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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Comparison of Manual and Automated Method for Speciation and Antifungal Susceptibility of Candida Species Causing Blood Stream Infection in Critically ill Patients
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Comparison of Manual and Automated Method for Speciation and Antifungal Susceptibility of Candida Species Causing Blood Stream Infection in Critically ill Patients

机译：手动和自动化方法的描述和抗真菌敏感性念珠菌的敏感性，导致患者血流感染的物种

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Globally, the incidence Blood Stream Infection (BSI) by Candida species is increasing. It is associated with high mortality rates especially in immunocompromised critically ill patients. The epidemiology has been shifted from Candida species to Non-albicans Candida (NAC) in recent decades. Speciation of Candida spp. can help to improve the outcome of patients as few Candida species are intrinsically resistant to antifungal agents.Aim: To identify the spectrum of Candida species causing BSI, study their sensitivity pattern to antifungal agents and comparison of conventional (germ tube test, Dalmau plate culture and Chromagar) and automated (Vitek-2) methods for the same.Materials and Methods: Blood specimens of the clinically suspected cases of septicaemic patients were cultured by BacT/ALERT before administration of antibiotics or antifungals during the study period of one and half year. The isolated Candida were identified to the species level along with antifungal susceptibility testing done by both conventional and automated (Vitek-2) methods. Statistical analysis was done using Chi-square test.Results: Of the total 100 Candida isolated, the most common Candida species was C.parapsilosis (26%), followed by C.tropicalis (23%), C.albicans (21%) and C.auris (15%). Total concordance between manual and Vitek-2 identification was 74%. Significant risk factors involved in patients with candidemia were malignancy, diabetes mellitus and chronic kidney disease. Antifungal susceptibility rate for amphotericin B, caspofungin, fluconazole, flucytosine, micafungin and voriconazole was 94%, 90.5%, 73.8%, 96.4%, 98.8% and 95.2%, respectively. Mortality rate was 45% due to sepsis and associated complications.Conclusion: Early isolation, speciation and antifungal susceptibility is the key for management of candidemia cases to get the better outcome as C.auris , the important multidrug resistant variant has caused a major epidemiologic shift in candidemia. Molecular studies are required for accurate speciation of Candida species like C. auris, C. haemulonii, C. famata , etc.
机译：在全球范围内，念珠菌物种的发病率血流感染（BSI）正在增加。它与高死亡率有关，特别是在免疫功能性危重患者中。近几十年来，流行病学已经从念珠菌种类转移到非白名单念珠菌（NAC）。 Candida SPP的形态。可以帮助改善患者的结果，因为念珠菌种类本质上对抗真菌剂无关紧要。目的：鉴定念珠菌种类的频谱，导致BSI，研究它们的敏感性模式与抗真菌剂和比较常规（种生殖器测试，达莫板培养和Chromagar）和自动化（Vitek-2）方法。材料和方法：在给药前通过Bact / Alert培养临床疑似患者的临床疑似病例的血液标本抗生素或抗真菌在一个半年里的研究期间。孤立的念珠菌与常规和自动化（Vitek-2）方法进行的抗真菌敏感性测试鉴定到物种水平。使用Chi-Square试验进行统计分析。结果：孤立的总量100 念珠菌，最常见的念珠菌物种是 C.parapleIs（26％），其次是 C.Tropicalis（23％）， C.albicans（21％）和 C.auris（15％）。手动和Vitek-2识别之间的总协调为74％。候选血症患者患有显着的风险因素是恶性肿瘤，糖尿病和慢性肾病。两性统计蛋白B，Caspofungin，氟康唑，氟葡萄球菌，Micafungin和伏立康唑的抗真菌敏感率分别为94％，90.5％，73.8％，96.4％，98.8％和95.2％。由于败血症和相关的并发症，死亡率为45％。结论：早期分离，物种和抗真菌敏感性是念珠菌病例管理的关键，以获得更好的结果作为 C.auris，这是重要的多药抗性变种曾因念珠菌血症造成了重大流行病学转变。需要分子研究，用于准确的念珠菌物种（如

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