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Taxonomic structure and susceptibility of Candida spp. in surgical ICU of cancer hospital

Abstract number: 1134_03_184

Petukhova I., Volkova Z.V., Malysheva E., Dmitrieva N.

Objective:  

To study pattern and isolation rate of Candida spp. in surgical ICU.

Methods:  

Candida spp. isolated from cancer pts in ICU after extensive and combined operations for esophageal, gastric, colorectal cancer etc., were analysed. ‘Chromagar’ and semi-automatic analyzer ‘ATB-Expression’ were used for identification.

Results:  

626 bacterial and fungal strains from 817 pathologic materials were isolated, including 121 Candida spp. (19.3%). C.albicans was isolated in 58 of 121 cases (47.9%). 2 strains C.non-albicans were isolated from blood. Wounds were infected with mixed microflora including Candida spp. in patients who have previously received 2 or 3 lines of antimicrobial therapy and all pts had C.non-albicans from wound discharge. 28 C. albicans and 16 C. non-albicans were isolated from sputum and 26 C. albicans and 27 C. non-albicans were isolated from bronchoscopic materials in pts with clinical and radiographic evidence of pneumonia. Prevalence of C.albicans in sputum may be explained as this material was taken from less severely ill patients, than bronchoscopy, which was undertaken in critically ill patients. Urine was colonized with 4 C. albicans and 13 C. non-albicans. All pts had urinary cateters and didn't have clinical evidences of urinary infection. C. non-albicans consisted of C. glabrata - 30 (24.8%), C. parapsilosis - 13 (10.8%), C. krusei - 6 .0%), C.inconspicua/norvegensis - 5 (4.1%), C. tropicalis - 3 (2.5%), Ñ. kefyr - 2 (1.7%), Ñ. globosa, C. sake, C. lusitaniae, C. dubliniensis - 1 strain each (0.8% each). Susceptibility testing performed in 3 more often isolated strains were the follows: All tested strains of C. albicans were susceptible to amphotericin B, flucitozine, miconazole. Intermediate susceptibility was seen to ketokonazole, econazole and nystatin (each - 2%) and resistance was revealed to nystatin (2%). In C. glabrata 22% of strains had intermediate susceptibility to ketokonazole, no resistant strains were found. C. parapsilosis was resistant and had intermediate susceptibility to miconazole in 50%, to econazole - 63% and was resistant to nystatin - 10% and amphotericin B - 10%.

Conclusion:  

ICU patients often suffer from severe infectious complications and are treated with broad spectrum antibiotics, resulting in fungal colonization and superinfections. The cause Candida non-albicans colonization and infections may be extensive and inappropriate prophylactic use of fluconazole.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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