埃塞俄比亚不同临床样本中分离出的白色念珠菌和非白色念珠菌的分布及其体外抗真菌药敏谱
Distribution of Candida albicans and non-albicans Candida species isolated in different clinical samples and their in vitro antifungal suscetibity profile in Ethiopia.
作者信息
Seyoum Elias, Bitew Adane, Mihret Amete
机构信息
Ethiopian Public Health Institute, Clinical Bacteriology and Mycology Research Case Team, Addis Ababa, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
BMC Infect Dis. 2020 Mar 19;20(1):231. doi: 10.1186/s12879-020-4883-5.
BACKGROUND
The spectrum of yeasts and their antifungal susceptibility profile are poorly known and treatment of fungal disease has remained empirical. The aim of this study is to determine the spectrum and antifungal susceptibility profile of yeasts particularly of Candida species.
METHODS
A descriptive study on the composition of Candida species and antifungal susceptibility profile were conducted from January 2018 to September 2018. Clinical samples collected from different sites were cultured on Sabouraud dextrose agar and incubated for an appropriate time. Identification of yeast isolates and their antifungal susceptibility profile were determined by the VITEK 2 compact system. Descriptive statistics such as frequency and percentage of Candida species were calculated using SPSS version 20.
RESULTS
Of 209 yeasts recovered, 104(49.8%), 90 (43.1%), 15(7.2%) were C. albicans, non albicans Candida species, and other yeasts, respectively. Among non albicans Candida species, Candida krusei was the commonest isolate. Of other yeast groups, 66.7% was represented by Cryptococcus laurentii. Regardless of Candida species identified, 85.6, 3.9, and 10.5% of the isolates were susceptible, intermediate, and resistant to fluconazole, respectively. C krusei was 100% resistant to the drug. Voriconazole demonstrated the greatest antifungal activity against Candida isolates in which 99.4% of Candida isolates were susceptible. The susceptibility and the resistance rate of Candida isolate to both caspofungin and micafungin were the same being 96 and 4% respectively. However, micafungin was more potent than caspofungin. The susceptibility, resistant, and intermediate rates of yeasts against flucytosine were, 86.2, 6.6, and 7.2%, respectively.
CONCLUSIONS
The present study demonstrated the distribution of Candida species in different clinical specimens where the isolation rate of non-albicans Candida species was comparable to Candida albicans. The high resistance rate of C. krusei to fluconazole and flucytosine may demonstrate that the treatment of candidiasis empirically is questionable.
背景
酵母菌的种类及其抗真菌药敏谱鲜为人知，真菌疾病的治疗一直是经验性的。本研究的目的是确定酵母菌尤其是念珠菌属的种类及其抗真菌药敏谱。
方法
于2018年1月至2018年9月对念珠菌属的组成及其抗真菌药敏谱进行了描述性研究。从不同部位采集的临床样本接种于沙氏葡萄糖琼脂培养基上，并培养适当时间。采用VITEK 2 compact系统对酵母菌分离株进行鉴定及其抗真菌药敏谱分析。使用SPSS 20版计算念珠菌属的频率和百分比等描述性统计数据。
结果
在分离出的209株酵母菌中，白色念珠菌、非白色念珠菌和其他酵母菌分别为104株（49.8%）、90株（43.1%）、15株（7.2%）。在非白色念珠菌中，克鲁斯念珠菌是最常见的分离株。在其他酵母菌组中，罗伦隐球菌占66.7%。无论鉴定出何种念珠菌属，分别有85.6%、3.9%和10.5%的分离株对氟康唑敏感、中介和耐药。克鲁斯念珠菌对该药物的耐药率为100%。伏立康唑对念珠菌分离株显示出最大的抗真菌活性，其中99.4%的念珠菌分离株敏感。念珠菌分离株对卡泊芬净和米卡芬净的敏感率和耐药率相同，分别为96%和4%。然而，米卡芬净比卡泊芬净更有效。酵母菌对氟胞嘧啶的敏感率、耐药率和中介率分别为86.2%、6.6%和7.2%。
结论
本研究显示了念珠菌属在不同临床标本中的分布情况，其中非白色念珠菌的分离率与白色念珠菌相当。克鲁斯念珠菌对氟康唑和氟胞嘧啶的高耐药率可能表明经验性治疗念珠菌病存在疑问。
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