Hepatosplenic involvement of tuberculosis: an uncommon presentation that demands attention in specific scenarios.

Abdominal tuberculosis (TB), a potential differential diagnosis for acute and chronic abdomen, should be considered in specific situations, such as immunosuppressant or biological drug use, HIV, or in patients residing in endemic areas. Although the presence of thoracic tuberculosis may indicate abdominal TB, only 15% of patients with abdominal TB have evidence of pulmonary disease. Involvement of the liver and spleen is a common autopsy finding in patients with disseminated TB. However, the most common pattern is of fine miliary lesions. Hepatic involvement with a macronodular pattern, a rare occurrence, is linked to dissemination through the portal vein. The splenic macronodular form, an extremely rare presentation, can manifest as solitary or multiple nodules, oval or round, with a variable appearance reflecting different stages of the disease, adding to the uniqueness of this case.

Forensic Geochemistry Reveals International Ship Dumping as a Source of New Oil Spill in Brazil's Coastline (Bahia) in Late 2023.

In the present study, we applied forensic geochemistry to investigate the origin and fate of spilled oils like tarballs stranded at the beaches of Bahia, in northeastern Brazil, in September 2023, based on their fingerprints. Saturated and aromatic compounds were assessed by gas chromatography, and the oceanic surface circulation patterns were deciphered to determine the geographic origin of the spill. Contamination by petroleum represents an enormous threat to the unique, species-rich ecosystems of the study area. The geochemical fingerprint of the oil spilled in 2023 did not correlate with those of previous events, including the one in 2019, the one in early 2022 in Ceará, and an extensive spill across the Brazilian Northeast in late 2022. However, the fingerprint did correlate with crude oils produced by Middle Eastern countries, most likely Kuwait. The oil of the 2023 spill had a carbonate marine origin from early mature source rocks. These findings, together with the moderate weathering of the 2023 tarballs and the ocean circulation patterns at the time of the event, indicate that the oil was discharged close to the shore of Brazil, to the east or southeast of Salvador, by a tanker on an international route in the South Atlantic.

The Influence of Time on the Epidemiology and Clinical Manifestations of Behçet's Disease in Brazil.

OBJECTIVE: Modifications in the severity and clinical expression of Behçet's disease (BD) have been described in some areas that are considered endemic for the disease. This study aims to evaluate the chronological changes in epidemiology and clinical characteristics of BD patients in a referral center in Brazil, which is considered a non-endemic area for the disease. METHODS: A descriptive and cross-sectional study involving BD patients divided into two groups: group 1 patients were diagnosed and followed between 1988 and 2010, and group 2 were diagnosed and followed between 2011 and 2022. RESULTS: No significant differences were found regarding gender and age at onset of symptoms between groups. We found a significant decrease in the frequency of bilateral ocular involvement, posterior uveitis, and retinal vasculitis. CONCLUSION: The demographic dates of this group of Brazilian BD patients remained similar over the last decade. Our study supports the notion that BD is becoming lighter in some regions. BD is a severe blinding disorder, and we found a lower frequency of ocular involvement over time. These findings may be attributed to a higher level of education of patients and a growing awareness of the disease. Newer immunomodulating and biologic agents may offer an improved prognosis in patients with BD with severe manifestations.

Turbidity buffers coral bleaching under extreme wind and rainfall conditions.

Coral reefs in turbid waters have been hypothesized to be a refuge from climate change. These naturally occurring communities were brought into the spotlight because some of their species exhibited record levels of resistance to marine heatwaves (MHWs) by disturbance-tolerant corals. However, long-term monitoring data on the drivers of coral bleaching in these extreme reef habitats are scarce. Here, we describe the population structure and bleaching rates of a widespread and resilient coral (Siderastrea stellata). We examine the links between environmental factors, namely, rainfall, wind speed, turbidity, solar irradiance, sea surface temperature, MHWs, and coral bleaching status under the worst recorded drought cycle in the Tropical South Atlantic (2013-2015). We examined 2880 colonies, most of which (∼93%) fit in the size group of 2-10 cm, with a small number (∼1%) of larger and older colonies (>20 cm). The results indicated the absence of MHWs and normal sea surface temperature variations (between 26.6 °C and 29.3 °C), however, we detected an extreme rainfall deficit (30-40% less annual volume precipitation). In general, a high proportion (44-84%) of bleached colonies was found throughout the months when turbidity decreased. Siderastrea is the only reef-building coral that comprises this seascape with encrusting and low-relief colonies. During drought periods, cloudiness is reduced, turbidity and wind speed are reduced, and solar irradiance increase, driving coral bleaching in turbid reefs. However, episodic rainfall and higher wind speeds increase turbidity and decrease coral bleaching. Our hypothesis is that turbidity decreases during drought periods which increases bleaching risk to corals even without thermal stress. Our results suggest that turbidity may have related to wind and rainfall to provoke the coral bleaching phenomenon.

