Navegando por Palavras-chave "Candidiasis"
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- ItemAcesso aberto (Open Access)Brazilian guidelines for the management of candidiasis - a joint meeting report of three medical societies: Sociedade Brasileira de Infectologia, Sociedade Paulista de Infectologia and Sociedade Brasileira de Medicina Tropical(Brazilian Society of Infectious Diseases, 2013-06-01) Colombo, Arnaldo Lopes [UNIFESP]; Guimarães, Thaís [UNIFESP]; Camargo, Luis Fernando Aranha [UNIFESP]; Richtmann, Rosana; Queiroz-Telles, Flávio de; Salles, Mauro José Costa; Cunha, Clóvis Arns da; Shikanai-Yasuda, Maria Aparecida; Moretti, Maria Luiza; Nucci, Marcio; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); IIIInstituto de Infectologia Emilio Ribas; Pro-Matre-Santa Joana; Universidade Federal do Paraná Hospital de Clínicas; Santa Casa de Misericórdia de São Paulo; UFPR; Universidade Estadual de Campinas (UNICAMP); Universidade Federal do Rio de JaneiroCandida infections account for 80% of all fungal infections in the hospital environment, including bloodstream, urinary tract and surgical site infections. Bloodstream infections are now a major challenge for tertiary hospitals worldwide due to their high prevalence and mortality rates. The incidence of candidemia in tertiary public hospitals in Brazil is approximately 2.5 cases per 1000 hospital admissions. Due to the importance of this infection, the authors provide a review of the diversity of the genus Candida and its clinical relevance, the therapeutic options and discuss the treatment of major infections caused by Candida. Each topography is discussed with regard to epidemiological, clinical and laboratory diagnostic and therapeutic recommendations based on levels of evidence.
- ItemSomente MetadadadosDoenças fúngicas invasivas em pacientes oncohematológicos e receptores de transplante de células-tronco hematopoéticas: série histórica e aspectos evolutivos(Universidade Federal de São Paulo (UNIFESP), 2021) Bergamasco, Maria Daniela Di Dea [UNIFESP]; Colombo, Arnaldo Lopes [UNIFESP]; Universidade Federal de São PauloObjective: To describe the epidemiology of invasive fungal diseases (IFDs) in hematologic patients and hematopoietic cell transplant (HCT) recipients, managed with fluconazole prophylaxis and an antifungal diagnostic-driven approach for mold infection. Methods: This is a retrospective, single-center cohort study of all consecutive cases of proven or probable IFDs according to the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium (EORTC/MSGERC) diagnosed between 2009 and 2019 (11-year period), in adult hematologic patients and HCT recipients, managed with fluconazole prophylaxis and an antifungal diagnostic-driven approach for mold infection. Cases of possible IFDs and pneumocistosis were excluded from analysis. Results: During the study period, 94 cases of IFDs occurred among 664 hematologic patients and 316 HCT recipients. The frequency of IFDs among patients with allogeneic HCT, autologous HCT, acute leukemia and other hematologic malignancies was 8.9%, 1.6%, 17.3%, and 6.4%, respectively. Aspergillosis was the leading IFD (53.2%), followed by fusariosis (18.1%), candidiasis (10.6%), and cryptococcosis (8.5%).The overall 6-week mortality rate was 37.2%, and varied according to the host and the etiology ofIFD, from 28% in aspergillosis to 52.9% in fusariosis. Although IFDs occurred frequently in our cohort of patients managed with an antifungal diagnostic driven approach, mortality rates were comparable to other studies. In the face of challenges posed by the use of anti-mold prophylaxis, this strategy remains a reasonable alternative.
- ItemSomente MetadadadosEfeito da candidemia hospitalar sobre a letalidade e o tempo de hospitalização(Universidade Federal de São Paulo (UNIFESP), 1988) Wey, Sergio Barsanti [UNIFESP]; Castelo Filho, Adauto [UNIFESP]
- ItemAcesso aberto (Open Access)Endoftalmite por Candida albicans após transplante penetrante de córnea: relato de caso(Conselho Brasileiro de Oftalmologia, 2004-04-01) Godoy, Glaucio De; Wahab, Sâmia Ali; Hofling-Lima, Ana Luisa [UNIFESP]; Moreira, Hamilton [UNIFESP]; Hospital de Olhos do Paraná; Instituto de Pesquisas Médicas; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Paraná; Faculdade Evangélica do ParanáThe authors report a case of a patient submitted to penetrating corneal graft for keratoconus with an exaggerated inflammatory response during the postoperative period. The patient was suspected of having an atypical rejection to the donor button. There were periods of improvement, followed by periods of worsening of the inflammation at each attempt of reducing the topical corticosteroid. After initiating immunosuppressive therapy with cyclosporin and high doses of topical corticosteroid, the patient developed Candida albicans endophthalmitis affecting the anterior segment of the eye and the vitreous body, but sparing the chorioretina. The patient improved after three injections of 5 µg intravitreal amphotericin B, 400 mg oral ketoconazole daily and topical clotrimazole every four hours. The authors also discuss the main possibilities of contamination of the patient, the infectious picture probably being related to the surgical procedure.
