Resumo

Candida glabrata is as an emerging pathogen in several countries, including Brazil, being responsible for both superficial and systemic infections. Based on molecular analyzes, C. nivariensis and C. bracarensis were described as two new species phylogenetically related to C. glabrata. The three species have been isolated from different clinical specimens, however C. nivariensis and C. bracarensis appear less frequently. So far, C. nivariensis and C. bracarensis have not been described in Brazil. The therapeutic and prophylactic use of antifungal drugs that are administered for prolonged periods, especially in immunocompromised patients, may be contributing to the rise of the phenomenon of resistance in C. glabrata. The aim of this study was molecularly characterize the clinical isolates of C. glabrata and determine their antifungal susceptibility profile to amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, and caspofungin. In this study, fifty clinical isolates of C. glabrata were analyzed. The samples were obtained from patients with cancer who had candidiasis between 1998 and 2013. Molecular characterization was performed by amplification and sequencing of the D1/D2 region of the 28S rDNA gene. The antifungal susceptibility profile was determined by the broth microdilution test according to the M27-A3 reference document recommended by the Clinical and Laboratory Standards Institute (CLSI). Candida nivariensis and/or C. bracarensis were not found in this study, all isolates were identified as C. glabrata. So far, the preliminary results indicate that some isolates were resistant to fluconazole and susceptible-dose dependent to itraconazole, but susceptible to the other tested drugs. The ranges of the minimum inhibitory concentrations were the following: amphotericin B (0.12 - 0.25 µg/ml), fluconazole (16 - 64 µg/ml), itraconazole (0.12 - 0.5 µg/ml), voriconazole (0.06 - 0.5 µg/ml), posaconazole (0.5 - 2 µg/ml) and caspofungin (0.03 - 0.12 µg/ml). This study will contribute to the knowledge of the frequency and distribution species of the C. glabrata complex, but also assist in the identification of resistant strains.