Evaluation of Candida colonization index, molecular identification, and antifungal susceptibility pattern of Candida species isolated from critically ill pediatric patients: A single_ center study in Iran
نویسندگان
1 Department of Ear, Nose, and Throat, Faculty of Medicine, Roohani Hospital, Babol University of Medical Sciences, Babol, Iran.
2 Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
3 Pediatric Stem Cell Transplant Department, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
4 Faculty of Medicine, Sari Branch, Islamic Azad University, Sari, Iran
5 Nosocomial Infection Medical Research Centre, Mazandaran University of Medical Sciences, Buali Sina Hospital, Sari, Iran;
6 Mazandaran university of medical sciences
7 Mazandaran university of medical sciences
8 Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
9 3- Invasive Fungi Research Center/Department of Medical mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
10 1-Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman; 2- Center of Expertise in Mycology of Radboud UMC / Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
doi
10.32598/CMM.2023.1372چکیده
Background and Purpose: Given the high mortality rate of invasive candidiasis inhospitalized pediatric patients, it is crucial to establish a predictive system to achieveearly diagnosis and treatment of patients who are likely to benefit from early antifungal treatment. This study aimed to assess the Candida colonization index, species distribution, and antifungal susceptibility pattern of Candida strains isolated frompediatric patients with high Candida colonization index (CI)Materials and Methods: This study was carried out at the Children’s Medical Center inTehran-Iran. In total, 661 samples were collected from 83 patients. The Candida CI wascalculated according to the descriptions of previous studies. The isolates were identified using polymerase chain reaction-based techniques. The Clinical and Laboratory Standard Institute protocol M60 was used to conduct the antifungal susceptibility test.Results: A colonization index greater than 0.5 was confirmed in 29 cases (58% ofpositive samples) with two children developing candidemia. Candida albicans (n=53,49.5%) was the most common Candida species in patients with CI > 0.5. Except foracute lymphoblastic leukemia, no risk factors were linked to a high index in colonizedchildren (P > 0.05). Twelve isolates (7.01%) were multi-azole resistant with high MICsagainst both isavuconazole and ravuconazole and seven strains (4.09%) wereechinocandins resistant.Conclusion: In pediatric intensive care units, patients are at risk of fungal infection,particularly candidemia. In this study, more than half of the children with positive yeastcultures had CI > 0.5, and 6.8% developed candidemia.
