title: Molecular assay to detect nosocomial fungal infections in intensive care units.
abstract: CONCLUSIONS
  The aims of this study were to determine the incidence of fungal infections in hospital intensive care units and to evaluate a molecular method to detect these infections.
  
  
  METHODS
  The participants in this study were patients admitted to any of the 10 intensive care units at Nemazi Hospital (Shiraz, southern Iran) between March 2009 and January 2010. Oral and rectal swabs, urine, and sputum samples from patients were checked for fungal colonization. If a nosocomial fungal infection was suspected, clinical samples were examined for fungal infection by culture, direct microscopic examination and real-time PCR. Blood samples were cultured by bedside inoculation onto BACTEC medium. Susceptibility of the isolates to antifungal agents was also determined.
  
  
  RESULTS
  Of 870 patients, 550 (63.2%) had Candida colonization in different body sites and 17 (1.9%) had fungal infections. The mortality rate in patients with fungal infections was 58.8% (10 cases). The etiologic agents were Candida albicans, Candida glabrata, Aspergillus flavus, Aspergillus fumigatus and Aspergillus spp. Three C. albicans were found to be resistant to amphotericin B and itraconazole, and one A. fumigatus and two A. flavus were resistant to amphotericin B, ketoconazole and itraconazole. One A. fumigatus was additionally resistant to caspofungin.
  
  
  CONCLUSIONS
  Considering the incidence of fungal infections and their high mortality rate, early detection, prompt diagnosis and treatment are critical. Molecular assays can serve as a diagnostic tool to manage patients admitted to the intensive care unit. Antifungal susceptibility testing in different geographical regions can support the choice of prophylaxis and treatment for these patients.
authors.affiliation: Shiraz University of Medical Sciences, Shiraz, Iran. Badieep@gmail.com
authors.forename: Parisa
authors.initials: P
authors.lastname: Badiee
authors.forename: Abdolvahab
authors.initials: A
authors.lastname: Alborzi
authors.forename: Mehrvash
authors.initials: M
authors.lastname: Joukar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D001231:Aspergillus flavus / Q000235:genetics / Q000302:isolation & purification*; D001232:Aspergillus fumigatus / Q000235:genetics / Q000302:isolation & purification; D002176:Candida albicans / Q000235:genetics / Q000302:isolation & purification*; D041221:Candida glabrata / Q000235:genetics / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D002648:Child; D003428:Cross Infection / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D004271:DNA, Fungal / Q000032:analysis; D025141:Drug Resistance, Fungal; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007492:Iran / Q000453:epidemiology; D008297:Male; D008828:Microbiological Techniques; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal