Gülay Zeynep, Ergon Cem, Ozkütük Aydan, Yücesoy Mine, Biçmen Meral
Dokuz Eylül Universitesi Tip Fakültesi Hastanesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Izmir.
Mikrobiyol Bul. 2002 Jul-Oct;36(3-4):309-16.
Patients in intensive care units (ICU) are at risk of nosocomial infections. The incidence of nosocomial fungal infections has increased in parallel with the increase of nosocomial infections. Candida albicans is the most frequent pathogenic species among the fungi. The aim of this study was to make an epidemiological surveillance of C. albicans urine isolates which were isolated from patients who were hospitalized in ICU between June 2000 and October 2001 by antifungal susceptibility testing and Randomly Amplified Polymorphic DNA (RAPD) analysis. For this purpose, 38 C. albicans which were isolated from 29 patients were investigated for amphotericin B and fluconazole susceptibility with the microdilution method. The range of minimal inhibitory concentration (MIC) of amphotericin B was between 0.25-1 microgram/ml and MIC50 value was 0.5 microgram/ml and none of the isolates had high (MIC > 1 microgram/ml) MIC values. The MIC values for fluconazole varied between 0.25-16 micrograms/ml and MIC50 value was 1 microgram/ml. While none of the isolates was resistant to fluconazole, two isolates were detected as dose dependent susceptible. RAPD analysis was performed with two different primers in order to investigate clonal relationship, and 22 patterns were detected with one of the primers and 24 patterns were detected with the other. In conclusion, it is thought that the origin of the C. albicans urine isolates were mostly endogenous but exogenous spread might also be considered as isolates that were clonally related were isolated from different patients at the same time interval.
重症监护病房(ICU)的患者存在医院感染的风险。医院真菌感染的发生率随着医院感染的增加而上升。白色念珠菌是真菌中最常见的致病菌种。本研究的目的是通过抗真菌药敏试验和随机扩增多态性DNA(RAPD)分析,对2000年6月至2001年10月在ICU住院患者中分离出的白色念珠菌尿液分离株进行流行病学监测。为此,采用微量稀释法对从29例患者中分离出的38株白色念珠菌进行两性霉素B和氟康唑药敏试验。两性霉素B的最低抑菌浓度(MIC)范围为0.25 - 1微克/毫升,MIC50值为0.5微克/毫升,且没有分离株的MIC值高(MIC > 1微克/毫升)。氟康唑的MIC值在0.25 - 16微克/毫升之间,MIC50值为1微克/毫升。虽然没有分离株对氟康唑耐药,但有两株分离株被检测为剂量依赖性敏感。为了研究克隆关系,用两种不同的引物进行RAPD分析,其中一种引物检测到22种模式,另一种引物检测到24种模式。总之,认为白色念珠菌尿液分离株的来源大多是内源性的,但外源性传播也可能存在,因为在同一时间间隔内从不同患者中分离出了克隆相关的分离株。