- ItemAcesso aberto (Open Access)Gastrointestinal translocation as a possible source of candidemia in an AIDS patient(Instituto de Medicina Tropical, 1996-06-01) Colombo, Arnaldo Lopes [UNIFESP]; Branchini, Maria Luiza; Geiger, Débora [UNIFESP]; Schimidt, Ana Lucia [UNIFESP]; Pignatari, Antonio Carlos Campos [UNIFESP]; Fischman, Olga [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)Apart from cryptococcosis and histoplasmosis, which are mycoses contained by T cell-mediated mechanisms of host defense, fungemia is rarely found in AIDS patients. The frequency of fungemia due to Candida spp. has been reported to be as low as 1 %. We report a non-neutropenic AIDS patient who presented a candidemia which probably arose from her gastrointestinal tract.
- ItemAcesso aberto (Open Access)Identificação e caracterização de Candida spp. isoladas de morcego da espécie Carollia perspicillata na região amazônica(Universidade Federal de São Paulo, 2024-09-03) Rosa, Camila Ribeiro [UNIFESP]; Pascon, Renata Castiglioni [UNIFESP]; http://lattes.cnpq.br/4203540318082044; http://lattes.cnpq.br/1244835103714016Candida spp. são patógenos oportunistas, naturalmente encontrados na microbiota humana e em animais endotérmicos e por serem oportunistas, causam doenças principalmente em pessoas imunocomprometidas, ou seja, com o sistema imunológico em desequilíbrio. Em pacientes imunocomprometidos, como os portadores do vírus HIV, que desenvolveram AIDS, assim como pessoas saudáveis com quedas esporádicas na imunidade ou quebras de barreiras (translocação, mudança de pH, corte ou queimadura acidental nas mucosas), esses microrganismos provocam a infecção fúngica conhecida como candidíase. Em casos mais graves, Candida spp. pode causar infecção de corrente sanguínea (ICS), denominada candidemia. Os morcegos são animais endotérmicos com grande potencial de resistência aos microrganismos; devido a sua capacidade de voar longas distâncias são fontes importantes de dispersão de contaminação ambiental. A espécie Carollia perspicillata, possui em sua microbiota as principais Candida spp. causadoras de candidíase no Brasil e no mundo. O objetivo deste trabalho foi caracterizar cinco isolados de Candida spp. coletados da microbiota de morcego da espécie C. perspicillata, do município de Ouro Preto do Oeste, em Rondônia. Foram empregadas técnicas de microscopia óptica, cultivo em meio diferencial e identificação molecular por sequenciamento do DNA ribossômico pela técnica de Sanger, para identificação dos isolados no nível de espécie; além disso, foram feitos testes de suscetibilidade ao fluconazol e anfotericina B. Com este Trabalho de Conclusão de Curso foi possível fazer uma caracterização macro e micromorfológica destas leveduras, bem como, foi possível confirmar a identificação inicial feita por MALDI-TOF MS e definir a espécie dos isolados como: C. tropicalis, C. krusei, C. parapsilosis, C. orthopsilosis e a quinta definida e confirmada como C. glabrata.
- ItemSomente MetadadadosInfecção 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 PauloIntroduction: 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.
- ItemAcesso aberto (Open Access)Invasive candidosis: contrasting the perceptions of infectious disease physicians and intensive care physicians(Sociedade Brasileira de Medicina Tropical - SBMT, 2013-07-23) Schultz, Vanessa; Colombo, Arnaldo Lopes [UNIFESP]; Pasqualotto, Alessandro Comaru; Santa Casa Complexo Hospitalar Divisao de Doencas Infecciosas; Universidade Federal de Ciencias da Saude de Porto Alegre Departamento de Ciencias Basicas da Saude; Universidade Federal de São Paulo (UNIFESP); Santa Casa Complexo Hospitalar Laboratorio de Biologia MolecularIntroduction We analyze how infectious disease physicians perceive and manage invasive candidosis in Brazil, in comparison to intensive care unit specialists. Methods A 38-question survey was administered to 56 participants. Questions involved clinicians' perceptions of the epidemiology, diagnosis, treatment and prophylaxis of invasive candidosis. P < 0.05 was considered statistically significant. Results The perception that candidemia not caused by Candida albicans occurs in less than 10% of patients is more commonly held by intensive care unit specialists (p=0.018). Infectious disease physicians almost always use antifungal drugs in the treatment of patients with candidemia, and antifungal drugs are not as frequently prescribed by intensive care unit specialists (p=0.006). Infectious disease physicians often do not use voriconazole when a patient's antifungal treatment has failed with fluconazole, which also differs from the behavior of intensive care unit specialists (p=0.019). Many intensive care unit specialists use fluconazole to treat candidemia in neutropenic patients previously exposed to fluconazole, in contrast to infectious disease physicians (p=0.024). Infectious disease physicians prefer echinocandins as a first choice in the treatment of unstable neutropenic patients more frequently than intensive care unit specialists (p=0.013). When candidemia is diagnosed, most infectious disease physicians perform fundoscopy (p=0.015), whereas intensive care unit specialists usually perform echocardiograms on all patients (p=0.054). Conclusions This study reveals a need to better educate physicians in Brazil regarding invasive candidosis. The appropriate management of this disease depends on more drug options being available in our country in addition to global coverage in private and public hospitals, thereby improving health care.