Perfil de suscetibilidade a antifúngicos de dermatófitos isolados de pacientes com insuficiência renal crônica

Abstract

BACKGROUND: The pre valence of der ma tophy to sis in the gene ral popu la tion is high, parti cularly in patients with chro-nicrenal failure. Treatment requi res the use of topi cal and/or syste mic anti fun gal drugs. The effi cacy of anti fun gal agents for the treatment of der matophy to sis has yet to be eva lua ted. Studies eva lua ting the in vitro activity of anti fun gal agents are rare, particu larly in filamen tous fungi. OBJECTIVE: To evaluate the sus cep ti bi lity pro file of dif fe rent spe cies of der matophytesiso la ted from patients with chronic renal failure to nine anti fun gal drugs available on the market for the treatment of dermatophy to sis. METHODS: Twenty-six iso la tes of der ma tophytes obtai ned from patients with chronicrenalfailu re were analyzed with res pect to their suscep tibility to nine anti fun gal agents (keto co na zole, ciclo piroxolamine, fluconazole, griseofulvin, itracona zole, micona - zole, piroc tone ola mine, ter bi nafine and tiocona zo le), using the broth micro dilu tion method proposed by the Clinical and Laboratory Standards Institute (CLSI) and adap ted for der ma tophy tes. RESULTS: Of the anti fun gal agents tested, the best results in terms of sen sitivity were found with ter bi na fine and tioco nazole, while the anti fun gal activity of fluconazole was found to be weak, particularly against strains of M. gypseum. Ciclopirox ola mi-ne, although less effective than terbina fine, also yielded satisfactory results. CONCLUSIONS: In general, the sensitivity pro file of the anti fungal agents tested in this study was similar to results obtained in pre-vious studies, con firming the need to deter mine which species is causing the der matophy to sis given that antifungal susceptibi-lity varies from one species to another. Furthermore, the present fin dings show the importance of conducting in vitro sensiti-vity tests, since the sensitivity profile may differamongiso lates of the same species. © 2011 by Anais Brasileiros de Dermatologia.