Marine debris provide long-distance pathways for spreading invasive corals.

Anthropogenic marine debris and invasive species are pervasive in the ocean. However, research on the mechanisms and dynamics controlling their distribution in marine systems (e.g.; by floating debris acting as vectors for invasive species) is limited. Applying a numerical modeling approach, we demonstrate that rafting invasive corals (Tubastraea spp.) can be transported over long distances and reach important tropical receptor regions. In <180 days, buoyant debris can cover distances between 264 and 7170 km moving from the Brazilian semiarid coast to the Amazon coast and reaching eight regions in the Wider Caribbean (mainly the Eastern Caribbean and Greater Antilles). Analyzing 48 simulated scenarios (4 years × 3 depths × 4 months), we demonstrate that in ~86 % of the scenarios the particles are stranded in the Caribbean and in ~71 % they end up in the Amazon coast. Our results showed litter floating trajectories at 0-10 m water depth, transported every year to the Caribbean province. However, in August this transport is frequently blocked by the retroflection of the North Brazil Current adjacent to the Amazon River estuarine plume. Our results indicate routes for fast and long-distance transport of litter-rafting invasive species. We hypothesized a high risk of bioinvasion on important marine ecosystems (e.g., coral reefs) likely becoming increasingly threatened by these invasive species and debris. This highlights the imperative need for an ocean governance shift in prevention, control, and eradication, not only focused on local actions to prevent the spread of invasive species but also a broad international action to decrease and mitigate marine debris pollution globally.

Intestinal pneumatosis as a manifestation of systemic sclerosis.

A 60-year-old female patient was admitted to the emergency room for a 7-day history of abdominal bloating, nausea, vomiting, constipation, and lack of flatus. She had been diagnosed with systemic sclerosis (SSc) 10 years ago and had been using methotrexate, sildenafil, and prednisone. She did not present any signs of instability, but physical examination showed malnourishment status and abdominal tenderness and distention. Plain abdominal radiography was suggestive of sigmoid volvulus, confirmed and successfully resolved after endoscopic decompression therapy. Eight months later, the patient developed a new episode of abdominal obstruction. Computed Tomography (CT) scan identified a distended sigmoid colon due to its torsion with gas areas within the bowel wall. This time, endoscopic decompression had failed to treat, so exploratory laparotomy was performed. Colonic distention and sigmoid volvulus were identified during the procedure, after which sigmoidectomy followed by primary anastomosis was performed. Neither perforation nor masses were found. Furthermore, the anatomopathological study was inconsistent with vascular, inflammatory, or neoplastic diseases.

Budd-Chiari syndrome in Behçet's disease.

A 36-year-old man was admitted to the emergency department due to a 30-day history of abdominal distention and epigastralgia. He had described a non-intentional 10kg weight loss, dry cough, and fever 6 months before his admission. He had a history of tobacco and cocaine abuse and reported recurrent oral and genital ulcers. Physical examination showed an extensive area of venous collateral circulation on the abdominal wall, hepatomegaly, signs of a moderate ascites, and lower limb edema. Liver and renal function tests were normal. The ascitic fluid analysis did not show an inflammatory or infectious pattern. Upper flexible endoscopy revealed esophageal fine-caliber varices and colonoscopy showed an isolated terminal ileal ulcer. Abdominal imaging revealed hepatomegaly, voluminous ascites, and thrombosis of hepatic veins, inferior and superior vena cava (Figure 1). Infections and coagulation or lymphoproliferative disorders were excluded. Thereafter, the diagnosis of Budd-Chiari Syndrome in Behçet disease was established and immunosuppression treatment was started with good initial clinical evolution.

The most extensive oil spill registered in tropical oceans (Brazil): the balance sheet of a disaster.

