XI International Meeting on Paracoccidioidomycosis

XI International Meeting on Paracoccidioidomycosis

Resume:126-1

Poster (Painel)

126-1

Prevalence and antifungal susceptibility of Candida parapsilosis complex isolated from the oral cavity of HIV-infected individuals.

Authors:

Daniela Vanessa Moris (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Marcia S.c Melhem (IAL - SÃO PAULO - Instituto Adolfo Lutz - São Paulo) ; Marilena A Martins (IAL - SÃO PAULO - Instituto Adolfo Lutz - São Paulo) ; Lenice R Souza (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Maria Walderez Szeszs (IAL - SÃO PAULO - Instituto Adolfo Lutz - São Paulo) ; Lidia Raquel Carvalho (IBB - UNESP - Instituto de Biociencias - UNESP) ; Rinaldo Poncio Mendes (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP)

Abstract

Introduction. Recently C. parapsilosis was found to exist in three different species classified by genotyping as C. parapsilosis, C. orthopsilosis, and C. metapsilosis (30). Although C. parapsilosis complex has been recognized for a number of years, little is known about the transmission and infectivity of two rare species present within the complex, C. orthopsilosis and . Few studies evaluated the prevalence of these three strains of C. parapsilosis in cases of infection or colonization, especially in the oral cavity of HIV-infected individuals. Patients and Methods. Fifteen of 318 Candida spp. isolates from oral cavities of HIV individuals, initially identified as C. parapsilosis, were identified by molecular methods by means of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Standard antifungal susceptibility tests were performed according to a reference microdilution method established by Europen Committee on Antimicrobial Susceptibility Testing (EUCAST). The employed antifungal agents were amphotericin B (AMB), ketoconazole (KTC), fluconazole (FLC), itraconazole (ITC), voriconazole (VRC) and caspofungin (CASPO). Results. Prevalence of the C. parapsilosis complex was 4.7%, with 2.2% being C. parapsilosis and 2.5% C. metapsilosis, while no C. orthopsilosis was isolated. In vitro studies demonstrated that all isolates were susceptible to amphotericin B (AMB), fluconazole (FLC), ketoconazole (KTC), itraconazole (ITC), voriconazole (VRC) and caspofungin (CASPO). Studies with C. parapsilosis and C. metapsilosis showed minimum inhibitory concentration MIC50 (mg/L) and MIC90 (mg/L), were similar for all drugs tested. There were no marked differences in the MICs for C. parapsilosis and C. metapsilosis isolates for all antifungal compounds tested, except for FLC, which was significantly higher for C. metapsilosis than C. parapsilosis. Conclusions. Based upon the frequency of candidiasis and that certain isolates of C. parapsilosis complex respond differently to FLC therapy, our data may be of therapeutic relevance with respect to susceptibility to specific antifungal agents and the potential for acquirement of drug resistance.

Keyword: Candida parapsilosis complex, oral cavity, HIV-infected individuals

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