Farklı Klinik Örneklerden İzole Edilen Candida Türlerinin Dağılımı ve Antifungal Duyarlılık Profilleri: 5 Yıllık Retrospoektif Analiz

Year 2022, Volume: 8 Issue: 1, 92 - 98, 21.03.2022

Gamze Alçi Sema Aşkın Keçeli Büşra Merve Sarıtaş

https://doi.org/10.30934/kusbed.1037788

Abstract

Amaç: Bu çalışmada Kocaeli Üniversite Hastanesinde Candida türlerinin dağılımının ve antifungal duyarlılık profillerinin değerlendirilmesi amaçlanmıştır.
Yöntem: Kocaeli Üniversitesi Hastanesinde Ocak 2017-Aralık 2021 arası izole edilen Candida türlerinin dağılımı ve antifungal duyarlılık profili hakkında retrospektif bir çalışma yürütülmüştür. Toplanan klinik örnekler Sabouraud dekstroz agarda ekilmiş ve uygun sürede inkübe edilmiştir. Candida spp. MALDI-TOF MS yöntemi ile tanımlanmıştır. Antifungal duyarlılık profilleri ise VITEK 2 Compact sistemi (bioMérieux, Fransa) ile belirlenmiştir.
Bulgular: Bu çalışmaya 1046 hastadan izole edilen toplam 1667 klinik örnek dahil edilmiştir. Klinik örneklerin %83,4'ü yetişkinlerden (≥18 yaş) ve %16,6'sı pediatrik gruptan (<18 yaş) alınmıştır. Tüm izolatların 1072'si (%64,3) C. albicans ve 596'sı (%35,7) non albicans-Candida (NAC) olarak tanımlanmıştır. Erişkinlerde en çok C. albicans izole edilirken, pediatrik gruptan en çok C. parapsilosis izole edilmiştir. Tanımlanan Candida spp.’lerin %88,7'si flukonazole duyarlı ve %9,3'ü dirençli idi. En yüksek flukonazol direnç oranı (%25,4) tüm bölümlerden izole edilen C. parapsilosis'te gözlendi. Vorikonazol direnç oranı %4,9 idi. Kaspofungin ve mikafungin duyarlılık oranları sırasıyla %94,7 ve %96 idi. Flusitozin ve amfoterisin B'nin direnç oranları sırasıyla %1,4 ve %4,5 idi.
Sonuç: Bu çalışmada en sık görülen NAC türü C. parapsilosis olarak belirlenmiştir. Hastanemizde C. parapsilosis'in yüksek prevalansı ve yüksek flukonazol direnci, ampirik flukanozol tedavisinin tartışmalı olduğunu gösterebilir.

Keywords

Candida türleri, antifungal duyarlılık, epidemiyoloji, retrospektif

Distribution of Candida Species Isolated from Different Clincal Specimens and Their Antifungal Susceptibility Profile: A 5 Year Retrospective Analysis

Abstract

Objective: In this study it was aimed to evaluate the distribution of Candida species and their antifungal susceptibility profiles in Kocaeli University Hospital, Kocaeli, Turkey.
Methods: A retrospective study on the distribution of Candida species and antifungal susceptibility profile were conducted from January 2017 to December 2021 in our laboratory. Different clinical samples collected were cultured on Sabouraud dextrose agar and incubated for an appropriate time. Candida spp. were identification by MALDI-TOF MS. And their antifungal susceptibility profile were determined by the VITEK 2 Compact system (BioMérieux, France).
Results: Totally 1667 clinical samples isolated from 1046 patients were included in this study. Of Clinical samples, 83.4% were from adults (≥ 18years) and 16.6% from pediatric group (< 18 years). Among all isolates, 1072 (64.3%) were C. albicans and 596 (35.7%) were non albicans Candida (NAC) species. C. albicans was mostly isolated from adults, whereas C. parapsilosis was mostly isolated from pediatric group. Regardless of Candida species identified, 88.7% were susceptible and 9.3% were resistant to fluconazole. The highest fluconazole resistance rate (25.4%) was observed in C. parapsilosis isolated from all departments. Voriconazole resistance ratio was 4.9%. The susceptibility rate of caspofungin and micafungin were 94.7% and 96%, respectively. The resistance rates of flucytosine and amphotericin B were 1.4% and 4.5%, respectively.
Conclusion: In present study, the most common NAC species was determined as C. parapsilosis. The high prevalence and high fluconazole resistance of C. parapsilosis in our hospital may demonstrate that empirical fluconazole treatment is debatable.

Keywords

Candida species, antifungal susceptibility, epidemiology, retrospective

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