Caracterização epidemiológica, genotípica e fenotípica da criptococose em uma unidade de referência no estado do Pará

Abstract

Cryptococcosis is a fungal infection caused by an encapsulated yeast Cryptococcus genus that affects both humans and animals, and is considered as an opportunistic infection commonly associated with immunosuppression. This is one of human fungal infections cause significant morbidity and mortality in both immunocompetent and in immunocompromised individuals and appears mainly in the form of meningoencephalitis. The aim of this study was to characterize epidemiological, genotypic and phenotypic cryptococcosis in a reference unit in the state of Pará. The target population was composed of patients treated at the University Hospital João de Barros Barreto/UFPA, January 2010 to December 2011 with laboratory confirmed diagnosis of cryptococcosis. Personal, clinical and laboratory data were collected from a review of medical records file HUJBB and the isolates were identified and characterized morphologically and biochemically. The type sexed and genotype were identified by PCR using specific primers. From January 2010 to December 2011 were identified 59 cases of cryptococcosis. Most patients were men (36/59, 61%), aged 5-70 years, mean 30.8 years. The predominant age group was 34-43 years (39% of cases). The main signs and symptoms presented by them were headache (85.5%), vomiting (80%) and fever (76.4%). All children (6/6) were HIV negative, and as the causative agent C. gattii (31.6%), while in adults 71.1% of infections were caused by C. neoformans, most HIV positive. The cases of death and recurrence were higher among patients infected with C. neoformans and the presence of sequelae was more frequent among patients infected with C. gattii. All isolates were MAT α and there was a predominance of two molecular types: VNI (64.4%) and VGII (35.6%). This study reinforces that the state of Pará is endemic to infection by Cryptococcus spp., Whose main clinical presentation, meningoencephalitis determines high rates of morbidity and mortality.