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Distribution and Antifungal Susceptibilities with VITEK 2 system of Yeast Isolated from Blood Cultures

Yıl 2015, Cilt: 12 Sayı: 2, 261 - 268, 30.08.2015

Öz

Backgrounds: The aim of this study is to investigate the identification and antifungal susceptibilities with VITEK 2 Compact automated system (BioMérieux, France) of yeast strains isolated from blood cultures in
Microbiology Laboratory, Kayseri Education and Research Hospital between January 2012-June 2014.
TM Methods: A total of 175 yeast strainsisolated from blood cultures by BACTEC 9240 and BACTEC Fx
automated system (Becton Dickinson, ABD) were included the study. The strains were identified by VITEK
®
2 Compact automated system YST ID card (BioMérieux, France)and antifungal susceptibilities for
amphotericin B, caspofungin, flucytosine, fluconazole and voriconazole were determined with automated
®
systemVITEK 2 Compact ASTYS06 card(BioMérieux, France).
Results: Atotal of 175 strains were included in the study, 68 of them being C.albicans and 107 non-albicans
Candida. The identification of 107 non-albicans yeast isolates were as follows: 67 Candida parapsilosis, 13
Candida glabrata, eight Candida famata, six Candida tropicalis, five Candida krusei, three Candida
lusitaniae and Candida kefyr, two Candida guilliermondii. The resistance rates for fluconazole and
amphotericin B among C.albicans strains were 2.9 % and 5.8 %, respectively. However, no resistance were
detected against other antifungals. The resistance rates for amphotericin B,flucytosine fluconazole and
voriconazole in non-albicans Candida strains were 8.4 %, 1.8 %, 7.4 % and 2.8 %, respectively. The rate of
fluconazole dose-dependent susceptible non-albicans Candida strains were % 17.7. The antifungal
susceptibility of C. famata strains could not be determined by Vitek 2 ASTcard.
Conclusions: This study points out the importance of identifying yeast isolates to species level, because of
the high frequency of non-albicans yeasts isolated from blood cultures. Species identification and reporting
in vitro antifungal susceptibility results might help todirect diagnosis and treatment policies

