PINAR ETİZ, Filiz KİBAR, Yağmur EKENOĞLU, AKGÜN YAMAN

KAN KÜLTÜRLERİNDEN İZOLE EDİLEN CANDIDA TÜRLERİNİN DAĞILIMININ VE ANTİFUNGAL DUYARLILIKLARININ RETROSPEKTİF OLARAK DEĞERLENDİRİLMESİ

Kandidemi yüksek mortalite ile seyreden ciddi bir klinik tablodur. Son yıllarda Candida infeksiyonlarının epidemiyolojisi ve tedavide kullanılan antifungallerle ilgili önemli değişiklikler ortaya çıkmıştır. Bu çalışmada kan kültürlerinden izole edilen Candida türlerinin tanımlanması ve bunların amfoterisin B, kaspofungin, flukonazol, flusitozin ve vorikonazole duyarlılıklarının retrospektif olarak araştırılması amaçlanmıştır.Laboratuvarımıza Ocak 2013-Aralık 2014 döneminde gönderilen kan kültürlerinde tespit edilen maya üremeleri konvansiyonel yöntemler, germ tüp ve VITEK 2 Compact (bioMérieux, Fransa) otomatize identifikasyon sistemi ile tiplendirilmiş ve antifungal duyarlılıkları VITEK 2 Compact sistemi ile belirlenmiştir.İzole edilen 280 Candida suşunun 95'i (% 33.9) Candida parapsilosis, 77'si (% 27.5) Candida albicans, 45'i (% 16) Candida tropicalis, 27'si (% 9.6) Candida glabrata, dokuzar tanesi (% 3.2) Candida kefyr ve Candida lusitaniae, beşi (% 1.7) Candida krusei, dörder tanesi (% 1.4) Candida famata ve Candida sphaerica, ikisi (% 0.7) Candida dubliniensis, birer tanesi de (% 0.3) Candida haemulonii, Candida norvegensis ve Candida pelliculosa olarak tanımlanmıştır. Antifungal duyarlılık yorumlamaları C.albicans, C.parapsilosis, C.tropicalis, C.glabrata, C.krusei olarak izole edilen 249 izolat için yapılmıştır. Antifungallere dirençli Candida türlerinin saptandığı çalışmamızda, üreme saptanan kan kültürlerindeki Candida türlerinin tanımlanmasının ve antifungal duyarlılıklarının bildirilmesinin, tedaviyi yönlendirmek için önemli olduğu sonucuna varılmıştır

Retrospective Evaluation of Distribution and Antifungal Susceptibilities of Candida Species Isolated from Blood Cultures

Candidemia is a serious clinical presentation with a rather high mortality. Over the last years, there have been important changes in the epidemiology of Candida infections and antifungal agents used to treat these infections. In this study, the identification of the Candida species isolated from blood cultures and investigation of their susceptibilities against amphotericin B, caspofungin, fluconazole, flucytosine and voriconazole retrospectively were aimed. Yeasts detected from blood cultures in our laboratory between January 2013 and December 2014 were identified by conventional methods, germ tube and VITEK 2 Compact (bioMérieux, France) automated identification system and susceptibilities to antifungal agents were determined by VITEK 2 Compact System. Among 280 Candida spp., strains isolated, 95 (33.9 %) were identified as Candida parapsilosis, the others were identified as follows: 77 (27.5 %) Candida albicans, 45 (16 %) Candida tropicalis, 27(9.6 %) Candida glabrata, nine (3.2 %) Candida kefyr, nine (3.2 %) Candida lusitaniae, five (1.7 %) Candida krusei, four (1.4 %) Candida famata, four (1.4 %) Candida sphaerica, two (0.7 %) Candida dubliniensis, one (0.3 %) Candida haemulonii, one (0.3 %) Candida norvegensis and one (0.3 %) Candida pelliculosa. Interpretation of antifungal susceptibility tests of C.albicans, C.parapsilosis, C.tropicalis, C.glabrata, C.krusei isolates were made to 249 as described. As a result of our study, in which Candida strains resistant to antifungal agents were isolated, identification to species level and determining antifungal susceptibilities of Candida species isolated from blood cultures is concluded to be important to guide treatment.

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