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[Molecular epidemiologic surveillance and antifungal agent sensitivity of Candida albicans isolated from anesthesia

Zeynep Gülay1, Cem Ergon, Aydan Ozkütük

  • 1Dokuz Eylül Universitesi Tip Fakültesi Hastanesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Izmir.

Mikrobiyoloji Bulteni
|July 4, 2003
PubMed

Insights

Nosocomial fungal infections, particularly Candida albicans, are a growing concern in intensive care units (ICUs). This study monitored C. albicans urine isolates, finding susceptibility to antifungals but evidence of both endogenous and exogenous spread among patients.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Intensive care unit (ICU) patients face increased risk of nosocomial infections.
  • Nosocomial fungal infections, especially from Candida albicans, are rising.
  • Candida albicans is the most common fungal pathogen in healthcare settings.

Purpose of the Study:

  • To conduct epidemiological surveillance of Candida albicans urine isolates from ICU patients.
  • To assess antifungal susceptibility and genetic relatedness of C. albicans isolates.
  • To investigate potential sources of C. albicans infections in ICUs.

Main Methods:

  • Collected and analyzed 38 C. albicans urine isolates from 29 ICU patients between June 2000 and October 2001.
  • Determined antifungal susceptibility to amphotericin B and fluconazole using microdilution method (MIC).
  • Employed Randomly Amplified Polymorphic DNA (RAPD) analysis with two primers to evaluate clonal relationships.

Main Results:

  • Amphotericin B showed low minimal inhibitory concentration (MIC) values (MIC50 = 0.5 µg/ml), with no high-level resistance.
  • Fluconazole MIC values ranged from 0.25-16 µg/ml (MIC50 = 1 µg/ml); no resistance was observed, but two isolates were dose-dependent susceptible.
  • RAPD analysis revealed significant genetic diversity, with 22 and 24 distinct patterns using two different primers, suggesting multiple C. albicans strains.

Conclusions:

  • The majority of C. albicans urine isolates likely originated endogenously from patients.
  • Exogenous spread of C. albicans between patients is also a possibility, indicated by clonally related isolates found in different patients concurrently.
  • Findings highlight the need for continued surveillance and infection control measures against C. albicans in ICUs.

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