title: Yeast colonization and drug susceptibility pattern in the pediatric patients with neutropenia.
abstract: BACKGROUND
  Pediatric patients with neutropenia are vulnerable to invasive Candida infections. Candida is the primary cause of fungal infections, particularly in immunosuppressed patients. Candida albicans has been the most common etiologic agent of these infections, affecting 48% of patients.
  
  
  OBJECTIVE
  The aim of this study was to identify Candida spp. isolated from children with neutropenia and determine the antifungal susceptibility pattern of the isolated yeasts.
  
  
  METHODS
  In this study 188 children with neutropenia were recruited, fungal surveillance cultures were carried out on nose, oropharynx, stool, and urine samples. Identification of Candida strains was performed using germ tube and chlamydospore production tests on an API 20 C AUX system. Susceptibility testing on seven antifungal agents was performed using the agar-based E-test method.
  
  
  RESULTS
  A total of 229 yeasts were isolated. Among those, C. albicans was the most common species followed by C. krusei, C. parapsilosis, C. glabrata, C. tropicalis, C. famata, C. dubliniensis, C. kefyr, and other Candida species. C. glabrata was the most resistant isolated yeasts, which was 70% resistant to fluconazole and 50% to itraconazole, 7.5% to amphotericin B and 14% to ketoconazole. All the tested species were mostly sensitive to caspofungin.
  
  
  CONCLUSIONS
  Knowledge about the susceptibility patterns of colonized Candida spp. can be helpful for clinicians to manage pediatric patients with neutropenia. In this study, caspofungin was the most effective antifungal agent against the colonized Candida spp. followed by conventional amphotericin B.
authors.affiliation: Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Pedram
authors.initials: P
authors.lastname: Haddadi
authors.affiliation: Hematology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Soheila
authors.initials: S
authors.lastname: Zareifar
authors.affiliation: Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Badiee
authors.affiliation: Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Abdolvahab
authors.initials: A
authors.lastname: Alborzi
authors.affiliation: Hematology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Maral
authors.initials: M
authors.lastname: Mokhtari
authors.affiliation: Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Kamiar
authors.initials: K
authors.lastname: Zomorodian
authors.affiliation: Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Pakshir
authors.affiliation: Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Hadis
authors.initials: H
authors.lastname: Jafarian
keywords: Amphotericin; Antifungal; Candidemia; Caspofungin; Neutropenia; Susceptibility