Susceptibilidade e resistência aos antifúngicos azóis em Candida parapsilosis e Candida tropicalis: desafios e perspectivas no contexto da saúde única

Abstract

Fungi are opportunistic agents present in diverse environments, including hospitals, domestic settings, soil, water, and animals. The increasing number of reports of antifungal resistance, particularly in non-albicans Candida species, represents an alarming problem that demands new clinical approaches. Aiming to investigate the resistance of C. parapsilosis and C. tropicalis within the context of One Health in the country, various samples of these species from diverse origins (isolates from human patients, pigs, birds, and hospital environment surfaces) were collected in four Brazilian states: Mato Grosso do Sul, Ceará, Rio Grande do Norte, and Minas Gerais. After identifying the isolates, susceptibility tests were performed using the Broth Microdilution method for fluconazole and tebuconazole, as described by the CLSI, at both 30°C and 37°C. A total of 99 isolates were identified and tested, including 27 C. parapsilosis and 72 C. tropicalis. The results revealed the presence of some C. tropicalis isolates with high MICs for fluconazole and others for tebuconazole, often with susceptibility profiles varying with temperature. Additionally, a limited number of strains showed resistance to both compounds, indicating the development of cross-resistance mechanisms. The research emphasizes the ongoing need for antifungal resistance surveillance and the development of new antifungal agents or therapeutic combinations to overcome emerging resistance mechanisms and ensure better clinical outcomes for patients.