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Nalu Teixeira de Aguiar Pereshttp://lattes.cnpq.br/4016244616460875Danielle Letícia da Silvahttps://lattes.cnpq.br/9041508275129322Gislaine Tolentino Saraiva e Alvarenga2024-02-26T15:24:41Z2024-02-26T15:24:41Z2023-12-15http://hdl.handle.net/1843/64690As infecções fúngicas são doenças negligenciadas, apresentando diversos desafios em relação ao diagnóstico, principalmente pela falta de capacitação dos laboratórios e dos profissionais de saúde. Isso leva à subnotificação dos casos e ao tratamento empírico que pode diminuir a qualidade de vida dos pacientes e levar à seleção de linhagens resistentes aos medicamentos comumente utilizados na clínica dermatológica. As micoses cutâneas são infeções fúngicas que acometem um percentual significativo da população mundial com manifestações na pele, pelo e unha, podendo ser causadas por fungos filamentosos e leveduras. Entre os fungos filamentosos, os dermatófitos são responsáveis por 25% das infecções seguidos pelas leveduras do gênero Candida. As micoses de unha e pele são as infecções que ocorrem com maior frequência, entretanto, a prevalência dessas infecções é variável e depende de parâmetros associados ao indivíduo e ao fungo, de suas interações mútuas e de fatores epidemiológicos e geográficos. Humanos de qualquer idade e ambos os sexos podem ser afetados pelas dermatomicoses constituindo este um importante problema de saúde pública. O objetivo do presente trabalho foi atualizar e aperfeiçoar as etapas do diagnóstico laboratorial dos exames micológicos, da coleta ao isolamento e identificação dos agentes etiológicos causadores das micoses cutâneas, no Laboratório Santa Clara (LSC) em Montes Claros, MG. Todos os parâmetros estabelecidos e reconhecidos de qualidade na área de Micologia Clínica foram revisados e adotados. Essa abordagem permitiu otimizar os procedimentos laboratoriais de microscopia e cultura em meios de cultivo específicos e implementar metodologias para determinar o perfil de suscetibilidade aos antifúngicos mais utilizados na clínica dermatológica pela técnica de microdiluição em caldo e de acordo com os documentos M38-A e M27-A2 do Clinical and Laboratory Standards Institute (CLSI), respectivamente, para os fungos filamentosos e leveduras. Além disso, foi possível correlacionar a etiologia das infecções com fatores relacionados ao indivíduo, como a presença de comorbidades, ocupação, convívio com animais de estimação, uso de medicamentos e tabagismo. Dessa forma, a otimização e a atualização das metodologias de diagnóstico micológico permitiram a correta identificação do agente causador. Foram analisadas amostras de 83 pacientes, com predomínio de mulheres, representando 65,06%. Dos 132 exames micológicos realizados, 68,18% foram positivos, entre as 112 culturas, atingimos 67,85% de positividade e o trabalho mostrou que as onicomicoses foram as principais manifestações clínicas, sendo os raspados subungueais dos Halux direito e esquerdo, os locais de maior acometimento, representando 59,39%. Além disso, Trichophyton rubrum foi o agente etiológico mais prevalente seguido de Trichophyton mentagrophytes e Candida parapsilosis. Os isolados de dermatófitos e leveduras, testados nesse estudo, foram susceptíveis ao Itraconazol, Fluconazol, Terbinafina ou Nistatina. Portanto, esse estudo fornece informações relevantes sobre a epidemiologia das dermatomicoses que podem ser úteis na promoção de estratégias terapêuticas adequadas que possam evitar o surgimento da resistência fúngica, e proporciona ao profissional médico importante ferramenta de diagnóstico para auxílio no tratamento dos seus pacientes, contribuindo dessa forma para a melhoria da qualidade de vida dos pacientes da cidade de Montes Claros.Fungal infections are neglected diseases, presenting several challenges in relation to diagnosis, mainly due to the lack of training of laboratories and medical professionals. health. This leads to underreporting of cases and empirical treatment that can reduce the quality of life of patients and lead to the selection of drug-resistant strains commonly used in dermatological clinics. Cutaneous mycoses are fungal infections that affect a significant percentage of the world population with skin manifestations, and