Yeasts isolated of bloodstream infection and catheter colonization in hospitalized pediatric patients

GIUSIANO G; MANGIATERRA M; ROJAS F; DIAZ MC

San Antonio, Texas - EEUU

Congreso; 15th. Congress of the International Society for Human and Animal Mycology. (ISHAM); 2003

International Society for Human and Animal Mycology.

Yeast infection is a growing problem in hospitalized children, particularly in neonatal (NCU) and intensive care units (ICU). The purposes of this study were to determine: a) incidence of funguemia and yeast catheter colonization, b) frequency of yeast species isolated and its antifungal susceptibility profile. This study was conducted between February 1999-February 2002. The clinical specimens were obtained at Pediatric Hospital “Juan Pablo II” and processed at Instituto de Medicina Regional (UNNE). Bloodstream (9465) were studied by lisis centrifugation and  catheters (909) by Maki and Cleri methods. Yeast identification was performed by Kreger van-Rij and Api ID 32C (bioMérieux) methods. Antifungal sensitivity test employed was NCCLS micromethod M27A. Among 200 positives catheters, yeasts (32%) were the most frequent colonizer. Among 757 blood cultures positives, yeasts were the 3rd cause of infection (11.72%) after Streptoccocus pneumonia (23%) and Staphylococcus aureus (21,4%). Of 88 funguemia, 31belonged to NCU, 42 to children in ICU and 15 to oncologic patients OP. Of 64 yeast catheters colonization, 20 were from NCU, 37 were from ICU and 7 from OP. Candida albicans (C.albicans) 11/88 (36%) and C. parapsilosis 11/88 (36%) were the most  frequent species isolated  from neonate’s blood stream and C. parapsilosis 32/64 (50%) in catheter. C. parapsilosis was the predominant species (55,4%) in OP. Bloodstreams in UTI showed C. albicans (44,4%) and C. tropicalis (36,1%). Catheters C. albicans (45,9%). Trichosporon cutaneum, C. krusei, C. glabrata and others Candida spp. were isolated from blood  and Malassezia species from catheters. All the isolates were susceptible to amphotericin B. C. albicans 3/49 (6,7%), C. tropicalis 3/31 (8,3%) and C. glabrata 3/6 (50%) were resistant to fluconazole. C. krusei 2/2 (100%) were resistant to fluconazole and itraconazole. These data show the emergency of yeasts different from C. albicans as a cause of funguemia and catheter colonization. Permanent surveillances should be important to detect emergence of resistance to azoles.