Perfil de susceptibilidade antifúngica e fatores de virulência de isolados fúngicos de hospital público do estado do Maranhão

Abstract

Fungal infections are neglected diseases and represent a significant public health problem. Fungi are cosmopolitan, exhibit enormous biodiversity, and can be found in various ecological niches. A growing number of hospitalizations due to invasive fungal infections has been increasing in the hospital environment, consequently leading to higher morbidity and mortality among affected individuals. In this context, the aim of this study was to evaluate the antifungal susceptibility and virulence profile of isolates from patients treated in hospitals in the state of Maranhão. The study was conducted with 14 biological samples from patients hospitalized in healthcare units in São Luís, MA, and fungi were isolated from the hospital environment between January 2020 and January 2024. The samples were collected for fungal species identification using MALDI-TOF/MS. Subsequently, antifungal susceptibility tests, virulence tests for the production of exoenzymes (proteinase, phospholipase, and catalase), and biofilm formation on abiotic surfaces such as catheters were performed. In the antifungal susceptibility test, approximately 92.8% of the samples were sensitive to amphotericin B, fluconazole, itraconazole, and voriconazole. It was observed that the samples had the ability to produce the exoenzymes phospholipase and proteinase, with all samples showing a precipitation zone (PZ) < 0.70, indicating strong proteinase production and positive catalase activity. Additionally, in the polyurethane catheter biofilm formation test, all samples were capable of producing biofilm, with an emphasis on the GCM and IJST strains, which were characterized as strong biofilm producers in plates. In conclusion, this study on the prevalence of invasive fungal infections in reference hospitals for infectious diseases will provide important support for the development of municipal and state prevention programs. Thus, it is expected that the proposed measures will effectively contribute to reducing the likelihood of future outbreaks of these infections, strengthening hospital control and safety.