Candida türlerinin tanımlanmasında iki farklı isitemin karşılaştırılması
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Date
2014
Authors
Gayıbov, Ülkü
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Publisher
Uludağ Üniversitesi
Abstract
Fırsatçı mantarlar, nozokomiyal enfeksiyonların önemli nedenlerinden biri olup, C. albicans ve diğer Candida türleri hastalardan artan sıklıkta izole edilmektedir. Bunlardan bir kısmı yaygın kullandığımız antifungallere dirençli olduklarından, uygun tedaviye başlamak için hızlı ve doğru tanımlama gerekir. Bu çalışmada da API ID 32 C (bioMerieux France) ve Phoenix Yeast ID (Becton, Dickinson Diagnostics, Sparks, MD) tanımlama sistemlerinin karşılaştırılması ve morfolojik bulguların tanımlamaya etkisinin değerlendirilmesi amaçlanmıştır. İzolatlar, çalışma döneminde Uludağ Üniversitesi Hastanesi'nde yatan hastaların örneklerinden elde edilmiştir. Tüm izolatlar çimlenme borusu ve mikroskobik morfoloji açısından incelenmiş ve üretici firmaların önerileri doğrultusunda tanımlama yapılmıştır. İki sistem arasındaki uyum yüzde olarak hesaplanmış ve uyumsuz sonuçlar, morfolojik bulgularla çözümlenmeye çalışılmıştır. Yüz otuz yedi hastadan toplam 211 maya izolasyonu olmuştur. İzolatların 159'unda aynı tanımlama elde edilmiş olup, %75,4 uyum saptanmıştır. Uyum, sık izole edilen türlerde (%81,7), seyrek olanlara (%38,7) göre anlamlı olarak (p=0.034; x2 test) daha yüksek bulunmuştur. Her ne kadar anlamlı olmasa da (p=0.31; x2 test) morfolojik bulguların eklenmesi ile uyum oranı (%88,1) artmıştır. Uyumlu tanımlama bulgularına göre, en sık izole edilen tür C. albicans (%44,1) olmuş, bunu C. tropicalis (%9,9), C. glabrata (%9,5), C. parapsilosis (%8,5) ve C. kefyr (%8,1) izlemiştir. Tür tanımlanmasında moleküler yöntemler daha doğru olsa da, klinik mikrobiyoloji laboratuvarlarında halen fenotipik yöntemlerden yararlanılmaktadır. Bu çalışmada da iki sistemin karşılaştırılabilir olduğu ve morfolojinin tanımlamaya pozitif etkisi görülmüştür. Phoenix Yeast ID Panel kullanımı ve yorumlanması kolay olup, API ID 32 C'den 24 saat daha erken sonuçlanmaktadır. Hiçbir yöntemin tek başına tamamen güvenilir olmadığı düşünülürse, laboratuvarlarda tür tanımlamasında dikkatli değerlendirme şarttır.
Comparison of Two Different Methods for Identification of Candida species Opportunistic fungal pathogens are becoming important causes of nosocomial infections. Candida albicans and other Candida species are increasingly recovered from patients. Since many of the yeasts have been found to be resistant to the most common antifungal agents, the introduction of appropriate therapy depends on the rapid and accurate identification. The aim of this study, was to compare the identification of API ID 32 C (bioMerieux France) and Phoenix Yeast ID (Becton, Dickinson Diagnostics, Sparks, MD) and to evaluate the effect of morphological findings in identification. İsolates were obtained from cultures of clinical specimens of individual patients, hospitalized at Uludağ University Hospital during the study period. Germ tube production and microscopic morphology were examined. All yeasts were tested according to manufacturer's recommandations and percentage of concordance between the two commerical systems was calculated. Discrepant results between the systems were tried to resolve by morphological tests. A total of 211 clinical yeast specimens from 137 patients were tested. Same identification was obtained among 159 isolates and 75,4% concordance was found. The concordance was found significantly higher (p=0.034; x2 test) in species more frequently isolated (81,7%) than the rare ones (38,7%). Although not significant (p=0.31; x2 test), the rate of concordance between the systems was increase (88,1%), when adding the morphological findings. According to the concordant identification, the most frequently isolated species was found C. albicans (44,1%) followed by C. tropicalis (9,9%), C. glabrata (9,5%), C. parapsilosis (8,5%) and C. kefyr (8,1%). Although molecular methods are more accurate to identify the species, many clinical microbiology laboratories still rely on phenotypic methods. We found that the two identification systems were comparable and careful observation of yeast morphology can add confidence to the identification. The Phoenix Yeast ID system was very easy to use and interpret, and the results were obtained approximately 24 hours earlier than those of the API ID 32 C system. As none of the methods evaluated was completely reliable as a stand-alone, careful evaluation is necessary for laboratories to identify these species.
Comparison of Two Different Methods for Identification of Candida species Opportunistic fungal pathogens are becoming important causes of nosocomial infections. Candida albicans and other Candida species are increasingly recovered from patients. Since many of the yeasts have been found to be resistant to the most common antifungal agents, the introduction of appropriate therapy depends on the rapid and accurate identification. The aim of this study, was to compare the identification of API ID 32 C (bioMerieux France) and Phoenix Yeast ID (Becton, Dickinson Diagnostics, Sparks, MD) and to evaluate the effect of morphological findings in identification. İsolates were obtained from cultures of clinical specimens of individual patients, hospitalized at Uludağ University Hospital during the study period. Germ tube production and microscopic morphology were examined. All yeasts were tested according to manufacturer's recommandations and percentage of concordance between the two commerical systems was calculated. Discrepant results between the systems were tried to resolve by morphological tests. A total of 211 clinical yeast specimens from 137 patients were tested. Same identification was obtained among 159 isolates and 75,4% concordance was found. The concordance was found significantly higher (p=0.034; x2 test) in species more frequently isolated (81,7%) than the rare ones (38,7%). Although not significant (p=0.31; x2 test), the rate of concordance between the systems was increase (88,1%), when adding the morphological findings. According to the concordant identification, the most frequently isolated species was found C. albicans (44,1%) followed by C. tropicalis (9,9%), C. glabrata (9,5%), C. parapsilosis (8,5%) and C. kefyr (8,1%). Although molecular methods are more accurate to identify the species, many clinical microbiology laboratories still rely on phenotypic methods. We found that the two identification systems were comparable and careful observation of yeast morphology can add confidence to the identification. The Phoenix Yeast ID system was very easy to use and interpret, and the results were obtained approximately 24 hours earlier than those of the API ID 32 C system. As none of the methods evaluated was completely reliable as a stand-alone, careful evaluation is necessary for laboratories to identify these species.
Description
Keywords
Candida türleri, Tanımlama, API ID 32 C, Phoenix yeast ID panel, Candida species, Identification
Citation
Gayıbov, Ü. (2014). Candida türlerinin tanımlanmasında iki farklı isitemin karşılaştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.