Typing and antifungal susceptibility of the candida species isolated in geriatric patients at a tertiary care center

Sevgi HANCI, Yeşer DERİCİ, Mümtaz ŞİRİN, Pınar ŞAMLIOĞLU, Arzu BAYRAM, Neval AĞUŞ, Nisel YILMAZ

Özet

Objective: In this study we aimed to detect, identification and distribution of the Candida species in blood and urine samples; and antifungal susceptibility of Candida bloodstream isolates in geriatric patientsMethods: All Candida species isolated from blood and urine cultures samples of patients over than 65 years of during the period December 2011 -November 2014 in İzmir Tepecik Training and Research Hospital were enrolled in this study. For Candida species identification conventional methods, colony appearance in candida chromogenic agar and for some unidentified isolates API ID32C AUX (BioMérieux, France) was used. Antifungal susceptibility testing of the isolates was performed with API ATB Fungus 3 (BioMérieux, France).Results: During the study period 681 Candida species were isolated in blood and urine samples of patients over than 65 years. When the sample species were evaluated, Candida species detected in 561(82.4%) urine sample, and 120 (17.6%) blood samples. Most isolated species were respectively detected C. albicans (47.0%), C.parapsilosis (16.0%), C.tropicalis (15.9%), C.glabrata (12.2%), C.kefy (3.7%) andC.krusei (2.8%). C. albicans detected the most common in urine samples (51.7 %), on the other hand C.parapsilosis the most common species in blood samples (50.8%). In general surgery unit, C.tropicalis was found as the most common isolate. On the other hand C.albicansthe most common species in the other units and services. C.parapsilosis rate in blood cultures increased with age. Antifungal susceptibility of the Candida bloodstream isolates were detected as 97.5% for flucytosine, 95.8% for amfotericin B, 82.5% for fluconazole, 91.7% for itraconazole and 77.5% for voriconazole.Conclusion: The most frequently isolated yeast species in blood and urinesamples of geriatric patients has been found C. albicans.C.parapsilosis especially frequently isolated from blood cultures and increasing the frequency with age. Voriconazole in Candida species is notable for low sensitivity rates.Key words: Candida species, candidemia, candiduria, blood culture, Antifungal susceptibility, geriatric

Abstract

Objective: In this study, it was aimed to compare the sensitivity of diagnostic tests in patients with a preliminary diagnosis of brucellosis.Methods: We have compared the serological methods, standard tube agglutination test (STA), Coombs Test (CT), Rose Bengal (RBT), and the gel centrifugation test. In patients with a preliminary diagnosis of brucellosis, subjects with a positive test result of RBT has been included in the research and other diagnostic tests STA, CT and Coombs Gel centrifugation tests were performed within the range of same titration.Results: Total 132 patient’s serums were studied. In RBT positive 92 patients’ serums, negative test results were found in 11 with STA, in 9 with CT and in 6 with gel test. While 35 patients were identified to be positive by using Brucella gel test at 1/5120 titer, no positive test results were seen with STA and CT at the same titer. Generally, CT results were one titration below the gel centrifugation test results.Conclusion: In conclusion, RBT and STA were not always adequate to determine the diagnosis of brucellosis. Low titer STA results should be supported by tests such as CT or gel centrifugation and the seroconversion must be monitored. Due to giving fast results, gel centrifugation test can be preferred in diagnosis of Brucellosis.Key words: Brucellosis, gel centrifugation, Coombs test