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Molecular assay to detect nosocomial fungal infections in intensive care units.

Abstract：

SUMMARY:The aims of this study were to determine the incidence of fungal infections in hospital intensive care units and to evaluate a molecular method to detect these infections. MATERIAL AND METHODS:The participants in this study were patients admitted to any of the 10 intensive care units at Nemazi Hospital (Shiraz, southern Iran) between March 2009 and January 2010. Oral and rectal swabs, urine, and sputum samples from patients were checked for fungal colonization. If a nosocomial fungal infection was suspected, clinical samples were examined for fungal infection by culture, direct microscopic examination and real-time PCR. Blood samples were cultured by bedside inoculation onto BACTEC medium. Susceptibility of the isolates to antifungal agents was also determined. RESULTS:Of 870 patients, 550 (63.2%) had Candida colonization in different body sites and 17 (1.9%) had fungal infections. The mortality rate in patients with fungal infections was 58.8% (10 cases). The etiologic agents were Candida albicans, Candida glabrata, Aspergillus flavus, Aspergillus fumigatus and Aspergillus spp. Three C. albicans were found to be resistant to amphotericin B and itraconazole, and one A. fumigatus and two A. flavus were resistant to amphotericin B, ketoconazole and itraconazole. One A. fumigatus was additionally resistant to caspofungin. CONCLUSIONS:Considering the incidence of fungal infections and their high mortality rate, early detection, prompt diagnosis and treatment are critical. Molecular assays can serve as a diagnostic tool to manage patients admitted to the intensive care unit. Antifungal susceptibility testing in different geographical regions can support the choice of prophylaxis and treatment for these patients.

journal_name

Eur J Intern Med

journal_title

European journal of internal medicine

authors

Badiee P,Alborzi A,Joukar M

doi

10.1016/j.ejim.2011.08.025

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

611-5

issue

6

eissn

0953-6205

issn

1879-0828

pii

S0953-6205(11)00198-1

journal_volume

22

pub_type

杂志文章,多中心研究

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