Pattern of candida urinary tract infections among cancer patients in south Egypt cancer institute

The last decade has seen the sustained medical importance of opportunistic infections due to different Candida species mainly because of the worldwide increasing in the number of immunocompromised patients, who are highly susceptible to opportunistic infections. Urine samples were collected from 106 cancer patients in South Egypt Cancer Institute [SECI] that were cultured on Sabouraud dextrose agar media for isolation of Candida species. After Gram staining subculture was done on Hicrome Candida Differential Agar media. Results of the previous media were compared with those obtained with API 20C AUX yeast identification kits. The study revealed an overall isolation rate of Candida species among urinary tract infections was 20.8% [22/106]. Single type of Candida species was isolated from cancer patients with candiduria 16/22 [72.7%] while six patients had mixed species. Candida albicans was the most frequent species isolated responsible for fungal urinary tract infections 27.3% [6/22]. Non-Candida albicans species including Candida tropicalis [13.6%], Candida glabrata [13.6%], Candida stellatoides [9.1%], Candida krusei [4.5%] and Candida guilliermondii [4.5%] were also isolated. Candida albicans, Candida stellatoides and Candida guilliermondii could not be identified on chrom agar as all the isolates gave similar green colonies. Also Candida glabrata and Candida krusei could not be identified on chrom agar as they gave similar white colonies. Chrom agar identifies all Candida tropicalis as the isolates gave the typical pattern of purple to blue colonies. Candida albicans identified on Czapek Dox Agar media as they produced chlamydospores. The results of API 20C AUX were in 100% agreement with the results of Chrom agar in identification of Candida tropicalis. E-test on [SDA] was found to be an accurate method for antifungal susceptibility as it was compared with the reference broth microdilution method recommended by National Committee for Clinical Laboratory Standards [NCCLs]. For fluconazole the E-test demonstrated 94.1% agreement for all candida species

Candiduria in a public hospital of São Paulo (1999-2004): characteristics of the yeast isolates

The study involved 100 yeast isolates, obtained from urine samples provided by a Public Pediatric Hospital of São Paulo, Brazil, from 1999 to 2004. The most frequent species was Candida albicans, followed by C. tropicalis, C. glabrata and C. parapsilosis. In regard to virulence, 97 percent of the isolates showed index 3 for proteinase and 63 percent index 2 for phospholipase. The most frequent killer biotypes were 511 and 888.

Estudou-se 100 amostras de leveduras, isoladas de urina, provenientes de Hospital Público Infantil de São Paulo Brasil, no período de 1999-2004. A espécie mais freqüente foi Candida albicans, seguida de C. tropicalis, C. glabrata e C. parapsilosis. Em relação à virulência, 97 por cento dos isolados apresentaram índice 3 para proteinase e, 63 por cento índice 2 para fosfolipase. Os biótipos "killer" mais freqüentes foram o 511 e 888.

Patrones de resistencia bacteriana en urocultivos en un hospital oncológico / Antimicrobial resistance patterns of isolates from urine cultures at an oncological center

OBJETIVOS: Describir los patrones de resistencia bacteriana en cultivos de orina en un hospital oncológico. MATERIAL Y MÉTODOS: Se incluyeron las cepas obtenidas de cultivos de orina de 1998 a 2005. Se obtuvo el porcentaje de sensibilidad para diferentes antibióticos, tras analizar por separado cepas nosocomiales y compararlas con las de la comunidad. RESULTADOS: Se detectaron 9 232 cultivos positivos (20.7 por ciento) de 44 447 muestras: gramnegativos, 78.8 por ciento; grampositivos, 13.8 por ciento; y levaduras, 7.4 por ciento. Escherichia coli fue el principal microorganismo identificado (41.3 por ciento); la resistencia en aislados nosocomiales fue mayor que en la comunidad para amikacina (92.4 y 97 por ciento), ceftazidima (83.1 y 95.1 por ciento) y ciprofloxacina (46.2 y 58.6 por ciento). De igual manera, Pseudomonas aeruginosa presentó mayor resistencia para amikacina y ceftazidima en las cepas nosocomiales (55.7 y 66.6 por ciento; y 65.5 y 84.8 por ciento, respectivamente). Enterococcus resistente a vancomicina se encontró sólo en 2.5 por ciento (3/119 aislados de E. faecium). CONCLUSIONES: Existe una mayor resistencia bacteriana en las cepas de origen nosocomial en comparación con las cepas comunitarias. Se encontró un incremento progresivo de la resistencia para E. coli, el patógeno aislado con más frecuencia de infecciones nosocomiales y comunitarias. Es prioritario intensificar una campaña educativa para el control y uso racional de los antibióticos.