Kaynakça

  • 1- Pappas PG. Invasive candidiasis. Infect Dis Clin North Am 2006;20(3):485-506. 2- Fridkin SK, Jarvis WR. Epidemiology of nosocomial fungal infections. Clin Microbiol Rev 1996;9(4):499- 511. 3- Lass-Flörl C. The chancing faxe of epidemiology of invasive fungal Disease in Europe. Mycoses 2009;52(3):197-205. 4- Cheng MF, Yu KW, Tang RB et al. Distribution and antifungal susceptibility of Candida species causing candidemia from 1996 to 1999. Diagn Microbiol Infect Dis 2004;48(1):33-7. 5- Pfaller MA, Diekema DJ. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev 2007;20(1):133-63. 6- Tan TY, Tan AL, Tee NW, Ng LS, Chee CW. The increased role of non-albicans species in candidaemia: results from a 3-year surveillance study. Mycoses 2010;53(6):515-21. 7- Baddley JW, Patel M, Jones M, Cloud G, Smith AC, Moser SA. Utility of real-time antifungal susceptibility testing for fluconazole in the treatment of candidemia. Diagn Microbiol Infect Dis 2004;50(2):119-24. 8- Singh N. Changing spectrum of invasive candidiasis and its therapeutic implications. Clin Microbiol Infect 2001;7(2):1-7. 9- Clinical And Laboratory Standards Institute (CLSI). 3th. Reference method for broth dilution anti- fungal susceptibility testing of yeasts (M27-A3). Wayne, PA, (2008a). 10- Clinical and Laboratory Standards Institute. 2012. Reference method for broth dilution antifungal susceptibility testing of yeasts; 4th informational supplement. CLSI document M27-S4. Clinical and Laboratory Standards Institute, Wayne, PA. 11- Çalışkan E, Dede A, Biten Güven G. Kan kültürlerinde saptanan Candida türlerinin dağılımı ve antifungal duyarlılıkları. ANKEM Derg 2013;27(1):25- 30. 12- Yapar N, Uysal U, Yucesoy M, Cakir N, Yuce A. Nosocomial bloodstream infections associated with Candida species in a Turkish University Hospital. Mycoses 2006;49(2):134-8. 13- Kuzucu Ç, Yetkin G, Çalışkan A.Bir yıl içerisinde kan kültürlerinden izole edilen Candida türlerinin dağılımı ve antifungal duyarlılıkları. Erciyes Tıp Derg 2007;29(2):115-9. 14- Gültekin B, Eyigör M, Telli M, Aksoy M, Aydın N. Yedi yıllık dönemde kan kültürlerinden izole edilen Candida türlerinin retrospektif olarak incelenmesi. ANKEM Derg 2010;24(4):202-8. 15- Atalay MA, Sav H, Demir G, Koç AN. Kan kültürlerinden izole edilen Candida türlerinin dağılımı ve amfoterisin B ve flukonazole in vitro duyarlılıkları. Selçuk Tıp Derg 2012;28(3):149-51. 16- Aydin F, Bayramoglu G, Guler NC, Kaklikkaya N, Tosun I. Bloodstream yeast infections in a university hospital in Northeast Turkey: a 4-year survey. Med Mycol 2011;49(3):316-9. 17- Ener B. Candida enfeksiyonları Türkiye'de mantar epidemiyolojisi: İzolatların klinik önemi, I. Klinik Mikrobiyoloji Kongresi Kitabı, s.104-8, Antalya (2011). 18- Pfaller MA, Diekema DJ, Rinaldi MGet al. Results from the ARTEMIS DISK Global Antifungal Surveillance Study: a 6.5-year analysis of susceptibilities of Candida and other yeast species to fluconazole and voriconazole by standardized disk diffusion testing. J Clin Microbiol 2005;43(12):5848-59. 19- Almirante B, Rodriguez D, Park BJet al. Epidemiology and predictors of mortality in cases of Candida bloodstream infection: results from populationbased surveillance, Barcelona, Spain, from 2002 to 2003. J Clin Microbiol 2005;43(4):1829-35. 20- Bedini A, Venturelli C, Mussini C et al. Epidemiology of candidemia and antifungal susceptibility patterns in an Italian tertiary-care hospital. Clin Microbiol Infect 2006;12(1):75-80. 21- Spiliopoulou A, Vamvakopoulou S, Bartzavali C, Dimitracopoulos G, Anastassiou ED, Christofidou M. Eleven-year retrospective survey of candidemia in a University Hospital in Southwestern Greece. Clin Microbiol Infect 2010;16(9):1378-81. 22- Pfaller MA, Diekema DJ, Jones RN et al. International surveillance of bloodstream infections due to Candida species: frequency of occurrence and in vitro susceptibilities to fluconazole, ravuconazole, and voriconazole of isolates collected from 1997 through 1999 in the SENTRY Antimicrobial Surveillance Program. J Clin Microbiol 2001;39(9):3254-9. 23- Tortorano AM, Peman J, Bernhardt Het 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(4):317-22. 24- Celebi S, Hacimustafaoglu M, Ozdemir O, Ozkaya G. Nosocomial candidemia in children: results of a 9-year study. Mycoses 2008;51(3):248-57. 25- Koç AN, Erdem F, Çetin N. Kan kültürlerinde üreyen mayaların retrospektif olarak değerlendirilmesi ve antifungal duyarlılıkları. Türk Mikrobiyol Cem Derg 1999;29(3-4):177-82. 26- Rodriguez-Tudela JL, Arendrup MC, Barchiesi F. EUCAST Definitive Document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts. Clin Microbiol Infect 2008;14(4):398-405. 27- Bourgeois N, Dehandschoewercker L, Bertout S, Bousquet PJ, Rispail P, Lachaud L. Antifungal susceptibility of 205 Candida spp. isolated primarily during invasive candidiasis and comparison of the Vitek 2 system with the CLSI broth microdilution and Etest methods. J Clin Microbiol 2010;48(1):154-61. 28- Pfaller MA, Diekema DJ, Procop GW, Rinaldi MG. Comparison of the Vitek 2 yeast susceptibility system with CLSI microdilution for antifungal susceptibility testing of fluconazole and voriconazole against Candida spp., using new clinical breakpoints and epidemiological cutoff values. Diagn Microbiol Infect Dis 2013;77(1):37-40. 29- Garnacho-Montero J, Diaz-Martin A, GarciaCabrera Eet al. Risk factors for fluconazole resistant candidemia. Antimicrob Agents Chemother 2010;54(8):3149-54. 30- Diekema DJ, Messer SA, Brueggemann AB et al. Epidemiology of candidemia: 3-year results from the emerging infections and the epidemiology of lowa organisms study. J Clin Microbiol 2002;40(4):1298-302. 31- Pfaller MA, Diekema DJ. The International Fungal Surveillance Participant Group. Twelve years of fluconazole in clinical practice: global trends in species distribution and fluconazole susceptibility of bloodstream isolates of Candida. Clin Microbiol Infect 2004;10(Suppl 1):11-23. 32- Toprak NÜ, Erdoğan S, Çelik C, Johansson C. Kan kültürlerinden soyutlanan Candida suşlarının Amfoterisin B ve flukonazole in vitro duyarlılıkları. Türk Mikrobiyol CemDerg 2003;33(3):252-6.

