1887

Abstract

Yeast identification and susceptibility testing provide helpful information for appropriate administration of antifungal treatments; however, few reports from the Latin American region have been published. The aim of this study was to identify the species present in isolates from bloodstream infections diagnosed in nine hospitals in Lima, Peru and to determine their susceptibility to four antifungal drugs. We tested and identified 153 isolates collected between October 2009 and August 2011 using standard methods. PCR and PCR-RFLP assays were performed to distinguish from and to identify species of the and complexes. Antifungal susceptibility testing for fluconazole, anidulafungin and voriconazole was performed using the CSLI M27-A3 method, and amphotericin B susceptibility was determined using the Etest method. The most frequently isolated species were: (61; 39.9 %), (43; 28.1 %), (36; 23.5%) and (8; 5.2 %). The overall susceptibility rates were 98.0 %, 98.7 %, 98.0 % and 97.4 % for amphotericin B, fluconazole, voriconazole and anidulafungin, respectively. No isolate was resistant to more than one drug. These results showed that the rate of resistance to four antifungal drugs was low among bloodstream isolates in Lima, Peru.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.071167-0
2014-06-01
2021-07-27
Loading full text...

Full text loading...

/deliver/fulltext/jmm/63/6/855.html?itemId=/content/journal/jmm/10.1099/jmm.0.071167-0&mimeType=html&fmt=ahah