This article presents a synthesis of information about the massive oil spill in Brazil (2019/2020). The event affected 11 states; however, the majority of the oil residue was collected (~ 5380 tons) near nine states (99.8%) in northeastern Brazil. This spill was not the largest in volume (between 5000 m3 and 12,000 m3) recorded in tropical oceans, but it was the most extensive (2890 km). This spill develops an overwashed tar that remains mostly in the undersurface drift (non-floating oil plume) below 17 m of depth while on the continental shelf. Ten ecosystems were impacted, with potentially more severe effects in mangroves and seagrasses. Certain negative effects are still understudied, such as effects on tropical reefs and rhodolith beds. A total of 57 protected areas in seven management categories were affected, most of which (60%) were characterized as multiple-use regions. The spill affected at least 34 threatened species, with impacts detected on plankton and benthic communities. Acute impacts were reported on echinoderms, coral symbionts, polychaetes, and sponges with evidence of oil ingestion. Socioeconomic impacts were detected in food security, public health, lodging, gender equality, tourism, and fishing, with reduced sales, prices, tourist attractiveness, gross domestic product, and employment. Moreover, chemical contamination was detected in some states by toxic metals (Hg, As, Cd, Pb, and Zn) and polycyclic aromatic hydrocarbons (acenaphthalene, fluoranthene, fluorene, naphthalene, and phenanthrene). This summary aims to aid in the design of science-based strategies to understand the impacts and develop strategies for the most extensive spill observed in tropical oceans.

An Ultrasonic-Capacitive System for Online Characterization of Fuel Oils in Thermal Power Plants.

This paper presents a ultrasonic-capacitive system for online analysis of the quality of fuel oils (FO), which are widely used to produce electric energy in Thermal Power Plants (TPP) due to their elevated heating value. The heating value, in turn, is linked to the quality of the fuel (i.e., the density and the amount of contaminants, such as water). Therefore, the analysis of the quality is of great importance for TPPs, either in order to avoid a decrease in generated power or in order to avoid damage to the TPP equipment. The proposed system is composed of two main strategies: a capacitive system (in order to estimate the water content in the fuel) and an ultrasonic system (in order to estimate the density). The conjunction of the two strategies is used in order to estimate the heating value of the fuel, online, as it passes through the pipeline and is an important tool for the TPP in order to detect counterfeit fuel. In addition, the ultrasonic system allows the estimation of the flow rate through the pipeline, hence estimating the amount of oil transferred and obtaining the total mass transferred as a feature of the system. Experimental results are provided for both sensors installed in a TPP in Brazil.

Marine debris from the past - Contamination of the Brazilian shore by a WWII wreck.

In 2018, unidentified packages appeared along approximately 1600 Km of the Brazilian coastline causing widespread pollution to beaches and danger to society. The packages were found to be bales of raw rubber ranging in size from 0.06 m³ to 3.4 m³ and weighing up to 200 kg. A few bales were marked with the stamp "Product of French Indochina" and colonized by the barnacle Lepas anatifera, an oceanic species. We found that unidentified packages are from a Second World War (WWII) shipwreck, and that the source is almost certainly the SS Rio Grande found at 5,762 m depth. Numerical simulations show that currents can carry out the bales from the SS Rio Grande to the beaches. We highlight transnational measures to study and protect the WWI shipwrecks because they represent an overlooked environmental risk.

Retirement risks: Invasive coral on old oil platform on the Brazilian equatorial continental shelf.

The objective of this study was to report, for the first time, the presence of an invasive coral (Tubastraea tagusensis) in an oil platform on the Brazilian equatorial continental shelf. This structure is located more than 1200 km north from other oil and gas structures colonized by this coral. We also discussed the retirement and decommissioning of old biofouling-encrusted oil and gas platforms (~62 platforms) from decreased production and the current oil crisis, exacerbated by the COVID-19 pandemic. This presents an ecological concern due invasive coral range expansion and potential impacts to poorly studied ecosystems such as marginal shallow-water coral reefs and mesophotic ecosystems. It is imperative that mindful risk analysis and rigorous environmental studies must precede the installation of new oil and gas platforms. In addition, decommissioning of retired structures should take into consideration marine restoration and non-indigenous species dispersal, and more specifically, Tubastraea bioinvasion.

Azole resistance in Candida from animals calls for the One Health approach to tackle the emergence of antimicrobial resistance.

