Antifungal susceptibility evaluation of Candida albicans isolated from buccal lesions of hiv-positive and HIV-negative patients

Ano: 2012 | Volume: 10 | Número: 1

Autores: Irany Mesquita COELHO, André Luis Ribeiro CLAUDINO, Juliana Moscardini CHAVASCO, Esther Goldenberg BIRMAN, Walderez GAMBALE, Natanael Atilas ALEVA, Amanda Latercia Tranches DIAS, Claudete Rodrigues PAULA, Jorge Kleber CHAVASCO

Palavras-chave: Candida albicans. Antifungal. MIC. Drug plasmatic level. HIV. Agar diffusion test

Resumo Inglês:

The antifungal minimal inhibitory concentrations (MIC) were determined to 35 samples of Candida
albicans; 14 of them were isolated from HIV-positive patients, and 21 from HIV-negative patients with oral erythematous
candidosis. The aim of this study was to evaluate the performance of agar dilution method in the determination of
susceptibility of Candida albicans isolated from buccal lesions of HIV-positive and negative patients to some antifungals
and compare the results with the plasmatic concentration reached by each one of these drugs. The samples were evaluated in
vitro by the agar dilution method and showed higher MIC values to ketoconazole, fluconazole, itraconazole and
amphotericin B than the concentrations achieved by these antifungals in plasma. 88.9% of the samples presented in vitro
resistance to ketoconazole and the plasmatic levels of this antifungal varied from 1 to 8 μg/mL. Regarding fluconazole and
itraconazole, most samples presented MIC larger than 128 μg/mL and plasmatic concentration varying from 0.4 to 8 μg/mL.
Only 11.9% of the samples were susceptible in vitro to fluconazole and 2.7% of them to itraconazol. The usage
concentrations prescribed for the topical antifungals nystatin, fenticonazole and miconazole are markedly higher than the
values of MIC obtained. Related to nystatin, it was verified that its MIC values were between 1 and 4 μg /mL. The
plasmatic levels to this drug are extremely low. Fenticonazole presented a MIC value larger than 128 μg/mL. Relating to
miconazole, the plasmatic levels vary from 1 to 8 μg/mL and 11.9% of the samples presented in vitro susceptibility to this
drug. No significant differences (p<0.05) were found in the susceptibility profiles of the samples obtained from HIVpositive
and HIV-negative patients.