RESUMO
OBJECTIVE: Candida species has become one of the most common blood isolates as well as one of the leading causes of nosocomial bloodstream infections. The purpose of our study was to determine the prevalence of Candida species among our bloodstream infecting organisms and the susceptibility pattern of the Candida isolates to antifungal agents. METHODS: A prospective study was carried out in the Division of Microbiology, King Khalid National Guard Hospital, Jeddah, Kingdom of Saudi Arabia of all positive blood cultures for Candida species. The study took place from 1st January 1998 to March 2002. Identification and susceptibility pattern of isolates were determined by the Candifast technique to amphotericin B, fluconazole, nystatin, Flucytosine, econazole, ketoconazole and miconazole. RESULTS: Over a 2-year period, 17,916 blood cultures were performed in our hospital. There were 2,972 positive cultures, of which 83 (2.8%) patients had Candida species isolated from their bloodstream. Of these, 38 (46%) were Candida albicans (C.albicans). The remaining 45 strains were made up of Candida tropicalis 9 (10.8%); Candida parapsilosis 9 (10.8%); Candida species 9 (10.8%); Candida guilliermondi 6 (7.2%); Candida krusei 5 (6%); Candida glabrata 4 (4.8%); Candida pseudotropicalis 2 (2.4%) and Trichosporon species 1 (1.2%). All Candida species were susceptible to amphotericin B. However, only 18 (47%) out of 38 C.albicans were susceptible to fluconazole, while only 8 (17.7%) of 45 non-C.albicans strains were susceptible to this drug. CONCLUSION: The susceptibility of C.albicans to fluconazole in our hospital using the Candifast method is very low (47%). These results need to be confirmed by carrying out the Etest or the NCCLS M27-A method to confirm the true susceptibilities of Candida strains in our locality.
Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidíase/microbiologia , Farmacorresistência Fúngica , Fungemia/microbiologia , Candida/isolamento & purificação , Humanos , Estudos ProspectivosRESUMO
OBJECTIVE: To determine the prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) colonization in our institution. METHODS: A 5-day period prevalence study of all adult and pediatric patients. Excluded areas were the adult intensive care unit (screened on admission and weekly thereafter), the outpatient hemodialysis population (screened monthly), and newborns. Our facility is a referral/teaching hospital for the National Guard population and their dependants in Western Saudi Arabia. A total of 240 patients were screened. Nasal sampling was carried out and isolation/identification of MRSA was performed using standard microbiological methods. RESULTS: The total number of patients sampled was 240 and of those 10 (4%) were colonized. The 10 positives were found in 4 patient care areas; adult male medicine 5, adult male oncology 3, adult female medicine one, adult high dependency unit one. These patients care areas had 69 patients (42 males and 27 females). Ten (14%) were colonized by MRSA; 9 males (21%) and one female (3%). Statistical analysis Chi Square for discontinuous variables, "F" test for continuous variables found that one), male gender (p=0.04), 2) the presence of a long term invasive device (p=0.04), 3), length of stay (p=0.004) were predictive of MRSA colonization. CONCLUSION: The overall prevalence of MRSA colonization in our hospital was low, however a sub-segment of the population identified as male, having long term invasive devices, and hospitalized more than 2 weeks, were frequently colonized. Any strategy, in our hospital, to control the spread of MRSA should include the testing of this population.