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Abstract(s)
O presente relatório de estágio insere-se na unidade curricular “Estágio” do Mestrado
Integrado em Ciências Farmacêuticas da Universidade da Beira Interior. Encontra-se
estruturado em três capítulos, que descrevem a experiência profissionalizante nas áreas
de investigação, farmácia hospitalar e farmácia comunitária, respetivamente.
O primeiro capítulo, correspondente à vertente de investigação, descreve o trabalho de
investigação efetuado no Centro de Investigação em Ciências da Saúde da Universidade
da Beira Interior, intitulado “Caracterização fenotípica de estirpes de Candida spp.
isolados em amostras do trato urinário.”
O género Candida spp. é dos mais importantes patógenos oportunistas, sendo a principal
causa de infeção fúngica em imunodeprimidos. Normalmente, coloniza a pele, unhas, o
trato gastrointestinal e urogenital. Esta colonização pode levar a uma infeção na presença
de um decréscimo das defesas do hospedeiro. O estudo realizado teve como objetivo a
caracterização dos isolados clínicos do trato urinário, através da avaliação da prevalência
das espécies, determinação da suscetibilidade ao clotrimazol e da capacidade de
formação de biofilmes. Para isso, foram isoladas as estirpes dos serviços de
internamento, urgência e consulta externa, dos utentes que realizaram uroculturas no
CHUCB, entre dezembro de 2021 e julho de 2022. Para a identificação das espécies
utilizaram-se meios seletivos (C. albicans) e análise automatizada dos perfis bioquímicos
(não-C. albicans). A concentração inibitória mínima para o clotrimazol foi determinada
recorrendo ao método de microdiluição em caldo. A formação de biofilmes foi aferida
através do método colorimétrico de biomassa total de biofilmes simples. Foi obtida, num
total de 36 amostras, a seguinte distribuição: 27 C. albicans, 4 C. glabrata, 2 C.
parapsilosis, 1 C. guilliermondii, 1 C. ciferri, 1 C. magnoliae. A maioria dos isolados
foram recolhidos de utentes do sexo feminino (52,78%) e de origem do serviço de
internamento (63,89%). Concluiu-se que todas as estirpes foram suscetíveis ao
clotrimazol (CMI50<1 mg/L). Todas as estirpes testadas foram capazes de produzir
biofilme, tendo a estirpe C. albicans testada demonstrado uma menor biomassa total
comparativamente às restantes espécies. Assim, conclui-se que as estirpes isoladas do
trato urinário demonstram ter suscetibilidade antifúngica, mas uma grande capacidade
de formação de biofilme. Com este estudo aferiu-se que a possibilidade de profilaxia com
clotrimazol em populações de risco poderá ser uma estratégia para o controlo da infeção. O segundo capítulo remete para as competências e conhecimentos adquiridos no estágio
curricular em Farmácia Hospitalar, realizado no Centro Hospitalar Universitário Cova
da Beira (CHUCB), na Covilhã, que teve início a 6 de outubro e término a 25 novembro
de 2022, sob a orientação da diretora dos Serviços Farmacêuticos, Drª. Olímpia Fonseca.
O terceiro e último capítulo descreve as competências e conhecimentos adquiridos
durante o estágio curricular em Farmácia Comunitária, realizado na farmácia Sant’Ana,
na Covilhã, entre 28 de novembro de 2022 a 17 de fevereiro de 2023, sob orientação da
diretora técnica, Drª. Paula Bártolo.
