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Revista da Sociedade Brasileira de Medicina Tropical

Print version ISSN 0037-8682

Rev. Soc. Bras. Med. Trop. vol.25 no.3 Uberaba July/Sept. 1992

http://dx.doi.org/10.1590/S0037-86821992000300003 

ARTIGOS

 

Candidíase em pacientes aidéticos

 

 

C.E.O.P. Campos; R.P. Igreja; E.P. Campos

Endereço para correspondência

 

 


RESUMO

Trinta e cinco aidéticos entre 19 e 55 anos admitidos e tratados de candidíase no Hospital Emílio Ribas, SP, com ELISA positivo para HIV e confirmado pelo Western Blot. Tuberculose em 9 sendo 2 com pericardite; neurotoxoplasmose em 6; neurocriptococose em 5; herpes labial em 4; pneumocistose em 3 e sarcoma de Kaposi em 2, achavam-se associadas. A concentração inibitória mínima 50% (MIC 50%) para os azoles foi: ketoconazol= 2,2 µg/ml; itraconazol— 21,0 µg/ml; fluconazol = 19,0 µg/ml. O MIC 50% para ospolienos: nistatina— 50,0 µg/ml; anfotericina B= 0,12 µg/ml e para 5 fluorcitosina= 1,6 µg/ml nas 35 amostras de Candida isoladas. Testes não paramétricos de Siegel revelaram significante identificação (80%) das Candida albicans na candidíase, e que a dose de AMB não modificou o número de óbitos, precoce e tardio, ocorridos nesses aidéticos. O uso prévio dos azoles e da nistatina explicaria, talvez, o elevado MIC 50% observado nas amostras de Candida isoladas.

Palavras-chave: Candidíase. AIDS. Terapia: polienos e imidazóis.


ABSTRACT

A total of 35 in patients admitted at Emilio Ribas Hospital - São Paulo, Brazil, with digestive candidiasis and AIDS clinical diagnostic were evaluated 10 month later, being 29 male and 6 female; white outnumbering black with age ranged from 30 to 50 years old. Agar Sabouraud culture and tube germinative tests identified 28 (80%) Candida albicans out 35 strains. Minimum inhibitory concentration (MIC) 50% was against azoles (ketoconazole= 2.2 µg/ml; itraconazole = 21.0 µg/ml and fluconazole— 19.0 µg/ml); polyenes (ny statine — 50.0 µg/ml and amphotericin B= 0.12 µg/ml) and 5 fluorcytosine= 1.6µg/ml. Siegeltests showed significant Candida albicans proportions in strains isolated from 35 AIDS patients. There was no significant relation between AMB dosis and early or late death. Conclusions: candidiasis in AIDS patients showed high MIC 50% to azoles and nystatine and significant Candida albicans proportion in all strains isolated from AIDS patients. Previous amphotericin B therapy had no influence in early or late death in 30 patients. Previous therapy possibily explained MIC 50% increases in Candida strains.

Keywords: Candidiasis. AIDS. Therapy: polyenes and imidazoles.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

REFERÊNCIAS BIBLIOGRÁFICAS

1. AckerbauerH, Meingassner JG, Mieth H. Preclinical antimycotic activity of SDZ 89-485: a new orally and topicaly effective triazole. Journal Medical Veterinary Mycology 29:445-454, 1990.         [ Links ]

2. Athar MA, Winner HI. The development of resistance by Candida species to polyene antibiotics in vitro. Journal of Medical Microbiology 4:505-517, 1971.         [ Links ]

3. Bodenhoff J. Development of strains of genus Candida and genus Torulopsis resistant to antimycotics. Acta Pathologica Microbiologica Scandinava 75:622-630, 1969.         [ Links ]

4. Bratyburg J, Powderly WG, Kobayashi GS, Medoff X. Amphotericin B: current understanding of mechanism of action. Antimicrobial Agents Chemotherapy 34:183-188, 1990.         [ Links ]

5. Campos CEOP. Resistência de Candida albicans a nistaüna e anfotericina B. Alterações no crescimento de mutantes resistentes. Tese de doutorado. Universidade de São Paulo, Botucatu, SP, 1974.         [ Links ]

6. Christine BM, Bard M, Lees ND. Polyene resistance in ergosterol producing strains of Candida albicans. Mycoses 34:75-83, 1991.         [ Links ]

7. Cole GF, Lynn KT, Seshon KR, Pope LM. Gastrointestinal and systemic candidosis in immunocompromised mice. Journal Medical Veterinary Mycology 27:363-380, 1989.         [ Links ]

8. Conly J, Rennie R, Johnson J, Farah S. Disseminated candidiasis due to amphotericin B - resistant Candida albicans. Journal of Infectious Diseases 165-.761-764, 1992.         [ Links ]

9. Edwards Jr JE. Candida species. In: Mandell GL, Gordon Douglas Jr R, Bennett JE (ed) Principles and practive of infectious diseases. John Wileys Sons, New York p. 1435-1447, 1985.         [ Links ]

10. Hitchcock CA, Barrett-Bee KS, Russell NJ. The lipid composition and permeability to azole of an azole and polyene-resistant mutant of Candida albicans. Journal Medical Veterinary Mycology 25:29-37, 1987.         [ Links ]

11. Hunter PR, Harrison GAJ, Traser CAM. Cross infection and diversity of Candida albicans strain carriage in patients and nursing staff on an intensive care. Journal Medical Veterinary Mycology 28:317- 326, 1990.         [ Links ]

12. McKenzie R, Travis WD, Dolan SA, Pittaluga S, Fenerstein IM, Shelhamer J, Yarchoan R, Mansur H. The causes of death in patients with human immunodeficiency virus infection. A clinical and pathology study with emphasis on the role of pulmonary diseases. Medicine 70:326-343, 1991.         [ Links ]

13. Odds FC. Candida and Candidosis. 2nd edition. London - Philadelphia - New York - Tokio - Balliere Tindall, 1988.         [ Links ]

14. Odds FC, Webster CE, Mayranathan P, Simmons PD. Candida concentrations in the vagine and their association with signs and symptons of vaginal candidosis. Journal Medical Veterinary Mycology 26:277-284, 1988.         [ Links ]

15. Penneys NS. Skin manifestations of AIDS. 1st edition. Martin Dunitz LTD, London, 1990.         [ Links ]

16. Pike WJ, Clarke J, Lacey CJN, Hunter PA, Evans EG. Candida cell wall mannan in the vagina and its association with the signs and symptoms of vaginal candidosis. Journal Medical Veterinary Mycology 29:305-312, 1991.         [ Links ]

17. Reynolds R, Braude AI. The filament inducing property of blood for Candida albicans; its nature and significance. Clinical Research Proceeding 4:40- 44, 1956.         [ Links ]

18. Siegel S. Estatística não paramétrica. Editora McGraw Hill, 1975.         [ Links ]

 

 

Endereço para correspondência:
Dra. Claudia E.O.P. Campos
Depto. de Microbiologia e Imunologia.
Instituto de Biociências da UNESP.
18618-000
Botucatu, SP.

 

 

Recebido para publicação em 26/02/92.

 

 

Depto. de Microbiologia e Imunologia - Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP e Hospital Emílio Ribas, São Paulo, Brasil.

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