RESUMO
ABSTRACT INTRODUCTION: Invasive fungal infections (IFIs) are an important complication in immunocompromised individuals, particularly neutropenic patients with hematological malignancies. In this study, we aimed to verify the epidemiology and diagnosis of IFIs in patients with hematologic problems at a tertiary hospital in Goiânia-GO, Brazil. METHODS: Data from 117 patients, involving 19 cases of IFIs, were collected. The collected data included diagnosis methods, demographics, clinical characteristics, and in vitro susceptibility to different antifungal agents. Among the 19 cases, 12 were classified as proven IFI and 7 as probable invasive aspergillosis with detection of galactomannan in blood and presence of lung infiltrates in radiographic images. Logistic regression analysis showed that the proven and probable IFIs were associated with increased risk of death. Statistical analysis demonstrated that age, sex, and underlying disease were not independently associated with risk of death in IFI patients. RESULTS: Most bloodstream isolates of Candida spp. exhibited low minimum inhibitory concentrations (MICs) to all antifungal agents tested. Voriconazole and amphotericin had the lowest MICs for Aspergillus spp. and Fusarium spp., but Fusarium spp. showed the least susceptibility to all antifungals tested. Amphotericin B, fluconazole, and itraconazole were found to be inactive in vitro against Acremonium kiliense; but this fungus was sensitive to voriconazole. CONCLUSIONS: Considering the high number of IFI cases, with crude mortality rate of 6%, we could conclude that IFIs remain a common infection in patients with hematological malignancies and underdiagnosed ante mortem. Thus, IFIs should be monitored closely.
Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Infecções Fúngicas Invasivas/microbiologia , Doenças Hematológicas/microbiologia , Aspergillus/isolamento & purificação , Aspergillus/efeitos dos fármacos , Acremonium/isolamento & purificação , Acremonium/efeitos dos fármacos , Candida/isolamento & purificação , Candida/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Prevalência , Sensibilidade e Especificidade , Hospedeiro Imunocomprometido , Infecções Fúngicas Invasivas/diagnóstico , Fusarium/isolamento & purificação , Fusarium/efeitos dos fármacos , Mananas/sangue , Pessoa de Meia-Idade , Antifúngicos/farmacologiaRESUMO
El desarrollo de Staphylococcus aureus y Bacillus subtilis fue inhibido por la decocción y el extracto de etanol de cáscara de frutos de Punica granatum L., raíz de Geum quellyon Sweet, corteza de Quillaja saponaria Mol.; la decocción y el extracto en acetato de etilo de cotiledones de Lucuma bifera Mol.; la decocción y el extracto en etanol o acetato de etilo de hojas y tallos de Calceolaria thyrsiflora Graham, Sphacele salviae (Lindl.) Briq. Haplopappus baylahuen Remy y la decocción y los extractos en etanol, acetato de etilo y cloroformo de Luma chequen (Mol.) A. Gray. El desarrollo de Escherichia coli fue escasamente inhibido por el extracto en acetato de etilo de cotiledones de L. bifera Mol. El desarrollo de Acremonium falciforme fue inhibido por la decocción y los extractos en etanol o acetato de etilo de hojas y tallos de C. thyrsiflora y H. baylahuen y por los extractos en etanol o acetato de etilo de hojas y tallos de S. salviae. Ninguna de las decocciones o extractos inhibió el desarrollo de Candida albicans
Assuntos
Técnicas In Vitro , Plantas Medicinais/análise , Acremonium/efeitos dos fármacos , Bacillus subtilis/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacosRESUMO
Se obtuvo la inhibición total del desarrollo fúngico in vitro durante 48 o más horas, al agregar al medio de cultivo los fármacos siguientes: para Acremonium potronii y A. falciforme 50 ug/ml de sulfametoxazol; para Fusarium solanii sulfametoxazol 100 ug/ml más fenilbutazona 30 ug/ml más etosuccimida 100 ug/ml o sulfametoxazol 100 ug/ml mas ibuprofeno 30 ug/ml más etosuccimida 100 ug/ml; para Candida albicans y Aspergillus niger ketoconazol 0.5 ug/ml más gentamicina 3-10 ug/ml; para A. fumigatus sulfametoxazol 100 ug/ml más yoduro de potasio 100 ug/ml más metamizol 100 ug/ml o sulfametoxazol 80-100 ug/ml más fenilbutazona 20-30 ug/ml más etosuccimida 100 ug/ml; o sulfametoxazol 80 ug/ml más clorpromacina 10 ug/ml