The present internship report is part of the “Internship” curriculum unit of the Integrated Master’s Degree in Pharmaceutical Sciences at the University of Beira Interior. It’s structured in three chapters, that describes the professional experience in the areas of research, hospital pharmacy and community pharmacy, respectively. The first chapter, corresponding to the investigation, describes the research done at the Health Sciences Research Centre of University of Beira Interior, entitled “Phenotypic Characterization of Candida spp. isolated from urinary tract samples.” Candida spp. is one of the most important opportunistic pathogens, being the main cause of fungal infection in immunocompromised patients. It can normally colonize the skin and nails, the gastrointestinal and the genitourinary tract. This can cause selfinfection when there is a decrease in the host’s defenses. The aim of this study was to determine the characteristics of Candida spp isolated from urocultures, through assessment of the prevalence of species, determination of susceptibility to clotrimazole and the ability to form biofilms. For that, Candida spp. were isolated, from consultation, internment, and urgency patients at Centro Hospitalar Universitário Cova da Beira who underwent urocultures, from December 2021 to June 2022. Species identification was performed by isolation on selective medium (C. albicans) and automated analysis of biochemical profiles (non-C. albicans). Susceptibility to clotrimazole was assessed by broth microdilution test. Biofilm formation was evaluated by the biomass biofilm formation test. A total of 36 Candida spp. isolates were collected, of which 27 were C. albicans, 4 were C. glabrata, 2 were C. parapsilosis, 1 was C. guilliermondii, 1 was C. ciferri and 1 was C. magnoliae. Most of the isolates were collected from women (52,78%) and from hospitalized patients (internment origin, 63,89%). In addition, we found that all the strains were susceptible to clotrimazole (MIC50<1 mg/L). All strains tested were capable of producing biofilm, with C. albicans demonstrating a lower total biomass compared to other species. Thus it is concluded that strains isolated from the urinary tract demonstrate antifungal susceptibility but a great capacity for biofilm formation. This study demonstrated that the possibility of prophylaxis with clotrimazole in at-risk populations could be a strategy for infection control. The second chapter refers to the skills and knowledge acquired in the curricular internship in Hospital Pharmacy, carried out at the Centro Hospitalar Universitário Cova da Beira (CHUCB), in Covilhã, which began on the 6th october and ended on 25th November of 2022, supervised by the director of the pharmaceutical services, Drª Olímpia Fonseca. The third and last chapter describes the skills and knowledge acquired in the curricular internship in Community Pharmacy, carried out in the Farmácia Sant’Ana, in Covilhã, from november 28th of 2022 to february 17th of 2023, supervised by the technical director, Drª. Paula Bártolo.
The present internship report is part of the “Internship” curriculum unit of the Integrated Master’s Degree in Pharmaceutical Sciences at the University of Beira Interior. It’s structured in three chapters, that describes the professional experience in the areas of research, hospital pharmacy and community pharmacy, respectively. The first chapter, corresponding to the investigation, describes the research done at the Health Sciences Research Centre of University of Beira Interior, entitled “Phenotypic Characterization of Candida spp. isolated from urinary tract samples.” Candida spp. is one of the most important opportunistic pathogens, being the main cause of fungal infection in immunocompromised patients. It can normally colonize the skin and nails, the gastrointestinal and the genitourinary tract. This can cause selfinfection when there is a decrease in the host’s defenses. The aim of this study was to determine the characteristics of Candida spp isolated from urocultures, through assessment of the prevalence of species, determination of susceptibility to clotrimazole and the ability to form biofilms. For that, Candida spp. were isolated, from consultation, internment, and urgency patients at Centro Hospitalar Universitário Cova da Beira who underwent urocultures, from December 2021 to June 2022. Species identification was performed by isolation on selective medium (C. albicans) and automated analysis of biochemical profiles (non-C. albicans). Susceptibility to clotrimazole was assessed by broth microdilution test. Biofilm formation was evaluated by the biomass biofilm formation test. A total of 36 Candida spp. isolates were collected, of which 27 were C. albicans, 4 were C. glabrata, 2 were C. parapsilosis, 1 was C. guilliermondii, 1 was C. ciferri and 1 was C. magnoliae. Most of the isolates were collected from women (52,78%) and from hospitalized patients (internment origin, 63,89%). In addition, we found that all the strains were susceptible to clotrimazole (MIC50<1 mg/L). All strains tested were capable of producing biofilm, with C. albicans demonstrating a lower total biomass compared to other species. Thus it is concluded that strains isolated from the urinary tract demonstrate antifungal susceptibility but a great capacity for biofilm formation. This study demonstrated that the possibility of prophylaxis with clotrimazole in at-risk populations could be a strategy for infection control. The second chapter refers to the skills and knowledge acquired in the curricular internship in Hospital Pharmacy, carried out at the Centro Hospitalar Universitário Cova da Beira (CHUCB), in Covilhã, which began on the 6th october and ended on 25th November of 2022, supervised by the director of the pharmaceutical services, Drª Olímpia Fonseca. The third and last chapter describes the skills and knowledge acquired in the curricular internship in Community Pharmacy, carried out in the Farmácia Sant’Ana, in Covilhã, from november 28th of 2022 to february 17th of 2023, supervised by the technical director, Drª. Paula Bártolo.
Description
Keywords
Biofilme Candida Spp Candidose Clotrimazol Farmácia Comunitária Farmácia Hospitalar Suscetibilidade Urocultura