Background and Purpose: This study aimed to evaluate the species distribution and susceptibility pattern of the strains isolated from Candida colonization in pediatric patients staying at pediatric intensive care unit (ICU) and infant
ICU of Children’s Medical Center in Tehran, Iran.Materials and Methods: This study was conducted in the Children’s Medical Center in Tehran, Iran. In total, ۴۴۰ samples from ۵۶ patients with oral cavity, skin surrounded catheters, and ear, throat, nasal, and urine cultures were collected. All patients were evaluated in terms of Candida colonization on the admission day as well as the days ۷, ۱۴, and ۲۸ according to the previous studies. CHROMagar Candida medium was applied for primary/multiple species identification and the isolates were identified by using polymerase chain reaction-based methods to the species-specific complex level. The antifungal susceptibility test was performed according to the Clinical and Laboratory Standards protocol published as M۲۷-A۳ and M۶۰ documents.Results: In total, ۱۳۶ yeast samples from ۲۶ individuals (۳۰.۹%) out of ۴۴۰ samples were considered colonization. The most prevalent species in IICU was C. albicans (۲۷%,n=۲۰) followed by C. krusei (۲۴ %, n=۱۸) and C. parapsilosis (۱۶%, n=۱۲). In PICU, the predominant species was C. krusei (۴۰%, n=۲۴) followed by C. parapsilosis (۱۸%, n=۱۱) and C. dubliniensis (۱۶%, n=۱۰). Among the ۴۰ tested isolates from both units, fluconazole-resistant isolates (n=۱۱, ۸.۱۵%) were determined according to the new breakpoints. In the case of echinocandins, ۲ isolates, including C. albicans (n=۱) and C. krusei (n=۱) were resistant against both caspofungin and anidulafungin (totally ۱.۴۸%).Conclusion: In the present study, since C. krusei is intrinsically-resistance against fluconazole, emphasizing the importance of species-level identification of Candida isolates is outstanding. However, according to the antifungal susceptibility testingresults, only ۷.۲% of the strains were resistant to fluconazole. It would be beneficial tomonitor the
ICU patients who are at high risk of invasive Candida infection.