O objetivo do presente trabalho foi estudar a ação de diversos antifúngicos isolados e associados a anfotericina B contra amostras sequenciais ou não recuperadas de pacientes com cromoblastomicose e submetidas ou não a tratamento. A partir de 18 pacientes foram isoladas 39 cepas, submetidas a testes de diluição em ágar contendo anfotericina B, cetoconazol, itraconazol, terbinafina, 5-fluorocitosina, fluconazol ou griseofulvina. Com base nas CIMs e nas concentrações séricas desses antifúngicos verificou-se que as amostras foram, de modo geral, sensíveis ao cetoconazol, a terbinafina e ao itraconazol. Somente 13 amostras foram sensíveis a anfotericina, 7 a 5-FC, 2 ao fluconazol e nenhuma à griseofulvina.Com relação as CFMs, 2 cepas foram sensíveis a AnB, 11 ao itraconazol, 20 ao cetoconazol e 3 a 5-FC. Seis não responderam a terbinafina e 38 ao fluconazol. As combinações de antifúngicos resultaram em interações principalmente aditivas ou indiferentes. O estudo de isolados seqüenciais evidenciou um ponto de corte para sensibilidade desses agentes ao itraconazol, correspondente a ClMs ≤0,06µg/ml desse azol. / The aim of the present work was to study the action of several antifungals isolated and combined with amphotericin B against sequential or non-sequential samples in patients infected with chromoblastomycosis and treated or not treated. Thirty nine strains from 18 patients were isolated and submitted to agar dilution testing containing amphotericin B, cetoconazole, itraconazole, terbinafine, 5-flucytosin, fluconazole or griseofulvin. Based on the CIMs and on the serum levels of these antifungals, the isolates were susceptible to ketoconazole, terbinafine and itraconazole. Only 13 of the isolates were susceptible to amphotericin; seven to 5-FC, two to fluconazole and none to a griseofulvin. Regarding the CFMs two strains were susceptible to AnB, 11 for itraconazole, 20 for ketoconazole and three for 5-FC. Six didn\'t respond to terbinafine and 38 for fluconazole. The combination of antifungals resulted in mainly additive or indifferent interaction. The study of the sequential isolated sample showed a breaking point for the susceptibility of these agents to itraconazole, corresponding CIMs ≤0,06µg/ml of this azole.

O objetivo do presente trabalho foi estudar a ação de diversos antifúngicos isolados e associados a anfotericina B contra amostras sequenciais ou não recuperadas de pacientes com cromoblastomicose e submetidas ou não a tratamento. A partir de 18 pacientes foram isoladas 39 cepas, submetidas a testes de diluição em ágar contendo anfotericina B, cetoconazol, itraconazol, terbinafina, 5-fluorocitosina, fluconazol ou griseofulvina. Com base nas CIMs e nas concentrações séricas desses antifúngicos verificou-se que as amostras foram, de modo geral, sensíveis ao cetoconazol, a terbinafina e ao itraconazol. Somente 13 amostras foram sensíveis a anfotericina, 7 a 5-FC, 2 ao fluconazol e nenhuma à griseofulvina.Com relação as CFMs, 2 cepas foram sensíveis a AnB, 11 ao itraconazol, 20 ao cetoconazol e 3 a 5-FC. Seis não responderam a terbinafina e 38 ao fluconazol. As combinações de antifúngicos resultaram em interações principalmente aditivas ou indiferentes. O estudo de isolados seqüenciais evidenciou um ponto de corte para sensibilidade desses agentes ao itraconazol, correspondente a ClMs ≤0,06µg/ml desse azol. / The aim of the present work was to study the action of several antifungals isolated and combined with amphotericin B against sequential or non-sequential samples in patients infected with chromoblastomycosis and treated or not treated. Thirty nine strains from 18 patients were isolated and submitted to agar dilution testing containing amphotericin B, cetoconazole, itraconazole, terbinafine, 5-flucytosin, fluconazole or griseofulvin. Based on the CIMs and on the serum levels of these antifungals, the isolates were susceptible to ketoconazole, terbinafine and itraconazole. Only 13 of the isolates were susceptible to amphotericin; seven to 5-FC, two to fluconazole and none to a griseofulvin. Regarding the CFMs two strains were susceptible to AnB, 11 for itraconazole, 20 for ketoconazole and three for 5-FC. Six didn\'t respond to terbinafine and 38 for fluconazole. The combination of antifungals resulted in mainly additive or indifferent interaction. The study of the sequential isolated sample showed a breaking point for the susceptibility of these agents to itraconazole, corresponding CIMs ≤0,06µg/ml of this azole.

