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巴西米纳斯吉拉斯州一家三级医院念珠菌属临床分离株的患病率及氟康唑药敏谱

Prevalence and Fluconazole Susceptibility Profile of Candida spp. Clinical Isolates in a Brazilian Tertiary Hospital in Minas Gerais, Brazil.

作者信息

Neves-Junior Athayde, Cartágenes-Pinto Ana Carolina, Rocha Débora A S, de Sá Leandro F Reis, Junqueira Maria de Lourdes, Ferreira-Pereira Antonio

机构信息

Laboratório de Bioquímica Microbiana, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR.

Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, BR.

出版信息

An Acad Bras Cienc. 2015 Aug;87(2 Suppl):1349-59. doi: 10.1590/0001-3765201520140717. Epub 2015 Aug 25.

Abstract

Candidiasis has become an important concern for clinical practice, especially with the increasing incidence of immunocompromised patients. In this scenario, the development resistance to fluconazole presents a challenge for treating these opportunistic infections. The aim of this study was to evaluate some epidemiology features of Candida infections in a Brazilian University Hospital using data, previously unavailable. We observed that 44% of the 93 clinical isolates tested, belonged to Candida albicans species and 56% belonged to non-Candida albicans species (mainly Candida tropicalis and Candida glabrata). Most strains were isolated from urine samples where C. albicans was predominantly detected. 29 strains presented a fluconazole resistance phenotype and of these, 22 were chemosensitised by FK506, a classical inhibitor of ABC transporters related to azoles resistance. These data suggest the probable role of efflux pumps in this resistance phenotype. Our study highlights the need for developing effective control measures for fungal infections, rational use of antifungal drugs and development of new molecules able to abrogate the active transport of antifungals.

摘要

念珠菌病已成为临床实践中的一个重要问题,尤其是在免疫功能低下患者发病率不断上升的情况下。在这种情况下,对氟康唑产生耐药性给治疗这些机会性感染带来了挑战。本研究的目的是利用此前无法获得的数据,评估巴西一家大学医院念珠菌感染的一些流行病学特征。我们观察到,在测试的93株临床分离株中,44%属于白色念珠菌,56%属于非白色念珠菌(主要是热带念珠菌和光滑念珠菌)。大多数菌株是从尿液样本中分离出来的,其中主要检测到白色念珠菌。29株菌株表现出氟康唑耐药表型,其中22株通过FK506(一种与唑类耐药相关的ABC转运蛋白的经典抑制剂)实现了化学增敏。这些数据表明外排泵在这种耐药表型中可能发挥的作用。我们的研究强调了制定真菌感染有效控制措施、合理使用抗真菌药物以及开发能够消除抗真菌药物主动转运的新分子的必要性。

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