The high mortality rates associated with candidemia episodes and the emergence of resistance to antifungal agents necessitate the monitoring of the susceptibility of fungal isolates to antifungal treatments. The new, recently approved, species-specific clinical breakpoints (SS-CBPs)(M27-S4) for evaluating susceptibility require careful interpretation and comparison with the former proposals made using the M27-A3 breakpoints, both from CLSI. This study evaluated the susceptibility of the different species of Candida that were isolated from candidemias based on these two clinical breakpoints. Four hundred and twenty-two isolates were identified and, among them, C. parapsilosis comprised 46.68%, followed by C. albicans (35.78%), C. tropicalis (9.71%), C. glabrata (3.55%), C. lusitaniae (1.65%), C. guilliermondii (1.65%) and C. krusei (0.94%). In accordance with the M27-A3 criteria, 33 (7.81%) non-susceptible isolates were identified, of which 16 (3.79%) were resistant to antifungal agents. According to SS-CBPs, 80 (18.95%) isolates were non-susceptible, and 10 (2.36%) of these were drug resistant. When the total number of non-susceptible isolates was considered, the new SS-CBPs detected 2.4 times the number of isolates that were detected using the M27-A3 interpretative criteria. In conclusion, the detection of an elevated number of non-susceptible species has highlighted the relevance of evaluating susceptibility tests using new, species-specific clinical breakpoints (SS-CBPs), which could impact the profile of non-susceptible Candida spp. to antifungal agents that require continuous susceptibility monitoring.

As micoses tiveram um significativo aumento nos últimos anos e dentre elas as candidíases constituem um sério problema médico, pela sua elevada taxa de morbidade e mortalidade. Com o aumento de casos de Síndrome de Imunodeficiência Adquirida os casos de criptococose aumentaram acentuadamente. Neste estudo foi avaliada a prevalência de casos de Candida spp. e Cryptococcus spp. em hemocultivos de pacientes no Hospital Universitário de Santa Maria - HUSM entre janeiro a dezembro de 2006, bem como sexo, idade e doença predisponente; 37 de 4336 amostras coletadas para análise de hemocultura realizada no ano de 2006 no HUSM (0,85%) foram positivas para fungos, dentre estas 70,2% positivas para Candida spp. prevalecendo o sexo feminino e 29,8% positivas para Cryptococcus spp. prevalecendo o sexo masculino. Estas fungemias acometeram pacientes na faixa de recém nascidos a 84 anos de idade. Concluiu-se que o exame, por meio de hemocultura, é a melhor forma de diagnóstico em fungemias.