R Yashavanth, M P Shiju, U A Bhaskar, R Ronald, K B Anita
Associate Professor, Department of Microbiology, AJ Institute of Medical Sciences , Mangalore, India .
Microbiologist, Columbia Asia, Referral Hospital , Bangalore, India .
J Clin Diagn Res. 2013 Nov;7(11):2459-61. doi: 10.7860/JCDR/2013/6298.3578. Epub 2013 Nov 10.
The incidence of Candida has been on rise worldwide. Urinary tract infections (UTIs) as a result of Candida species are becoming, common in hospitalised patients. Clinicians face dilemma in differentiating colonization from true candiduria. The species identification of Candida is important, as non albicans Candida species are increasing in number and more resistant to antifungal drugs. The aim of the study was to find out the frequency of Candida among uropathogens, their speciation and to determine the susceptibilities to antifungal drugs of Candida species isolated from candiduria.
A total of 2900 urine samples were analysed in a tertiary care hospital. Candida species isolated from urine samples were subjected to speciation using CHROM agar and standard yeast identification protocol. Antifungal susceptibility testing for fluconazole, voriconazole, flucytosine, amphotericin B was carried out using VITEK-2 compact system of Biomerieux.
A total of 66(2.27%) Candida species were isolated from 2900 urine samples. Among them non albicans Candida species were predominant (69.7%) compared to Candida albicans (30.3%). The Candida isolated were more susceptible to amphotericin B (91%) and flucytosine (82%) compared to voriconazole (72.72%) and fluconazole (66.66%).
The present study reiterates the prevalence of Candida species among UTIs and their antifungal susceptibility pattern. Prevalence of non albicans Candida was more than Candida albicans. Non albicans Candida species are more resistant to antifungal drugs compared to C.albicans. Therefore, the species identification of Candida isolates along with their antifungal susceptibility pattern can help the clinicians in better treating the patients with candiduria.
念珠菌的发病率在全球范围内呈上升趋势。念珠菌属引起的尿路感染在住院患者中日益常见。临床医生在区分定植与真正的念珠菌尿方面面临困境。念珠菌的菌种鉴定很重要,因为非白色念珠菌的数量在增加,且对抗真菌药物的耐药性更强。本研究的目的是找出尿路病原体中念珠菌的频率、它们的种类,并确定从念珠菌尿中分离出的念珠菌属对抗真菌药物的敏感性。
在一家三级护理医院共分析了2900份尿液样本。从尿液样本中分离出的念珠菌属使用CHROM琼脂和标准酵母鉴定方案进行菌种鉴定。使用生物梅里埃公司的VITEK-2紧凑型系统对氟康唑、伏立康唑、氟胞嘧啶、两性霉素B进行抗真菌药敏试验。
从2900份尿液样本中总共分离出66株(2.27%)念珠菌属。其中,非白色念珠菌占主导(69.7%),而白色念珠菌占30.3%。与伏立康唑(72.72%)和氟康唑(66.66%)相比,分离出的念珠菌对两性霉素B(91%)和氟胞嘧啶(82%)更敏感。
本研究重申了念珠菌属在尿路感染中的流行情况及其抗真菌药敏模式。非白色念珠菌的流行率高于白色念珠菌。与白色念珠菌相比,非白色念珠菌对抗真菌药物的耐药性更强。因此,念珠菌分离株的菌种鉴定及其抗真菌药敏模式有助于临床医生更好地治疗念珠菌尿患者。