Antifungal Resistance Among Candida Species: Diagnostic and Clinical Challenges in Specialized Cancer Care Hospital of Lahore

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis Pub Date : 2025-03-29 DOI:10.1002/jcla.70022

Zunaira Akbar, Muhammad Aamir, Zikria Saleem, Muhammad Rehan Khan Niazi, Hasan Ejaz, Muharib Alruwaili, Khalid Abosalif

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Abstract

Background

The increased consumption of antifungal agents increases the emergence of resistant fungal strains among immunocompromised patients. The present study aims to determine the antifungal consumption and resistance pattern among adult and pediatric cancer patients with systemic Candida infections.

Method

A descriptive, retrospective study was conducted by reviewing admitted patients' electronic medical records from 2019 to 2023. Consumption was estimated using Days of Therapy (DOT) metrics. Culture reports of Candida-positive isolates were collected from the hospital microbiology laboratory to determine the resistance pattern of Candida species.

Results

Consumption of antifungals showed a declining trend, with highest consumption of oral voriconazole (mean DOT/1000 pt. days 18653.49) and oral fluconazole (mean DOT/1000 pt. days 15258.14). Candida albicans was the most isolated pathogen 768 (53.60%) and among all Candida species, major resistance was found in C. tropicalis 58 (4.05%). All Candida species except C. parapsilosis and C. guilliermondii exhibited more resistance to fluconazole.

Conclusion

The findings indicated that the number of resistant isolates is clinically important 133 (9.2%) in the immunocompromised population, which underscores the necessity of conducting culture sensitivity analyses of antifungals. This approach is crucial for early detection and mitigation of antifungal resistance and optimizing therapy.

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念珠菌的抗真菌耐药性：拉合尔癌症专科医院的诊断和临床挑战。

背景：抗真菌药物用量的增加增加了免疫功能低下患者中耐药真菌菌株的出现。本研究旨在确定成人和儿童癌症患者与全身念珠菌感染的抗真菌消耗和耐药模式。方法：对2019 - 2023年住院患者的电子病历进行描述性回顾性研究。使用治疗天数（DOT）指标估计消耗量。从医院微生物实验室收集念珠菌阳性分离株的培养报告，确定念珠菌的耐药模式。结果：抗真菌药物用量呈下降趋势，以口服伏立康唑用量最高（平均DOT/ 1000pt）。18653.49天)和口服氟康唑（平均DOT/ 1000pt）。15258.14天)。白色念珠菌是检出最多的病原菌768株（53.60%），热带念珠菌58株（4.05%）耐药最多。除假丝酵母菌和假丝酵母菌外，其余假丝酵母菌对氟康唑的抗性均较高。结论：免疫功能低下人群中耐药菌株的数量具有重要临床意义（133株（9.2%）），提示开展抗真菌药培养敏感性分析的必要性。这种方法对于早期发现和减轻抗真菌耐药性和优化治疗至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Laboratory Analysis 医学-医学实验技术

CiteScore

5.60

自引率

7.40%

发文量

584

审稿时长

6-12 weeks

期刊介绍： Journal of Clinical Laboratory Analysis publishes original articles on newly developing modes of technology and laboratory assays, with emphasis on their application in current and future clinical laboratory testing. This includes reports from the following fields: immunochemistry and toxicology, hematology and hematopathology, immunopathology, molecular diagnostics, microbiology, genetic testing, immunohematology, and clinical chemistry.