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    Infecção e colonização por Candida spp, em cavidade oral de pacientes transplantados hepáticos: identificação das espécies e perfil de sensibilidade
    (Universidade Federal de São Paulo (UNIFESP), 2020-06-25) Sabadin, Clarice Elvira Saggin [UNIFESP]; Barbosa, Dulce Aparecida [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Fungal infections are frequent after liver transplantation, and these microorganisms are responsible for a high rate of morbidity and mortality. Objective: To verify infection and oral colonization by Candida in liver transplant patients, to identify the species, to test the main antifungals and to verify associated factors. Methodology: Cross-sectional study carried out with 97 liver transplant patients from a hospital in southern Brazil, in which an oral clinical examination was performed at the beginning of the study and another after six months (collection "A" and collection "B"), to check for infection/colonization by Candida. A form was filled out with sociodemographic and clinical data, after oral material from all patients was collected with a sterile swab, seeded on plates with Sabouraud Dextrose agar culture medium with Chloramphenicol and incubated at 350 C for 48 hours. The samples were identified by sequencing the ITS (Internal transcribed spacer) region of the rDNA. The antifungal sensitivity tests were performed according to CLSI (Clinical and Laboratory Standards Institute) protocol M-27A4, and the broth microdilution technique was performed with the antifungals fluconazole, amphotericin B and micafungin. Results: Of the 97 patients investigated, 15.47% had candidiasis in one of the collections, with C. albicans being the prevalent species. A strain of C. albicans and one of C. tropicalis resistant to fluconazole were found. In the 82 patients who did not present oral candidiasis, colonization was verified in 61% of them in collection A and in 59.8% in collection B. The distribution of species found in collections A and B respectively were C. albicans 29 (58%) and 27 (55.1%), C. glabrata 8 (16%) and 9 (18.4%), C. tropicalis 5 (10%) and 3 (6.12%), C. dubliniensis 5 (10% ) and 8 (16.3%) and C. fermentatti 03 (6%) and 2 (4.1%). Regarding micafungin, all isolates were susceptible. For amphotericin B all suggestive of susceptibility. The levels of resistance to fluconazole in collections A and B respectively were C. albicans (6.9% and 7.4%), C. glrabrata (12.5% and 11.1%), C. dubliniensis (20% and 12.5%), C. tropicalis (20% and 33.3%). There was no statistically significant difference between candidiasis, colonization and resistance with the associated factors. Conclusion: Liver transplant patients have candidiasis and oral colonization by Candida, the main species identified was C. albicans. Eleven fluconazole-resistant Candida isolates were found.