RESUMO
BACKGROUND: Oropharyngeal candidiasis (OPC) and esophageal candidiasis (EPC) are frequent complications in AIDS patients. The use of Fluconazole, an effective and a low toxicity drug, has been associated to the emergency of secondary resistant strains. For this reason, in vitro antifungal susceptibility tests are necessary to predict a therapeutic failure. Etest is an easy to perform alternative test, that has showed a good agreement with the broth microdilution reference method (NCCLS, document M27-A). AIM: To measure the susceptibility of C. albicans isolates from AIDS patients complicated with OPC and EPC to Amphotericin B (AmB) and Fluconazole (Flu) using Etest. MATERIAL AND METHODS: Twenty strains from 20 AIDS patients were studied. AmB was tested in RPMI 1640 agar and Flu in Casitone agar. RESULTS: All studied strains showed minimal inhibitory concentrations (MICs) < 1 mg/mL for AmB. A highly resistant strain to Flu (> 256 mg/mL) was isolated from a patient previously treated with Flu. CONCLUSIONS: In AIDS patients with OPC and EPC, the susceptibility to Flu of the isolates should be screened, to detect resistant strains. Etest is a reliable alternative in these cases, for laboratories that cannot use the reference method.
Assuntos
Humanos , Masculino , Feminino , Antifúngicos , Candida albicans/efeitos dos fármacos , Candidíase/tratamento farmacológico , Doenças do Esôfago/mortalidade , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Antifúngicos , Anfotericina B/farmacologia , Anfotericina B/uso terapêutico , Candida albicans/isolamento & purificação , Candidíase Bucal/tratamento farmacológico , Doenças Faríngeas/tratamento farmacológico , Doenças do Esôfago/complicações , Doenças do Esôfago/tratamento farmacológico , Fluconazol/farmacologia , Fluconazol/uso terapêutico , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Farmacorresistência Fúngica , Testes de Sensibilidade Microbiana/métodosRESUMO
En este trabajo se describen los resultados de dos estudios de asociación de patologías a determinados alelos de clase I y clase II del sistema HLA en pacientes caucásicos argentinos: la hepatitis crónica activa (virus B) y la enfermedad celíaca. Se presentan evidencias que muestran para ambas patologías que los alelos HLA involucrados no son los mismos que los hallados para otros grupos éticos. Estas diferencias residen tanto a nivel serológico como a nivel del DNA (evaluable por RFLP). Estos hallazgos son relevantes tanto en lo referente a las aplicaciones clínicas de las asociaciones descriptas (por ejemplo la tipificación de hermanos o hijos de pacientes celíacos para identificar a los portadores de los alelos de riesgo), como así también para invetigar las bases moleculares de las maismas