Suscetibilidade Antifúngica in vitro de Agentes de Feohifomicoses Superficiais
Resumo
A seleção de isolados fúngicos resistentes aos tratamentos disponíveis associada a um aumento no número de pacientes imunossuprimidos contribui para a incidência de infecções causadas por fungos demáceos. Assim, este estudo avaliou a eficácia terapêutica dos principais antifúngicos atualmente utilizados na prática clínica em relação à Curvularia spp. e Hortaea werneckii de casos de feohifomicose superficiais do sul do Brasil. O perfil de suscetibilidade para anfotericina B, fluconazol, itraconazol, terbinafina e voriconazol foi avaliado por microdiluição em caldo frente a fungos demáceos (Curvularia lunata, C. pallescens e H. werneckii). A terbinafina demonstrou maior eficácia contra C. lunata - média gemométrica (GM = 0,38 μg/mL), C. pallescens (MIC = 0,125 μg/mL) e H. werneckii (GM = 0,031 μg/mL) quando comparado aos demais antifúngicos testados. A maioria das espécies apresentou sensibilidade ao itraconazol e ao voriconazol, com uma concentração inibitória mínima (CIM) variando entre 1 - 8,0 μg/mL e 0,5 - 2,0 μg/mL, respectivamente. Todos os isolados testados apresentaram menor sensibilidade ao fluconazol (faixa de CIM 4 - 16 μg/mL). Embora o itraconazol seja considerado padrão ouro, a terbinafina demonstrou ser uma ótima alternativa para o tratamento das feohifomicose superficiais. O teste de suscetibilidade antifúngica é essencial para indicar a terapia ideal frente a essas infecções.
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