Os objetivos deste estudo foram: re-identificar 70 isolados de Candida em micoteca por método tradicional e API 20C; identificar a presença de C. dubliniensis; determinar e comparar as concentrações inibitórias mínimas (CIMs) das amostras, frente a sete antifúngicos (E-test); caracterizar molecularmente as amostras seqüenciais de Candida pela técnica de PFGE; estudar e comparar o perfil genotípico de isolados de C. albicans e C. parapsilosis, através da análise de marcadores microsatélites e cariotipagem. O nível de concordância entre o método tradicional e o API 20C foi de 93%. Nenhum isolado de C. dubliniensis foi identificado no estudo. Em relação à sensibilidade antifúngica, a maioria das amostras apresentou alta porcentagem de sensibilidade às sete drogas testadas. A análise molecular pela técnica de PFGE, mostrou seis perfis de cariótipos diferentes em 24 amostras seqüenciais. Em relação à comparação das técnicas de PFGE e microssatélites, observamos que a última mostrou maior poder discriminatório para as amostras de estudadas. / This study was aimed to: identify the 70 isolates of Candida in a culture collection by the traditional method and by API 20C; identify the presence of C. dubliniensis; determine and compare the minimum inhibitory concentrations (MICs) of these samples in regard to the seven drugs (E-test); molecularly characterize sequential samples from the same patient by the PFGE technique; study the genotypic profile of all the isolates of C. albicans and C. parapsilosis by means of the microsatellite technique and compare the results with those obtained by the PFGE technique. The level of agreement between the traditional method and the API 20C was 93%. No isolate of C. dubliniensis was identified in the study. In relation to antifungal susceptibility, most of the samples presented a high percentage of susceptibility to the seven drugs tested. The molecular analysis by the PFGE technique revealed six different karyotype profiles among 24 sequential samples. In the comparison between the PFGE and microsatellite, the latter showed a greater discriminatory power for samples.

Os objetivos deste estudo foram: re-identificar 70 isolados de Candida em micoteca por método tradicional e API 20C; identificar a presença de C. dubliniensis; determinar e comparar as concentrações inibitórias mínimas (CIMs) das amostras, frente a sete antifúngicos (E-test); caracterizar molecularmente as amostras seqüenciais de Candida pela técnica de PFGE; estudar e comparar o perfil genotípico de isolados de C. albicans e C. parapsilosis, através da análise de marcadores microsatélites e cariotipagem. O nível de concordância entre o método tradicional e o API 20C foi de 93%. Nenhum isolado de C. dubliniensis foi identificado no estudo. Em relação à sensibilidade antifúngica, a maioria das amostras apresentou alta porcentagem de sensibilidade às sete drogas testadas. A análise molecular pela técnica de PFGE, mostrou seis perfis de cariótipos diferentes em 24 amostras seqüenciais. Em relação à comparação das técnicas de PFGE e microssatélites, observamos que a última mostrou maior poder discriminatório para as amostras de estudadas. / This study was aimed to: identify the 70 isolates of Candida in a culture collection by the traditional method and by API 20C; identify the presence of C. dubliniensis; determine and compare the minimum inhibitory concentrations (MICs) of these samples in regard to the seven drugs (E-test); molecularly characterize sequential samples from the same patient by the PFGE technique; study the genotypic profile of all the isolates of C. albicans and C. parapsilosis by means of the microsatellite technique and compare the results with those obtained by the PFGE technique. The level of agreement between the traditional method and the API 20C was 93%. No isolate of C. dubliniensis was identified in the study. In relation to antifungal susceptibility, most of the samples presented a high percentage of susceptibility to the seven drugs tested. The molecular analysis by the PFGE technique revealed six different karyotype profiles among 24 sequential samples. In the comparison between the PFGE and microsatellite, the latter showed a greater discriminatory power for samples.