in 50% of cases, with high frequency of antibiotic use (87,5%) and inhaled steroids (62,5%). Positive oral steroids and antifungal treatment response was 62,5%. Refractary response was 25% and 12,5% needed intravenous metilprednisolone pulses. A 37,5% of cases presented adverse effects to steroids. Prevalence of ABPA is comparable to literature. A prospective study is needed to identified national prevalence and trends, identifying risks factors.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Aspergillosis, Allergic Bronchopulmonary/epidemiology , Cystic Fibrosis/epidemiology , Aspergillosis, Allergic Bronchopulmonary/diagnosis , Aspergillosis, Allergic Bronchopulmonary/drug therapy , Aspergillus fumigatus , Chile , Prevalence , Risk Factors , Cystic Fibrosis/complications , Hospitals, Pediatric/statistics & numerical data , Antifungal Agents/therapeutic use
16.
Braz. j. med. biol. res ; 54(9): e10928, 2021. graf
Article in English | LILACS | ID: biblio-1278587

ABSTRACT

This study aimed to evaluate the frequency of cryptic Candida species from candidemia cases in 22 public hospitals in São Paulo State, Brazil, and their antifungal susceptibility profiles. During 2017 and 2018, 144 isolates were molecularly identified as 14 species; C. parapsilosis (32.6%), C. albicans (27.7%), C. tropicalis (14.6%), C. glabrata (9.7%), C. krusei (2.8%), C. orthopsilosis (2.8%), C. haemulonii var. vulnera (2.1%), C. haemulonii (1.4%), C. metapsilosis (1.4%), C. dubliniensis (1.4%), C. guilliermondii (1.4%), C. duobushaemulonii (0.7%), C. kefyr (0.7%), and C. pelliculosa (0.7%). Poor susceptibility to fluconazole was identified in 6.4% of C. parapsilosis isolates (0.12 to >64 µg/mL), 50% of C. guilliermondii (64 µg/mL), 66.6% of C. haemulonii var. vulnera (16-32 µg/mL), and C. duobushaemulonii strain (MIC 64 µg/mL). Our results corroborated the emergence of C. glabrata in Brazilian cases of candidemia as previously reported. Importantly, we observed a large proportion of non-wild type C. glabrata isolates to voriconazole (28.6%; <0.015 to 4 µg/mL) all of which were also resistant to fluconazole (28.6%). Of note, C. haemulonii, a multidrug resistant species, has emerged in the Southeast region of Brazil. Our findings suggested a possible epidemiologic change in the region with an increase in fluconazole-resistant species causing candidemia. We stress the relevance of routine accurate identification to properly manage therapy and monitor epidemiologic trends.


Subject(s)
Candida , Antifungal Agents/pharmacology , Brazil , Microbial Sensitivity Tests , Drug Resistance, Fungal , Hospitals
18.
Biosci. j. (Online) ; 36(6): 1951-1960, 01-11-2020. tab, graf, ilus
Article in English | LILACS | ID: biblio-1147960

ABSTRACT

This work aimed to compare the antifungal activity of the essential oil of Varronia curassavica obtained by hydrodistillation and microwave against the fungus Colletotrichum musae and verify the alterations caused by these extraction methods on the leaf surface. This study used four essential oil samples obtained by different methods, two by hydrodistillation [HD1 (1.0 L of water and 100 min.) and HD2 (2.0 L of water and 140 min.)] and two by microwave [MI1 (500W, 20 min, without water) and MI2 (700W, 40 min, with 50 mL of water added to fresh leaves)]. Essential oils concentrations of 0.05, 0.1, 0.5, 1.0, and 3.0% (v / v) were tested in PDA medium. The mycelial growth of C. musae was evaluated by measuring the diameter, every 24 hours up to 144 hours after the beginning of the incubation. Untreated leaves and leaves treated with HD1 and MI1 were prepared for observation in a scanning electron microscope (SEM) LEO EVO 40. The most abundant compounds detected in the essential oil samples analyzed by gas chromatography were: shyobunol, germacrene D-4-ol, E-caryophyllene, bicyclogermacrene, and α-cadinol. Up to 72 hours after the beginning of the incubation, C. musae presented no mycelial growth, even at the lowest essential oil concentration. Conversely, mycelial growth was detected in the control (PDA + DMSO) from 24 hours after incubation. At 144 hours after incubation, regardless of the concentration, the essential oil samples obtained by HD provided lower mycelial growth of C. musae (1.49 cm) when compared with samples obtained by MI (1.80 cm). This difference possibly occurred due to the reduction to less than half of the germacrene D-4-ol content in the samples obtained by MI. The four essential oil samples tested inhibited the mycelial growth and thus presented a inhibitory effect on C. musae. The SEM revealed more drastic changes on the surface of the leaf treated with MI than on those treated with HD. The essential oil of V. curassavica, mainly when obtained by hydrodistillation, has the potential for use in the control of C. musae.


