Volume 6, Issue 4 (11-2016)                   Iran J Ped Hematol Oncol 2016, 6(4): 209-215 | Back to browse issues page

XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Kafshdooz Jabari S, Chadeganipour M, Ghahri M, Mohammadi R. Etiologic Agents of Candidemia in Pediatric Immunocompromised Patients. Iran J Ped Hematol Oncol 2016; 6 (4) :209-215
URL: http://ijpho.ssu.ac.ir/article-1-270-en.html
Assistant professor, Medical Mycology, Department of Medical Parasitology and Mycology, Infectious Diseases and Tropical Medicine Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract:   (4356 Views)

Abstract

Background:

Candidemia is the main cause of fungal nosocomial bloodstream infections and is related to meaningful mortality specially, in pediatrics. Mortality rate range from 5% to 71%, and it can reach as high as 81%. Delays in beginning of treatment have also been linked to intensified mortality. The epidemiology of Candida infection is changing from region to region. Regional surveillance of the epidemiology of candidemia is necessary to identify patients at highest risk. The aim of this study is rapid and precise detection of Candida species isolated from blood stream by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique.

Materials and Methods:

This cross sectional study was conducted during October 2013 to January 2015. Sixteen Candida strains were isolated from 36 patients with positive blood culture in Milad hospital, Resalat Lab., Tehran, Iran. All isolates were identified by PCR-RFLP patterns after digestion with the restriction enzyme HpaII. Results:

Candida albicans (72.2%) and Candida glabrata (22.2%) were the most prevalent species among isolates. Male to female ratio was 9/7, ranging in age from 4-16 years.

Conclusion:

Candida albicans remains the most frequently isolated species in the present study; however nonalbicans Candida species are increasing. Precise identification of Candida spp. can lead to a better management of candidemia. 

Full-Text [PDF 233 kb]   (1171 Downloads)    
Type of Study: Research | Subject: Heart
Received: 2016/06/1 | Accepted: 2016/09/27 | Published: 2016/10/29

