Introduction: Fungal infections in patients hospitalized in Intensive Medical Care Unit are a serious clinical problem. Candida genus is the leading fungal pathogen in intensive care units. Objective: In our study we analyzed the occurrence of fungal strains and their susceptibility to antifungal agents in samples of clinical material taken from patients hospitalized in Intensive Medical Care Unit of Central Clinical Hospital in Warsaw in 2007. Material and Methods: In total 1697 samples of clinical materials from hospitalized patients were tested in Microbiological Laboratory. From Intensive Care Unit the most common clinical specimens were taken from respiratory tract 22 (30%), digestive tract (stool) 15 (21%), urine samples 14 (19%), blood 13 (18%), wound swabs 5 (7%) and other 4 (5%). Specimens were cultured on Saboraud medium plates supplemented with gentamicine and chloramphenicol (Becton Dickinson). Isolated strains were identified using CHROMagar Candida agar and automatic test ID32 C (bioMerieux). Susceptibility tests were done with E-tests (AB Biodisck) for Amphotericin B, Fluconazole, Itraconazole and Voriconazole. Results: In total number of 1697 microbiological examination, 73 samples (4.3%) were positive. We cultured 88 of fungal strains. 86 (97.7%) of them were yeast like fungi and 2 were moulds (2.3%). Yeast like fungi isolated from clinical materials belonged to ten species: C. albicans 41 (47.6%), C. glabrata 16 (18.6%), C. tropicalis 11 (12.8%) and C. parapsilosis 9 (10.5%), other 9 (10.5%). The isolated moulds 2 strains (2.3%) were Aspergillus niger and Aspergillus fumigatus. We cultured n=31 (35%) fungal strains from respiratory tract samples and n=14 strains (16%) from blood. The major etiological factors of fungemia in our study were: C. parapsilosis 5 strains, C.albicans 4, C. tropicalis 4. All fungal strains were sensitive to Amphotericin B and Voriconazole, 30% of the C. glabrata were resistant to Itraconazole. C. albicans strains were sensitive to Fluconazole. The moulds were sensitive to Amphotericin B and Voriconazole (100%). Conclusions: C. albicans species was dominated pathogen cultured from Department of Medical Intensive Care Unit. C. glabrata was resistant to Itraconazole in 30%. Amphotericin B and Voriconazole were the most active in vitro antifungal agents against isolated fungal strains.
Full conference title:
15th International Symposium on Infections in the Immunocompromised Host
- ISIIH 15th