title: Candida infection in the intensive care unit: A study of antifungal susceptibility pattern of Candida species in Milad hospital, Tehran, Iran.
abstract: OBJECTIVE
  The occurrence of Candida infections has improved during the past two decades as a result of increase in the number of immunocompromised patients. In this study the antifungal susceptibility patterns of Candida species isolated from sterile body sites of patients admitted in Milad Intensive Care Unit (ICU) during 6 months were determined.
  
  
  METHODS
  Candidal isolates were obtained from 50 patients admitted in Milad ICUs from April to September 2013. Identification of the isolates was performed by using morphological and polymerase chain reaction assay. Resistance to the antifungal agents containing caspofungin, posoconazole, voriconazole and amphotericin B was determined using E-test method.
  
  
  RESULTS
  Out of 67 Candida isolates 47.8% were Candida glabrata, 28.3% were C. albicans, 7.5% were C. tropicalis, 7% were C. guilliermondii, 3% were C. krusei and 2% were C. dubliniensis. C. glabrata was the least susceptible species, with 9.4% of the isolates resistant to amphotericin B and 6.3% resistant to posoconazole and voriconazole. No resistance to caspofungin was observed among C. glabrata isolates. One of the C. krusei isolates was resistant to amphotericin B while no resistance to voriconazole, caspofungin and posoconazole was detected among C. krusei strains. Increase in the prevalence of antifungal-resistant non-C. albicans species in recent years has become a problematic event amongst clinicians caring for ICU patients. C. glabrata as the most common species isolated from ICU patients in this study indicated higher levels of antifungal resistance in comparison with other species. This observation accentuates the importance of managing preventive treatments to avoid development of resistance to the current antifungal drugs.
authors.affiliation: Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Shariati Avenue, 1546815514 Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Alimehr
authors.affiliation: Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Shariati Avenue, 1546815514 Tehran, Iran. Electronic address: sayeh.shekari0@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Shekari Ebrahim Abad
authors.affiliation: Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Shariati Avenue, 1546815514 Tehran, Iran.
authors.forename: F
authors.initials: F
authors.lastname: Fallah
authors.affiliation: Department of Microbiology, Iranian Reference Health Laboratory, Tehran, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Rahbar
authors.affiliation: Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Shariati Avenue, 1546815514 Tehran, Iran; Department of Microbiology, Milad Hospital, Tehran, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Mohammadzadeh
authors.affiliation: Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Shariati Avenue, 1546815514 Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Vossoghian
authors.affiliation: Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Shariati Avenue, 1546815514 Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Rafeei Tabatabaee
authors.affiliation: Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Science, Tehran, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Roudbary
authors.affiliation: Department of Medical Parasitology and Mycology School of Public Health and Institute of Public Health Research Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: F
authors.initials: F
authors.lastname: Zaini
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification*; D002177:Candidiasis / Q000453:epidemiology / Q000382:microbiology*; D025141:Drug Resistance, Fungal; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007492:Iran / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D015995:Prevalence
chemical_list: D000935:Antifungal Agents
keywords: Antifungal susceptibility; Candida albicans; Candida sp.; E-test; ICUs; Sensibilité aux antifongiques; Unités de soins intensifs