Davari Amirhossein, Jafarzadeh Jalal, Hedayati Mohammad Taghi, Shokohi Tahereh, Abastabar Mahdi, Nikmanesh Bahram, Moazeni Maryam
Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Curr Med Mycol. 2022 Jun;8(2):25-31. doi: 10.18502/cmm.8.2.10329.
This study aimed to evaluate the species distribution and susceptibility pattern of the strains isolated from Candida colonization in pediatric patients staying at pediatric intensive care unit (ICU) and infant ICU of Children's Medical Center in Tehran, Iran.
This study was conducted in the Children's Medical Center in Tehran, Iran. In total, 440 samples from 56 patients with oral cavity, skin surrounded catheters, and ear, throat, nasal, and urine cultures were collected. All patients were evaluated in terms of colonization on the admission day as well as the days 7, 14, and 28 according to the previous studies. CHROMagar medium was applied for primary/multiple species identification and the isolates were identified by using polymerase chain reaction-based methods to the species-specific complex level. The antifungal susceptibility test was performed according to the Clinical and Laboratory Standards protocol published as M27-A3 and M60 documents.
In total, 136 yeast samples from 26 individuals (30.9%) out of 440 samples were considered colonization. The most prevalent species in IICU was (27%, n=20) followed by (24 %, n=18) and (16%, n=12). In PICU, the predominant species was (40%, n=24) followed by (18%, n=11) and (16%, n=10). Among the 40 tested isolates from both units, fluconazole-resistant isolates (n=11, 8.15%) were determined according to the new breakpoints. In the case of echinocandins, 2 isolates, including C. albicans (n=1) and C. krusei (n=1) were resistant against both caspofungin and anidulafungin (totally 1.48%).
In the present study, since is intrinsically-resistance against fluconazole, emphasizing the importance of species-level identification of isolates is outstanding. However, according to the antifungal susceptibility testing results, only 7.2% of the strains were resistant to fluconazole. It would be beneficial to monitor the ICU patients who are at high risk of invasive infection.
本研究旨在评估从伊朗德黑兰儿童医学中心儿科重症监护病房（ICU）和婴儿ICU的念珠菌定植患儿中分离出的菌株的种类分布和药敏模式。
本研究在伊朗德黑兰儿童医学中心开展。共收集了56例患者口腔、导管周围皮肤、耳、咽喉、鼻和尿液培养的440份样本。根据既往研究，对所有患者在入院当天以及第7、14和28天进行定植评估。使用科玛嘉培养基进行初步/多种菌种鉴定，并采用基于聚合酶链反应的方法将分离株鉴定到种特异性复合体水平。根据作为M27 - A3和M60文件发布的临床和实验室标准协议进行抗真菌药敏试验。
440份样本中，共136份来自26名个体（30.9%）的酵母样本被视为定植。在婴儿ICU中最常见的菌种是[具体菌种1]（27%，n = 20），其次是[具体菌种2]（24%，n = 18）和[具体菌种3]（16%，n = 12）。在儿科ICU中，主要菌种是[具体菌种4]（40%，n = 24），其次是[具体菌种5]（18%，n = 11）和[具体菌种6]（16%，n = 10）。在两个科室检测的40株分离株中，根据新的断点确定了氟康唑耐药分离株（n = 11，8.15%）。对于棘白菌素，2株分离株，包括白色念珠菌（n = 1）和克鲁斯念珠菌（n = 1）对卡泊芬净和阿尼芬净均耐药（共1.48%）。
在本研究中，由于[具体菌种]对氟康唑具有固有耐药性，强调对该菌种分离株进行种水平鉴定的重要性十分突出。然而，根据抗真菌药敏试验结果，仅7.2%的菌株对氟康唑耐药。监测有侵袭性[具体感染类型]感染高风险的ICU患者将是有益的。
