Fatma Mutlu SARIGÜZEL, Ayşe Nedret KOÇ, Selma KARAGÖZ

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

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.

Anahtar Kelimeler:

Antifungal duyarlılık, Candida spp., otomatize sistem, tanımlama

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

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

Keywords:

antifungal susceptibilities, automated systems, Candida spp., identification,

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