由于广泛化疗后免疫系统减弱,癌症患者中会出现念珠菌属的机会性真菌感染。抗真菌药物的预防已经发展出念珠菌属的抗性。抗真菌药。准确识别酵母菌和易感性模式是直接影响患者治疗的主要问题。
■在三年的时间里,目前的调查包括了325名疑似念珠菌感染的癌症患者。通过聚合酶链反应-限制性片段长度多态性(PCR-RFLP)对临床分离株进行分子鉴定。所有菌株,对两性霉素B的体外敏感性进行了检查,伊曲康唑,氟康唑,和anidulafungin根据CLSIM27文档。
■74例癌症患者有念珠菌感染(22.7%)。白色念珠菌是最常见的物种(83.8%)。抗真菌药敏结果表明,100%的念珠菌分离株对两性霉素B敏感;17.6%,9.4%,5.4%的临床分离株对阿尼达芬净耐药,氟康唑,和伊曲康唑,分别。
■本工作的结果表明,对棘白菌素的抗性有警告性增加。由于所有氟康唑耐药菌株均来自念珠菌菌血症,我们推荐两性霉素B作为这种潜在致死性感染的一线治疗药物.
Opportunistic fungal infections by Candida species arise among cancer patients due to the weakened immune system following extensive chemotherapy. Prophylaxis with antifungal agents have developed the resistance of Candida spp. to antifungals. Accurate identification of yeasts and susceptibility patterns are main concerns that can directly effect on the treatment of patients.
Over a period of three years, 325 cancer patients suspected to Candida infections were included in the current investigation. The clinical isolates were molecularly identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). All strains, were examined for in vitro susceptibility to the amphotericin B, itraconazole, fluconazole, and anidulafungin according to the CLSI M27 document.
Seventy-four cancer patients had Candida infections (22.7%). Candida albicans was the most common species (83.8%). Antifungal susceptibility results indicated that 100% of the Candida isolates were sensitive to amphotericin B; however, 17.6%, 9.4%, and 5.4% of clinical isolates were resistant to anidulafungin, fluconazole, and itraconazole, respectively.
The findings of the present work shows a warning increase in resistance to echinocandins. Since all fluconazole resistance isolates were obtained from candidemia, we recommend amphotericin B as the first line therapy for this potentially fatal infection.