Abstract
The aim of the present study was to investigate antifungal susceptibility of Candida strains isolated from blood cultures in our tertiary hospital. Patients hospitalized between December 2008 and April 2011 whose more than one blood cultures revealed growth of Candida species and Candida strains isolated in these cultures were included in the study. In order to identify isolated yeast species, appearance and configuration of the colonies, germ tube test results and their morphological appearance in corn flour Tween 80 agar were evaluated. Within the study period, among 65 Candida strains isolated, 36 (55.4%) Candida parapsilosis, 17 (26.2%) Candida albicans, 6 (9.2%) Candida glabrata, 4 (6.2%) Candida tropicalis, and 2 (3.1%) Candida lusitaniae isolates were identified. According to Fungifast susceptibility panel, antifungal susceptibility rates were as follows: amphotericin B and flucytosine (100%) fluconazole (93.8%), itraconazole (87.6%) and voriconazole (96.9%). Antifungal susceptibility rates of Candida isolates based on E-test method were as follows: amphotericin B (100%), voriconazole (92.3 %) itraconazole (53.8%) and fluconazole (89.2%). In consideration of higher morbidity, mortality and economic burden of the cases with fungemia, measures against emergence of these infections convey crucial importance. Typing of fungi isolated from intensive care units in particular, and their antifungal susceptibility tests should be done regularly to reveal resistance patterns of pathogens, and any increase in resistance (if any) over time, must be determined with scientific methods. We think that similar studies will guide the clinician in planning treatment of Candida infections especially in patients at risk. Key words: Candidemia, candida, in vitro, microbial sensitivity tests.
Highlights
Hematologic infections due to Candida species in the world are becoming increasingly important
Patients hospitalized between December 2008 and April 2011 whose more than one blood cultures revealed growth of Candida species and Candida strains isolated in these cultures were included in the study
The incidence of nosocomial Candida infections increased due to increasing number of patients receiving chemotherapy and other immunosuppressive therapies, innovations in transplantation surgery, use of broad-spectrum antibiotics, higher number of patients hospitalized in the intensive care units and invasive procedures performed on patients (Lunel et al.,1999; Cheng et al.,2004)
Summary
Hematologic infections due to Candida species in the world are becoming increasingly important. In the United States, Candida spp. yeasts ranked fourth among the most frequently isolated microorganisms from blood cultures (Martin et al, 2005). The incidence of nosocomial Candida infections increased due to increasing number of patients receiving chemotherapy and other immunosuppressive therapies, innovations in transplantation surgery, use of broad-spectrum antibiotics, higher number of patients hospitalized in the intensive care units and invasive procedures performed on patients (Lunel et al.,1999; Cheng et al.,2004). Due to differences in antifungal use and infection control strategies, distribution and antifungal susceptibility of Candida spp. differ between countries and hospitals (Pfaller et al, 2003; Dimopoulos et al, 2008). Antifungal susceptibility tests guide the antifungal therapy during episodes of fungemia
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