Kan Kültürlerinden İzole Edilen Maya Türlerinin Vıtek 2 Sistemi ile Tanımlanması ve Antifungal Duyarlılıkları

Yıl 2015, Cilt: 12 Sayı: 2, 261 - 268, 30.08.2015

Öz

Amaç: Bu çalışmada Ocak 2012-Haziran 2014 tarihleri arasında Kayseri Eğitim Araştırma Hastanesi Tıbbi
Mikrobiyoloji Laboratuvarı'na gelen kan kültürlerinden izole edilen maya suşlarının tam otomatik VITEK 2
® Compact sistemi ile tanımlanması ve antifungal duyarlılıklarının değerlendirilmesi amaçlanmıştır
TM Metod: Çalışmaya BACTEC 9240 cihazı ve BACTEC Fx cihazı (Becton Dickinson, ABD) ile kan
kültürlerinden izole edilen 175 maya suşu alınmıştır. İzolatlar tam otomatik VITEK 2 Compact® sisteminde
YST ID kartı (Biomerieux, France) ile tanımlanmışlardır. Suşların amfoterisin B, kaspofungin, flusitozin,
®
flukonazol ve vorikonazol için antifungal duyarlılık durumu VITEK 2 Compact AST YS06 kartı
(BioMérieux, France)ile belirlenmiştir.
Bulgular: Çalışmaya alınan 175 maya suşunun 68'inin Candida albicans, 107'sinin C.albicans dışı Candida
türü olduğu saptanmıştır. C.albicans dışı maya suşlarının 67'si Candida parapsilosis, 13'ü Candida glabrata,
sekizi Candida famata, altısı Candida tropicalis, beşi Candida krusei, üçer tanesi Candida lusitaniae ve
Candida kefyr, iki tanesi Candida guilliermondii olarak tanımlanmıştır. C.albicans suşlarının % 5.8'i
amfoterisin B' ye, % 2.9'u flukonazol'e dirençli olarak bulunurken diğer antifungallere direnç
saptanmamıştır. C.albicans dışı Candida suşlarının %8.4'ü amfoterisin B, %1.8'i flusitozine, %7.4'ü
flukonazole, %2.8'i vorikonazole direçli, %17.7'si flukonazole doza bağlı duyarlı olarak bulunmuştur.
VITEK 2 AST YS06 kartı ile C.famata suşları için eşik değer bulunmadığı için antifungal duyarlılığı
çalışılamamıştır.
Sonuç: Bu çalışmada, C.albicans dışı Candida türlerinin izolasyon sıklığının yüksek bulunması Candida
suşlarının tür düzeyinde tanımlanmasının önemli olduğunu göstermiştir. Bununla birlikte mayalarda tür
düzeyinde tanı konması ve invitro antifungal duyarlılık sonuçlarının bildirilmesi, tanı ve tedavi
politikalarında yol gösterici olabilecektir. 

