Resumo

JEREZ PUEBLA, LE et al. In vitro susceptibility of Candida spp. isolated fromthe oral cavity of HIV / AIDS patients to itraconazole, clotrimazole and ketoconazole. AVFT [online]. 2012, vol.31, n.4, pp.79-83. ISSN 0798-0264.

Introduction: The oropharyngeal candidiasis (OFC) remains as one of the principal opportunistic infections in patients infected with the human immunodeficiency virus (HIV) and with the acquired immunodeficiency syndrome (aids), and although his incidence has declined with the introduction of the highly active anti-retroviral therapy (HAART), remains as a typical complaint in these patients. Materials and Methods: A study of antifungal in vitro susceptibility testing, following the CLSI methodology, was realized against itraconazole, ketoconazole and clotrimazole of 144 clinical isolations of Candida, isolated from the oral cavity of patients infected with HIV/aids, with clinical pictures of OFC. Results: The isolation’s identification, demonstrated that more than 90% belonged to Candida albicans. The determination of the general pattern of susceptibility, following the document M27-A2 of the Clinical and Laboratory Standard Institute, against to the studied azoles by means of the method of microdilution in liquid medium, show that the majority of C. albicans isolates showed values of MIC against ketoconazole and clotrimazole lower than 0.06 µg/mL, representing a 96,9% (129 isolations) and a 97,7% (129 isolations), respectively. C. albicans exhibited the widest range of minimal inhibitory concentration (MIC). Only 2.1% of the isolations showed resistance against to itraconazole, while 3.5 % remained classified in the category “sensible dose - dependent” for this triazole. The majority of the strains showed values of MIC against ketoconazole and clotrimazole below 0.06 µg/mL. The clotrimazole had a better in vitro activity compared with the remaining azoles opposite to the isolations. Conclusion: Candida spp. showed a high in vitro sensibility to the azoles studied. It becomes necessary the maintenance of epidemiologic studies for the determination of susceptibility patterns and of resistances rates against to the antifungal agents.

Palavras-chave : in vitro antifungal susceptibility testing; Candida; itraconazole; ketoconazole; clotrimazole; oropharyngeal candidiasis; HIV/aids.