Background: Human candidiasis is increasing now in incidence and in clinical manifestation, due to the high frequency of prolonged antibiotic therapy, the invasive procedures and immune deficiencies. The immunosuppression by transplant, the drug therapy for cancer and AIDS favour the disseminated infections. Knowledge of clinical manifestations and predisposing factors is profitable in order to establish the proper prophylaxis and treatment. Objectives: Patients hospitalized for clinical assumption of candidiasis were assessed. The aim of this study was to evaluate species distribution and antifungal susceptibility of Candida isolates recovered from pathological products, at some hospitals in Cluj-Napoca. Methods: In a period of 2 years, 338 Candida isolates were collected. All isolates of Candida spp. were identified by the germ tube test and the API test (bioMerieux). Identification of species was followed by examination with broth the microdilution method, as described in NCCLS M27-A2, of the antifungal susceptibility to six agents, with readings after 24 and 48 h of incubation. MIC of antifungal agents was determined by the E test. Results: The candidiase aetiology was established in 338 patients. 70% of the candidiasis were nosocomial infections, 5% occurred in patients hospitalized in an intensive care unit, 25% in patients hospitalized for cancer therapy. Mucosal candidiasis prevails (63.1%) followed by cutaneous candidiasis (25.2%) and disseminated candidiasis (10.8%). The overall species distribution was:41%C.albicans, 22.3%C. parapsilosis, 12.4%Candida glabrata, 12%Candida tropicalis, 2% C. krusei, 0.7%C. guilliermondii, and 5.8%Candida spp. Conclusions: An important issue in candidiasis therapy is the occurrence of the resistant strains, both to common antifungal drugs and to those recently discovered. Our data suggest that the Candida species distribution and the antifungals resistance rate are similar to those reported previously in USA and Europe, but disparities in the species distribution and in the antifungal susceptibility of Candida isolates from other studies and countries are described. Our future goal is to study the susceptibility of Candida to antifungal drugs in order to struggle against these wide spread infections. The findings emphasize the need for continuous surveillance and further clinical investigational studies.
Full conference title:
16th European Congress of Clinical Microbiology and Infectious Diseases
- ECCMID 16th (2006)