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A 3-Year Study of Candida Infections Among Patients With Malignancy: Etiologic Agents and Antifungal Susceptibility Profile Publisher Pubmed



Sharifi M1 ; Badiee P2 ; Abastabar M3, 4 ; Morovati H5 ; Haghani I3, 4 ; Noorbakhsh M6 ; Mohammadi R1, 7
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Authors Affiliations
  1. 1. Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  3. 3. Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  4. 4. Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  5. 5. Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  6. 6. Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  7. 7. Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Frontiers in Cellular and Infection Microbiology Published:2023


Abstract

Objective: Opportunistic fungal infections by Candida species arise among cancer patients due to the weakened immune system following extensive chemotherapy. Prophylaxis with antifungal agents have developed the resistance of Candida spp. to antifungals. Accurate identification of yeasts and susceptibility patterns are main concerns that can directly effect on the treatment of patients. Methods: Over a period of three years, 325 cancer patients suspected to Candida infections were included in the current investigation. The clinical isolates were molecularly identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). All strains, were examined for in vitro susceptibility to the amphotericin B, itraconazole, fluconazole, and anidulafungin according to the CLSI M27 document. Results: Seventy-four cancer patients had Candida infections (22.7%). Candida albicans was the most common species (83.8%). Antifungal susceptibility results indicated that 100% of the Candida isolates were sensitive to amphotericin B; however, 17.6%, 9.4%, and 5.4% of clinical isolates were resistant to anidulafungin, fluconazole, and itraconazole, respectively. Conclusion: The findings of the present work shows a warning increase in resistance to echinocandins. Since all fluconazole resistance isolates were obtained from candidemia, we recommend amphotericin B as the first line therapy for this potentially fatal infection. Copyright © 2023 Sharifi, Badiee, Abastabar, Morovati, Haghani, Noorbakhsh and Mohammadi.
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