The high rate of multiple-species candidemia detected with fluorescence in situ hybridization (FISH) methods: what are the clinical and prognostic implications?

Objective: The fluorescence in situ hybridization (FISH) with rRNA-targeted probes is a molecular method that allows identification of microorganisms in mixed assemblages from direct clinical samples without cultivitation. The aim of this study was to investigate the clinical features and risk facto...

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Publicado en:Turkiye Klinikleri Journal of Medical Sciences Vol. 30; no. 6; pp. 1944 - 1953
Autores principales: Börekci, Gülay, Ersöz, Gülden, Göksu, Musa, Erdogan, Semra, Emekdas, Gural
Formato: research tables/charts Journal Article
Publicado: Turkiye Klinikleri Dec2010
Acceso en línea:Ver este registro en EBSCOhost
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        atl: The high rate of multiple-species candidemia detected with fluorescence in situ hybridization (FISH) methods: what are the clinical and prognostic implications?
      aug:
        au:
          Börekci, Gülay
          Ersöz, Gülden
          Göksu, Musa
          Erdogan, Semra
          Emekdas, Gural
        affil: Mersin University Health School, Departments of Clinical Microbiology and Infectious Diseases, Biostatistic, Clinical Microbiology, Mersin University Faculty of Medicine, Mersin
      sug:
        subj:
          Candidiasis Diagnosis
          In Situ Hybridization, Fluorescence
          Academic Medical Centers
          Adult
          Aged
          Candidiasis Prognosis
          Candidiasis Symptoms
          Chi Square Test
          Data Analysis Software
          Descriptive Statistics
          Female
          Human
          Male
          Maximum Likelihood
          Microbial Culture and Sensitivity Tests
          Middle Age
          Polymerase Chain Reaction
          Turkiye
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objective: The fluorescence in situ hybridization (FISH) with rRNA-targeted probes is a molecular method that allows identification of microorganisms in mixed assemblages from direct clinical samples without cultivitation. The aim of this study was to investigate the clinical features and risk factors in patients with single and multiple-species candidemia detected with FISH method and also to evaluate the episodes of breakthrough candidemia. Material and Methods: A total of 325 positive blood culture samples were examined between January and August 2004 in medical microbiology laboratory of Mersin University Hospital. The demographic and clinical data of 45 patients with candidemia detected with conventional culture methods, FISH and PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) were analyzed retrospectively, single and multiple-species candidemia were investigated among patients with candidemia and these patients were compared with respect to risk factors. Results: Thirty five (77.8%) of 45 patients with candidemia had a single Candida species and 10 (22.2%) had multiple-species detected by FISH method. Of these 45 cases, 31.1% had associated solid and hematologic malignancies. The mean duration of hospitalization was 27 (2-180) days. All patients had at least one indwelling catheter (urinary catheter: 80%, peripheric venous catheter: 55.6%, central venous catheter: 26.7%). Most of the patients (95.6%) had been treated with broad spectrum antibiotics. The candidemias were mostly caused by non-albicans Candida spp., particularly Candida parapsilosis (71.1%). The rate of breakthrough candidemia was detected in 11.1% of the patients with candidemia and all of these were in patients with single species candidemia. Surprisingly, in case of single-species candidemia, the mortality rate (77.8%) was higher than that of multiple-species candidemia (22.2%). Conclusion: According to our data, the indwelling catheters and treatment with multiple antibiotics were considered as the risk factors for single and multiple-species candidemia. Although the rate of multiple-species candidemia detected with FISH method was found to be high, clinical and prognostic significance of multiple-species candidemia are still debatable.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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