Kaynakça

  • 1- Pappas PG. Invasive candidiasis. Infect Dis Clin North Am 2006;20(3):485-506. 2- Fridkin SK, Jarvis WR. Epidemiology of nosocomial fungal infections. Clin Microbiol Rev 1996;9(4):499- 511. 3- Lass-Flörl C. The chancing faxe of epidemiology of invasive fungal Disease in Europe. Mycoses 2009;52(3):197-205. 4- Cheng MF, Yu KW, Tang RB et al. Distribution and antifungal susceptibility of Candida species causing candidemia from 1996 to 1999. Diagn Microbiol Infect Dis 2004;48(1):33-7. 5- Pfaller MA, Diekema DJ. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev 2007;20(1):133-63. 6- Tan TY, Tan AL, Tee NW, Ng LS, Chee CW. The increased role of non-albicans species in candidaemia: results from a 3-year surveillance study. Mycoses 2010;53(6):515-21. 7- Baddley JW, Patel M, Jones M, Cloud G, Smith AC, Moser SA. Utility of real-time antifungal susceptibility testing for fluconazole in the treatment of candidemia. Diagn Microbiol Infect Dis 2004;50(2):119-24. 8- Singh N. Changing spectrum of invasive candidiasis and its therapeutic implications. Clin Microbiol Infect 2001;7(2):1-7. 9- Clinical And Laboratory Standards Institute (CLSI). 3th. Reference method for broth dilution anti- fungal susceptibility testing of yeasts (M27-A3). Wayne, PA, (2008a). 10- Clinical and Laboratory Standards Institute. 2012. Reference method for broth dilution antifungal susceptibility testing of yeasts; 4th informational supplement. CLSI document M27-S4. Clinical and Laboratory Standards Institute, Wayne, PA. 11- Çalışkan E, Dede A, Biten Güven G. Kan kültürlerinde saptanan Candida türlerinin dağılımı ve antifungal duyarlılıkları. ANKEM Derg 2013;27(1):25- 30. 12- Yapar N, Uysal U, Yucesoy M, Cakir N, Yuce A. Nosocomial bloodstream infections associated with Candida species in a Turkish University Hospital. Mycoses 2006;49(2):134-8. 13- Kuzucu Ç, Yetkin G, Çalışkan A.Bir yıl içerisinde kan kültürlerinden izole edilen Candida türlerinin dağılımı ve antifungal duyarlılıkları. Erciyes Tıp Derg 2007;29(2):115-9. 14- Gültekin B, Eyigör M, Telli M, Aksoy M, Aydın N. Yedi yıllık dönemde kan kültürlerinden izole edilen Candida türlerinin retrospektif olarak incelenmesi. ANKEM Derg 2010;24(4):202-8. 15- Atalay MA, Sav H, Demir G, Koç AN. Kan kültürlerinden izole edilen Candida türlerinin dağılımı ve amfoterisin B ve flukonazole in vitro duyarlılıkları. Selçuk Tıp Derg 2012;28(3):149-51. 16- Aydin F, Bayramoglu G, Guler NC, Kaklikkaya N, Tosun I. Bloodstream yeast infections in a university hospital in Northeast Turkey: a 4-year survey. Med Mycol 2011;49(3):316-9. 17- Ener B. Candida enfeksiyonları Türkiye'de mantar epidemiyolojisi: İzolatların klinik önemi, I. Klinik Mikrobiyoloji Kongresi Kitabı, s.104-8, Antalya (2011). 18- Pfaller MA, Diekema DJ, Rinaldi MGet al. Results from the ARTEMIS DISK Global Antifungal Surveillance Study: a 6.5-year analysis of susceptibilities of Candida and other yeast species to fluconazole and voriconazole by standardized disk diffusion testing. J Clin Microbiol 2005;43(12):5848-59. 19- Almirante B, Rodriguez D, Park BJet al. Epidemiology and predictors of mortality in cases of Candida bloodstream infection: results from populationbased surveillance, Barcelona, Spain, from 2002 to 2003. J Clin Microbiol 2005;43(4):1829-35. 