ABSTRACT
The incidence of opportunistic fungal infection has increased dramatically in the past few decades, especially in immunocompromised hosts. Candida albicans the major cause of invasive candidiasis, has become one of the pathogens most frequently isolated from the blood of post-operative and imunocompromised patients in the last decade with a mortality rate of about 50%. Diagnosis of candidemia or hematogenous candidiasis has been problematic due to the low positivity of blood cultures, with the rate of recovery from blood cultures ranged between 40-60%. The development of DNA-based methods for detection of candida provides an alternative and potentially more sensitive means for diagnosing disseminated candidiasis. The aim of the work was detection of candidemia in children with hematological malignancies and determination of Candida species using PCR-REA in comparison with fungal blood culture. Thirty-two [32] children [20 males and 12 females] with hematological malignancies their ages were below 18 years; were admitted at Oncology Unit of Pediatric Department of Tanta University Hospitals and were subjected to complete history taking, thorough clinical examination complete blood picture and bone marrow examination. They were tested for candidemia by conventional blood culture, and polymerase chain reaction [PCR] method with appropriate restriction enzyme analysis [REA] of the resultant amplicons. The study revealed that the PCR-REA method detected that 8 patients [25% of the examined Population] had Positive results for candidemia with Candida albicans was the most common species found in 50% of patients with candidemia, while conventional blood culture detected candidemia in only 2 patients [6.25% of the examined population]. However, emergence of other Candida species were noticed. This study also revealed that patients suffering from fever of unknown origin [FUO], severe neutropenia dysphagia, and mucosal barrier injuries are at high risk to develop candidemia. Immunocompromised patients especially those at high risk to develop candidemia such as hematological malignant patients should be examined for candidemia using PCR-REA technique to obtain rapid and accurate results