Iatta R, Caggiano G, Cuna T, Montagna M T
Department of Biomedical Science and Human Oncology, Section of Hygiene - Aldo Moro, University of Bari, Italy.
J Chemother. 2011 Apr;23(2):92-6. doi: 10.1179/joc.2011.23.2.92.
Nosocomial yeast infections have increased significantly worldwide and especially in surgical and intensive care unit (ICU) patients. Although Candida species have various degrees of susceptibility to frequently used drugs, antifungal resistance is rare. A ten-year retrospective surveillance of candidemia was carried out in a University Hospital of Southern Italy. The aim of this study was the determination of Candida bloodstream infections (BSI) and central venous catheter (CVC)- related episodes, prevalence and in vitro susceptibility. 320 candidemia episodes were registered and 374 yeasts collected. Etest and Sensititre methods were used to test the isolates' susceptibility to amphotericin B, anidulafungin, caspofungin, fluconazole, itraconazole, posaconazole and voriconazole. The results were compared with those of CLSI reference broth microdilution method. Most yeasts were susceptible to all antifungal drugs, with the exception of C. Glabrata susceptibility to triazoles and C. tropicalis to fluconazole and voriconazole. As expected, C. parapsilosis isolates were generally associated with higher echinocandin minimum inhibitory concentrations (miCs) than the other Candida species. This study confirms the different antifungal susceptibility patterns among species, and underlines the need to perform antifungal susceptibility testing of clinically relevant yeasts.
医院获得性酵母菌感染在全球范围内显著增加,尤其是在外科和重症监护病房(ICU)患者中。尽管念珠菌属对常用药物有不同程度的敏感性,但抗真菌耐药性很少见。在意大利南部的一家大学医院对念珠菌血症进行了为期十年的回顾性监测。本研究的目的是确定念珠菌血流感染(BSI)和中心静脉导管(CVC)相关事件、患病率及体外药敏情况。记录了320例念珠菌血症事件并收集了374株酵母菌。采用Etest和Sensititre方法检测分离株对两性霉素B、阿尼芬净、卡泊芬净、氟康唑、伊曲康唑、泊沙康唑和伏立康唑的敏感性。将结果与CLSI参考肉汤微量稀释法的结果进行比较。大多数酵母菌对所有抗真菌药物敏感,但光滑念珠菌对三唑类药物不敏感,热带念珠菌对氟康唑和伏立康唑不敏感。正如预期的那样,近平滑念珠菌分离株通常比其他念珠菌属具有更高的棘白菌素最低抑菌浓度(miCs)。本研究证实了不同菌种之间抗真菌药敏模式的差异,并强调了对临床相关酵母菌进行抗真菌药敏试验的必要性。