Fluconazole and Itraconazole Resistance of Yeasts Isolated from the Bloodstream and Catheters of Hospitalized Pediatric Patients

Abstract

Background: In critically ill children, Candida species and other yeasts appear as an important nosocomial pathogen. The emerging fungal pathogens are usually less susceptible to azole compounds, and the management of such infections could be problematic. Methods: 6,065 bloodstream cultures and 627 catheters from intensive care units and hospitalized oncology pediatric patients were studied. Antifungal susceptibility testing of isolates was performed according to the reference broth microdilution method describedby the National Committee for Clinical Laboratory Standards (M27-A). Results: We found a low activity of fluconazole (FCZ) and itraconazole (ITZ) against Candida glabrata, C. albicans, C. tropicalis and C. haemulonii. Resistant strains to FCZ and ITZ were detected. Conclusion: Results reveal the emergence of antifungal-resistant species and a change in the predominant role of C. albicans as a cause of candidemia in hospitalized children.

Adaptive immune responses toCandida albicansinfection

“…C. albicans is also capable of causing life threatening illness and accounts for significant rates of mortality (40%) in the immunocompromised and those receiving immunosuppressive therapies. 2 The dichotomy between harmless carriage and the onset of potentially life threatening infection stems from 2 critically important factors, namely the presence or absence of an effective immune response and the ability of the fungus to alter its morphology.…”

Candida albicans-epithelial interactions and pathogenicity mechanisms: scratching the surface

“…11,12 Given the immunocompromised state of many hospital patients, this has led to Candida infections being the 3rd or 4th most common nosocomial bloodstream infection. 13,14 Given this ever-increasing prevalence of Candida infections, it is therefore important to understand the events that occur during host-Candida interaction. While much work has been done to explore these interactions at the level of host immune cells during systemic immunity, it is only recently that efforts have turned to examining the events and mechanisms involved in mucosal-Candida interactions -in particular the interactions between the fungus and host epithelial cells.…”

Outbreak of Fungemia among Neonates Caused by Candida haemulonii Resistant to Amphotericin B, Itraconazole, and Fluconazole

“…Although it is rarely isolated in clinical microbiology laboratories, C. haemulonii has been reported to be intrinsically resistant to amphotericin B and azoles (4,11), thus posing diagnostic and therapeutic challenges. With the exception of some Candida lusitaniae strains, the occurrence of amphotericin B resistance among Candida species is rarely reported.…”