Changing face of Candida colonization pattern in pediatric patients with hematological malignancy during repeated hospitalizations, results of a prospective observational study (2016–2017) in shiraz, Iran

BMC Infectious Diseases

Mansooreh Dehghani¹  Abbas Norouzian Baghani²  Sezaneh Haghpanah³  Hadis Jafarian⁴  Seyedeh Sedigheh Hamzavi⁴  Mohammad Rahim Kadivar⁴  Parisa Badiee⁴  Fatemeh Ghasemi⁴  Ali Amanati⁴ 

[1] Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences;Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences;Hematology Research Center, Shiraz University of Medical Sciences;Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences;

关键词: Candida albicans;    Fungal colonization;    Pediatric leukemia;   

DOI  :  10.1186/s12879-019-4372-x

来源: DOAJ

【 摘 要 】

Abstract Background Surveillance of current changes in the epidemiology of Invasive Fungal Diseases (IFDs) as an important component of the antifungal stewardship programs (ASP), requires careful regular monitoring, especially in high-risk settings such as oncology centers. This study aimed to examine Candida colonization status and corresponding current changes in children with malignancy during repeated admissions and also investigate the possible epidemiological shifts after the implementation of ASP. Methods In this prospective observational study, all eligible patients younger than 18 years were recruited during 2016–2017 at Amir Medical Oncology Center (AMOC) in Shiraz, Iran. Totally, 136 patients were enrolled and 482 samples were collected from different sites (oral/nasal discharges, urine and stool). Weekly regular sampling was carried out during hospitalization. Candida colonization status and epidemiological changes were monitored during repeated admissions. Samples were cultivated on Sabouraud Dextrose agar medium and identified by Polymerase Chain Reaction -Restriction Fragment Length Polymorphism (PCR-RFLP). Results Estimated Candida colonization incidence was 59.9% (82/136) in our patients. Candida colonization was found to be higher in oral cavity and rectum than that in nasal cavity. Among those long-term follow ups and repetitive hospitalizations, a significant number of patients exhibited changes in their colonization patterns (37.7%). Candida colonization did not reveal any significant relationship with age, sex, oncologic diseases and degree of neutropenia. C. albicans (72.0%) was found as the most common Candida species in colonized patients, followed by C. krusei, C. kefyr, C. glabrata and C. parapsilosis. Conclusion Given the high incidence of Candida infections in children with cancers, close monitoring of epidemiologic changes is essential for judicious management, based on local surveillance data and improvement of overall quality of care in high risk patients.

【 授权许可】

Unknown