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A relevância clínica dos biofilmes nas espécies Candida spp.
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Abstract(s)
Na última década, Candida spp., microrganismo constituinte da flora comensal do organismo humano, tem vindo a registar um aumento da sua prevalência como consequência da capacidade de se tornar oportunista no organismo humano.
Dada a facilidade que Candida spp. tem em aderir e colonizar as superfícies, a maioria das infeções geradas manifestam-se sob a forma de biofilme.
Os biofilmes, na sua globalidade são responsáveis por 80% das infeções provocadas por agentes microbianos, sendo Candida spp. um dos microrganismos com mais expressão.
Face ao aumento do índice de morbilidade e mortalidade e do aumento dos custos associados ao desenvolvimento e tratamento de infeções por biofilmes de Candida, é fundamental que a compreensão dos mecanismos de formação dos biofilmes e novas estratégias terapêuticas sejam aprofundadas e desenvolvidas.
Os antifúngicos mais utilizados no tratamento de Candidoses associadas à formação de biofilmes pertencem às classes dos azóis, polienos e equinocandinas. No entanto, estas classes são responsáveis por muitos efeitos adversos e desenvolvimento de resistências.
Uma nova classe, os triterpenóides surge nos últimos anos, com melhores índices de biodisponibilidade, menos efeitos adversos e menos desenvolvimento de resistências, encontrando-se aprovada para o tratamento de candidoses vulvovaginais.
No entanto, são necessários mais estudos para colmatar as lacunas na nossa compreensão da incidência de biofilmes de Candida spp. e igualmente para monitorizar as tendências da resistência antifúngica, de modo a preservar os recursos de saúde pública e, em última análise, a diminuir a mortalidade entre os doentes.
In the last decade, Candida spp., a constituent microorganism of the human body's commensal flora, has been experiencing an increase in its prevalence due to its ability of becoming an opportunistic fungus in the human body. Given Candida spp. capacity to adhere and colonize surfaces, the majority of infections are created in the form of biofilms. Biofilms, in general, are responsible for 80% of infections caused by microbial agents with Candida spp. being one of the most prominent microorganisms. With the rising rates of morbidity and mortality and the increasing costs associated with the development and treatment of Candida biofilm infections, it is essential to deepen the understanding of biofilm formation mechanisms and develop new therapeutic strategies. The most commonly used antifungals in the treatment of Candidiasis associated with biofilm formation belong to the classes of azoles, polyenes, and echinocandins. However, these classes are responsible for many adverse effects and the development of resistance. A new class, triterpenoids, has emerged in recent years, with better bioavailability, fewer adverse effects, and less resistance development. It has been approved for the treatment of vulvovaginal candidiasis. However, further studies are needed to fill the gaps in our understanding of the incidence of Candida spp. biofilms as well as to monitor antifungal resistance trends in order to preserve public health resources and ultimately reduce mortality among patients.
In the last decade, Candida spp., a constituent microorganism of the human body's commensal flora, has been experiencing an increase in its prevalence due to its ability of becoming an opportunistic fungus in the human body. Given Candida spp. capacity to adhere and colonize surfaces, the majority of infections are created in the form of biofilms. Biofilms, in general, are responsible for 80% of infections caused by microbial agents with Candida spp. being one of the most prominent microorganisms. With the rising rates of morbidity and mortality and the increasing costs associated with the development and treatment of Candida biofilm infections, it is essential to deepen the understanding of biofilm formation mechanisms and develop new therapeutic strategies. The most commonly used antifungals in the treatment of Candidiasis associated with biofilm formation belong to the classes of azoles, polyenes, and echinocandins. However, these classes are responsible for many adverse effects and the development of resistance. A new class, triterpenoids, has emerged in recent years, with better bioavailability, fewer adverse effects, and less resistance development. It has been approved for the treatment of vulvovaginal candidiasis. However, further studies are needed to fill the gaps in our understanding of the incidence of Candida spp. biofilms as well as to monitor antifungal resistance trends in order to preserve public health resources and ultimately reduce mortality among patients.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Biofilme Candida spp. Fatores de virulência Resistência e terapêutica antifúngica