Sütçü Murat, Acar Manolya, Genç Gonca Erköse, Kökçü İlknur, Aktürk Hacer, Atay Gürkan, Törun Selda Hançerli, Salman Nuran, Erturan Zayre, Somer Ayper
Department of Pediatrics, Division of Pediatric Infectious Diseases, Istanbul University Faculty of Medicine, Istanbul, Turkey.
Department of Microbiology and Clinical Microbiology, Istanbul University Faculty fo Medicine, Istanbul, Turkey.
Turk Pediatri Ars. 2017 Sep 1;52(3):145-153. doi: 10.5152/TurkPediatriArs.2017.5291. eCollection 2017 Sep.
Non-albicans and resistant microorganisms have been more commonly isolated in invasive candidiasis in recent years. The aim of this study was to evaluate the distrubution of spp and antifungal resistance in our clinic.
Fifty-four Candida isolates and antifungal susceptibility results obtained from patients diagnosed as having invasive candidiasis between December 2012 and June 2016 were included. Clinical and laboratory data were retrospectively analyzed. E-test method was used in order to determine antifungal susceptibilities of for amphotericin B, fluconazole, voriconazole, ketoconazole, itraconazole, anidulafungin, caspofungin, and flucytosine.
The clinical diagnoses of the patients were candidemia (n=27, 50%), catheter-related blood stream infection (n=1, 1.8%), urinary tract infection (n=13, 24%), surgical site infection (n=4, 7.4%), intraabdominal infection (n=3, 5.5%), empyema (n=2, 3.7%), and pneumonia (n=4, 7.4%). The most common isolated agent was (n=27, 50%) and the others were (n=13, 24%), (n=6, 11.1%), (n=3, 5.6%), (n=2, 3.7%), and unspecified . (n=3, 5.6%). Fluconazole resistance was 7.4% among all isolates. Resistance against itraconazole, ketoconazole, anidulafungin, voriconazole and caspofungin were 33.3%, 12.5%, 11.1%, 5%, and 2.5%, respectively. Isolates presented intermediate resistance against itraconazole (41.7%), voriconazole (5.6%), and amphotericin B (3.7%) to varying extents. All of the isolates were susceptible to flucytosine.
In our clinic, and non-albicans were equally distributed and antifungal susceptibilities against major antifungal agents such as fluconazole, amphotericin B, and caspofungin were found considerably high.
近年来,非白色念珠菌和耐药微生物在侵袭性念珠菌病中分离更为常见。本研究旨在评估我院念珠菌属分布及抗真菌药物耐药情况。
纳入2012年12月至2016年6月间诊断为侵袭性念珠菌病患者的54株念珠菌分离株及抗真菌药敏结果。对临床和实验室数据进行回顾性分析。采用E-test法测定两性霉素B、氟康唑、伏立康唑、酮康唑、伊曲康唑、阿尼芬净、卡泊芬净和氟胞嘧啶对念珠菌的抗真菌药敏。
患者的临床诊断为念珠菌血症(n = 27,50%)、导管相关血流感染(n = 1,1.8%)、尿路感染(n = 13,24%)、手术部位感染(n = 4,7.4%)、腹腔内感染(n = 3,5.5%)、脓胸(n = 2,3.7%)和肺炎(n = 4,7.4%)。最常见的分离菌株是白色念珠菌(n = 27,50%),其他为光滑念珠菌(n = 13,24%)、热带念珠菌(n = 6,11.1%)、近平滑念珠菌(n = 3,5.6%)、季也蒙念珠菌(n = 2,3.7%)和未明确的念珠菌(n = 3,5.6%)。所有分离株中氟康唑耐药率为7.4%。对伊曲康唑、酮康唑、阿尼芬净、伏立康唑和卡泊芬净的耐药率分别为33.3%、12.5%、11.1%、5%和2.5%。分离株对伊曲康唑(41.7%)、伏立康唑(5.6%)和两性霉素B(3.7%)呈现不同程度的中介耐药。所有分离株对氟胞嘧啶敏感。
在我院,白色念珠菌和非白色念珠菌分布相当,对氟康唑、两性霉素B和卡泊芬净等主要抗真菌药物的抗真菌药敏率相当高。