Investigation of Antifungal Susceptibility Profile in Fungi Isolated from Patients with Chronic Wounds: A Focus on Venous Ulcers
Marcos Ereno Auler *
Mycology Laboratory, School of Pharmacy, Midwestern Paraná State University, UNICENTRO/PR, Brazil.
Marcella Bordinhão Batista Stricker
Mycology Laboratory, School of Pharmacy, Midwestern Paraná State University, UNICENTRO/PR, Brazil.
Rubiana Mara Mainardes
School of Pharmacy, Midwestern Paraná State University, UNICENTRO/PR, Brazil.
Camila Freitas de Oliveira
School of Pharmacy, Midwestern Paraná State University, UNICENTRO/PR, Brazil.
Luciana da Silva Ruiz
Center for Biomedical Sciences, Adolfo Lutz Institute, CLR II Bauru/SP, Brazil.
Rinaldo Ferreira Gandra
University Hospital of West Paraná, University State of Western Paraná/UNIOESTE, Cascavel/PR, Brazil.
Carine Teles Sangaleti Miyahara
School of Nursing, Midwestern Paraná State University, UNICENTRO/PR, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background: The complexity and challenges in managing patients with chronic wounds, combined with high morbidity rates, make this condition a significant public health issue. The polymicrobial presence of microorganisms, particularly fungi, in these wounds poses a major challenge for understanding the infectious process and defining therapeutic approaches.
Aims: This study investigated, over the course of one year, the presence of fungi in 30 clinical samples collected from 10 patients with chronic wounds caused by venous ulcers and characterized the susceptibility profile to the antifungal agents amphotericin B and fluconazole using the microdilution method following the EUCAST protocol.
Results: We observed that 30% of the patients had positive fungal cultures, with Candida tropicalis (67%) being the most frequently isolated species, followed by Candida guilliermondii (33%). The highest minimum inhibitory concentration (MIC) values for fluconazole were observed in Candida guilliermondii (4 mg/L), while for amphotericin B (0.5 mg/L), MIC values did not differ significantly between the isolated species.
Conclusion: Our findings indicate that fungi can be present in chronic venous ulcer wounds and may impair the healing process. We demonstrated the persistent presence of yeasts in 30% patients with chronic wounds caused by venous ulcers, suggesting that they may negatively impact the healing process. Performing microbiological laboratory tests and monitoring antifungal susceptibility profiles are important for implementing appropriate therapeutic strategies and aiding in the clinical management of these patients.
Keywords: Chronic wounds, venous ulcer, antifungal susceptibility, minimum inhibitory concentration (MIC)