This study initially aimed at investigating the occurrence of azole resistance among Candida spp. from animals and analyzing the involvement of efflux pumps in the resistance phenomenon. Then, the dynamics of antifungal resistance was assessed, by comparing the antifungal epidemiological cutoff values (ECVs) against C. albicans and C. tropicalis from humans and animals. Fifty azole-resistant isolates (24 C. albicans, 24 C. tropicalis; 2 C. parapsilosis sensu lato) were submitted to the efflux pump inhibition assay with promethazine and significant MIC reductions were observed for fluconazole (2 to 250-fold) and itraconazole (16 to 4000-fold). Then, the antifungal ECVs against C. albicans and C. tropicalis from human and animal isolates were compared. Fluconazole, itraconazole and voriconazole ECVs against human isolates were lower than those against animal isolates. Based on the antifungal ECVs against human isolates, only 33.73%, 50.39% and 63.53% of C. albicans and 52.23%, 61.85% and 55.17% of C. tropicalis from animals were classified as wild-type for fluconazole, itraconazole and voriconazole, respectively. Therefore, efflux-mediated mechanisms are involved in azole resistance among Candida spp. from animals and this phenomenon seems to emerge in animal-associated niches, pointing to the existence of environmental drivers of resistance and highlighting the importance of the One Health approach to control it.

Azole resistance in Candida albicans from animals: Highlights on efflux pump activity and gene overexpression.

This study investigated potential mechanisms of azole resistance among Candida albicans from animals, including efflux pump activity, ergosterol content and gene expression. For this purpose, 30 azole-resistant C. albicans strains from animals were tested for their antifungal susceptibility, according to document M27-A3, efflux pump activity by rhodamine 6G test, ergosterol content and expression of the genes CDR1, CDR2, MDR1, ERG11 by RT-qPCR. These strains were resistant to at least one azole derivative. Resistance to fluconazole and itraconazole was detected in 23 and 26 strains respectively. Rhodamine 6G tests showed increased activity of efflux pumps in the resistant strains, showing a possible resistance mechanism. There was no difference in ergosterol content between resistant and susceptible strains, even after fluconazole exposure. From 30 strains, 22 (73.3%) resistant animal strains overexpressed one or more genes. From this group, 40.9% (9/22) overexpressed CDR1, 18.2% (4/22) overexpressed CDR2, 59.1% (13/22) overexpressed MDR1 and 54.5% (12/22) overexpressed ERG11. Concerning gene expression, a positive correlation was observed only between CDR1 and CDR2. Thus, azole resistance in C. albicans strains from animals is a multifactorial process that involves increased efflux pump activity and the overexpression of different genes.

Candida tropicalis isolates obtained from veterinary sources show resistance to azoles and produce virulence factors.

Candida tropicalis has been associated with invasive candidiasis, being the first or second most common non-Candida albicans Candida species isolated in humans with candidemia and candiduria, as well as being frequently isolated from healthy animals. This study aimed to characterize C. tropicalis isolates (n = 64) obtained from several animal species regarding antifungal susceptibility and production of virulence factors. The isolates were obtained from the microbiota of healthy animals (goats, n = 25; sheep, n = 6; psittacines, n = 14; rheas, n = 6; horses, n = 2; sirenians, n = 5; shrimp, n = 1), as well as from aquatic mammals found dead in the environment (cetaceans, n = 5). The isolates were subjected to in vitro susceptibility testing by broth microdilution according to the CLSI M27-A3 protocol against amphotericin B, caspofungin, itraconazole, and fluconazole. We also evaluated the virulence attributes, such as proteases and phospholipases, as well as biofilm formation. Resistance to itraconazole (n = 29) and fluconazole (n = 30) was detected among isolates from every source; resistance to both azoles was detected in 24 isolates, but none of them were resistant to amphotericin B and caspofungin. Protease production was detected in the majority of the isolates (n = 59), but phospholipase was produced by only a few of them (n = 6). The isolates showed different patterns in biofilm production, being considered strong producers (n = 41), moderate producers (n = 11), weak producers (n = 9) or non-producers (n = 3). In summary, C. tropicalis isolated from animals showed high rate of resistance to azoles, expressed virulence factors and therefore may represent a potential threat to human and animal health.

