Aim: Fungemias show an epidemiologic shift in etiologic agents, recently. The aim of this study is to evaluate fungemia agents and antifungal resistance in a tertiary hospital.
Materials and Methods: Fungemia cases in all age groups between years of 2017-2021 in Balýkesir Atatürk City Hospital were included. BacT/Alert® 3D (bioMérieux, Marcyl’Etoile, France) and Render BC128 System (Render Biotech Co. Ltd., Shenzhen, China) were used for blood cultures (BCs). Only the first fungal positive samples or the first isolates in different episodes of the same patients were investigated. Conventional methods and PhoenixTM 100 System (Becton Dickinson, MA, USA) for identification and antifungal susceptibility testing were performed according to CLSI disk diffusion guidelines.
Results: In a total of 38682 BC sets, 325 (0.84%) were positive for fungal growth. In all but four patients (1.2%) (Saprochaete capitata, n=2; Trichosporon asahii, n=1; Saccharomyces cerevisiae, n=1), Candida spp. (98.8%) were detected. Candida albicans (n=155; 47.7%), Candida parapsilosis complex (n=127; 39.1%), Candida glabrata complex (n=19; 5.85%), Candida tropicalis (n=12; 3.7%), Candida kefyr (n=5; 1.54%), Candida krusei (n=2; 0.62%) and Candida guilliermondii complex (n=1; 0.31%) were isolated, respectively. None of the Candida spp. had echinocandin resistance, 8 C.parapsilosis complex isolates were resistant to fluconazole, 17 C.parapsilosis complex and 2 C.tropicalis isolates were susceptible dose-dependent to fluconazole.
Conclusions: Antifungal resistance limits therapeutic options. Although there are recent reports, it is not common in Turkey. Species level identification and congruity to management guidelines like ESCMID are crucial. Data sharing of local laboratories will contribute to consist a national data. ORCID NO: 0000-0003-2907-257X
Anahtar Kelimeler: Invasive fungal infections, Bloodstream infectons, Fungi, Candida
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