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Candida isolates from neonates: frequency of misidentification and reduced fluconazole susceptibility
J L Rowen1, J M Tate, N Nordoff
1Departments of Pediatrics, University of Texas Medical Branch, Galveston, Texas 77555, USA. jrowen@utmb.edu
Journal of Clinical Microbiology
|October 19, 1999
Abstract:
Systemic candidiasis affects 1.6 to 4.5% of very low birth weight (8 microg/ml.
Insights
Systemic candidiasis impacts vulnerable premature infants. A study found some Candida strains were misidentified, and several non-albicans species showed resistance to fluconazole, impacting treatment efficacy.
Area of Science:
- Medical Mycology
- Neonatal Intensive Care
Background:
- Systemic candidiasis is a significant concern in very low birth weight infants.
- Incidence ranges from 1.6% to 4.5% in this vulnerable population.
Purpose of the Study:
- To assess the accuracy of Candida strain identification in neonatal intensive care units.
- To evaluate the antifungal susceptibility of Candida isolates, particularly to fluconazole.
Main Methods:
- Creation of a Candida strain archive from multiple intensive care nurseries.
- Identification of 98 Candida isolates.
- Antifungal susceptibility testing (MICs) for fluconazole.
Main Results:
- Eight percent of isolates (8.2%) were initially misidentified.
- Seven isolates (7.1%), all non-Candida albicans species, exhibited fluconazole minimum inhibitory concentrations (MICs) greater than 8 microg/ml.
- One of the fluconazole-resistant isolates was initially misidentified.
Conclusions:
- Inaccurate identification of Candida species can occur in clinical settings.
- Emerging fluconazole resistance in non-albicans Candida species poses a therapeutic challenge for systemic candidiasis in neonates.