Moringa oleifera inhibits growth of Candida spp. and Hortaea werneckii isolated from Macrobrachium amazonicum prawn farming with a wide margin of safety / Moringa oleifera inibe o crescimento de Candida spp. e Hortaea werneckii isoladas da criação de camarões Macrobrachium amazonicum com ampla margem de segurança

This study aimed to evaluate the antifungal activity of M. oleifera extracts against fungi isolated from farmed prawns and test the toxicity of the extracts on larvae of Macrobrachium amazonicum. The ethanol extracts of pods, seeds, leaves, stems and flowers and chloroform extract of flowers of M. oleifera were tested against 14 strains of Candida spp. and 10 strains of Hortaea werneckii isolated from farming water and the digestive tract of M. amazonicum. Antifungal activity was determined by microdilution, based on the M27-A3 and M38-A2 CLSI documents. Toxicity was evaluated by exposing larvae of M. amazonicum at concentrations between 10-1000mg mL-1, counting dead larvae (CL50) after 24 hours. The best results were verified with the chloroform extract of flowers, acting against all tested strains, with MICs ranging from 0.019 to 2.5 mg mL-1. Ethanol extracts of leaves, flowers and seeds acted against 22/24, 21/24 and 20/24 strains, respectively. The extract of pods was only effective against strains of Candida spp. (14/24) and extract of stem only against four strains of H. werneckii (4/24). Extracts of seeds, flowers (chloroform fraction), stems and leaves showed low or no toxicity, whereas extracts of pods and flowers (ethanol fraction) showed moderate toxicity. Thus, the antifungal activity of these extracts agaisnt Candida spp. and H. werneckii was observed, a wide margin of safety for larvae of M. amazonicum, demonstrating to be promising for the sustainable management of effluents from M. amazonicum farming.

Este estudo teve como objetivo avaliar a atividade antifúngica de extratos de M. oleifera frente a fungos isolados de camarões, cultivados em água doce, e testar a toxicidade dos extratos em larvas de Macrobrachium amazonicum. Os extratos etanólicos de vagens, sementes, folhas, caules e flores e o extrato clorofórmico de flores de M. oleifera foram testados contra 14 cepas de Candida spp. e 10 cepas de Hortaea werneckii isolados da água de cultivo e do trato digestório de M. amazonicum. A atividade antifúngica foi determinada por microdiluição, com base nos documentos M27-A3 e M38-A2 do CLSI. A toxicidade foi avaliada por exposição das larvas de M. amazonicum a concentrações entre 10-1000 mg mL-1 dos extratos, realizando contagem de larvas mortas (CL50), após 24 horas. Os melhores resultados foram verificados com o extrato clorofórmico de flores, agindo frente a todas as cepas testadas, com concentrações inibitórias mínimas variando entre 0,019-2,5 mg mL-1. O extrato etanólico de folhas, flores e sementes agiu ante 22/24, 21/24 e 20/24 cepas, respectivamente. O extrato de vagens foi eficaz contra cepas de Candida spp. (14/24) e o extrato de caule apenas contra quatro cepas de H. werneckii (4/24). Os extratos de sementes, flores (fração clorofórmica), caules e folhas apresentaram baixa ou nenhuma toxicidade, enquanto que extratos de vagens e flores (fração etanólica) apresentaram toxicidade moderada. Assim, observou-se atividade antifúngica dos extratos em Candida spp . e H. werneckii com uma ampla margem de segurança para as larvas de M. amazonicum, demonstrando ser promissor para o manejo sustentável dos efluentes do cultivo de M. amazonicum .

Macrobrachium amazonicum: an alternative for microbiological monitoring of aquatic environments in Brazil / Macrobrachium amazonicum uma alternativa para o monitoramento microbiológico de ambientes aquáticos no Brasil

This study aimed to evaluate the role of the Amazon River prawn, Macrobrachium amazonicum, as carrier of Candida spp., by analyzing the correlation between Candida spp. from these prawns and their environment (surface water and sediment), through M13-PCR fingerprinting and RAPD-PCR. For this purpose, 27 strains of Candida spp. were evaluated. These strains were recovered from the gastrointestinal tract of adult M. amazonicum (7/27) from Catú Lake, Ceará State, Brazil and from the aquatic environment (surface water and sediment) of this lake (20/27). Molecular comparison between the strains from prawns and the aquatic environment was conducted by M13-PCR fingerprinting and RAPD-PCR, utilizing the primers M13 and OPQ16, respectively. The molecular analysis revealed similarities between the band patterns of eight Candida isolates with the primer M13 and 11 isolates with the primer OPQ16, indicating that the same strains are present in the digestive tract of M. amazonicum and in the aquatic environment where these prawns inhabit. Therefore, these prawns can be used as sentinels for environmental monitoring through the recovery of Candida spp. from the aquatic environment in their gastrointestinal tract.