O objetivo do trabalho foi comparar a atividade antifúngica do óleo essencial de Varronia curassavica obtido por hidrodestilação e micro-ondas frente ao fungo Colletotrichum musae e verificar as alterações que esses métodos de extração causam na superfície da folha. Quatro amostras de óleo essencial obtidas em diferentes condições foram utilizadas. Sendo duas por hidrodestilação, HD1 (1,0 L de água e 100 min.) e HD2 (2,0 L de água e 140 min.); e duas por micro-ondas, MI1 (500W, 20 min. sem adição de água) e MI2 (700W, 40 min. com adição de 50 mL de água às folhas frescas). Foram testadas as concentrações 0,05; 0,1; 0,5; 1,0 e 3,0 % (v/v) de óleo essencial em meio BDA. O crescimento micelial do C. musae foi avaliado por medições do diâmetro, a cada 24 horas até 144 horas após o início da incubação. Folhas sem qualquer tratamento e após os tratamentos HD1 e MI1 foram preparadas para observação em microscópio eletrônico de varredura (MEV) LEO EVO 40. Os compostos mais abundantes nas amostras de óleo essencial analisadas por cromatografia gasosa foram: shyobunol, germacreno D-4-ol, E-cariofileno, biciclogermacreno e α-cadinol. Até 72 horas após o início da incubação, não foi observado nenhum crescimento micelial do C. musae, mesmo nas concentrações mais baixas de óleo essencial, enquanto, para o controle (BDA + DMSO), foi observado crescimento do fungo a partir de 24 horas. Após 144 horas, independentemente da concentração, as amostras de óleo essencial obtidas por HD proporcionaram menor crescimento micelial do C. musae (1,49 cm) quando comparadas às amostras obtidas por MI (1,80 cm). Possivelmente essa diferença ocorreu devido à redução para menos da metade, do teor de germacreno D-4-ol, nas amostras obtidas por MI. As quatro amostras de óleo essencial testadas foram capazes de inibir o crescimento micelial, apresentando portanto, um efeito inibitório sobre o C. musae. Alterações mais drásticas observadas através da MEV foram visualizadas na superfície da folha submetida ao processo de extração por MI em comparação à HD. O óleo essencial de V. curassavica, sobretudo o obtido por hidrodestilação, apresenta potencial para o controle de C. musae.


Subject(s)
Oils, Volatile , Distillation , Cordia , Antifungal Agents
19.
Rev. chil. infectol ; 37(5): 604-609, nov. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144258

ABSTRACT

Resumen Los hongos dematiáceos son un grupo heterogéneo de microorganismos capaces de sintetizar melanina. Las infecciones de este grupo que producen hifas en tejidos se denominan feohifomicosis y generalmente afectan la piel y tejidos vecinos. Presentamos el caso de un varón de 86 años con un tumor quístico blando progresivo en su mano y muñeca derecha, no asociado a dolor o signos inflamatorios. Se demostró una tenosinovitis de los flexores con pseudocapsula y sinovitis adherida a los tendones. El cultivo demostró un hongo dematiáceo compatible con Pleurostomophora richardsiae que se confirmó por secuenciación de la región ITS. La biopsia mostró una inflamación crónica granulomatosa e hifas. Después del drenaje quirúrgico, el paciente fue dado de alta sin terapia antifúngica, pero falleció por causas no relacionadas, tres meses después. Esta es la primera descripción de P. richardsiae como causa de feohifomicosis en Chile. Esta patología se puede sospechar cuando una lesión quística cutánea crónica involucra extremidades sin signos inflamatorios. Puede afectar a pacientes inmunocompetentes o inmunocomprometidos. El tratamiento contempla la escisión quirúrgica con o sin terapia antifúngica.


Abstract Dematiaceous fungi are a heterogeneous group of microorganisms able to synthesize melanin. Infections by this group that provoke tissular hyphae are called phaeohyphomycosis and usually involve skin and neighbor tissues. We present the case of a 86 years old men with a progressive soft cystic tumor in his right hand and wrist not associated to pain or inflammatory signs. A surgical intervention demonstrated flexor tenosynovitis with serous secretion, pseudocapsule and synovitis. Fungal culture demonstrated a dematiaceous fungi compatible with Pleurostomophora richardsiae that was confirmed by sequencing of the ITS region. Biopsy showed chronic inflammation with granuloma and hyphae. After surgical drainage, the patient was discharged without antifungal therapy but died of unrelated causes three month later. This is the first description of P. richardsiae as a cause of phaeohyphomycosis in Chile, a country with a template climate. Phaeohyphomycosis can be suspected when a chronic skin cystic lesion involves extremities without inflammatory signs, sometimes with an associated fistula. It may affect immunocompetent or immunosuppressed patients. Treatment involves surgical excision with or without antifungal therapy and prognosis is favorable.


Subject(s)
Humans , Male , Aged, 80 and over , Abscess , Phaeohyphomycosis/diagnosis , Phaeohyphomycosis/drug therapy , Ascomycota , Chile , Hand , Antifungal Agents/therapeutic use
20.
Rev. bras. cir. cardiovasc ; 35(5): 789-796, Sept.-Oct. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1137325

ABSTRACT

Abstract Introduction: Although it is the most common agent among the fungal causes of endocarditis, Candida albicans endocarditis is rare. Objective: To evaluate the efficacy of amphotericin B in the treatment of C. albicans endocarditis beyond a systematic review. Data search: Articles in English, Spanish and Portuguese, conducted in the following databases: MEDLINE, LILACS, IBECS and SciELO, in humans and published in the last 25 years. Study selection: Observational studies, clinical trials, and case series providing data on the amphotericin B use in patients with a C. albicans endocarditis diagnosis without age limitations. Data synthesis: From the initial search (n=79), 25 articles were fully evaluated, of which 19 were excluded for meeting one or more exclusion criteria, remaining five articles (two observational studies and three case series). Patients using amphotericin B demonstrated improvement in survival rates, and its main use was in association with the surgical method as well as with caspofungin association. Conclusion: Literature lacks evidence to conclude about efficacy and safety of amphotericin B in the treatment of fungal endocarditis. Randomized clinical trials are necessary to provide better evidence on the subject.


Subject(s)
Humans , Infant, Newborn , Child , Candida albicans , Amphotericin B/therapeutic use , Endocarditis/microbiology , Endocarditis/drug therapy , Antifungal Agents/therapeutic use , Cross-Sectional Studies
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