References
1. Perlroth J, Choi B, Spellberg B. Nosocomial fungal infections: epidemiology, diagnosis, and treatment. Med Mycol 2007;45:321-46. [Article]
2. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004;39:309-17. [Article]
3. Horn DL, Neofytos D, Anaissie EJ, Fishman JA, Steinbach WJ, Olyaei AJ, et al. Epidemiology and outcomes of candidemia in 2019 patients: data from the prospective antifungal therapy alliance registry. Clin infectious dis 2009;48:1695-703. [Article]
4. Wisplinghoff H, Seifert H, Tallent SM, Bischoff T, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in pediatric patients in United States hospitals: epidemiology, clinical features and susceptibilities. Pediatr Infect Dis 2003;22:686-91. [Article]
5. Peres‐Bota D, Rodriguez‐Villalobos H, Dimopoulos G, Melot C, Vincent JL. Potential risk factors for infection with Candida spp. in critically ill patients. Clin Microbiol Infect 2004;10:550-5. [Article]
6. Antoniadou A, Torres HA, Lewis RE, Thornby J, Bodey GP, Tarrand JP, et al. Candidemia in a tertiary care cancer center: in vitro susceptibility and its association with outcome of initial antifungal therapy. Medicine 2003;82:309-21. [Article]
7. Falagas ME, Roussos N, Vardakas KZ. Relative frequency of albicans and the various non-albicans Candida spp among candidemia isolates from inpatients in various parts of the world: a systematic review. Int J Infect Dis 2010;14:e954-e66. [Article]
8. Zilberberg MD, Kollef MH, Arnold H, Labelle A, Micek ST, Kothari S, et al. Inappropriate empiric antifungal therapy for candidemia in the ICU and hospital resource utilization: a retrospective cohort study. BMC infect Dis 2010;10:150. [Article]
9. McMullan R, Metwally L, Coyle P, Hedderwick S, McCloskey B, O'Neill H, et al. A prospective clinical trial of a real-time polymerase chain reaction assay for the diagnosis of candidemia in nonneutropenic, critically ill adults. Clin Infect Dis 2008;46:890-6. [Article]
10. Mohammadi R, Mirhendi H, Rezaei-Matehkolaei A, Ghahri M, Shidfar MR, Jalalizand N, et al. Molecular identification and distribution profile of Candida species isolated from Iranian patients. Med Mycol 2013;51:657-63. [Article]
11. Ascioglu S, Rex J, De Pauw B, Bennett J, Bille J, Crokaert F, et al. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis 2002;34:7-14. [Article]
12. Borman AM, Linton CJ, Miles S-J, Campbell CK, Johnson EM. Ultra-rapid preparation of total genomic DNA from isolates of yeast and mould using Whatman FTA filter paper technology-a reusable DNA archiving system. Med Mycol 2006;44:389-98. [Article]
13. Mohammadi R, Nazeri M, Mesdaghinia E, Mirhendi SH. Identification of Candida Species among Patients with Vulvovaginal Candidiasis in Kashan by PCR-RFLP Method. J Isfahan Med Sch 2012;29(165):1-8. [Article]
14. Mirhendi H, Makimura K, Khoramizadeh M, Yamaguchi H. A one-enzyme PCR-RFLP assay for identification of six medically important Candida species. Nippon Ishinkin Gakkai Zasshi 2006;47:225-9. [Article]
15. Marchetti O, Bille J, Fluckiger U, Eggimann P, Ruef C, Garbino J, et al. Epidemiology of candidemia in Swiss tertiary care hospitals: secular trends, 1991–2000. Clin Infect Dis 2004;38:311-20. [Article]
16. Sipsas NV, Lewis RE, Tarrand J, Hachem R, Rolston KV, Raad II, et al. Candidemia in patients with hematologic malignancies in the era of new antifungal agents (2001‐2007). Cancer 2009;115:4745-52. [Article]
17. Krcmery V, Barnes A. Non-albicans Candida spp. causing fungaemia: pathogenicity and antifungal resistance. J Hosp Infect 2002;50:243-60. [Article]
18. Pfaller M, Diekema D. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev 2007;20:133-63. [Article]
19. Groll A, Ritter J. Diagnosis and management of fungal infections and pneumocystis pneumonitis in pediatric cancer patient. Klinische Padiatrie 2005;217:S37-66. [Article]
20. Ahmad S, Khan Z, Mustafa AS, Khan ZU. Seminested PCR for diagnosis of candidemia: comparison with culture, antigen detection, and biochemical methods for species identification. J Clin Microbiol 2002;40:2483-9. [Article]
21. Ellepola A, Morrison CJ. Laboratory diagnosis of invasive candidiasis. J Microbiol 2005;43:65-84. [Article]
22. Posteraro B, Sanguinetti M, Masucci L, Romano L, Morace G, Fadda G. Reverse cross blot hybridization assay for rapid detection of PCR-amplified DNA from Candida species, Cryptococcus neoformans, and Saccharomyces cerevisiae in clinical samples. J Clin Microbiol 2000;38:1609-14. [Article]
23. Khan Z, Mustafa A. Detection of Candida species by polymerase chain reaction (PCR) in blood samples of experimentally infected mice and patients with suspected candidemia. Microbiol Res 2001;156:95-102. [Article]
24. Pfeiffer CD, Samsa GP, Schell WA, Reller LB, Perfect JR, Alexander BD. Quantitation of Candida CFU in initial positive blood cultures. J Clin Microbiol 2011;49:2879-83. [Article]
25. Pappas PG, Rex JH, Lee J, Hamill RJ, Larsen RA, Powderly W, et al. A prospective observational study of candidemia: epidemiology, therapy, and influences on mortality in hospitalized adult and pediatric patients. Clin Infect Dis 2003;37:634-43. [Article]
26. Tortorano AM, Kibbler C, Peman J, Bernhardt H, Klingspor L, Grillot R. Candidaemia in Europe: epidemiology and resistance. Inter J Antimicrob Agen 2006;27:359-66. [Article]
27. Kibbler C, Seaton S, Barnes RA, Gransden W, Holliman R, Johnson E, et al. Management and outcome of bloodstream infections due to Candida species in England and Wales. J Hosp Infect 2003;54:18-24. [Article]
28. Zaoutis TE, Argon J, Chu J, Berlin JA, Walsh TJ, Feudtner C. The epidemiology and attributable outcomes of candidemia in adults and children hospitalized in the United States: a propensity analysis. Clin Infect Dis 2005;41:1232-9. [Article]
29. Gudlaugsson O, Gillespie S, Lee K, Berg JV, Hu J, Messer S, et al. Attributable mortality of nosocomial candidemia, revisited. Clin Infect Dis 2003;37:1172-7. [Article]
30. Weinberger M, Leibovici L, Perez S, Samra Z, Ostfeld I, Levi I, et al. Characteristics of candidaemia with Candida-albicans compared with non-albicans Candida species and predictors of mortality. J Hosp Infect 2005;61:146-54. [Article]
31. Malani A, Hmoud J, Chiu L, Carver PL, Bielaczyc A, Kauffman CA. Candida glabrata fungemia: experience in a tertiary care center. Clin Infect Dis 2005;41:975-81. [Article]
32. Garey KW, Rege M, Pai MP, Mingo DE, Suda KJ, Turpin RS, et al. Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis 2006;43:25-31. [Article]
33. Morrell M, Fraser VJ, Kollef MH. Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality. Antimicrob Agen Chemoth 2005;49:3640-5. [Article]
34. Aghili SR, Shokohi T, Boroumand MA, Fesharaki SH, Salmanian B. Intravenous Catheter-Associated Candidemia due to Candida membranaefaciens: The First Iranian Case. J Tehran Heart Cent 2015;10:101-5. [Article]
35. Shahhosseiny MH, Nematian Soteh M, Ghahri M, Saadatmand S, Hosseiny SA. Identification of CandidaSpecies by Seminested PCR in Candidemia. Iranian J Med Microbiol 2010;4:91-9. [Article]
36. Ghahri M, Mirhendi H, Imani FAA, Beyraghi S. Species Identification of Candida Strains Isolated from Patients with Candidemia, Hospitalized in Tehran, by Enzymatic Digestion of ITS–rDNA. Isfahan Med Sch 2012.29. [Article]
37. Kalantar E, Assadi M, Pormazaheri H, Hatami S, Barari MA, Asgari E, et al. Candida non albicans with a High Amphotericin B Resistance Pattern Causing Candidemia among Cancer Patients. Asian Pacific journal of cancer prevention: APJCP 2013;15:10933-5. [Article]

Add your comments about this article : Your username or Email:
CAPTCHA

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Iranian Journal of Pediatric Hematology and Oncology

Designed & Developed by : Yektaweb