Biofilmes e suspensões celulares de Candida spp. isoladas de ambiente hospitalar: efeitos de antifúngicos sintéticos e bioativos vegetais

Abstract

Invasive fungal infections are associated with high morbidity and mortality, mainly caused by Candida. The formation of biofilms has been considered one of the main factors associated with the virulence of these strains, primarily due to increased resistance to antimicrobial therapies presented by sessile cells compared to planktonic cells. It is necessary to select the effective antifungal therapy for infections associated with biofilm. The present study aims to evaluate and compare the effect of synthetic antifungals (Fluconazole and Amphotericin B) and plant bioactives (Guttiferone-A and 7-Epiclusianone) in biofilms and cell suspensions of Candida spp. isolated from the hospital environment. 180 samples were collected, with an incidence of 17.8% of isolates of Candida spp., isolated mainly from the hands of professionals (28% of samples), drug storage and preparation places (16%) and beds of patients (16%). The isolated Candida species were mainly Candida parapsilosis complex (59%) and C. tropicalis (19%), the species considered most associated with candidemia in Latin America, and C. guilliermondii (13%), associated with cross-resistance, not being isolated any sample of C. albicans. All isolates were able to produce biofilm, with metabolically active biofilms. The biofilms of C. parapsilosis complex and C. tropicalis showed lower metabolic activity in relation to isolates of C. famata, C. glabrata and C. guilliermondii. The isolates showed no resistance to Fluconazole and Amphotericin B and bioactives demonstrated activity. Results of Susceptibility Tests in biofilms showed a large increase in IC in biofilms for all tested substances. The plant bioactives studied showed good activity against biofilms, especially Guttiferone-A. The results demonstrate the importance of implementing standardized techniques for antifungal susceptibility testing in biofilms and of environmental contamination research, helping to establish the epidemiological chain of infections in hospital environments.