Cryptococcus spp., Identification and Susceptibility to Antifungals in Isolated in Laboratory of Reference in The State of Rio Grande Do Sul, Brazil (Research Article)

Author(s): Silva L P R, Garcia E S, Charles F C, Martinez K V, Leandro R N, Victoria Marcon Giudice V M, Nascimento C G S , Pereira P A, Borges J S, Gonçalves S M B, Rodrigues D M G, Picanço J M A, Calil L N and Mezzari A Department of Analysis, Faculty of Ph

Abstract: Introduction: The Cryptococcus spp., fungus with opportunistic behavior, present in environmental sources, bird excreta, remains of trees, among others. It is inhaled by the individual, causing infection that can spread to other organs and systems with tropism through the central nervous system, causing meningoencephalitis. It is estimated that C. neoformans causes more than one million new cases of cryptococcosis per year, about 625,000 deaths. Meningoencephalitis, the most common clinical manifestation, is estimated to cause 120,000 to 240,000 deaths per year worldwide. Methods: This study was conducted from January 2012 to June 2019. Biological materials were processed, mainly the cerebrospinal fluid of patients with suspected cryptococcosis. All the phenotypically identified isolates were confirmed by the Polymerase Chain Reaction (PCR) molecular technique. The antifungals fluconazole, itraconazole and amphotericin B were also tested to verify the sensitivity profile of the isolates. Conclusions and discussion: In this study it was possible to observe and confirm a higher prevalence of Cryptococcus neoformans species than C. gattii. Azole resistance was also observed by the fungus Cryptococcus spp., suggesting a possible synergism of azoles with anti-inflammatory substances, but further studies are needed both in vitro and in vivo. The imminent biological risk from the presence of the two fungal species in the environment, including the confirmation of antifungal resistant strains, corroborates the need for continuous environmental monitoring, including the presence of new pathogenic species and consequently how to conduct treatment in the various clinic presentations by this yeast.

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