A 9year species and antifungal susceptibility study of bloodstream Candida isolates in a Greek trauma hospital
Abstract number: P854
Objectives: To study the epidemiology of candidaemias, the species distribution among Candida isolates recovered from blood cultures and their antifungal susceptibility profiles in a trauma Hospital in Greece, during a nine year time period (11/200010/2009).
Methods: During the examined period 316 candidaemias were studied, corresponding to equal numbered patients. The blood cultures were incubated in the automated blood culture system BACTEC9240(Becton & Dickinson). The fungal identification procedure to species level included microscopic examination of the yeast colonies, germ-tube test, assimilation test of carbohydrates by API20AUX(Biomerieux) and/or using the automated system VITEK2(Biomerieux). The antifungal susceptibility testing (MIC) was performed by E-test strips(AB, Biodisk) according to the manufacturer's instructions. MIC was evaluated according to CLSI criteria for 5-flucytocine(FC), fluconazole(FL), ketokonazole(KE), itraconazole(IT), voriconazole(VO). As susceptible to amphotericin B(AP) considered the isolates possessing MIC values of 1 mg/L.
Results: The 66.1%(209/316) of candidaemias occurred in the ICUs, the 23.4%(74/316) in the surgical wards and the rest 10.4%(33/316) in the medical wards. The crude fatal rate was 34.5%. All candidemia episodes were caused by a single Candida species. The species distribution was C. parapsilosis (n = 159, 50.3%), C. albicans (n = 67, 21.2%), C. glabrata (n = 24, 7.6%), C. tropicalis (n = 20, 6.3%), C. lusitaniae (n = 14, 4.4%), C. famata (n = 14, 4.4%), C. guilliermondii (n = 11, 3.5%), C. intermedie (n = 4, 1.3%) and C. utilis (n = 3, 1.0%). All isolates were susceptible to AP. A decreased susceptibility (DD-S) to VO was found in two C. parapsilosis isolates and in one C. albicans isolate while two C. albicans isolates were resistant to the same agent. The number and the susceptibility percentage of the two most common, C. parapsilosis(n)/C. albicans(n1) isolates to the rest antifungal agents were: n = 152, 95.4%/n1=62, 91.9% for FC, n = 79, 68.4%/n1=33, 60.6% for FL, n = 63, 84.1%/n1=33, 30.3% for KE, n = 62, 64.5%/n1=23, 43.5% for IT, respectively.
Conclusion:C. parapsilosis was the predominant cause of candidaemias in our Hospital. The crude mortality rate was high. The low susceptibility to triazoles and the dose-dependent susceptibility or resistance emerged to VO, weak the armamentarium against this serious infection. Present study shows that AP remains the drug of choice against bloodstream Candida isolates.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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