References

  1. Amran F., Aziz M. N., Ibrahim H. M., Atiqah N. H., Parameswari S., Hafiza M. R., Ifwat M. 2011; In vitro antifungal susceptibilities of Candida isolates from patients with invasive candidiasis in Kuala Lumpur Hospital, Malaysia. J Med Microbiol 60:1312–1316 [View Article][PubMed]
    [Google Scholar]
  2. Arendrup M. C., Dzajic E., Jensen R. H., Johansen H. K., Kjaeldgaard P., Knudsen J. D., Kristensen L., Leitz C., Lemming L. E.& other authors ( 2013; Epidemiological changes with potential implication for antifungal prescription recommendations for fungaemia: data from a nationwide fungaemia surveillance programme. Clin Microbiol Infect 19:E343–E353 [View Article][PubMed]
    [Google Scholar]
  3. Becerra M. R., Tantaleán J. A., Suárez V. J., Alvarado M. C., Candela J. L., Urcia F. C. 2010; Epidemiologic surveillance of nosocomial infections in a Pediatric Intensive Care Unit of a developing country. BMC Pediatr 10:66–74 [View Article][PubMed]
    [Google Scholar]
  4. Bonfietti L. X., Szeszs M. W., Chang M. R., Martins M. A., Pukinskas S. R. B. S., Nunes M. O., Pereira G. H., Paniago A. M. M., Purisco S. U., Melhem M. S. G. 2012; Ten-year study of species distribution and antifungal susceptibilities of Candida bloodstream isolates at a Brazilian tertiary hospital. Mycopathologia 174:389–396 [View Article][PubMed]
    [Google Scholar]
  5. Cleveland A. A., Farley M. M., Harrison L. H., Stein B., Hollick R., Lockhart S. R., Magill S. S., Derado G., Park B. J., Chiller T. M. 2012; Changes in incidence and antifungal drug resistance in candidemia: results from population-based laboratory surveillance in Atlanta and Baltimore, 2008-2011. Clin Infect Dis 55:1352–1361 [View Article][PubMed]
    [Google Scholar]
  6. CLSI 2008a; Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; 3rd edn, M27–A3. Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  7. CLSI 2008b; Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; 3rd edn, Informational Supplement M27–S3. Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  8. CLSI 2012; Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; 4th informational supplement M27–S4. Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  9. Córdoba S., Melhem M., Dolande M., Puime A., Martínez G., Zurita S., Cuenca-Estrella M., Rodriguez-Tudela J. L., Gabastou J. M. RLN. 2012; Species distribution and susceptibility profile of yeasts isolated from blood cultures: preliminary results of a multicenter study for Latin America. In Abstracts of the ICAAC abstract M-327 Washington, DC: American Society for Microbiology;
    [Google Scholar]
  10. Costa S. F., Marinho I., Araújo E. A. P., Manrique A. E. I., Medeiros E. A. S., Levin A. S. 2000; Nosocomial fungaemia: a 2-year prospective study. J Hosp Infect 45:69–72 [View Article][PubMed]
    [Google Scholar]
  11. Cruz R., Piontelli E. 2011; Invasive fungal disease in patients from five hospitals in the Valparaiso region, Chile. 2004 to 2009. Rev Chilena Infectol 28:123–129 (in Spanish) [View Article][PubMed]
    [Google Scholar]
  12. Cuenca-Estrella M., Gomez-Lopez A., Cuesta I., Zaragoza O., Mellado E., Rodriguez-Tudela J. L. 2011; Frequency of voriconazole resistance in vitro among Spanish clinical isolates of Candida spp. according to breakpoints established by the Antifungal Subcommittee of the European Committee on Antimicrobial Susceptibility Testing. Antimicrob Agents Chemother 55:1794–1797 [View Article][PubMed]
    [Google Scholar]
  13. Erdem I., Oguzoglu N., Ozturk Engin D., Ozgultekin A., Sengoz Inan A., Ceran N., Kaya F., Genc I., Goktas P. 2010; Incidence, etiology and risk factors associated with mortality of nosocomial candidemia in a tertiary care hospital in Istanbul, Turkey. Med Princ Pract 19:463–467 [View Article][PubMed]
    [Google Scholar]
  14. Jang M. J., Shin J. H., Lee W. G., Kim M. N., Lee K., Lee H. S., Lee M. K., Chang C. L., Jang H. C.& other authors ( 2013; In vitro fluconazole and voriconazole susceptibilities of Candida bloodstream isolates in Korea: use of the CLSI and EUCAST epidemiological cutoff values. Ann Lab Med 33:167–173 [View Article][PubMed]
    [Google Scholar]
  15. Jung S.-I., Shin J. H., Song J.-H., Peck K. R., Lee K., Kim M.-N., Chang H. H., Moon C. S.The Korean Study Group for Candidemia 2010; Multicenter surveillance of species distribution and antifungal susceptibilities of Candida bloodstream isolates in South Korea. Med Mycol 48:669–674 [View Article][PubMed]
    [Google Scholar]
