MAYALARIN TANIMLAMASININ KÖRLEME KARŞILAŞTIRILMASI: MİKOLOJİ UZMANI+GELENEKSEL YÖNTEMLER İLE BD PHOENİXTM

Yıl 2023, Cilt: 4 Sayı: 2, 127 - 133, 28.07.2023

Ali Korhan Sığ , Muharrem Naslı

https://doi.org/10.48176/esmj.2023.119

Öz

Amaç: Fungal enfeksiyonların epidemiyolojisi son yıllarda birçok sebebe bağlı olarak değişmeye başlamıştır. Etkenlerin laboratuarlarca doğru tanımlanabilmesi tedavinin yönlendirilmesi açısından çok kritiktir. Bu çalışmadaki amaç konvansiyonel yöntemlerle mikoloji uzmanının ve PhoenixTM 100 sistemi (Becton Dickinson, ABD)’nin tanımlamalarının karşılaştırılmasıdır.
Gereç ve Yöntem: Balıkesir Atatürk Şehir Hastanesi’nde 2020-2023 yılları arasındaki hastaların çeşitli mantar kültürleri çalışmaya dahil edildi. Üreyen maya mantarlarına çift-körleme şekilde; koloni morfolojisi, germ tüp, üreaz, siklohegzimid direnci, cornmeal tween 80 agar, ısı toleransı, asit-fast boyama ile askospor gözlenmesi, eozin-metilen-mavisi besiyerinde metalik refle görünümü, kapsül incelemesi ve sabouraud dekstroz brothda zar oluşumu şeklindeki geleneksel yöntemler ve BD PhoenixTM 100 sistemi (Becton Dickinson, ABD) ile tanımlama yapıldı.
Bulgular: Çeşitli kültürlerden üretilmiş ağırlıklı 353 maya mantarı çalışmaya dahil edildi. Candida albicans, Candida parapsilosis kompleks, Candida glabrata kompleks, Candida tropicalis, Candida dubliniensis, Candida kefyr, Saprochaete capitata, Candida krusei, Candida lipolytica, Candida inconspicua, Trichosporon asahii tür düzeyinde; Rhodotorula spp. ve Saccharomyces spp. cins düzeyinde uyumlu tanımlanmıştır. Konvansiyonel olarak Candida spp. şeklinde tanımlanan 6 suş, sistem tarafından Candida sake, Candida zeylanoides, Candida lambica ve Candida guilliermondii kompleks şeklinde tanımlanmıştır. Beş izolat iki yöntemle de tanımlanamazken, konvansiyonel olarak tanımlanamayan iki suş da sistem tarafından Saprochaete capitata olarak tanımlanmıştır. Tür düzeyinde %92,9; cins düzeyinde %99,4; en sık enfeksiyon etkeni 5 tür için %100 uyum görülmüştür.
Sonuçlar: Tür düzeyinde doğru tanımlama tedavinin yönlendirilmesi açısından kritiktir ve laboratuvarlar tanısal kapasitelerini optimize etmelidirler. Her ne kadar en sık konvansiyonel yöntemler nadir türlerde görece yetersiz görülse de, sık görülen türlerde tam bir uyum söz konusudur. Laboratuvarlar, kapasitelerine ve hasta profillerine göre maliyet etkinlik analizi ile iki yöntemi de tercih edebilirler.

Anahtar Kelimeler

fungal enfeksiyonlar, mantarlar, mayalar, tanımlama, Candida

Proje Numarası

Yok

BLINDED COMPARISON IN IDENTIFICATION OF YEASTS: MYCOLOGIST+CONVENTIONAL METHODS VS BD PHOENIXTM

Öz

Objective: Epidemiology of fungal infections has changed in the last years due to various reasons. Accurate identification of causative fungi is crucial to guide treatment. The aim of this study is to compare yeast identifications of BD PhoenixTM 100 System (Becton Dickinson, USA) device and mycologist+conventional methods.
Materials and Methods: Various fungal cultures of years 2020-2023 in Balıkesir Atatürk City Hospital were included. Isolated yeasts were double-blindly evaluated in identification by conventional methods (colony morphology, germ tube testing, urease positivity, cycloheximide resistance, cornmeal tween 80 agar testing, thermotolerance, ascospore existance, producing metallic green sheen with eosin-methylene blue agar, existance of capsule formation and observation for pellicle formation on sabouraud dextrose broth) and BD PhoenixTM 100 System (Becton Dickinson, USA).
Bulgular: A total of 353 yeast isolates with Candida albicans that had the highest amount (n=142) were included. Candida albicans, Candida parapsilosis complex, Candida glabrata complex, Candida tropicalis, Candida dubliniensis, Candida kefyr, Saprochaete capitata, Candida krusei, Candida lipolytica, Candida inconspicua and Trichosporon asahii were identified in species-level by both methods, while Rhodotorula spp. and Saccharomyces spp. were compatibly identified in genus-level by conventional method, but in species-level by automated method. Conventionally identified six Candida spp. strains were resulted as Candida sake, Candida zeylanoides, Candida lambica, Candida guilliermondii complex by automated system. Five isolates could not be identified by both methods and two isolates were defined as S.capitata by only the system. In overall, 92.9%, 99.4% and 100% compatibility were observed in species-level, genus-level and in top 5 species, respectively
Results: Species-level identification takes an important place in order to guide treatments and laboratories should optimize their diagnostic capacities. Although conventional methods are generally unsuccessful in identification of rare species, total compatibility was observed for common species. Laboratories should evaluate their patient profile and capacities to choose either one of them.

Anahtar Kelimeler

fungal infections, fungi, yeasts, identification, Candida

Destekleyen Kurum

The authors wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

Proje Numarası

Yok

Teşekkür

The authors wish to declare special thanks to İlkay BOZDAĞ, M.D. and Onur IRMAK, M.D. (Balıkesir Atatürk City Hospital, Department of Medical Microbiology, Balıkesir, Turkey) for their precious support

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