FUNDAMENTO: Leveduras do gênero Candida determinam colonização, infecções superficiais e infecções sistêmicas em imunodeprimidos. As várias apresentações da doença levam à necessidade de utilizar diferentes métodos diagnósticos e tratamentos. OBJETIVOS: Diferenciar as espécies de Candida e correlacioná-las com as regiões anatômicas. Avaliar a susceptibilidade a cetoconazol, fluconazol, itraconazol e anfotericina B. MÉTODOS: Foram avaliados 100 pacientes imunocompetentes com candidíase cutânea ou mucosa atendidos na Santa Casa de S. Paulo entre maio de 1999 e julho de 2001. Correlacionou-se a região acometida e a espécie de Candida, isolada através técnica CHROMagar Candida®. Avaliou-se a susceptibilidade das espécies a cetoconazol, fluconazol, itraconazol e anfotericina B, através do Etest®. RESULTADOS: C. albicans foi isolada em 76,0% dos materiais, C. krusei em 19% e C. tropicalis em 1%. Não houve correlação significante entre a região acometida e as espécies. A maioria das amostras mostrou susceptibilidade aos antifúngicos. CONCLUSÃO: C. albicans foi a espécie mais observada. A maioria das amostras de Candida mostrou-se susceptível aos antifúngicos.

BACKGROUND: Yeasts of the genus Candida create colonization, superficial infections and systemic infections in immunodeficient individuals. The presentations of the disease lead to the necessity of using various diagnostic methods and treatments. OBJECTIVES: To differentiate among the Candida species, correlate them with the anatomical region involved and evaluate in vitro susceptibility to ketoconazole, fluconazole, itraconazole and amphotericin B. METHODS: An evaluation of 100 cases of immunocompetent patients with cutaneous or mucous candidiasis attended at the Santa Casa de Sao Paulo Hospital from May 1999 to July 2001. This study attempted to correlate the site of the involvement and the Candida species, isolated using the CHROMagar Candida® technique. The species were evaluated using the Etest® antifungal susceptibility to ketoconazole, fluconazole, itraconazole and amphotericin B. RESULTS: C. albicans was isolated in 76% of the material, C. krusei in 19% and C. tropicalis in 1%. It was not possible to establish a significant correlation between the involved area and the species isolated. Most of the samples proved to be susceptible to the antifungals tested. CONCLUSIONS: C. albicans was the most commonly observed species. The majority of samples presented susceptibility to the tested antifungals.

PROTEKT (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin) is a global surveillance study established in 1999 to monitor antibacterial resistance of respiratory tract organisms. Thirteen centers from Argentina, Brazil and Mexico participat ed during 1999-2000; they collected 1,806 isolates (Streptococcus pneumoniae 518, Haemophilus influenzae 520, Moraxella catarrhalis 140, Staphylococcus aureus 351, S. pyogenes 277). Overall, 218 (42.1%) of the S. pneumoniae isolates had reduced susceptibility to penicillin, 79 (15.3%) were penicillin-resistant and 79 (15.3%) were erythromycin-resistant. Mexico had the highest prevalence of penicillin (76.5%) and erythromycin (31.2%) resistance. Of 77 erythromycin-resistant S. pneumoniae tested for resistance genotype, 43 possessed mef(A), 33 possessed erm(B) and 1 possessed both erm(B) and mef(A) mechanism. All S. pneumoniae isolates were fully susceptible to telithromycin, linezolid, teicoplanin and vancomycin. Among H. influenzae isolates, 88 (16.9%) produced b-lactamase, ranging from 11% (Brazil) to 24.5% (Mexico). Among M. catarrhalis isolates, 138 (98.6%) produced b-lactamase. Twenty-four (8.7%) of the S. pyogenes isolates were erythromycin-resistant; resistance being attributable to mefA (n=18), ermTR (n=5) and ermB (n=1). All H. influenzae, M. catarrhalis and S. pyogenes were fully susceptible to telithromycin. Methicillin resistance was found in 26.5% of the S. aureus isolates (Argentina 15%; Mexico 20%; Brazil 31.3%). Telithromycin was effective against 97.7% of methicillin-susceptible isolates. PROTEKT confirms that antibacterial resistance is an emerging problem in Latin America. The previously reported high levels of pneumococcal resistance to the b-lactam and macrolides were exceeded. New agents that do not induce resistance or that exert low selective pressure, e.g. telithromycin, are essential to safeguard future antibacterial efficacy.

OBJETIVO: Avaliar a etapa de ingestão da fagocitose e do metabolismo oxidativo de neutrófilos em crianças portadoras de desnutrição moderada. MÉTODOS: Foi analisado o sangue periférico de vinte e duas crianças portadoras de desnutrição moderada, sem infecção, comparando-se os resultados aos de vinte crianças eutróficas da mesma faixa etária (2 a 5 anos de idade). A ingestão fagocitária por neutrófilos foi avaliada através da ingestão de partículas de zimosan e o metabolismo oxidativo avaliado pela redução do nitro blue tetrazolium entre um número fixo de 200 neutrófilos. RESULTADOS: As médias aritméticas da ingestão por neutrófilos de partículas de zimosan, zimosan incubado com soro homólogo e zimosan incubado com soro autólogo foram 18, 41 e 46 em desnutridos e 20, 57 e 63 em eutróficos. A redução espontânea e estimulada de nitro blue tetrazolium foi de 6 e 11 em desnutridos e 12 e 17 em eutróficos. CONCLUSÃO: Concluiu-se haver uma diminuição da etapa da ingestão e do metabolismo oxidativo de neutrófilos nos pacientes estudados portadores de desnutrição moderada.

PURPOSE: To evaluate the phagocytic function of polymorphonuclear neutrophils in moderate malnutrition. METHODS: The phagocytic function of neutrophils obtained through peripheral blood sampling of twenty two children with moderate malnutrition without infections was analyzed. The results were compared to a group of twenty well nourished children matched for age (two to five years old). The phagocytic function was assessed by the ingestion of zymosan particles and nitro blue tetrazolium reduction among 200 cells. RESULTS: The mean number of zymosan particles ingested by neutrophils incubated with homologous human serum and autologous human serum were 18, 41 and 46 in the malnutrition group compared to 20, 57 and 63 in the well nourished group. The spontaneous and stimulated reduction of nitro blue tetrazolium was 6 and 11 in the malnourished patients, respectively, and 12 and 17 in the well nourished group. CONCLUSION: A decrease in the process of ingestion and digestion during phagocytosis occurs in malnourished patients.