Alişan YILDIRAN, Nurşen BELET, Murat GÜNAYDIN, Şükrü KÜÇÜKÖDÜK

Comparison of antifungal susceptibilities in candidemic newborns according to their body weights

Amaç: Ağırlığı 1500 g'ın altındaki ve üstündeki bebeklerin kandida suşlarının antifungal duyarlıkları konusunda yeterli bilgi yoktur. Bu çalışmanın amacı kandidemik yenidoğanlardaki antifungal ilaç duyarlıklarının doğum ağırlıklarına göre değerlendirilmesidir. Hastalar ve Yöntemler: Tüm kandidemik yenidoğanlar retrospektif olarak değerlendirildi. Kandida türleri API 20C AUX system kullanılarak belirlendi. Flukonazol, ketokonazol, itrakonazol ve amfoterisin B için in vitro duyarlıklar E-test ve broth macrodilution metodu ile ölçüldü. Hastaların klinik özellikleri kaydedildi. Bulgular: Yenidoğan yoğun bakım ünitemize 2001- 2002 yıllarında başvuran 2700 yenidoğandan 375'i (%14) 1500 gramın altında idi. Tüm bebeklerin 45'inde (%1.7) kandidemi gelişti. Bunlar doğum ağırlıklarına göre sınıflandırıldı (Grup 1 ≤1500 g; Grup 2 >1500 g). Grup 1'de 19 olgu, Grup 2'de 26 olgu kaydedildi. Olası risk faktörlerinden ortalama mekanik ventilasyon süresi ve kateter süresi Grup 2'de daha fazla idi. Grup 1'deki üretilen kandida türlerinin antifungal ilaçlara daha duyarlı olduğu belirlendi. Grup 2'deki nonalbikans türlerin minimum inhibitör konsantrasyon (MIC)-50 ve 90 değerleri daha yüksekti. Sonuç: Bu çalışmada 1500 g'ın altındaki bebeklerdeki kandida türlerinin antifungal ilaçlara daha duyarlı olduğu bulundu. Bu durum 1500 g altındaki bebeklerdeki olası risk faktörlerinin daha az olmasından kaynaklanmış olabilir.

Kandidemik yenidoğanların vücut ağırlıklarına göre antifungal ilaç duyarlıklarının değerlendirilmesi

Objectives: There is a lack of data comparing antifungal susceptibilities of Candida isolates in candidemic newborns weighing ≤1500 g versus those weighing >1500 g. This study aims to compare antifungal susceptibilities of newborns according to their birth weights. Patients and Methods: All candidemic newborns assessed retrospectively. Candida species were identified using the API 20C AUX system. In vitro susceptibility of isolates for fluconazole, ketoconazole, itraconazole and amphotericine B were determined using the E-test and the broth macrodilution method. Clinical backgrounds of patients were also examined. Results: Of 2700 newborns admitted to our neonatal intensive care unit in years 2001-2002, 375 (14%) were <1500 g. Forty five (1.7%) of all infants developed candidemia. Nineteen were in Group 1, 26 were in Group 2. As possible risk factors, mean length of ventilation and catheter days were greater in Group 2. All Candida species yielded from Group 1 were more susceptible to antifungal drugs. Minimum inhibitory concentration (MIC) 50 and 90 values of non-albicans strains were almost always higher in Group 2. Conclusion: In this study, Candida species were more susceptible in the newborns weighing <1500 g. We believe this situation is related to less number of possible risk factors for the newborns weighing <1500 g.

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