Fisiopatogenia, epidemiologia e diagnóstico laboratorial da candidemia

Abstract

Candidemia é a infecção da corrente sanguínea causada por leveduras do gênero Candida. As espécies mais comumente isoladas em amostras de sangue venoso de pacientes hospitalizados são C. albicans, C. tropicalis, C. parapsilosis, C. glabrata e C. krusei. A finalidade desse estudo é fornecer uma revisão sobre candidemia, mostrando aspectos importantes sobre etioepidemiologia, relação fungo/hospedeiro e diagnóstico laboratorial desta infecção sistêmica emergente. Durante o processo de estabelecimento da candidemia, a levedura participa ativamente, expressando diversos fatores de virulência, o que acaba por favorecer a patogênese da candidemia. Entre esses fatores, destacam-se produção de enzimas extracelulares, dimorfismo, síntese de hemolisinas, capacidade de adesão e formação de biofilme. Nos pacientes acometidos, a intervenção medicamentosa deve ser precoce para minimizar os riscos de complicações e de resistência microbiana, portanto um diagnóstico laboratorial eficiente se faz necessário. O estudo e o conhecimento desses fatores, associados à genotipagem, podem contribuir de maneira decisiva para a descoberta de novos fármacos que possam atuar como profiláticos e/ou terapêuticos em pacientes com candidemia ou em risco de desenvolvê-la.

Antifungal susceptibility and distribution of Candida spp. isolates from the University Hospital in the municipality of Dourados, State of Mato Grosso do Sul, Brazil

“…The latter compound is a triazole frequently prescribed to treat Candida spp. infections because of its excellent patient tolerance and minimal side effects 11 , although a number of species of Candida display fl uconazole resistance 12,13 and the growing worldwide use of this drug to treat candidemia is one of the principal causes of the recent increase in the prevalence of NCAC species 14 .…”

Prevalence of fungemia in a tertiary hospital: Analysis of the last decade

“…This increase was consistent with epidemiological data from other national and international hospitals. 6,13,[19][20][21] The increased prevalence of fungemia in hospital services may be related to advances in health care, which allowed greater survival of immunosuppressed patients. 19 The frequent use of invasive instruments and materials in hospital care, and the indiscriminate use of broad-spectrum antimicrobials also contributed to the increase in fungemia.…”

“…6,13,[19][20][21] The increased prevalence of fungemia in hospital services may be related to advances in health care, which allowed greater survival of immunosuppressed patients. 19 The frequent use of invasive instruments and materials in hospital care, and the indiscriminate use of broad-spectrum antimicrobials also contributed to the increase in fungemia. 2,19 The increase in the percentage of fungemia diagnosed in the last decade can be more significant, considering that false-negative results can occur if the minimum incubation time for growth of fungal species is not observed.…”

“…19 The frequent use of invasive instruments and materials in hospital care, and the indiscriminate use of broad-spectrum antimicrobials also contributed to the increase in fungemia. 2,19 The increase in the percentage of fungemia diagnosed in the last decade can be more significant, considering that false-negative results can occur if the minimum incubation time for growth of fungal species is not observed. At HC-UFMG, only samples reported as suspected fungemia were subjected to longer incubation times, either 2013).…”

Influence of glucose and stirring in the fermentation process in order to produce anti- Candida metabolites produced by Streptomyces sp.

“…The increasing incidence of multidrug-resistant organisms is a major public health problem, especially Candida albicans, which although it is considered a commensal inhabitant of various parts of the body, particularly the gastrointestinal and genital tract, is associated with many cases of hospital infection, including the ability to promote primary infections in immunocompromised patients. (Avrella, Goulart, 2008;Giolo, Svidzinski, 2010).…”