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Etiologia das infeções fúngicas invasivas e subcutâneas: análise dos dados da Rede Nacional de Vigilância Laboratorial das Infeções Fúngicas Invasivas e Subcutâneas (IFIs), 2013-2018
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Orientador(es)
Resumo(s)
A epidemiologia das infeções fúngicas invasivas tem vindo a alterar-se com
o surgimento de novos agentes etiológicos. A Rede Nacional de Vigilância
Laboratorial de Infeções Fúngicas Invasivas e Subcutâneas (IFI) teve início
em 2013 com o objetivo de melhor compreender a epidemiologia destas
infeções em Portugal. O objetivo deste estudo é analisar os dados obtidos
através da Rede entre junho de 2013 e setembro de 2018. Os laboratórios
participantes asseguram a comunicação dos casos de IFIs ao Laboratório
Nacional de Referência do INSA, enviando amostras biológicas ou isolados, acompanhados de um inquérito contendo informações demográficas,
laboratoriais e avaliações clínicas dos doentes com suspeita de infeção
fúngica. O estudo incluiu: i) casos de infeção fúngica invasiva (IFI) por
fungos filamentosos/dimórficos, ii) casos de IFI provável, de acordo com
os critérios estabelecidos pelo EORTC/MSG 2008, e iii) casos de infeções
fúngicas subcutâneas. As infeções por leveduras não foram incluídas. Entre
junho de 2013 e setembro de 2018, foram incluídos 52 casos, distribuídos
da seguinte forma: IFI comprovada (por fungos filamentosos) (n=9); Infeção
fúngica subcutânea (n=17); Infeção por fungos dimórficos endémicos (n=9),
totalizando 67% de casos de IFI comprovados (n=35) e 33% de casos IFI
provável (n=17). Os dados obtidos chamam a atenção para a grande diversidade de espécies envolvidas em infeções fúngicas profundas, com implicações para o diagnóstico clínico/laboratorial bem como para o tratamento
destas infeções
The epidemiology of deep fungal infections has been changing with the emergence of new species as etiological agents. The National Laboratory Surveillance Network for Invasive and Subcutaneous Fungal Infections (IFIs) began in 2013 with the aim of better understanding the epidemiology of invasive and subcutaneous fungal infections in Portugal. The goal of this study is to analyse the data obtained from this Network between June 2013 and September 2018. The participating laboratories ensured the reporting of suspected or confirmed IFIs cases to the National Reference Laboratory of INSA, by sending biological samples or isolates, accompanied by a survey containing demographic information, laboratory and clinical evaluation of patients with suspicion of having an IFIs. The study included: i) cases of invasive fungal infection (IFI) caused by filamentous/dimorphic fungi, ii) cases of probable IFI, according to the criteria established by EORTC/MSG 2008, and iii) cases of subcutaneous fungal infections. Yeast infections were not included. Between June 2013 and September 2018, 52 cases were included. The cases were distributed as follows: Proven IFI (by filamentous fungi) (n=9); Subcutaneous fungal infection (n=17); Infection due to endemic dimorphic fungi (n=9), totalizing 67% of proven IFI cases (n=35) and 33% of probable IFI cases (n=17). The obtained data raise the awareness to the great diversity of species involved in deep fungal infections, with implications to the clinical/laboratory diagnosis of these infections as well as their treatment.
The epidemiology of deep fungal infections has been changing with the emergence of new species as etiological agents. The National Laboratory Surveillance Network for Invasive and Subcutaneous Fungal Infections (IFIs) began in 2013 with the aim of better understanding the epidemiology of invasive and subcutaneous fungal infections in Portugal. The goal of this study is to analyse the data obtained from this Network between June 2013 and September 2018. The participating laboratories ensured the reporting of suspected or confirmed IFIs cases to the National Reference Laboratory of INSA, by sending biological samples or isolates, accompanied by a survey containing demographic information, laboratory and clinical evaluation of patients with suspicion of having an IFIs. The study included: i) cases of invasive fungal infection (IFI) caused by filamentous/dimorphic fungi, ii) cases of probable IFI, according to the criteria established by EORTC/MSG 2008, and iii) cases of subcutaneous fungal infections. Yeast infections were not included. Between June 2013 and September 2018, 52 cases were included. The cases were distributed as follows: Proven IFI (by filamentous fungi) (n=9); Subcutaneous fungal infection (n=17); Infection due to endemic dimorphic fungi (n=9), totalizing 67% of proven IFI cases (n=35) and 33% of probable IFI cases (n=17). The obtained data raise the awareness to the great diversity of species involved in deep fungal infections, with implications to the clinical/laboratory diagnosis of these infections as well as their treatment.
Descrição
Palavras-chave
Infeções Fúngicas Invasivas e Subcutâneas Etiologia Rede Nacional de Vigilância Laboratorial das Infeções Fúngicas Invasivas e Subcutâneas Infecções Sistémicas e Zoonoses
Contexto Educativo
Citação
Boletim Epidemiológico Observações. 2019 janeiro-abril;8(24):39-44
Editora
Instituto Nacional de Saúde Doutor Ricardo Jorge, IP