Razzaghi-Abyaneh M, Sadeghi G, Zeinali E, Alirezaee M, Shams-Ghahfarokhi M, Amani A, Mirahmadi R, Tolouei R
Department of Medical Mycology, Pasteur Institute of Iran, 13164 Tehran, Iran.
Department of Medical Mycology, Pasteur Institute of Iran, 13164 Tehran, Iran.
J Mycol Med. 2014 Jun;24(2):e43-50. doi: 10.1016/j.mycmed.2014.01.004. Epub 2014 Apr 21.
Candidiasis is the most prevalent fungal infection affecting human and animals all over the world. This study represents the epidemiological aspects of superficial candidiasis in outpatients and in vitro antifungal susceptibility of etiologic Candida species.
Clinical samples were taken from 173 patients including skin and nail scrapings (107; 61.8%), vaginal discharge (28; 16.2%), sputum (20; 11.6%), oral swabs (7; 4.0%), bronchoalveolar lavage (6; 3.5%) and 1 specimen (0.6%) of each eye tumor, gastric juice, urine, biopsy and urinary catheter and confirmed as candidiasis by direct microscopy, culture and histopathology. Susceptibility patterns of the isolated Candida species were determined using the disk diffusion and broth microdilution methods.
Among 173 Candida isolates, C. albicans (72.3%) was the most prevalent species followed by C. parapsilosis (11.5%). Other identified species were C. glabrata, C. krusei, C. tropicalis, C. guilliermondii, C. intermedia and C. sake. Majority of the Candida isolates were susceptible to fluconazole (95.4%) followed by 5-flucytosine (89.6%), voriconazole (78.6%) itraconazole (48.0%) and ketoconazole (42.8%). Caspofungin was the most potent antifungal drug against C. albicans (MICs; 0.062-1 μg/mL), ketoconazole for C. parapsilosis and C. tropicalis (MICs; 0.031-0.25 μg/mL) and itraconazole for C. krusei, C. glabrata and C. guilliermondii (MICs; 0.031-1 μg/mL).
This study reinforces the significance of superficial candidiasis as an important fungal infection with multiple clinical presentations. Our results further indicate that susceptibility testing to commonly used antifungals is crucial in order to select the appropriate therapeutic strategies which minimize complications while improving patients' life.
念珠菌病是全球影响人类和动物的最普遍真菌感染。本研究阐述了门诊患者浅表念珠菌病的流行病学情况以及致病念珠菌属的体外抗真菌药敏性。
从173例患者采集临床样本，包括皮肤和指甲刮屑（107例；61.8%）、阴道分泌物（28例；16.2%）、痰液（20例；11.6%）、口腔拭子（7例；4.0%）、支气管肺泡灌洗样本（6例；3.5%）以及各1份眼肿瘤、胃液、尿液、活检组织和导尿管样本（0.6%），通过直接显微镜检查、培养和组织病理学确诊为念珠菌病。采用纸片扩散法和肉汤微量稀释法测定分离出的念珠菌属的药敏模式。
在173株念珠菌分离株中，白色念珠菌（72.3%）是最常见的菌种，其次是近平滑念珠菌（11.5%）。其他鉴定出的菌种有光滑念珠菌、克柔念珠菌、热带念珠菌、季也蒙念珠菌、中间念珠菌和清酒念珠菌。大多数念珠菌分离株对氟康唑敏感（95.4%），其次是5-氟胞嘧啶（89.6%）、伏立康唑（78.6%）、伊曲康唑（48.0%）和酮康唑（42.8%）。卡泊芬净是对白色念珠菌最有效的抗真菌药物（MIC值；0.062 - 1μg/mL），酮康唑对近平滑念珠菌和热带念珠菌有效（MIC值；0.031 - 0.25μg/mL），伊曲康唑对克柔念珠菌、光滑念珠菌和季也蒙念珠菌有效（MIC值；0.031 - 1μg/mL）。
本研究强化了浅表念珠菌病作为一种具有多种临床表现的重要真菌感染的重要性。我们的结果进一步表明，对常用抗真菌药物进行药敏试验对于选择合适的治疗策略至关重要，这可以在改善患者生活的同时尽量减少并发症。