Este estudo teve como objetivo avaliar o papel do camarão Macrobrachium amazonicum como carreador de Candida spp. do ambiente aquático, por meio da análise da correlação entre Candida spp. isoladas desse camarão e do seu ambiente (água de superfície e sedimento) através das técnicas de M13-PCR fingerprinting e RAPD-PCR. Para tanto, 27 cepas de Candida spp. foram avaliadas. Essas cepas foram recuperadas a partir do trato gastrointestinal de M. amazonicum adultos (7/27), oriundos da lagoa do Catú, Ceará, Brasil, e do meio aquático (águas superficiais e sedimentos) desse lago (20/27). A comparação molecular entre as cepas de camarões e o ambiente aquático foi conduzida por M13-PCR fingerprinting e RAPD-PCR, utilizando os iniciadores M13 e OPQ16, respectivamente. A análise molecular revelou semelhanças entre os padrões de bandas de oito isolados de Candida com o iniciador M13 e 11 isolados com o primer OPQ16, indicando que elas estão presentes no trato digestivo de M. amazonicum e no ambiente aquático, onde esses camarões habitam. Portanto, essa espécie de camarão pode ser usada como sentinela para monitoramento ambiental através da recuperação de Candida spp. do ambiente aquático, a partir do seu trato gastrointestinal.

Antifungal susceptibility and virulence attributes of animal-derived isolates of Candida parapsilosis complex.

This study aimed to identify strains of the Candida parapsilosis complex isolated from animals, as well as to assess their in vitro antifungal susceptibility profile and in vitro production of virulence attributes. We used 28 isolates of C. parapsilosis sensu lato recovered from clinically healthy animals. The strains were characterized phenotypically, followed by molecular identification of the species through PCR-restriction enzyme analysis. The susceptibility of the strains to amphotericin B, itraconazole, voriconazole, fluconazole and caspofungin was assessed through broth microdilution. Additionally, the ability of the strains to produce biofilm, phospholipases and proteases was analysed. Molecular analysis showed 13 C. parapsilosis sensu stricto, 10 Candida orthopsilosis and five Candida metapsilosis strains. In vitro resistance to fluconazole was observed in three strains of C. parapsilosis sensu stricto and two C. metapsilosis. All tested strains were able to form biofilms and 23/28 isolates presented protease production, whilst none was able to produce phospholipases. Our study showed that C. parapsilosis sensu stricto and C. orthopsilosis are the most common species of the C. parapsilosis species complex and that these cryptic species present no significant phenotypical differences.

The calcineurin inhibitor cyclosporin A exhibits synergism with antifungals against Candida parapsilosis species complex.

Candida parapsilosis complex comprises three closely related species, C. parapsilosis sensu stricto, Candida metapsilosis and Candida orthopsilosis. In the last decade, antifungal resistance to azoles and caspofungin among C. parapsilosis sensu lato strains has been considered a matter of concern worldwide. In the present study, we evaluated the synergistic potential of antifungals and the calcineurin inhibitor cyclosporin A (Cys) against planktonic and biofilms of C. parapsilosis complex from clinical sources. Susceptibility assays with amphotericin, fluconazole, voriconazole, caspofungin and Cys were performed by microdilution in accordance with Clinical and Laboratory Standards Institute guidelines. Synergy testing against planktonic cells of C. parapsilosis sensu lato strains was assessed by the chequerboard method. Combinations formed by antifungals with Cys were evaluated against mature biofilms in microtitre plates. No differences in the antifungal susceptibility pattern among species were observed, but C. parapsilosis sensu stricto strains were more susceptible to Cys than C. orthopsilosis and C. metapsilosis. Synergism between antifungals and Cys was observed in C. parapsilosis sensu lato strains. Combinations formed by antifungals and Cys were able to prevent biofilm formation and showed an inhibitory effect against mature biofilms of C. parapsilosis sensu stricto, C. metapsilosis and C. orthopsilosis. These results strengthen the potential of calcineurin inhibition as a promising approach to enhance the efficiency of antifungal drugs.