Navegando por Palavras-chave "Susceptibility Profiles"

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    Avaliação e comparação de métodos laboratoriais para diagnóstico das onicomicoses – clássico, molecular e MALDI-TOF
    (Universidade Federal de São Paulo (UNIFESP), 2020-12-01) Santana, Gilglecia Novaes Pereira [UNIFESP]; Camargo, Zoilo Pires De [UNIFESP]; Universidade Federal de São Paulo
    Onychomycosis or fungal nail infection is the infection of the nail bed caused by dermatophytes, yeasts or non dermatophyte filamentous fungi. The infection is not considered serious, although it represents a public health issue due to its high prevalence and associated morbidity, which negatively influences the quality of life of patients. The general objective of this study was to evaluate laboratory methods for the precise and specific diagnosis of the etiologic agents of onychomycosis in immunocompetent (IC) and immunocompromised patients (renal transplant receptors- RTR) with clinical suspicion of onychomycosis. seen at the Dermatology Department of the Federal University of São Paulo (UNIFESP / EPM), Dermatology Service of the Heliópolis Hospital / São Paulo and Private Dermatological Office / São Paulo. Participants were included in this study only after signing the informed consent form. The clinical material of the nails was collected from 50 IC and 50 RTR patients. The isolates were identified by phenotypic, molecular methods and mass spectrometry (MALDI-TOF MS). The susceptibility profile was carried out using the broth microdilution method against the drugs amorolfine, isoconazole, terbinafine itraconazole, fluconazole. The prevalence of onychomycosis was 80% in the IC group and lowered in the RTR group with 76%. In CI patients, the prevalence of onychomycosis was found in females in 72.5%, while in the RTR group, the prevalence was in males in 78.95%. In our investigation, onychomycosis was caused mainly by dermatophytes (55.18%), followed by yeasts 24.14%, FFND and NF were similar, both with 10.34% in the total group in both groups, the T. rubrum species complex was the most frequent, followed by T. mentagrophytes variety T. interdigitale. Regarding yeasts in our investigation, there was a predominance of the genus Candida among the isolates, with the complex of species C. parapsilosis prevalent in both groups. However, in our study, the presence of FFND was found only in the IC group, where no immunodeficiency was observed. As for the identification by mass spectrometry (MALDI-TOF MS), the on-line MSI-IHEM platform, produced significantly better results compared to the Biotyper Bruker database. Based on the high identification rate and the low percentage of errors, our study suggests that the on-line MSI platform is a promising method for the identification of fungi. Despite the statistical similarity between phenotypic and molecular techniques and mass spectrometry (MSI-IHEM Platform), our results reinforce that the molecular technique is more accurate, sensitive to the level of the species complex, providing correct identification, with precision and no error, even without using specific markers, this makes it the gold standard method in our study and has also been reported by several authors. Our data also revealed that the and susceptibility of the isolated species is similar to those described in the literature.