OBJECTIVE: To describe the patterns of antimicrobial resistance of organisms isolated from urine cultures at a teaching oncological hospital for adult patients. MATERIAL AND METHODS: All strains obtained from urine cultures from 1998 to 2005 were included. Mean susceptibilities were obtained for each antimicrobial tested; nosocomial and community-acquired isolates were analyzed separately. RESULTS: A total of 9 232 positive urine cultures were obtained (20.7 percent) from 44 447 samples taken. Gram negative bacteria were reported in 78.8 percent, Gram-positive in 13.8 percent and yeasts in 7.4 percent. Escherichia coli was the most frequently isolated bacterium (41.3 percent); antimicrobial resistance was higher in nosocomial isolates than in community strains (amikacin 92.4 vs. 97 percent, ceftazidime 83.1 vs. 95.1 percent and ciprofloxacin 46.2 vs. 58.6 percent). Pseudomonas aeruginosa showed a greater resistance to amikacin and ceftazidime in nosocomial cultures compared to community-acquired bacterial cultures (55.7 vs. 66.6 percent and 65.5 vs. 84.8 percent respectively). Vancomycin-resistant enterococci were found in only 2.5 percent (3 of 119 E. faecium isolates). CONCLUSIONS: Higher bacterial resistance was observed in nosocomial cultures than in community ones. Antimicrobial resistance was found to be progressively increasing for E. coli, the most frequent pathogen isolated both in nosocomial and community infections. We consider imperative the establishment of an intense educational campaign for the use and control of antibiotics.

Candidúria: uma abordagem clínica e terapêutica / Candiduria: a clinical and therapeutic approach

O achado laboratorial de candidúria traz dilemas em relação a sua interpretação visto que pode refletir uma amplitude de possibilidades clínicas, incluindo colonização, infecção urinária alta ou doença sistêmica por Candida spp. Neste artigo, abordaremos a epidemiologia, o diagnóstico e a terapêutica da candidúria em diversos cenários clínicos, incluindo pacientes transplantados renais. De forma prática e para efeito de abordagem terapêutica, a interpretação do achado de candidúria é baseada na presença de dados clínicos e epidemiológicos Quando necessária, a terapêutica antifúngica para os casos de candidúria pode ser realizada com: anfotericina B sistêmica, anfotericina B tópica (irrigação vesical) ou fluconazol. A coleta de hemoculturas deve ser indicada em pacientes com candidúria sob risco para desenvolvimento de candidíase hematogênica. A retirada da sonda vesical de demora deve ser considerada sempre que possível, pois reduz a possibilidade de persistência ou recorrência da infecção urinária por Candida spp.

Candiduria remains a controversial issue for clinicians once that it may represent a broad variety of possibilities including colonization, local or systemic infection. We will discuss the epidemiology, diagnosis and treatment of candiduria in different settings of patients, including renal transplant recipients. Definitions on therapy are mostly based on epidemiological and clinical data. Once antifungal therapy is required the following antifungal treatment may be used: intravenous amphotericin B, bladder irrigation with amphotericin B or fluconazole. Blood cultures may be required in patients with candiduria and high risk for developing hematogenous infection. Removal of the urinary catheter must be considered in order to avoid persistent candiduria and recurrence.

Candida colonization in intensive care unit patients' urine

The objective of this study was to identify possible predisposing factors for candiduria in intensive care unit (ICU) patients from Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, Brazil, during one year. Urine samples from 153 ICU patients were obtained by catheterization on admission day and every seven days. Data such as sex, age, antifungal therapy, and variables as antibiotics, underlying diseases or comorbid conditions and stay in the hospital, were collected from patients who had at least one urine culture that yielded > 10³ yeast colonies/ml. Candiduria was recovered in 68 patients and the commonest predisposing factors were antibiotic therapy (100 percent) and indwelling urinary catheter (92.6 percent). The percentage of Candida spp. isolation increased during the extended periods in which patients remained in the ICU. C. albicans was isolated in 69.1 percent, and the other species non-albicans as C. glabrata, C. kefyr, C. parapsilosis, C. famata, C. guilliermondii, C. krusei, and C. tropicalis were isolated in lower percentage. The high frequency of candiduria and the possible predisposing factors found in ICU patients show that candiduria surveillance should be performed to help reducing nosocomial infections.

Candidiase sistemica neonatal: rastreamento rotineiro em UTI neonatal e seu efeito sobre a mortalidade associada / Neonatal systemic candidiasis: routine screening and the impact over mortality in a NICU

O diagnostico e o tratamento precoce sao fatores determinantes da mortalidade associada a candidiase sistemica, particularmente no periodo neonatal. Este estudo relata os resultados obtidos na UTI do bercario anexo a maternidade do HC-FMUSP, apos instituicao de triagem para candidiase - com base em coletas urinarias semanais, com realizacao de micologico direto e cultura - em RN de risco. Os dados obtidos foram tambem comparados aos de estudo realizado anteriormente ao inicio do rastreamento, acompanhado de revisao da literatura. Observou-se uma tendencia a reducao da mortalidade neonatal associada a candidiase sistemica. Com base nesses resultados, os autores recomendam a realizacao de rastreamento para deteccao precoce de quadros fungicos em unidades neonatais de alto risco

Candidiase do aparelho urinario / Candidiasis of the urinary tract

Os autores relatam um caso de candidiase do aparelho urinario em lactente de cinco meses de idade e chamam a atencao para os principais fatores predisponentes: antibioticoterapia prolongada, acessos vasculares centrais, alimentacao parenteral, desnutricao e entubacao endo-traqueal.