Fatores de virulência e suscetibilidade a drogas antifúngicas de cepas clínicas e ambientais de Cryptococus spp.

Abstract

The cryptococcosis is a systemic mycosis, which the meningoencephalitis is the most severe and most common clinical manifestation. The main species involved in your etiology are Cryptococcus neoformans and Cryptococcus gattii. The ecology of these species is not well, known, C. neoformans has the excrement of birds, mainly pigeons, as its principal habitat and C. gattii is commonly associate to the trees. The presence of C. gattii was investigated in different regions of Espirito Santo State and it was found in only two (0,7%) of the 209 samples of trees analyzed whereas C. neoformans was isolated in 9 (17%) of the 54 pigeon excrements analyzed. The occurrence of C. neoformans (63 isolates) at both clinical and environmental samples was higher than C. gattii (4 isolates). In the total, 67 isolates, clinical and environmental, of C. neoformans and C. gattii, were analyzed and all of then were sensitive to the voriconazole (VCZ) and amphotericin B (AMB). For the drug itraconazole (ITZ), 82% were sensitive (S), 18% sensitive-dose-dependent (SDD) and for fluconazole (FCZ), 75% S, 24% SDD and 1% resistant (R). Considering the origin of the isolates, the susceptibility profile was similar between the clinical and environmental origin. Among the azoles, the VCZ was the drug that showed higher activity and FCZ which showed less activity in vitro. There was no crossresistance between FCZ and VCZ. Regard the production of the phospholipase enzyme, 84% of the isolates had high production and only 3% showed no production of the enzyme. All the 67 isolates showed activity of phenoloxidase enzyme, being 71% low and none of then with negative activity. Lower production of phospholipase and higher phenoloxidase activity were observed in strains isolated from HIV-pos. All the clinical and environmental strains of C. neoformans belonged to genotype VNI and all C. gattii to VGII genotype. These results showed similarity in the genetic pattern, susceptibility profile of the drugs and production of extracellular enzymes, phospholipase and phenoloxidase between environmental and clinical isolates and confirm that the infection can be from environmental source.