  16. Kovacicova G., Hanzen J., Pisarcikova M., Sejnova D., Horn J., Babela R., Svetlansky I., Lovaszova M., Gogova M., Krcmery V. 2001; Nosocomial fungemia due to amphotericin B-resistant Candida spp. in three pediatric patients after previous neurosurgery for brain tumors. J Infect Chemother 7:45–48 [View Article][PubMed]
    [Google Scholar]
  17. Labbé A. C., Pépin J., Patiño C., Castonguay S., Restieri C., Laverdiere M. 2009; A single-centre 10-year experience with Candida bloodstream infections. Can J Infect Dis Med Microbiol 20:45–50[PubMed]
    [Google Scholar]
  18. Lee I., Fishman N. O., Zaoutis T. E., Morales K. H., Weiner M. G., Synnestvedt M., Nachamkin I., Lautenbach E. 2009; Risk factors for fluconazole-resistant Candida glabrata bloodstream infections. Arch Intern Med 169:379–383 [View Article][PubMed]
    [Google Scholar]
  19. Levy I., Rubin L. G., Vasishtha S., Tucci V., Sood S. K. 1998; Emergence of Candida parapsilosis as the predominant species causing candidemia in children. Clin Infect Dis 26:1086–1088 [View Article][PubMed]
    [Google Scholar]
  20. Lockhart S. R., Messer S. A., Pfaller M. A., Diekema D. J. 2008; Geographic distribution and antifungal susceptibility of the newly described species Candida orthopsilosis and Candida metapsilosis in comparison to the closely related species Candida parapsilosis. J Clin Microbiol 46:2659–2664 [View Article][PubMed]
    [Google Scholar]
  21. Lockhart S. R., Iqbal N., Cleveland A. A., Farley M. M., Harrison L. H., Bolden C. B., Baughman W., Stein B., Hollick R.& other authors ( 2012; Species identification and antifungal susceptibility testing of Candida bloodstream isolates from population-based surveillance studies in two U.S. cities from 2008 to 2011. J Clin Microbiol 50:3435–3442 [View Article][PubMed]
    [Google Scholar]
  22. Luo G., Mitchell T. G. 2002; Rapid identification of pathogenic fungi directly from cultures by using multiplex PCR. J Clin Microbiol 40:2860–2865 [View Article][PubMed]
    [Google Scholar]
  23. Ma C. F., Li F. Q., Shi L. N., Hu Y. A., Wang Y., Huang M., Kong Q. Q. 2013; Surveillance study of species distribution, antifungal susceptibility and mortality of nosocomial candidemia in a tertiary care hospital in China. BMC Infect Dis 13:337–345 [View Article][PubMed]
    [Google Scholar]
  24. Mannarelli B. M., Kurtzman C. P. 1998; Rapid identification of Candida albicans and other human pathogenic yeasts by using short oligonucleotides in a PCR. J Clin Microbiol 36:1634–1641[PubMed]
    [Google Scholar]
  25. Miranda-Zapico I., Eraso E., Hernández-Almaraz J. L., López-Soria L. M., Carrillo-Muñoz A. J., Hernández-Molina J. M., Quindós G. 2011; Prevalence and antifungal susceptibility patterns of new cryptic species inside the species complexes Candida parapsilosis and Candida glabrata among blood isolates from a Spanish tertiary hospital. J Antimicrob Chemother 66:2315–2322 [View Article][PubMed]
    [Google Scholar]
  26. Nishikaku A. S., Melo A. S. A., Colombo A. L. 2010; Geographic trends in invasive candidiasis. Curr Fungal Infect Rep 4:210–218 [View Article]
    [Google Scholar]
  27. Nucci M., Queiroz-Telles F., Alvarado-Matute T., Tiraboschi I. N., Cortes J., Zurita J., Guzman-Blanco M., Santolaya M. E., Thompson L.& other authors ( 2013; Epidemiology of candidemia in Latin America: a laboratory-based survey. PLoS ONE 8:e59373 [View Article][PubMed]
    [Google Scholar]
  28. Ostrosky-Zeichner L., Rex J. H., Pappas P. G., Hamill R. J., Larsen R. A., Horowitz H. W., Powderly W. G., Hyslop N., Kauffman C. A.& other authors ( 2003; Antifungal susceptibility survey of 2,000 bloodstream Candida isolates in the United States. Antimicrob Agents Chemother 47:3149–3154 [View Article][PubMed]
    [Google Scholar]
  29. Pappas P. G., Kauffman C. A., Andes D., Benjamin D. K. Jr, Calandra T. F., Edwards J. E. Jr, Filler S. G., Fisher J. F., Kullberg B.-J.& other authors ( 2009; Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 48:503–535 [View Article][PubMed]
    [Google Scholar]
  30. Park B. J., Arthington-Skaggs B. A., Hajjeh R. A., Iqbal N., Ciblak M. A., Lee-Yang W., Hairston M. D., Phelan M., Plikaytis B. D.& other authors ( 2006; Evaluation of amphotericin B interpretive breakpoints for Candida bloodstream isolates by correlation with therapeutic outcome. Antimicrob Agents Chemother 50:1287–1292 [View Article][PubMed]
    [Google Scholar]