20- Bedini A, Venturelli C, Mussini C et al. Epidemiology of candidemia and antifungal susceptibility patterns in an Italian tertiary-care hospital. Clin Microbiol Infect 2006;12(1):75-80. 21- Spiliopoulou A, Vamvakopoulou S, Bartzavali C, Dimitracopoulos G, Anastassiou ED, Christofidou M. Eleven-year retrospective survey of candidemia in a University Hospital in Southwestern Greece. Clin Microbiol Infect 2010;16(9):1378-81. 22- Pfaller MA, Diekema DJ, Jones RN et al. International surveillance of bloodstream infections due to Candida species: frequency of occurrence and in vitro susceptibilities to fluconazole, ravuconazole, and voriconazole of isolates collected from 1997 through 1999 in the SENTRY Antimicrobial Surveillance Program. J Clin Microbiol 2001;39(9):3254-9. 23- Tortorano AM, Peman J, Bernhardt Het 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(4):317-22. 24- Celebi S, Hacimustafaoglu M, Ozdemir O, Ozkaya G. Nosocomial candidemia in children: results of a 9-year study. Mycoses 2008;51(3):248-57. 25- Koç AN, Erdem F, Çetin N. Kan kültürlerinde üreyen mayaların retrospektif olarak değerlendirilmesi ve antifungal duyarlılıkları. Türk Mikrobiyol Cem Derg 1999;29(3-4):177-82. 26- Rodriguez-Tudela JL, Arendrup MC, Barchiesi F. EUCAST Definitive Document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts. Clin Microbiol Infect 2008;14(4):398-405. 27- Bourgeois N, Dehandschoewercker L, Bertout S, Bousquet PJ, Rispail P, Lachaud L. Antifungal susceptibility of 205 Candida spp. isolated primarily during invasive candidiasis and comparison of the Vitek 2 system with the CLSI broth microdilution and Etest methods. J Clin Microbiol 2010;48(1):154-61. 28- Pfaller MA, Diekema DJ, Procop GW, Rinaldi MG. Comparison of the Vitek 2 yeast susceptibility system with CLSI microdilution for antifungal susceptibility testing of fluconazole and voriconazole against Candida spp., using new clinical breakpoints and epidemiological cutoff values. Diagn Microbiol Infect Dis 2013;77(1):37-40. 29- Garnacho-Montero J, Diaz-Martin A, GarciaCabrera Eet al. Risk factors for fluconazole resistant candidemia. Antimicrob Agents Chemother 2010;54(8):3149-54. 30- Diekema DJ, Messer SA, Brueggemann AB et al. Epidemiology of candidemia: 3-year results from the emerging infections and the epidemiology of lowa organisms study. J Clin Microbiol 2002;40(4):1298-302. 31- Pfaller MA, Diekema DJ. The International Fungal Surveillance Participant Group. Twelve years of fluconazole in clinical practice: global trends in species distribution and fluconazole susceptibility of bloodstream isolates of Candida. Clin Microbiol Infect 2004;10(Suppl 1):11-23. 32- Toprak NÜ, Erdoğan S, Çelik C, Johansson C. Kan kültürlerinden soyutlanan Candida suşlarının Amfoterisin B ve flukonazole in vitro duyarlılıkları. Türk Mikrobiyol CemDerg 2003;33(3):252-6.
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Fatma Mutlu Sarıgüzel

Ayşe Nedret Koç Bu kişi benim

Selma Karagöz Bu kişi benim

Yayımlanma Tarihi 30 Ağustos 2015
Gönderilme Tarihi 24 Şubat 2015
Kabul Tarihi 6 Mart 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 12 Sayı: 2

Kaynak Göster

Vancouver Sarıgüzel FM, Koç AN, Karagöz S. Kan Kültürlerinden İzole Edilen Maya Türlerinin Vıtek 2 Sistemi ile Tanımlanması ve Antifungal Duyarlılıkları. Harran Üniversitesi Tıp Fakültesi Dergisi. 2015;12(2):261-8.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty