Antifungal susceptibility patterns of colonized Candida species isolates from immunocompromised pediatric patients in five university hospitals

  • Parisa Badiee Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Maral Choopanizadeh Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Abdolkarim Ghadimi Moghadam Department of Pediatrics, University of Medical Sciences, Yasuj, Iran
  • Ali Hossaini Nasab Department of Pediatrics, Kerman University of Medical Science, Kerman, Iran
  • Hadis Jafarian Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Ahmad Shamsizadeh Infectious and Tropical Diseases Research Center, Health Research Institute, Ahwaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Jafar Soltani Department of Pediatrics, Besat Tertiary Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
Keywords: Candida species, Colonized, Amphotericin B, Voriconazole, Posaconazole, Itraconazole

Abstract

Background and Objectives: Colonization of Candida species is common in pediatric patients admitted to hematology-oncology wards. The aim of this study was to identify colonized Candida species and their susceptibility patterns in hematologic pediatric patients.Materials and Methods: Samples were collected from mouth, nose, urine and stool of the patients admitted to five university hospitals and cultured on sabouraud dextrose agar. The isolates were identified by API 20 C AUX system and their susceptibility patterns were evaluated by CLSI M27-A3 and S4. Results: From 650 patients, 320 (49.2%) were colonized with 387 Candida species. Candida albicans was the most prevalent isolated species, followed by Candida glabrata, Candida tropicalis, Candida famata, Candida kefyr and Candida kuresi. The epidemiological cut off value (ECV) for all Candida species to amphotericin B was ≤0.25 μg except C. krusei (4 μg). The resistance rate to fluconazole in this study in C. albicans was 4.9% with ECV 8 μg/ml, followed by C. tropicalis 8.8% with ECV 0.5 μg/ml. Voriconazole and posaconazole were effective antifungal agents for all Candida isolates. The ECV of C. albicans, Candida parapsilosis, C. tropicalis, C. glabrata and C. krusei for itraconazole were 0.5, 0.25, 0.5, 1 and 2 μg, respectively. The resistant and intermediate rates of Candida species to caspofungin in this study were 2.9%, 5.9%, 18.8%, 47.9%, 0.0% and 16.7% in C. tropicalis, C. glabrata and C. parapsilosis respectively.Conclusion: C. albicans was the most prevalent species in pediatric colonized patients. New azole agents like voriconazole and posaconazole are effective against non- albicans Candida species. Increase in intermediate species is alarming to future emerging resistant species.

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Published
2018-01-26
How to Cite
1.
Badiee P, Choopanizadeh M, Ghadimi Moghadam A, Hossaini Nasab A, Jafarian H, Shamsizadeh A, Soltani J. Antifungal susceptibility patterns of colonized Candida species isolates from immunocompromised pediatric patients in five university hospitals. IJM. 9(6):363-71.
Section
Original Article(s)