First experience of Candida non-albicans isolates with high antibiotic resistance pattern caused oropharyngeal candidiasis among cancer patients.

BACKGROUND AND AIM: In cancer patients, Candida species can cause a variety of diseases particularly oropharyngeal candidiasis which is a common infection. In this study, an attempt has been made to determine susceptibility pattern of four antifungal agents against the Candida species isolated from cancer patients with oropharyngeal candidiasis. MATERIALS AND METHODS: Samples were taken from 50 cancer patients with oropharyngeal candidiasis by the physician, and isolation and identification of Candida spp. was done based on standard procedures. Antifungal resistance pattern was carried out according to CLSI guidelines, and 18s ribosomal RNA among Candida spp. was identified using multiplex polymerase chain reaction. RESULTS: Of the 50 patients, 18 (36%) were females and 32 (64%) were males; mean age was 38.4 years. Leukemia and lymphoma were the most frequent cancer types in the studied group, accounting for 17 (34%) and 12 (24%), respectively. A total of 29 Candida spp. were isolated from 29 cancer patients, of which 17 were C. albicans and 12 were C. non-albicans. All the Candida spp. were confirmed having 18s ribosomal RNA. Among all the Candida spp., C. non-albicans showed higher resistance pattern to amphotericin B (MIC 07 µg/ml) and ketoconazole (MIC = 05 µg/ml). CONCLUSION: In conclusion, oropharyngeal Candidiasis is a serious infection among cancer patients. The isolated Candida spp. were resistant to common antifungal agents, which may lead to longer hospital stay, more expensive/toxic drugs and higher mortality. Therefore, interval surveillance is necessary in developing institutional guidelines.

The Relationship between Disease, Work and Sickness Absence among Psoriasis Patients.

BACKGROUND: The aim of this study was to assess the prevalence of absenteeism in patients with psoriasis and determine the factors influencing the incidence of absenteeism in these patients. METHODS: A cross-sectional study from December 2012 to November of 2013 was conducted on 192 psoriasis patients referred to the Dermatology Clinic of Imam Khomeini Hospital, Tehran, Iran. The number day of absence from work due to psoriasis in the last year was asked from the patients; the absence of 7 days has been considered as short-term and more than 7 days as long-term. Logistic regression was used to data analysis. RESULTS: Sickness absence in 21.4% of patients was positive. The average numbers of days of absence were 10.25 and the duration of absence from work in 48.7% were long-term ≥7 days. 51.3% had short-term absence (<7 days). Among disease factors: moderate to severe disease (SAPASI score >10), palms and soles involvement, joint problems and radiation therapy and among job factors: hazardous physical and chemical exposures in the workplace, non-office work, disability, exacerbations of disease on work days and problem on employment were associated with high incidence of sickness absence. CONCLUSION: Psoriasis with its chronic and recurrent nature especially in higher severities causes disabilities that deeply affect Work performance and can decrease the efficiency. In better management of psoriasis patients, physicians should pay special attention to occupational factors.

Candida non albicans with a High amphotericin B resistance pattern causing candidemia among cancer patients.

BACKGROUND: Many scientists have reported Candida species to be of great concern because of the high frequency that they colonize and infect human hosts, particularly cancer patients. Moreover, in the last decades Candida species have developed resistance to many antifungal agents. Based on this, we aimed to identify and determine the prevalence of Candida spp from blood culture bottles among cancer patients and their antifungal resistance pattern. MATERIALS AND METHODS: From the blood culture bottles isolation and identification of the Candida spp were performed by conventional microbiological techniques. The in vitro antibiotic resistance pattern of the isolates was determined by CLSI guidelines. Genomic DNA was isolated and amplified. Each gene was separated by agar gel electrophoresis. RESULTS: Identification of Candida spp was based on the presence of yeast cells in direct examination, culture and DNA extraction. Of the 68 blood samples collected during the study period (April 2013 to October 2013), five (7.35%) were positive for the presence of Candida spp, 2 (40%) of which were identified as Candida albicans and 3 (60%) were Candida non-albicans. CONCLUSIONS: High resistance to amphotricin B was observed among all the Candida non-albicans isolates. Regular investigations into antifungal resistance will help us to get an updated knowledge about their antibiotic resistance pattern which may help the physician in selecting the antibiotics for empirical therapy.