Laboratório de Microbiologia Aplicada, Faculdade de Ciências Biológicas e Ambientais, Universidade Federal da Grande Dourados, Dourados, MS, Brazil.
Rev Soc Bras Med Trop. 2013 May-Jun;46(3):335-9. doi: 10.1590/0037-8682-0074-2012.
Hospital infections caused by Candida spp. are a leading cause of morbidity and mortality in hospitalized patients, particularly those that are critically ill or immunocompromised. In this study, the distribution of Candida species in isolates from the University Hospital of the Federal University at Grande Dourados and their in vitro susceptibility to antifungal drugs were analyzed.
Yeasts were phenotypically identified using classical methodologies. Antifungal susceptibility tests to amphotericin B and fluconazole were performed using the broth microdilution technique.
A total of 50 Candida isolates were obtained from hospitalized patients during the study period. We analyzed yeast isolates from urine (n=31; 62%), blood (n=12; 24%), and tracheal secretions (n=7; 14%). The following Candida species were identified: C. tropicalis (n=21; 42%), C. albicans (n=18; 36%), C. glabrata (n=10; 20%), and C. krusei (n=1; 2%). Antifungal susceptibility tests demonstrated that C. albicans was susceptible to both antifungal agents. However, 31.2% of the non-C. albicans Candida isolates displayed dose-dependent susceptibility to fluconazole, and 3.1% were resistant to amphotericin B.
In contrast to previous reports, our results indicated that C. tropicalis was the most commonly isolated yeast species among the hospital patients. The predominance of non-C. albicans Candida infections confirms the importance of species-level identification for implementing appropriate antifungal therapies.
念珠菌属引起的医院感染是住院患者发病率和死亡率的主要原因,尤其是那些重病或免疫功能低下的患者。本研究分析了大若热里奥联邦大学医院分离株中念珠菌属的分布及其对抗真菌药物的体外敏感性。
采用经典方法对酵母进行表型鉴定。采用肉汤微量稀释法测定两性霉素 B 和氟康唑的抗真菌药敏试验。
在研究期间,从住院患者中获得了 50 株念珠菌分离株。我们分析了来自尿液(n=31;62%)、血液(n=12;24%)和气管分泌物(n=7;14%)的酵母分离株。鉴定出以下念珠菌属:热带念珠菌(n=21;42%)、白念珠菌(n=18;36%)、光滑念珠菌(n=10;20%)和克柔念珠菌(n=1;2%)。抗真菌药敏试验表明,白念珠菌对两种抗真菌药物均敏感。然而,31.2%的非白念珠菌属念珠菌对氟康唑显示出剂量依赖性敏感性,3.1%对两性霉素 B 耐药。
与之前的报告不同,我们的结果表明,热带念珠菌是医院患者中最常分离到的酵母种。非白念珠菌属念珠菌感染的流行证实了进行适当的抗真菌治疗时进行种水平鉴定的重要性。