Gaceta medica de Mexico · 2008
[Antifungal resistance: an emerging problem in Mexico].
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Manzano-Gayosso Patricia, Méndez-Tovar Luis J, Hernández-Hernández Francisca, López-Martínez Rubén
Аннотация
BACKGROUND: An increase in mycosis associated with therapeutic failure has been observed worldwide. The dearth of data in Mexico led us to study antifungal resistance.
MATERIAL AND METHODS: Seventy six isolates of patients from the Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social were included: 36 with dermatophytoses and 40 with candidiasis. Dermatophytes were assesed using the E-test method and Candida spp. using the broth microdilution method. Antifungal drugs included itraconazole, ketoconazole and fluconazole for dermatophytes; in addition, voriconazole and amphotericin B were used to treat yeasts.
RESULTS: From the 36 dermatophytes, seven isolates (19.4%) showed resistance to one or more antifungal drugs: three to Trichophyton rubrum, three to T. mentagrophytes and one to T. tonsurans. One T. rubrum isolate was resistant to the three azoles; the other six isolates were resistant to fluconazole only. From the 40 Candida isolates, 11 (27.5%) showed resistance: seven to ketoconazole and itraconazole; three only to itraconazole and one to ketoconazole. One C. glabrata isolate showed resistance to the four azoles. None of the yeasts showed resistance to amphotericin B.
CONCLUSION: Therapeutic failure could be caused by drug resistance. In our study we found an antifungal resistance of 20% and 27.5% in dermatophytes and in yeasts respectively.
MATERIAL AND METHODS: Seventy six isolates of patients from the Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social were included: 36 with dermatophytoses and 40 with candidiasis. Dermatophytes were assesed using the E-test method and Candida spp. using the broth microdilution method. Antifungal drugs included itraconazole, ketoconazole and fluconazole for dermatophytes; in addition, voriconazole and amphotericin B were used to treat yeasts.
RESULTS: From the 36 dermatophytes, seven isolates (19.4%) showed resistance to one or more antifungal drugs: three to Trichophyton rubrum, three to T. mentagrophytes and one to T. tonsurans. One T. rubrum isolate was resistant to the three azoles; the other six isolates were resistant to fluconazole only. From the 40 Candida isolates, 11 (27.5%) showed resistance: seven to ketoconazole and itraconazole; three only to itraconazole and one to ketoconazole. One C. glabrata isolate showed resistance to the four azoles. None of the yeasts showed resistance to amphotericin B.
CONCLUSION: Therapeutic failure could be caused by drug resistance. In our study we found an antifungal resistance of 20% and 27.5% in dermatophytes and in yeasts respectively.