Abstract
Background: Candida species are among the most common fungal pathogens in ICU patients. Candida albicans was the predominant species, but a shift toward non-albicans Candida species has been recently observed. Objectives: To detect the prevalence of different Candida species and determine their antifungal susceptibility profile in ICU patients using phenotypic methods, the Vitek 2 system compared with CHROMagar Candida agar and a genotypic method; PCR-RFLP. Methodology: Various clinical samples were collected from 248 ICU patients in Sohag University Hospital from the period between September 2014 and May 2015. Samples were cultured on CHROMagar Candida agar. Results were compared with those of Vitek 2 system and confirmed by PCR- RFLP method and antifungal susceptibility profiles were analyzed by disc diffusion and Vitek 2 antifungal susceptibility tests. Results: The study revealed an overall isolation rate of Candida species among ICU patients was 29 % by PCR-RFLP. Candida albicans was the most frequent species isolated (40.3%). Non- albicans Candida species including Candida tropicalis (22.2%), Candida glabrata (18%), Candida krusei (12.5%), C. parapsilosis (4.2%), C. dubliniensis (1.4%) and Candida guilliermondii (1.4%) were also isolated. The sensitivity of vitek 2 with regard to correct identification of Candida species was 96%; the specificity was 100 % , also CHROMagar Candida agar enable the correct identification with sensitivity 89% , specificity 100 %. Vitek 2 antifungal susceptibility tests results were found to be an accurate method as it was compared with the disc diffusion method for fluconazole, voriconazole and amphotracin B. Conclusion : CHROMagar Candida agar supported by Vitek 2 system is a valuable method for identification of common Candida species, these methods are easy to interpret and give rapid results in comparison with the expensive PCR-RFLP method. Although amphotericin B and fluconazole are widely used in clinical practice, there was no evidence of enhanced resistance. Moreover, voriconazole could be used in treatment of fluconazole-resistant Candida species.
Published Version
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