Mine YÜCESOY, Meral KARAMAN, Nuran YULUĞ

İdrar kültürlerinden soyutlanan Candida türlerinin flukonazol ve amfoterisin B'ye duyarlılıkları

Amaç: Araştırma, kandidüri tablolarının sağaltımına yön verebilmek amacıyla gerçekleştirildi. Gereç ve Yöntem: Çalışmaya idrar kültürlerinden soyutlanmış 77 kandida suşu alındı ve suşlar çimlenme borusu testi, mısır-unu tween 80 ağardaki görünümü ile Vitek identifikasyon sistemi kullanılarak tanımlandı. Suşların flukonazol ve amfoterisin B'ye duyarlılıkları ise NCCLS M27-A standartlarına uygun olarak mikrodilüsyon yöntemi ile çalışıldı. Bulgular: Suşların 60'ı C. albicans, 13'ü C. tropicalis, 2'si C. parapsilosis, 1'i C. kefyr, 1'i de C. rugosa olarak saptandı. C. albicans izolatlarının flukonazol için belirlenen MİK50 ve MİK90 değerleri sırasıyla 0.50 ve 4 $\mu$g/ml olarak bulunurken; C.tropicalis izoladan için bu değerler 1 ve 2 $\mu$g/ml olarak belirlendi. C.albicans ve tropicalis suşlarının amfoterisin B için saptanan MİK50 ve MİK90 değerleri sırasıyla 0.06 ve 0.25 $\mu$g/ml ile 0.25 ve 0.50 $\mu$g/ml idi. Suşların tümünün NCCLS kriterlerine göre, çalışılan antifungal ajanlara duyarlı olduğu görüldü. Sonuç: Bulgularımız doğrultusunda; sağaltım gerektiren kandidüri tablolarında flukonazol ve amfoterisin B'nin kullanılabileceği ve bu ajanlara henüz bir direnç gelişiminin söz konusu olmadığı sonucuna varıldı.

Anahtar Kelimeler:

Amfoterisin B, Candida, Duyarlılık ve özgüllük, Flukonazol

Susceptibility of Candida strains isolated from urine cultures to fluconazole and amphotericin B

Objective: This study was designed to guide the treatment of candiduria cases which need therapy. Material and Methods: Seventy seven Candida strains isolated from urine cultures were included in this study. The strains were identified by germ tube test morphology on cornmeal tween 80 agar and Vitek identification system. Fluconazole and amphotericin B susceptibilities were determined by microdilution method according to NCCLS M27-A standards. Results: Sixty of the strains were determined to be C. albicans, 13 to be C. tropicalis, 2 C. parapsilosis, one C. kefyr and one C. rugosa. Among C.albicans strains, MIC50 and MIC90 values obtained for fluconazole were 0.50 and 4 $\mu$g/ml, respectively whereas those for C.tropicalis were 1 and 2 $\mu$g/ml. MIC50 and MIC90 of amphotericin B were 0.06 and 0.25 $\mu$g/ml against C.albicans and 0.25 and 0.50 $\mu$g/ml against C.tropicalis strains, respectively. All strains were found to be susceptible to the tested antifungal agents according to the NCCLS standards. Conclusion: It is concluded that fluconazole and amphotericin B can be used for the treatment of candiduria cases when since indicated antifungal resistance hasn't been detected against these agents, yet.

Keywords:

Amphotericin B, Candida, Sensitivity and Specificity, Fluconazole,

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