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Volume 4, Issue 7(Suppl) J Infect Dis Ther 2016
ISSN: 2332-0877, JIDT an open access journal
Page 27
Notes:
Skin Diseases & Microbiology 2016
October 03-05, 2016
conferenceseries.com
October 03-05, 2016 Vancouver, Canada
International Conference on
Infectious Diseases, Diagnostic Microbiology &
Dermatologists Summit on Skin Infections
Correlation between antifungals susceptibility of Cryptococcus spp. and outcome of patients with HIV/
AIDS with cryptococcal meningitis
Marcia de Souza Carvalho Melhem1, Oscar Jose Chagas 2, Renata Buccheri2, Maria Walderez Szeszs1, Marilena dos Anjos Martins1, Lidiane de Oliveira1,
Dulcilena de Matos Castro e Silva1 and Daniel Wagner de Castro Lima Santos2
1Adolfo Lutz Institute, Brazil
2Emilio Ribas Research Institute, Brazil
Cryptococcal meningitis is one of the most common opportunistic infections (OIs) in HIV patients and affects one million people
per year worldwide, resulting in 625,000 deaths. The aim of our study was to examine the association between the clinical and
laboratorial findings of cryptococcal meningitis cases with antifungal minimum inhibitory concentration (MICs) and molecular types
of the etiological agents and risk factors associated with in-hospital mortality. Data from 34 patients were reviewed, retrospectively.
Regarding the susceptibility test for fluconazole (FLU), using a cutoff of 8 μg/mL and 16 μg/mL, there were no significant differences
between clinical presentation, cytological analyses of CSF, time to sterilize the CSF, isolation of fungus at another site, molecular
type, previous diagnosis of cryptococcal meningitis or the use of FLU and overall mortality. There was a statistical association between
mortality and patients who did not have sterilized CSF (p=0.002) when lacking of neurosurgical shunt (p=0.021) and in those who
presented with other OIs (p=0.037). In addition, patients who died presented with a higher yeast count (median 1720 cells/mcL)
in the first CSF level than those who survived (median 351 cells/mcL) (p=0.021). Patients who presented with yeast cell counts
>400/mm3 were associated with greater lethality when compared with ≤400 (p=0.014). We concluded that cryptococcal meningitis
is difficult to manage and that the aspects associated with greater mortality should be analyzed carefully. The clinical role of MIC is
uncertain, and there is no good evidence for its use in routine practice.
Biography
Marcia de Souza Carvalho Melhem is a Pharmacist and has completed her MSc and PhD from Sao Paulo University in Public Health. She is a Scientific Researcher and
Master’s/Doctorate Advisor at Secretary of Health of the Government of Sao Paulo State. She has published about 60 papers in reputed journals and has been serving as
a Reviewer Member.
Marcia de Souza Carvalho Melhem et al., J Infect Dis Ther 2016, 4:7(Suppl)