Resistance profile of opportunistic mycosis agents in Brazil

Abstract

The indiscriminate use of antifungals has contributed to the change in the epidemiological profile of resistant fungi, increasing the mortality rate in affected patients. In Brazil, due to the absence of official data, there are no precise reports on the first detection of antifungal resistance. Among the causative agents of opportunistic mycoses, the most isolated species is Candida albicans, but other species such as Cryptococcus neoformans, Sporothrix schenckii and Aspergillus spp. have been described. This study aimed to highlight the progressive increase in resistance rates of opportunistic fungi to commonly used antifungals and to highlight the importance of knowing the sensitivity profile before the start of treatment, because the incorrect treatment of these infections aggravates therapeutic failures and leads to the remission of mycoses. A review of scientific literature was conducted based on the Bireme, Scielo, Pubmed and Google Acadêmico database, using with descriptors: Candida albicans, Sporothrix schenckii, Cryptococcus neoformans, Aspergillus spp., opportunistic mycoses, resistance, resistance in opportunistic mycoses, resistance profile and fungal resistance in Brazil. They were searched in Portuguese, English and Spanish. With the increasing number of immunocompromised patients, the rates of opportunistic infections have increased. Opportunistic fungal pathogens belonging to these genera have been shown to be resistant to polyenes (amphotericin B), imidazole (ketoconazole, miconazole, econazole), flucitosin, triazole (voriconazole, fluconazole, itraconazole) and multiazoles in many studies. The inadequate use of some antifungals has contributed to the increase in incidence rates of opportunistic infections, especially by resistant strains, worsening the prognosis of these patients.