C.E.O.P. Campos; R.P. Igreja; E.P. Campos
RESUMO
Trinta e cinco aidéticos entre 19 e 55 anos admitidos e tratados de candidíase no Hospital Emílio Ribas, SP, com ELISA positivo para HIV e confirmado pelo Western Blot. Tuberculose em 9 sendo 2 com pericardite; neurotoxoplasmose em 6; neurocriptococose em 5; herpes labial em 4; pneumocistose em 3 e sarcoma de Kaposi em 2, achavam-se associadas. A concentração inibitória mínima 50% (MIC 50%) para os azoles foi: ketoconazol= 2,2 µg/ml; itraconazol— 21,0 µg/ml; fluconazol = 19,0 µg/ml. O MIC 50% para ospolienos: nistatina— 50,0 µg/ml; anfotericina B= 0,12 µg/ml e para 5 fluorcitosina= 1,6 µg/ml nas 35 amostras de Candida isoladas. Testes não paramétricos de Siegel revelaram significante identificação (80%) das Candida albicans na candidíase, e que a dose de AMB não modificou o número de óbitos, precoce e tardio, ocorridos nesses aidéticos. O uso prévio dos azoles e da nistatina explicaria, talvez, o elevado MIC 50% observado nas amostras de Candida isoladas.
Palavras-chave: Candidíase. AIDS. Terapia: polienos e imidazóis.
ABSTRACT
A total of 35 in patients admitted at Emilio Ribas Hospital – São Paulo, Brazil, with digestive candidiasis and AIDS clinical diagnostic were evaluated 10 month later, being 29 male and 6 female; white outnumbering black with age ranged from 30 to 50 years old. Agar Sabouraud culture and tube germinative tests identified 28 (80%) Candida albicans out 35 strains. Minimum inhibitory concentration (MIC) 50% was against azoles (ketoconazole= 2.2 µg/ml; itraconazole = 21.0 µg/ml and fluconazole— 19.0 µg/ml); polyenes (ny statine — 50.0 µg/ml and amphotericin B= 0.12 µg/ml) and 5 fluorcytosine= 1.6µg/ml. Siegeltests showed significant Candida albicansproportions in strains isolated from 35 AIDS patients. There was no significant relation between AMB dosis and early or late death. Conclusions: candidiasis in AIDS patients showed high MIC 50% to azoles and nystatine and significant Candida albicans proportion in all strains isolated from AIDS patients. Previous amphotericin B therapy had no influence in early or late death in 30 patients. Previous therapy possibily explained MIC 50% increases in Candida strains.
Keywords: Candidiasis. AIDS. Therapy: polyenes and imidazoles.
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Endereço para correspondência:
Dra. Claudia E.O.P. Campos
Depto. de Microbiologia e Imunologia.
Instituto de Biociências da UNESP.
18618-000
Botucatu, SP.
Recebido para publicação em 26/02/92.
Depto. de Microbiologia e Imunologia – Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP e Hospital Emílio Ribas, São Paulo, Brasil.
