CANDİDA TÜRLERİNİN TANIMLANMASINDA KROMOJENİK BESİYERİNİN DEĞERLENDİRİLMESİ

Abstract

Mayalar morfolojik, biyokimyasal ve fizyolojik benzerliklerinden dolayı sıklıkla karıştırılabilir. Bu çalışmanın amacı, sistemik kandidoz şüphesi olan hastalardan izole edilen Candida suşlarının örneklerinin tanımlanmasının değerlendirilmesidir. Kasım 2007 Aralık 2008 ayları arasında sistemik kandidoz hastalarından toplanan 48 farklı örnek (bronkoalveolar lavaj, beyin omurilik sıvısı, steril vücut sıvısı, doku ve kan) çalışmaya dahil edildi. Morfolojik ve biyokimyasal testlerle Candida cinsi olarak tanımlanan mayaların kromojenik besiyeri (CHROMagar ID Candida, Biomerieux, Fransa) ekimi yapıldı. İzole edilen toplam 48 Candida suşları, morfolojik ve biyokimyasal yöntemler kullanılarak 22’si C. albicans, 5’i C. keyfr, 6’sı C. tropicalis, 7’isi C. glabrata, 6’sı C. parapisilosis, biri C. krusei ve biri de C. rugosa olarak tanımlandı. Kromojenik besiyerinde 22 C.albicans, 13 C. tropicalis/C. keyfr ve 15’i diğer Candida türleri olarak tanımlandı. İki C. parapisilosis suşu hatalı olarak tanımlandı. Sonuç olarak, kromojenik besiyerinin, konvansiyonel yöntemlerle birlikte Candida türlerinin erken tanısında faydalı bir yöntem olduğu kanaatine varıldı

Keywords

• Candida türleri, kromojenik besiyeri, tanımlama

The Evaluation of Chromogenic Medium in Identification of Candida Species

Abstract

Yeasts can often be confused owing to similarities of their morphological, biochemical and physiological properties. The aim of the study was to evaluate the identification of Candida samples by chromogenic medium which are isolated from systemic candidiasis suspected patients. Between 2007 November and 2008 December, 48 different samples (bronchoalveolar lavage, cerebrospinal fluid, sterile body fluids, tissue, blood) recovered from systemic candidiasis suspected patients have been included in this study. Isolated yeasts identified as Candida with morphological and biochemical tests were inoculated on to chromogenic medium (CHROMagar ID Candida, Biomeriux, France). A total number of 48 Candida isolates were identified as 22 C. albicans, 5 C. keyfr, 1 C. rugosa, 6 C. tropicalis, 7 C. glabrata, 6 C. parapisilosis, 1 C. krusei with morphological and biochemical methods. In chromogenic medium, results were 22 C. albicans, 13 C. tropicalis/C.keyfr and 15 other Candida species. Two C. parapsilosis isolates were identified as incorrect. In conclusion; it is suggested that chromogenic medium with conventional methods is a useful method in early diagnosis of Candida species

Keywords

• Candida species, chromogenic medium, identification

References

1. 1. Edwards JE. Candida Species. in: Mandell GL,Douglas RG, Bennett JE (eds). Principles and Practice of Infectious Disease (4rd edition). Vol 2. Newyork, Churchill Livingstone, 1995;2289-2306.
2. 2. Erbakan N. Derinin Mantar Hastalıkları. Ankara, Türkiye Klinikleri Yayınevi, 1989: 1-332.
3. 3. Kuştimur S. Kandida patogenezinde rol oynayan faktörler. Mikrobiyol Bült 1994; 28:175- 181.
4. 4. Warren NG, Shadomy HJ. Candida, crypococcus and other yeasts of medical importance. in Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH (eds). Manual of Clinical Microbiology (6th edition). Washington DC, ASM Press 1995;723-737.
5. 5. Edwards JE. Candida Species. In: Mandell GL, Douglas RG, Bennett JE(eds), Principles and Practice of Infectious Disease. Vol 2. New York, Churchill Livingstone, 1995:pp2289- 2306.
6. 6. Kuştimur S. Kandida patogenezinde rol oynayan faktörler. Mikrobiyol Bült 1994; 28: 175 -181.
7. 7. Clark TA, Hajjeh RA. Recent trends in the epidemiology of invasive mycoses. Curr Opin Infect Dis 2002; 15: 569-574
8. 8. Eggimann P, Garbino J, Pittet D. Epidemiology of Candida species infections in crititically ill non-immunosuppressed patients. Lancet Infect Dis 2003; 3:685-702.

