Abstract
INTRODUCTION: Systemic mycoses represent a major global challenge and are still a neglected topic by public health authorities. It is estimated that more than 300 million people worldwide suffer from yeast infections each year with an estimated 1.0 to 2.0 million deaths. It is known that the delay in the diagnosis of systemic mycoses makes it impossible to start immediate antifungal therapy, which can lead to death or their worsening. Mycological diagnosis is usually based on the identification of fungi through observation of their morphological characteristics, isolated from the cultivated clinical material. However, when it comes to blood samples, automated blood culture systems are used. OBJECTIVE: This study aimed to evaluate the epidemiological profile of fungi isolated from blood samples cultivated in an automated blood culture system and in the usual means of classical mycology. METHODOLOGY: Blood samples from 596 patients admitted to Hospital Eduardo de Menezes, Minas Gerais, from March 2017 to December 2019, were inoculated paired in Sabouraud agar and Mycosel agar media and in the aerobic flask of the BacT/ALERT® system. RESULTS: Candida spp. 0.3% (2/596, 95% CI 0.09 - 1.22) Cryptococcus spp. 0.8% (5/596, 95% CI 0.36 - 1.95) and Sporothrix spp. 0.2% (1/596, 95% CI 0.03 - 0.94) were the fungi isolated in the automated blood culture. On the other hand, we recovered Cryptococcus spp. 1.0% (6/596, 95% CI 0.46 - 2.18), Histoplasma spp. 3.0% (18/596, 95% CI 1.92 - 4.72), Paracoccidioides spp. 0.5% (3/596, 95% CI 0.17 - 1.47) and Sporothrix spp. 0.2% (1/596, 95% CI 0.03 - 0.94) in classical mycological cultures. CONCLUSION: Fungi showed remarkable variability between genera in the preference of the methodologies used. In practice, we can conclude that the methodologies complement each other and, thus, the simultaneous application of automated blood cultures and mycological cultures in Sabouraud and Mycosel offer the possibility of detecting a greater diversity of fungal agents and improves the sensitivity of the diagnosis.
Keywords: systemic mycoses, mycological diagnosis, automated blood culture.