Surveillance of clinical distribution and resistance characteristics of deep fungal isolates in children / 中华实用儿科临床杂志

ABSTRACT

Objective:To investigate the distribution of fungal species and their sensitivity to antifungal drugs in children with invasive fungal infections.Methods:All the fungal strains primarily isolated from the sterile parts of children in Beijing Children′s Hospital, Capital Medical University from January 2010 to December 2016 were analyzed.The sensitivity of strains to 5-Fluorocytosine, Fluconazole, Amphotericin B, Itraconazole and Voriconazole was tested using ATB-FUNGUS 3 yeast drug sensitivity test strip in accordance with the standards of Clinical and Laboratory Standards Institute M27-A2.Statistical analysis of data was performed using WHONET 5.6 software.Results:Among 236 fungi isolated from aseptic samples, 64.0% (151 strains) were from blood, 22.9%(54 strains) from cerebrospinal fluid, 3.8%(9 strains) from bone marrow, 3.8%(9 strains) from ascites, 3.4%(8 strains) from pleural effusion and 2.1%(5 strains) from tissues.The top 3 dominant species detected in the 236 strains of fungi were Candida spp.(175 strains, 74.2%), Cryptococcus neoformans (31 strains, 13.1%), and Saccharomyces spp.(9 strains, 3.8%). Among the Candida spp., the main isolates were Candida albicans (107 strains, 61.1%), Candida parapsilosis (33 isolates, 18.9%), and Candida tropicalis (13 isolates, 7.4%). Rare fungi of Penicillium marneffei, Exophiala spp.and Rhizopys spp.were also detected. Candida spp.was 100% sensitive to Amphotericin B. Cryptococcus neoformans was 100% sensitive to Fluconazole, Voliconazole and Amphotericin B. Conclusions:The most common strain isolated from pediatric patients with invasive fungal infections is Candida spp., especially Candida albicans. Cryptococcus neoformans causes central nervous system and systemic disseminated infections that can′t be ignored.Amphotericin B has higher antibacterial activity against Candida spp.and Cryptococcus neoformans.Separation of species of invasive fungal infections and monitoring of drug resistance in children should be strengthened to effectively control invasive fungal infections and facilitate rational use of antifungal drugs.