9. 9. Marchetti O, Bile J, Fluckiger U, et al. Epidemiology of candidemia in Swiss tertiary care hospitals:secular trends, 1991-2000. Clin Infect Dis 2004; 38: 311-320
10. 10. Tortorano MA, Peman J, Bernhardt H, et al. Epidemiology of candidaemia in Europe:results of 28-month European Confederation of Medical Mycology (ECMM) hospital -based surveillance study. Eur J Clin Microbiol Infect Dis 2004; 23: 317-322.
11. 11. Vermitsky JP, Edlind TD. Azole resistance in Candida glabrata:Coordinate upregulation of multidrug transporters and evidence for a Pdrlike transcription factor. Antimicrob Agents Chemother 2004; 48: 3773-3881.
12. 12. Viscoli C, Girmenia C, Marinus A, et al. Candidemia in cancer patients a prospective, multicenter surveillance study by the Invasive Fungal Infection Group (IFIG) of the European Organization for Research and Treatment of Cancer (EORTC). Clin Infect Dis 1999; 28:1071-1079.
13. 13. Dooley DP, Beckius ML, Jeffrey BS. Misidentification of clinical yeast isolates by using the uptated Vitek yeast biocnemical card. J Clin Microbiol 1994; 32:2889-2992.
14. 14. Warren NG, Hazen KC. Candida, Cryptococcus and other yeasts of medical importance. In Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH (eds). Manual of Clinical Microbiology (6th edition). Washington DC, ASM Press 1995; pp 1184-1199
15. 15. Richards MJ, Edwars JR, Culver DH, Gaynes RP. Nosocomial infenctions in medical intensive care units in the United States. Crit Care Med 1999; 27: 887-892.
16. 16. Hsu MC, Chen KW, Lo HJ, et al. Species identificaiton of medically important fungi by use real-time LightCycler PCR. J Med Microbiol 2003; 52:1071-1076.
17. 17. Cooke M, Miles RJ, Price RG, et al. New chromogenic agar medium fort he idendification of Candida spp. Applied and Environmental Microbiology 2002; 68:3622-3627.
18. 18. Pfaller MA, Houston A, Coffmann S. Application of CHROMagar Candida for rapid screening of clinical specimens for Candida albicans, Candida tropicalis, Candida krusei, and Candida (Torulopsis) glabrata. J Clin Microbiol 1996; 34: 58-61.
19. 19. Duane R, Miriam L, Karon L, et al. Presumptive identification of Candida species other than C. albicans, C. krusei, and C. tropicalis with the chromogenic medium CHROMagar Candida. Ann Clin Microbiol Antimicrob 2006; 5: 1-5.
20. 20. Hospenthal DR, Murray KC, Beckius ML et al. Persistence of pigment production by yeast isolates grown on CHROMagar Candida medium. J Clin Microbiol 2002; 40: 4768-4770.
21. 21. Houang ETS, Chu KC, Koehler AP, Cheng AFB. Use of CHROMagar Candida for genital specimens in the diagnostic laboratory. J Clin Pathol 1997; 50: 563-565.
22. 22. Horvath L, Hospenthal R, Murray K, Dooley D. Direct Isolation of Candida spp.from blood cultures on the chromogenic medium CHROMagar Candida. JClin Microbiol 2003; 41: 2629-2632.
23. 23. Willinger B, Hillowoth C, Selitsch B, Manafi M. Performance of Candida ID, a new chromogenic medium for presumptive identification of Candida species, in comparison to CHROMagar Candida. J Clin Microbiol 2001; 39: 3793-3795.