MIKOLOGICZNA ANALIZA PRÓBEK MATERIAŁU KLINICZNEGO UZYSKANEGO OD CHORYCH ŻYWIONYCH POZAJELITOWO
[MYCOLOGICAL ANALYSIS OF CLINICAL MATERIALS OF PATIENTS RECEIVING TOTAL PARENTERAL NUTRITION.]

Streszczenie

Chorzy po zabiegach chirurgicznych, żywieni pozajelitowo, są szczególnie narażeni na zakażenie grzybicze o etiologii Candida. Dokonano analizy mikologicznej próbek materiałów klinicznych pozyskanych od chorych żywionych pozajelitowo, a także od chorych, u których nie zastosowano tej metody leczenia. W materiale klinicznym pochodzącym od chorych żywionych pozajelitowo, dominującym gatunkiem była Candida glabrata. W posiewach materiałów klinicznych pozyskanych od chorych nie otrzymujących żywienia pozajelitowego dominował gatunek Candida albicans

Abstract

The most frequent etiological factors of fungal infections in patients receiving total parenteral nutrition (TPN) belong to Candida genus of the yeastlike fungi. In the TPN patients the several infectious complications can develop: venous catheter infection, catheter candidemia (fungemia), fungal endocarditis or fungal ophtalmitis. The capability of hydrolytic (proteolytic, lipolytic) enzymes
secretion as well as biofilm formation on artificial surfaces are the most important factors of fungal strains pathogenity. In the study from clinical materials of 37 patients receiving total parenteral nutrition
31 strains of Candida glabrata (56,4%), 13 strains of Candida albicans (23,6%), 3 Candida tropicalis strains, 2 Candida krusei strains, 2 Candida lusitaniae strains and 1 strain of Candida inconspicua were identified. The phenotypic analysis of isolated strains were performed using API – ZYM (bioMerieux) tests for the enzymatic activity determination. Simultaneously the proteolytic and
lipolytic activity analysis were performed. Candida albicans isolates secreted 10 out of 19 enzymes
and Candida glabrata 7. The secretion of proteases was demonstrated in 12 C. albicans strains. All Candida glabrata isolates from examined and from control group secreted proteolitic enzymes. Candida glabrata is the dominant species in clinical materials of patients receiving total parenteral nutrition. The numerous isolation of C. glabrata from clinical materials of patients receiving total parenteral nutrition might be connected with the selection of azole resistant strains and also to ability of creatin
biofilm on the biomaterial surfaces.