ISSN 1306-0015 | E-ISSN 1308-6278
Original Article
Evaluation of Candida species and antifungal susceptibilities among children with invasive candidiasis
1 Department of Pediatrics, Division of Pediatric Infectious Diseases, Istanbul University Faculty of Medicine, Istanbul, Turkey  
2 Department of Microbiology and Clinical Microbiology, Istanbul University Faculty fo Medicine, Istanbul, Turkey  
3 Department of Pediatrics, Istanbul University Faculty of Medicine, Istanbul, Turkey  
Turk Pediatri Ars 2017; 52: 145-153
DOI: 10.5152/TurkPediatriArs.2017.5291
Key Words: Antifungal susceptibility, child, invasive candidiasis
Abstract

Aim: Non-albicans Candida species and resistant microorganisms have been more commonly isolated in invasive candidiasis in recent years. The aim of this study was to evaluate the distrubution of Candida spp and antifungal resistance in our clinic.

 

Material and Methods: Fifty-four Candida isolates and antifungal susceptibility results obtained from patients diagnosed as having invasive candidiasis between December 2012 and June 2016 were included. Clinical and laboratory data were retrospectively analyzed. E-test method was used in order to determine antifungal susceptibilities of Candida spp for amphotericin B, fluconazole, voriconazole, ketoconazole, itraconazole, anidulafungin, caspofungin, and flucytosine.

 

Results: The clinical diagnoses of the patients were candidemia (n=27, 50%), catheter-related blood stream infection (n=1, 1.8%), urinary tract infection (n=13, 24%), surgical site infection (n=4, 7.4%), intraabdominal infection (n=3, 5.5%), empyema (n=2, 3.7%), and pneumonia (n=4, 7.4%). The most common isolated agent was C. albicans (n=27, 50%) and the others were C. parapsilosis (n=13, 24%), C. tropicalis (n=6, 11.1%), C. glabrata (n=3, 5.6%), C. lusitaniae (n=2, 3.7%), and unspecified Candida spp. (n=3, 5.6%). Fluconazole resistance was 7.4% among all isolates. Resistance against itraconazole, ketoconazole, anidulafungin, voriconazole and caspofungin were 33.3%, 12.5%, 11.1%, 5%, and 2.5%, respectively. Isolates presented intermediate resistance against itraconazole (41.7%), voriconazole (5.6%), and amphotericin B (3.7%) to varying extents. All of the isolates were susceptible to flucytosine.

 

Conclusions: In our clinic, C. albicans and non-albicans Candida species were equally distributed and antifungal susceptibilities against major antifungal agents such as fluconazole, amphotericin B, and caspofungin were found considerably high.

 

Cite this article as: Sütçü M, Acar M, Erköse Genç G, Kökçü İ, Aktürk H, Atay G, Hançerli Törun S, Salman N, Erturan Z, Somer A. Evaluation of Candida species and antifungal susceptibilities among children with invasive candidiasis.Turk Pediatri Ars 2017; 52: 145-53.

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