  31. Paz Rojas E. L., de León Pandolfi D. P., Ramírez Ponce R. 2008; Antimicrobial resistance in an intensive care unit and current trends: Critical Care Department, IntensiveCare Service of Guillermo Almenara-Irigoyen National Hospital, EsSalud, Lima, Peru, 2004-2006.. Acta méd peruana 25:140–147 (in Spanish)
    [Google Scholar]
  32. Pemán J., Cantón E., Quindós G., Eraso E., Alcoba J., Guinea J., Merino P., Ruiz-Pérez-de-Pipaon M. T., Pérez-del-Molino L.& other authors ( 2012; Epidemiology, species distribution and in vitro antifungal susceptibility of fungaemia in a Spanish multicentre prospective survey. J Antimicrob Chemother 67:1181–1187 [View Article][PubMed]
    [Google Scholar]
  33. Pereira G. H., Müller P. R., Szeszs M. W., Levin A. S., Melhem M. S. C. 2010; Five-year evaluation of bloodstream yeast infections in a tertiary hospital: the predominance of non-C. albicans Candida species. Med Mycol 48:839–842 [View Article][PubMed]
    [Google Scholar]
  34. Pfaller M. A., Diekema D. J. 2002; Role of sentinel surveillance of candidemia: trends in species distribution and antifungal susceptibility. J Clin Microbiol 40:3551–3557 [View Article][PubMed]
    [Google Scholar]
  35. Pfaller M. A., Diekema D. J. 2007; Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev 20:133–163 [View Article][PubMed]
    [Google Scholar]
  36. Pfaller M. A., Diekema D. J. 2012b; Progress in antifungal susceptibility testing of Candida spp. by use of Clinical and Laboratory Standards Institute broth microdilution methods, 2010 to 2012. J Clin Microbiol 50:2846–2856 [View Article][PubMed]
    [Google Scholar]
  37. Pfaller M. A., Boyken L., Hollis R. J., Messer S. A., Tendolkar S., Diekema D. J. 2006; In vitro susceptibilities of Candida spp. to caspofungin: four years of global surveillance. J Clin Microbiol 44:760–763 [View Article][PubMed]
    [Google Scholar]
  38. Pfaller M. A., Diekema D. J., Gibbs D. L., Newell V. A., Ellis D., Tullio V., Rodloff A., Fu W., Ling T. A.Global Antifungal Surveillance Group 2010; Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-year analysis of susceptibilities of Candida species to fluconazole and voriconazole as determined by CLSI standardized disk diffusion. J Clin Microbiol 48:1366–1377 [View Article][PubMed]
    [Google Scholar]
  39. Pfaller M. A., Castanheira M., Lockhart S. R., Ahlquist A. M., Messer S. A., Jones R. N. 2012a; Frequency of decreased susceptibility and resistance to echinocandins among fluconazole-resistant bloodstream isolates of Candida glabrata. J Clin Microbiol 50:1199–1203 [View Article][PubMed]
    [Google Scholar]
  40. Pfaller M. A., Messer S. A., Woosley L. N., Jones R. N., Castanheira M. 2013; Echinocandin and triazole antifungal susceptibility profiles for clinical opportunistic yeast and mold isolates collected from 2010 to 2011: application of new CLSI clinical breakpoints and epidemiological cutoff values for characterization of geographic and temporal trends of antifungal resistance. J Clin Microbiol 51:2571–2581 [View Article][PubMed]
    [Google Scholar]
  41. Porte L., León P., Gárate C., Guzmán A. M., Labarca J., García P. 2012; Susceptibility to azoles and amphotericin B of isolates of Candida spp. Experience of a university health network, between 2004 and 2010. Rev Chilena Infectol 29:149–155 (in Spanish) [View Article][PubMed]
    [Google Scholar]
  42. Rodero L., Davel G., Soria M., Vivot W., Córdoba S., Canteros C. E., Saporiti A.EMIFN 2005; [Multicenter study of fungemia due to yeasts in Argentina]. Rev Argent Microbiol 37:189–195 (in Spanish) [PubMed]
    [Google Scholar]
  43. Sampaio Camargo T. Z., Marra A. R., Silva C. V., Cardoso M. F., Martino M. D., Camargo L. F., Correa L. 2010; Secular trends of candidemia in a tertiary care hospital. Am J Infect Control 38:546–551 [View Article][PubMed]
    [Google Scholar]
  44. Tavanti A., Davidson A. D., Gow N. A., Maiden M. C. J., Odds F. C. 2005; Candida orthopsilosis and Candida metapsilosis spp. nov. to replace Candida parapsilosis groups II and III. J Clin Microbiol 43:284–292 [View Article][PubMed]
    [Google Scholar]
  45. Wanger A., Mills K., Nelson P. W., Rex J. H. 1995; Comparison of Etest and National Committee for Clinical Laboratory Standards broth macrodilution method for antifungal susceptibility testing: enhanced ability to detect amphotericin B-resistant Candida isolates. Antimicrob Agents Chemother 39:2520–2522 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.071167-0
Loading
/content/journal/jmm/10.1099/jmm.0.071167-0
Loading

Data & Media loading...

Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error