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Epidemiology of Yeast Species Causing Bloodstream Infection in Tehran, Iran (2015-2017); Superiority of 21-Plex Pcr Over the Vitek 2 System for Yeast Identification Publisher Pubmed



Kord M1 ; Salehi M2 ; Khodavaisy S1 ; Hashemi S1 ; Ghazvini R1 ; Rezaei S1 ; Maleki A1 ; Elmimoghaddam A1 ; Alijani N3 ; Abdollahi A4 ; Doomanlou M4 ; Ahmadikia K1 ; Rashidi N1 ; Pan W5 Show All Authors
Authors
  1. Kord M1
  2. Salehi M2
  3. Khodavaisy S1
  4. Hashemi S1
  5. Ghazvini R1
  6. Rezaei S1
  7. Maleki A1
  8. Elmimoghaddam A1
  9. Alijani N3
  10. Abdollahi A4
  11. Doomanlou M4
  12. Ahmadikia K1
  13. Rashidi N1
  14. Pan W5
  15. Boekhout T6, 7
  16. Arastehfar A6, 7
Show Affiliations
Authors Affiliations
  1. 1. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Infectious Diseases, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China
  6. 6. Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
  7. 7. Institute of Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, Netherlands

Source: Journal of Medical Microbiology Published:2020


Abstract

Introduction. Given the limited number of candidaemia studies in Iran, the profile of yeast species causing bloodstream infections (BSIs), especially in adults, remains limited. Although biochemical assays are widely used in developing countries, they produce erroneous results, especially for rare yeast species. Aim. We aimed to assess the profile of yeast species causing BSIs and to compare the accuracy of the Vitek 2 system and 21-plex PCR. Methodology. Yeast blood isolates were retrospectively collected from patients recruited from two tertiary care training hospitals in Tehran from 2015 to 2017. Relevant clinical data were mined. Identification was performed by automated Vitek 2, 21-plex PCR and sequencing of the internal transcribed spacer region (ITS1-5.8S-ITS2). Results. In total, 137 yeast isolates were recovered from 107 patients. The overall all-cause 30-day mortality rate was 47.7 %. Fluconazole was the most widely used systemic antifungal. Candida albicans (58/137, 42.3 %), Candida glabrata (30/137, 21.9 %), Candida parapsilosis sensu stricto (23/137, 16.8 %), Candida tropicalis (10/137, 7.3 %) and Pichia kudriavzevii (Candida krusei) (4/137, 2.9 %) constituted almost 90 % of the isolates and 10 % of the species detected were rare yeast species (12/137; 8.7 %). The 21-plex PCR method correctly identified 97.1 % of the isolates, a higher percentage than the Vitek 2 showed (87.6 %). Conclusion. C. albicans was the main cause of yeast-derived fungaemia in this study. Future prospective studies are warranted to closely monitor the epidemiological landscape of yeast species causing BSIs in Iran. The superiority of 21-plex PCR over automated Vitek 2 indicates its potential clinical utility as an alternative identification tool use in developing countries. © 2020 Microbiology Society. All rights reserved.
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