Mikrobiyoloji ve klinik mikrobiyoloji anabilim dalı derin mikoz laboratuarında 01 Nisan 1999-27 Mart 2001 arasında ayrılan maya ve küflerin tür dağılımları ve duyarlılık paterni

The species distribution and antifungal susceptibility pattern of yeasts and molds isolated in the department of microbiology and clinical microbiology deep mycoses laboratory between 01 April 1999-27 March 2001

Özet

Bu çalışmanın amacı, Cerrahpaşa Tıp Fakültesi Kliniklerinden Mikrobiyo- loji ve Klinik Mikrobiyoloji Anabilim amfoterisin B, flukonazol, itrakonazol, ketokonazol, mikonazol, flusitozin ve terbinafin karşısındaki duyarlılıkları NCCLS referans M27-A ve M38-P yön- temleri ile belirlenmiştir. Toplam 146 maya ve 12 küf ayrılmış- tır. C. albicans’lar %66.4 (97/146) ve C. albicans dışı Candida’lar %33.6 (49/146) oranındadır. Ayrılan çeşitli maya türle- rinin karşılaşma sıklığı C. catenulata 1 (% 0.7), C. glabrata 6 (%4.1), C. kefyr 4 (% 2.7), C. krusei 6 (%4.1), C. lipolytica 3 (% 2.0), C. lusitaniae 1 (%0.7), C. Para- psilosis 8 (% 5.5), C. rugosa 2 (% 1.4), C. tropicalis 12 (% 8.2), M. furfur 1 (% 0.7), T. beigelii 3 (% 2.0), Cryptococcus neofor- mans 2 (%1.4)’dir. İnfeksiyon etkeni o- larak ayrılan küf mantarlarının sıklığı Aspergillus flavus 4 (%33.3), A. Fumi- gatus 2 (%16.6), A. niger 3 (%25), A. versicolor 1 (%8.3), Cladosporium clado- sporioides 1 (%8.3), Scopulariopsis can- dida 1 (%8.3) ve Cladosporium sp 1 (% 8.3)’dir. NCCLS kriterlerine göre değerlendi- rildiğinde çalışmamızda FKZ için direnç (MIC ³64 mg/ml) C. albicans kökenlerin- de 21 (%21.6), albicans dışı Candida türlerinde 19 (%38.8), İTZ’e direnç (MIC ³1 mg/ml) C. albicans kökenlerin- de 31 (%32), albicans dışı Candida’larda 15 (%30.6), 5-FC’e karşı direnç (MIC ³32 mg/ml) C. albicans kökenlerinde 5 (% 5.1), albicans dışı Candida’larda 7 (% 14.3)’dir.

Abstract

The purpose of this study was to characterize the species distribution and antifungal susceptibility patterns of yeast and mold strains isolated at deep mycoses laboratory, Department of Microbiology and Clinical Microbiology. The species distribution and antifungal susceptibility patterns of the clinically significant yeast and mold isolates recovered from deep mycoses suspected patients. specimens over a two year period were determined against amphotericin B, fluconazole, itraconazole, ketoconazole, miconazole, flucytosine and terbinaphyne using the M27-A and M38-P reference methods. Results.- A total of 146 yeast and 12 mould strains were isolated. C. albicans strains was %66.4 (97/146), and non-albicans Candida species were %33.6 (49/146). The frequency of various yeast species identified was Candida catenulata 1 (0.7%), C. glabrata 6 (4.1%), C.kefyr 4 (2.7%), C. krusei 6 (4.1%), C. lipolytica 3 (2.0%), C. lusitaniae 1 (0.7%), C.parapsilosis 8 (5.5%), C. rugosa 2 (1.4%), C. tropicalis 12 (8.2%), M. furfur 1 (0.7%), T.beigelii 3 (2.0%), Cryptococcus neoformans 2 (1.4%). The frequency of mold species identified Aspergillus flavus 4 (33.3%), A. fumigatus 2 (16.6%), A. niger 3 (25%), A.versicolor 1 (8.3%), Cladosporium cladosporioides 1 (8.3%), Scopulariopsis candida 1 (8.3%) and Cladosporium sp 1 (8.3%). Resistance to fluconazole (MIC > or = 64 micrograms/ml) as per NCCLS criteria was observed in 21 C. albicans (21.6%), 19 non-albicans Candida strains (38.8%); resistance to itraconazole (MIC > or = 1 micrograms/ml) in 31 C. albicans (32.2%), 15 nonalbicans Candida strains (30.6%) and resistance to flucytosine (MIC > or = 32 micrograms/ml) in 5 C. albicans (5.1%), 7 non-albicans Candida strains 7 (14.3%). Conclusion.- The present study indicates that Candida sp. are emerging as important pathogens in immunocompromised patients and the tendency of yeasts to develop resistance to antifungal agents and the appearance of species/strain specific susceptibility of molds, in vitro tests seem to be useful for patient management.