Abstract
Invasive candidiasis is a common nosocomial infection with high attributable mortality among ICU patients. This study was performed to determine isolation rate of Candida spp. in cardiac surgical ICUs during the period of 2001–2007 and to assess changes in prevalence of different Candida species and their susceptibilities to modern antifungal agents. A total of 16352 different clinical specimens were tested. Candida species were isolated in 547 patients; there was a trend toward increase of their prevalence (from 9% to 15%) among pathogens isolated, particularly from blood and respiratory secretions. Proportion of non-albicans strains has been increased more than 2 times during the study period (form 25% in 2002 to 55% in 2007). The predominant species isolated from sputum was C. albicans (77%), followed by C. tropicalis and C. krusei. Incidence of candidemia in ICU patients has been increased 3 times during the 2005–2007. The most common Candida species isolated from blood (both in children and adults) were C. parapsilosis and C. albicans. A total of 144 Candida spp. strains were tested for susceptibility to antifungals. All strains (100%) were susceptible to amphotericin B. Susceptibilities to fluconasole and itraconasole among Candida spp. were 51% and 50%, respectively. The most active antifungal against Candida spp. was voriconasole (81%).
-
1.
Климко Н.Н. Микозы: диагностика и лечение. – М.: Премьер МТ, 2007.–146 с.
-
2.
Fluit A.C., Verhoof G., Schmitz F.G., et al. The SENTRY antimicrobial serveillance program, 1997 and 1998. Clin Infect Dis 2000; 30:454-60.
-
3.
Wisplinghoff H. Clin Inf Dis 2004; 39:309-17.
-
4.
Wey S.B., Mori M., Pfaller M.A., et al. Hospital acquired candidemia: the attributable mortality and excess of study. Arch Inter Med 1988; 148:264.
-
5.
Gudlangsson O., Gillespie S., Lee K., et al.: Attributable mortality of nosocomial candidemia, revisited. Clin Infect Dis 2003; 37:1172-7.
-
6.
Munos P. Rev Clin Es 1993; 193:47-8.
-
7.
Rex J.H., Bennet J.E., Sugar A.M., et al. A randomized trial comparing fluconazol with amphotericin B for the treatment of candidemia in patients without neutropenia. Candidemia Study Group and the National Institute. New Engl J Med 1994; 331:1325-30.
-
8.
Бокерия Л.А., Белобородова Н.В. Инфекция в кардиохирургии.– М.: НЦ ССХ им. А.Н. Бакулева РАМН, 2007. – с.
-
9.
Pauw B. Serious Candida infections: diagnosis, treatment and prevention. Ed. B. Pauw, J. Dodey. Health Communication Press 1998, p. 1-3.
-
10.
Веселов А.В. и соавт. Эпидемиология возбудителей кандидозов и их чувствительность к азолам. Клин микробиолог антимикроб химиотер 2005; 7(1):68-76.
-
11.
Rex J.H., Pfaller M.A., Galgiani G.N., et al. Clin Infect Dis 1997; 24:235-47.
-
12.
Ostrosky-Zeichner L., Rex J.H., Pappas P.G., et al. Antifungal susceptibility survey of 2,000 bloodstream Candida isolates in the United States. Antimicrob Agents Chemother 2003; 47(10):3149-54.
-
13.
Barchiesi F., Tortorano A.M., Di Francesco L.F., et al. Invitro activity of five antifungal agents against uncommon clinical isolates of Candida spp. J Antimicrob Chemother 1999; 43(2):295-9.
-
14.
Pfaller M.A., Diekema D.J., Rinaldi M.G., et. al. Results from the ARTEMIS DISK Global Antifungal Surveillance Study: a 6.5-year analysis of susceptibilities of Candida and other yeast species to fluconazole and voriconazole by standardized disk diffusion testing. J Clin Microbiol 2005 ;43(12):5848-59.
-
15.
Espinel-Ingroff A. In vitro antifungal activities of anidulafungin and micafungin, licensed agents and the investigational triazole posaconazole as determined by NCCLS methods for 12,052 fungal isolates: review of the literature. Rev Iberoam Micol 2003; 20(4):121-36.
-
16.
Stevens D.A., White T.C., Perlin D.S., Selitrennikoff C.P. Studies of the paradoxical effect of caspofungin at high drug concentrations. Diagn Microbiol Infect Dis 2005; 51(3):173-8.
-
17.
Chamilos G., Lewis R.E., Albert N., Kontoyiannis D.P. Paradoxical effect of echinocandins across Candida species in vitro: evidence for echinocandin-specific and candida species-related differences. Antimicrob Agents Chemother 2007; 51(6):2257-9.