Identification and Antifungal Susceptibility Patterns of Candida Strains Isolated From Blood Specimens in Iran

Abstract

Background:In the past two decades, the incidence of fungal infections has significantly increased worldwide. Despite treatment with a broad range of antifungal agents, nosocomial candidemia is associated with high mortality rates and resistance to antifungal agents is becoming increasingly prevalent in Candida species. Therefore, detection and identification of pathogens at the species level and antifungal susceptibility testing are essential to select the appropriate antifungal therapy. The incidence of candidemia and the antifungal susceptibility patterns of the associated strains have not been extensively studied in Iran. Objectives: The current study aimed to assess the microbial epidemiology of candidemia and the antifungal susceptibility profiles of Candida isolates. Patients and Methods: Out of 5141 blood culture specimens analyzed in Iran, 48 specimens from 32 patients were yeast-positive. The isolates were precisely identified at the species level using the well-established phenotypic polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The yeasts were also tested for antifungal susceptibility to fluconazole, itraconazole, ketoconazole, voriconazole, and caspofungin using the broth microdilution method.

In Vitro Susceptibilities of Candida albicans Isolates to Antifungal Agents in Tokat, Turkey

“…Resistance to caspofungin among C. albicans isolates has been reported by previous researchers (29, 43). Ghahri et al ( 44 ) have observed that the MIC range for caspofungin as 0.125 - 4 mg/L in Candida species isolated from blood specimens. Although none of the isolates was found to be resistant to caspofungin, based on the new CLSI criteria, 15% of isolates were classified as showing intermediate resistance.…”

High Recovery Rate of Non-albicans Candida Species Isolated From Burn Patients With Candidemia in Iran

“…The incidence of infections caused by Candida spp. other than C. albicans has increased markedly during recent years ( 9 , 20 - 22 ). In this study, we found that non- albicans Candida was the most common yeast isolated from burn patients.…”

“…The predisposing factor in these patients was surgery, cancer, hematological malignancy, diabetes, renal filature, premature birth and pancreatitis. Voriconazole was the most active drug and fluconazole was associated with high Minimum Inhibitory Concentration (MIC) results ( 9 ). Reduced susceptibility of non- albicans Candida species to antifungal agents has been reported ( 10 , 11 ).…”

Scientific Opinion on the update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA†

“…In the majority of the publications, physiological criteria were used or the methodologies used were not specified. Using this approach, the presence of D. hansenii has been described in patients infected by HIV (Nidhi et al., ; Ribeiro et al., ; Minea et al., ), with cancer (Li et al., ; Nidhi et al., ), with post‐operational acute respiratory distress syndrome (Mun et al., ), with invasive candidiasis (Ghahri et al., ; Wang et al., ; Jung et al., ; Nieto et al., ), in pregnant women in Malaysia hospital (Masri et al., ) or vulvovaginal candidiasis (Liu et al., ), in patients with fungal eye infections (Ghodasra et al., ), with psoriasis (Sarvtin et al., ), with chronic diarrhoea (Banerjee et al., ), athlete′s foot (Chan et al., ) and in children with neutropenia (Haddadi et al., ). The value of these reports is often limited considering the limitations of the identification method.…”

“…Quite a few of the reports deemed relevant in the ELS (43) presented information demonstrating a low or very low prevalence (seldom above 5%) of K. marxianus among fungi (mainly Candida spp.) isolated from patients with various serious underlying diseases, like cancer or HIV, or other immunosuppressed states, and patients with catheters (de Freitas et al., ; Ghahri et al., ; Parmeland et al., ; Abrantes et al., ; Dufresne et al., ; Haddadi et al., ; Taj‐Aldeen et al., ; Youngster et al., ; Leuck et al., ; Menezes et al., ; Nidhi et al., ; Nieto et al., ; Sahin et al., ).…”