Yeast infections and antifungal susceptibility patterns in Malta

Abstract

Candida species are yeast-like fungi that normally occur as commensal organisms in the gastrointestinal tract. They can colonize healthy mucosa or induce various clinical syndromes in susceptible patients. One of the major tasks in the prevention and therapy of candidiasis is the difficulty in differentiating colonization from systemic infections . These may remain , localized (oesophagitis, abdominal abscess) or may disseminate in the bloodstream and cause fungemia. However isolation media for blood cultures have a high failure rate in detecting fungi, even in clinically proven fungemia. This increases the risk of false negative diagnosis. Although over 100 species of Candida have been identified, only a few have been isolated from humans, C. albicans and C. tropica/is being the two species most commonly isolated from clinical specimens. The most frequent causative agent of fungemia and hematogenously disseminated candidiasis is C. albicans. However, recent studies have shown an increase in infections caused by C. tropicalis, C. parapsilosis, C. krusei and C. lusitaneae (4, 7-9). Both C. albicans and C. tropicalis, are emerging as significant pathogens, capable of causing local and systemic infections in seriously-ill immunocompetent patients and also in severely immunocompromised patients (1' 3, 6). The aims of this preliminary study, which is part of a larger two-year study, were: (i) to assess the incidence of yeast infections and prevalent species in patients admitted to St. Luke's Hospital, and, (ii) to determine if there are emerging resistant species.