Prevalence of Candida Infection at the Intensive Care Unit with Nested Polymerase Chain Reaction (PCR) Using Primer Mixes Specific to Candida DNA Topoisomerase II Genes

Abstract

Background: The occurrence of invasive Candida infections has increased during the past two decades as a result of increasing in the number of immunocompromised patients. Objectives: In this study (cross sectional design), during six months, the prevalence patterns of Candida species isolated from sterile body sites of patients admitted to the general hospital of Milad Intensive Care Units (ICUs) in Tehran (Iran), were determined. Methods: Candidal isolates were obtained from 50 patients admitted to Milad ICUs from April to September 2013. Identification of the isolates was performed using morphological and Polymerase Chain Reaction assay. For identification of Candida at the species level, degenerated and specific primers based on the genomic sequences of DNA topoisomerase II of Candida species were used and their specificities tested by PCR-based identifications. Results: A total of 67 Candida isolates were obtained from 50 patients. Out of 67 Candida isolates, 47.8% were C. glabrata, 28.3% were C. albicans, 7.5% were C. tropicalis, 7.5% were C. guilliermondii, 3% were C. krusei and 4.4% were C. dubliniensis. The main patient group affected by candidal infections was aged 50 to 70 years. Overall, 11.7% of patients had cancer while other diseases such as diabetes were less reported. The mean time of stay at the ICU before identification was 25.3 days (ranging from 2 to 120 days). Conclusions: Increase in the prevalence of non-C. albicans species in the recent years has become a problematic event amongst clinicians caring for ICU patients. Candida glabrata is the most common species isolated from ICU patients in comparison with other species in this study. These findings emphasized on the significance of organizing treatable prevention programs.

Frequency and co-colonization of vancomycin-resistant Enterococci and Candida in ICU-hospitalized children

“…These results were in contrast to the previously published studies of Rahbar et al. from Iran [ 30 ], Motoa et al. from Colombia [ 31 ], Kumar et al.…”

“…and Alimehr et al. from Iran [ 30 , 33 ]. However, in the studies carried out by Ardehali et al.…”

“…Significantly, C. glabrata is more resistant to antifungal agents, and is harder to eradicate than other Candida species [ 36 ]. Therefore, this species is probably a problematic challenge to clinicians in health-care settings [ 30 ]. In total, the subgroup analysis of the present research in different age groups indicated that both Candida species and Enterococcus species had the highest proportion in the <1 year and 1–3 year age groups, respectively.…”

“…A switch from yeast-form growth to a hyphal, invasive and pathogenic state is a critical step in Candida pathogenesis. In co-infections, the hyphal morphogenesis of Candida species was inhibited by bacteria-derived products or molecules [ 30 , 39 ]. However, the exact mechanism of this process is not fully understood.…”

Molecular detection of ALS1, ALS3, HWP1 and SAP4 genes in Candida Genus isolated from hospitalized patients in Intensive Care Unit, Tehran, Iran

“…Administration, workers, and individuals admitted or visiting the hospital must take into account such programs to play their role in the prevention of infections (28).In this study C. albicans isolated frequently in the urine specimen, which is by other studies that described C. albicans as the most prevalent isolate in patients with urinary candidiasis (29)(30)(31)(32). However, these results were dissimilar to other studies that revealed Candida non-albicans group such as C.glabrata as the most predominant isolate in patients with urinary candidiasis (33,34). In this study, thirty candida species were isolated from blood specimen of which 21 isolates (32.4%) revealed C. albicans which is in accordance with other studies that were conducted by Pfaller et al…”