The aim of this study was to evaluate the enteroparasite and commensal occurrence in inhabitants living in the city of Abadia dos Dourados, Minas Gerais, Brazil. Three hundred and seventy six people were selected at random, 188 living in the rural area and 188 living in the urban area, from January through December of 1996. Using the Lutz method 177 (47.1%) individuals infected: 102 (57.6%) in the rural population and 75 (39.9%) in the urban population (P < 0.05). Of the total 177 enteroparasite and commensal occurrences diagnosed were: Entamoeba coli (18.3%), hookworm (17.8%), Endolimax nana (6.1 %>), Giardia lamblia (5.8%), Ascaris lumbricoides (2.6%>), Entamoeba hartmanni (2.1%), Iodamoeba biltschlii (1.6%), Strongyloides ster cor alls (1.3%), Enterobius vermicularis (0.5%), and Trichostrongylus sp (0.5%). Geohelminths were predominant in the rural area, with an occurrence ofhookworm infections at 28.2% in these individuals and 7.4% in the urban people (OR: 14.33 CI: 6.230 to 32.970). The infection rate of enteroparasites was high in the population studied. In conclusion, it is necessary to implement regular parasitological exams and education about the forms and consequences of transmitting parasites, primarily among people living in the rural area.

El objetivo de este estudio fue evaluar la presencia de enteroparasitas y comensales en habitantes de la ciudad de Abadia dos Dourados, Minas Gerais, Brasil. 376 personas fueron seleccionadas aleatoriamente, 188 viviendo en el área rural y 188 viviendo en el área urbana, enero a diciembre de 1996. Usando el método de Lutz, 177 (47,1%) individuos estaban infectados, siendo 102 (57,6%) del área rural y 75 (39,9%) del área urbana (P < 0,05). Del total de 177 positivos, la ocurrencia de entoparasitas y comenzáis diagnosticadas fueron: Entamoeba coli (18,3%), hookworm (17,8%), Endolimax nana (6,1%), Giardia lamblia (5,8%), Ascaris lumbricoides (2,6%), Entamoeba hartmanni (2,1%), Iodamoeba butschlii (1,6"%), Stron-gyloides stercolaris (1,3%), Enterobius vermicularis (0,5%), y Trichostrongylus sp (0,5%), Geohelmintos fueron predominantes en el área rural, con 28,2% de infección para hookworm en esta populación y 7,4% en la populación urbana (OR: 14,33 CI: 6.230 para 32.970). La tasa de infección para enteroparasitas fue alta en los individuos estudiados, siendo necesario hacer exámenes parasitológicos regulares en estas personas y adoptar medidas profilácticas sobre las formas y consecuencias de transmisión de parásitas, principalmente entre personas que viven en el área rural.

Comparou-se a suscetibilidade de 69 amostras de C. neoformans isoladas de pacientes com SIDA com 13 amostras de C. neoformans isoladas do meio ambiente, frente a quatro agentes antifúngicos. Com base na metodologia preconizada pelo NCCLS (M27-A) as concentrações inibitórias mínimas (CIMs) obtidas para a anfotericina B, itraconazol e cetoconazol foram muito semelhantes nos dois grupos estudados. Todavia, frente ao fluconazol, os isolados clínicos evidenciaram menor sensibilidade do que os provenientes do meio ambiente. Alguns aspectos envolvendo a importância e dificuldades dos testes de suscetibilidade com Cryptococcus neoformans são também discutidos pelos autores.

The purpose of the present study was to compare the susceptibility to four antifungal agents of 69 Cryptococcus neoformans strains isolated from AIDS patients with that of 13 C. neoformans strains isolated from the environment. Based on the NCCLS M27-A methodology the Minimal Inhibitory Concentrations (MICs) obtained for amphotericin B, itraconazole and ketoconazole were very similar for clinical and environmental isolates. Clinical isolates were less susceptible to fluconazole than environmental isolates. The significance of these findings and aspects concerning the importance, role and difficulties of C. neoformans susceptibility testing are also discussed.

Relatamos um caso de meningite por Cryptococcus neoformans em paciente com Síndrome de Imunodeficiência Adquirida (SIDA). A terapia de manutenção com fluconazol não evidenciou melhora clínica e micológica, ao mesmo tempo em que o teste de suscetibilidade in vitro revelou aumento progressivo da concentração inibitória mínima (CIM). Estes resultados sugerem o desenvolvimento de resistência secundária ao fluconazol, todavia, resistência cruzada com outros derivados azólicos não foi constatada

Cryptococcus neoformans is the fifth most common opportunistic agent of infection in patients with AIDS in the USA, exceeded only by Candida species, Pneumocystis carinii, cytomegalovirus and Mycobacterium avium1, 2, 6, 10, 11. In Brazil is the sixth, exceeded by Candida species, P. carinii, Mycobacterium species, Toxoplasma gondii, and herpes simplex virus (AIDS, Boletim Epidemiológico, set/nov 96, Ministério da Saúde, Brasil). During 30 years, the treatment of C. neoformans meningitis was based on the use of amphotericin B with or without flucytosine13. Nowadays, with the immunodepression caused by human immunodeficiency virus (HIV) infection and the availability of new antifungal drugs as the triazoles, the concept related to cure and relapses of cryptococcosis has been altered7, 20. Patients are treated with amphotericin B with or without flucytosine as initial therapy, but maintenance therapy is always necessary in AIDS patients with C. neoformans infections

Relatam-se oito casos de criptococose não associada à AIDS diagnosticados em Santa Maria, RS, no período 1961-1995. É revisada a literatura sul-riograndense sobre a micose e comentada a prevalência da infecção pela var. neoformans em pacientes sem doença predisponente nas regiões subtropicais.

We report eight cases of cryptococcosis in non AIDS patientes diagnosed in Santa Maria, RS, during 1961-1995. A review of the literature is performed and the prevalence of the infection caused by var. neoformans in patients without underlying disease in subtropical regions is commented.