nail, which can be caused by filamentous fungi and yeasts. Among the fungi filamentous, dermatophytes are responsible for 25% of infections followed by yeasts of the genus Candida. Nail and skin mycoses are the infections that occur most frequently. frequency, however, the prevalence of these infections is variable and depends on parameters associated with the individual and the fungus, their mutual interactions and epidemiological and geographical. Humans of any age and both sexes can be affected by dermatomycosis, which constitutes an important public health problem. The objective of This work was to update and improve the stages of laboratory diagnosis of exams mycological, from collection to isolation and identification of the etiological agents causing cutaneous mycoses, at the Santa Clara Laboratory (LSC) in Montes Claros, MG. All the established and recognized quality parameters in the area of Clinical Mycology were reviewed and adopted. This approach made it possible to optimize laboratory procedures for microscopy and culture in specific culture media and implement methodologies for determine the susceptibility profile to the most commonly used antifungals in dermatological clinics using the broth microdilution technique and in accordance with documents M38-A and M27-A2 of the Clinical and Laboratory Standards Institute (CLSI), respectively, for fungi filamentous and yeast. Furthermore, it was possible to correlate the etiology of infections with factors related to the individual, such as the presence of comorbidities, occupation, coexistence with pets, medication use and smoking. In this way, optimization and updating mycological diagnostic methodologies allowed the correct identification of the Causer agent. Samples from 83 patients were analyzed, with a predominance of women, representing 65.06%. Of the 132 mycological tests performed, 68.18% were positive, among the 112 cultures, we reached 67.85% positivity and the work showed that onychomycosis were the main clinical manifestations, with subungual scrapings of the right and left, the places most affected, representing 59.39%. Additionally, Trichophyton rubrum was the most prevalent etiological agent, followed by Trichophyton mentagrophytes and Candida parapsilosis. The dermatophyte and yeast isolates tested in this study were susceptible to Itraconazole, Fluconazole, Terbinafine or Nystatin. Therefore, this study provides relevant information on the epidemiology of dermatomycoses that may be useful in promotion of appropriate therapeutic strategies that can prevent the emergence of resistance fungal infection, and provides the medical professional with an important diagnostic tool for assistance in the treatment of their patients, thus contributing to the improvement of quality life of patients in the city of Montes Claros.porUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em MicrobiologiaUFMGBrasilICB - DEPARTAMENTO DE MICROBIOLOGIAhttp://creativecommons.org/licenses/by-nc-sa/3.0/pt/info:eu-repo/semantics/openAccessDissertaçãoDermatomicosesArthrodermataceaeCandidíase CutâneaTécnicas de Tipagem MicológicaEpidemiasMicoses cutâneasDermatófitosCandida sppDiagnóstico micológicoEpidemiologiaAperfeiçoamento dos procedimentos de diagnóstico micológico e o perfil epidemiológico dos agentes de micoses superficiais e cutâneas na cidade de Montes Claros – MGinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALDissertação Gislaine Tolentino PDFA.pdfDissertação Gislaine Tolentino PDFA.pdfapplication/pdf5012246https://repositorio.ufmg.br/bitstream/1843/64690/1/Disserta%c3%a7%c3%a3o%20Gislaine%20Tolentino%20PDFA.pdfe6edbb1292b7743617503f5fbaf9756dMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-81037https://repositorio.ufmg.br/bitstream/1843/64690/2/license_rdfd434b2e45b27c6ef831461f4412a9d4eMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82118https://repositorio.ufmg.br/bitstream/1843/64690/3/license.txtcda590c95a0b51b4d15f60c9642ca272MD531843/646902024-02-26 12:24:42.455oai:repositorio.ufmg.br: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ório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2024-02-26T15:24:42Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
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