Korean J Clin Microbiol.  2010 Jun;13(2):79-84. 10.5145/KJCM.2010.13.2.79.

Species Distribution and Susceptibilities to Azoles of Candida Species Including C. tropicalis in a Tertiary Burn Center

Affiliations
  • 1Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
  • 2Department of Urology, Hallym University College of Medicine, Chuncheon, Korea.
  • 3Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea. cpworld@cau.ac.kr
  • 4Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea.

Abstract

BACKGROUND
Candida species are the fourth leading cause of nosocomial bloodstream infections and have one of the highest mortality rates among nosocomial pathogens. C. tropicalis has been reported to be one of the leading Candida species other than C. albicans to cause Candida infection in patients who have malignancy, diabetes mellitus, and burn. This study was designed to determine whether burn might influence the species distribution and susceptibilities of azoles against clinical isolates of Candida species including C. tropicalis.
METHODS
A total 372 Candida isolates from various samples in a tertiary burn center were studied, and the MICs of Candida isolates to fluconazole, itraconazole, and voriconazole were tested by broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI) M27-A2. A comparison was made between Candida isolates from burn patients and non-burn patients.
RESULTS
The percentages of C. albicans, C. tropicalis, C. parapsilosis and C. glabrata isolates from burn patients and non-burn patients were 42.3% and 64.2% (P=0.000), 35.7% and 21.6% (P=0.002), 11.9% and 7.8%, and 10.1% and 6.4%, respectively. Decreased susceptibilities to fluconazole, itraconazole, and voriconazole were observed more frequently in burn patients (4.76%, 19.05%, and 0.60%, respectively) than non-burn patients (2.45%, 14.22%, and 0%, respectively).
CONCLUSION
The results of this study suggest that burn may lead to influence the species distribution and susceptibilities to azoles of Candida species.

Keyword

Candida species; Candida tropicalis; Burn; Azole; Antifungal susceptibility

MeSH Terms

Azoles
Burn Units
Burns
Candida
Candida tropicalis
Danazol
Diabetes Mellitus
Fluconazole
Humans
Itraconazole
Pyrimidines
Triazoles
Azoles
Danazol
Fluconazole
Itraconazole
Pyrimidines
Triazoles

Reference

1. Murray CK, Loo FL, Hospenthal DR, Cancio LC, Jones JA, Kim SH, et al. Incidence of systemic fungal infection and related mortality following severe burns. Burns. 2008; 34:1108–12.
Article
2. Santucci SG, Gobara S, Santos CR, Fontana C, Levin AS. Infections in a burn intensive care unit: experience of seven years. J Hops Infect. 2003; 53:6–13.
Article
3. de Macedo JLS, Santos JB. Baterial and fungal colonization on burn wounds. Mem Inst Oswaldo Cruz, Rio de Janeiro. 2005; 100:535–9.
4. Krcmery V and Barnes AJ. Non-albicans Candida spp. causing fungemia: pathogenicity and antifungal resistance. J Hops Infect. 2002; 50:243–60.
5. Hachem R, et al. Risk factors for Candida tropicalis fungemia in patients with cancer. Clin Infect Dis. 2001; 33:1676–81.
6. Wingard JR. Importance of Candida species other than C. albicans as pathogens in oncology patients. Clin Infect Dis. 1995; 20:115–25.
Article
7. Chae MJ, Shin JH, Cho D, Kee SJ, Kim SH, Shin MG, et al. Antifungal susceptibilities and distribution of Candida species recovered from blood cultures over an 8-year period. Korean J Lab Med. 2003; 23:329–35.
8. Yang YL, Ho YA, Cheng HH, Ho M, Lo HJ. Susceptibilities of Candida species to amphotericin B and fluconazole: the emergence of fluconazole resistance in Candida tropicalis. Infect Control Hosp Epidemiol. 2004; 25:60–4.
9. Barchiesi F, Calabrese D, Sanglard D, Francesco LFD, Caselli F, Giannini D, et al. Experimental induction of fluconazole resistance in Candida tropicalis ATCC 750. Antimicrob Agents Chemother. 2000; 44:1578–84.
10. Mcneil MM. Candida. Mayhall CG, editor. Hospital Epidemiology and Infection Control. 3rd ed.Philadelphia: Lippincott Williams and Wilkins;2006. p. 685–703.
11. Gupta N, Haque A, Lattif AA, Narayan RP, Mukhopadhyay G, Prasad R. Epidemiology and molecular typing Candida isolates from burn patients. Mycopathologia. 2004; 158:397–409.
12. Odds FC, Gow NAR, Brown JP. Toward a molecular understanding of Candida albicans virulence. Heitman J, Filler SG, Edwards JE, Mitchell AP, editors. Molecular Principles of Fungal Pathogenesis. 1st ed.Washington, DC: ASM Press;2006. p. 305–19.
Article
13. Clinical and Laboratory Standards Institute. Reference method for broth dilution antifungal susceptibility testing of yeasts: Approved Standard M27-A2. Wayne, PA, USA. 2002.
14. Shin JH, Kim HR, Lee JN. Distribution and antifungal susceptibility of Candida species isolated from clinical specimens during the past six years. Korean J Clin Microbiol. 2004; 7:164–70.
15. Lee JS, Shin JH, Lee K, Kim MN, Shin BM, Uh Y, et al. Species distribution and susceptibility to azole antifungals of Candida bloodstream isolates from eight university hospitals in Korea. Yonsei Med J. 2007; 48:779–86.
Article
16. Kim SH, Shin JH, Kim EG, Lee K, Kim MN, Lee WG, et al. The relationship between antifungal usage and antifungal susceptibility in clinical isolates of Candida: a multicenter Korean study. Medical Mycology. 2009; 47:296–304.
17. Yoo JI, Shoi CW, Lee KM, Kim YK, Kim TU, Kim EC, et al. National surveillance of antifungal susceptibility of Candida species in South Korean hospitals. Medical Mycology. 2009; 47:554–58.
18. Pfaller MA, Diekema DJ, Gibbs DL, Newell VA, Meis JF, Gould IM, et al. Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2005: an 8.5-year analysis of susceptibilities of Candida species and other yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing. J Clin Microbiol. 2007; 45:1735–45.
19. Byun HW, Kim CH, Kim JK, Eom KS, Park YB, Jang SH, et al. A 5-year review of clinical characteristics and mortality of burn patients with candidemia in a tertiary burn center. Korean J Med. 2006; 70:298–308.
20. Still Jr JM, Law EJ, Belcher KE, Spencer SA. A comparison of susceptibility to five antifungal agents of yeast cultures from burn patients. Burn. 1995; 21:167–70.
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