Talebshoushtari Zadeh Maryam, Lotfali Ensieh, Fattahi Mahsa, Abolgasemi Sara
Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Curr Med Mycol. 2022 Sep;8(3):18-22. doi: 10.18502/cmm.8.3.11210.
Candidiasis is regarded as one of the most important fungal infections and a cause of disease and mortality in patients with hematological malignancy. Accordingly, antifungal prophylaxis is of significant importance in this regard. This study aimed to identify the epidemiology of colonization and evaluate its antifungal susceptibility pattern in patients with hematological malignancy.
In this study, the samples were collected from the oral cavity of 100 patients, and colonization was confirmed by fungal culture. strains were also identified by ITS-PCR. antifungal susceptibility tests against fluconazole, amphotericin B, and caspofungin were performed according to CLSI M60.
Demographic characteristics, comorbidities, distribution of species (spp.), and antifungal susceptibility were analyzed in this study. The study participants included 100 patients with a mean age of 15.48%±48.74 years (age range: 17-84 years). Regarding gender distribution, the majority (64%) of the patients were male. In terms of the distribution of underlying hematologic malignancy, 27% of the cases had lymphoma. The most commonly isolated species among patients were complex (49%; n=49), (39%; n=39), and co-colonization of complex and with (10%; n=10). The overall resistance of complex was 5% to fluconazole (n=5) and 2% to amphotericin B (n=2). Furthermore, showed 11% (n=11) resistance to fluconazole and was susceptible to amphotericin B. All spp. isolated from patients who were susceptible to caspofungin.
The high rate of colonization of spp., especially the significant increase in the frequency of in patients with blood malignancies and the gradual increase in resistance to fluconazole, necessitate a change in the use of antifungal drugs for the prevention and experimental treatment of hematological malignancy.
念珠菌病被视为最重要的真菌感染之一，是血液系统恶性肿瘤患者发病和死亡的原因。因此，抗真菌预防在这方面具有重要意义。本研究旨在确定血液系统恶性肿瘤患者的定植流行病学，并评估其抗真菌药敏模式。
在本研究中，从100例患者的口腔采集样本，通过真菌培养确认定植情况。还通过ITS-PCR鉴定菌株。根据CLSI M60对氟康唑、两性霉素B和卡泊芬净进行抗真菌药敏试验。
本研究分析了人口统计学特征、合并症、菌种分布及抗真菌药敏情况。研究参与者包括100例患者，平均年龄为15.48%±48.74岁（年龄范围：17 - 84岁）。关于性别分布，大多数患者（64%）为男性。就潜在血液系统恶性肿瘤的分布而言，27%的病例患有淋巴瘤。患者中最常分离出的菌种是白色念珠菌复合体（49%；n = 49）、光滑念珠菌（39%；n = 39）以及白色念珠菌复合体与光滑念珠菌的共定植（10%；n = 10）。白色念珠菌复合体对氟康唑的总体耐药率为5%（n = 5），对两性霉素B的耐药率为2%（n = 2）。此外，光滑念珠菌对氟康唑的耐药率为11%（n = 11），对两性霉素B敏感。从患者中分离出的所有菌种对卡泊芬净敏感。
念珠菌属菌种的高定植率，尤其是血液恶性肿瘤患者中光滑念珠菌频率的显著增加以及对氟康唑耐药性的逐渐上升，使得在血液系统恶性肿瘤的预防和实验性治疗中抗真菌药物的使用有必要改变。
