Background: Systemic candidiasis is a major complication in neutropenic cancer patients undergoing treatment. Most systemic fungal INFECTIONS emerge from endogenous microflora so the aim of the present study was to identify CANDIDA species isolated from the different regions of body in neutropenic patients in compare with the control group.Methods: A total of 309 neutropenic cancer patients and 584 patients without cancer (control group) entered in the study. Molecular identification of clinical isolates was performed by PCR-RFLP technique.Results: Twenty-two out of 309 patients had candidiasis (7.1%). Male to female ratio was 1.1 and age ranged from 23 to 66 years. Colorectal cancer and acute myeloid leukemia (AML) were the most common cancers. CANDIDA albicans was the most prevalent CANDIDA species among neutropenic patients (50%) and control group (57.9%). Mortality rate in cancer patients was 13.6% in comparison with control group (5.2%).Conclusion: Since candidiasis is an important cause of morbidity and mortality in neutropenic patients, precise identification of CANDIDA species by molecular techniques can be useful for the appropriate selection of antifungal drugs particularly in high risk patients.

Background and purpose: The choice of antifungal agent in treatment of CANDIDA urinary tract INFECTIONS (CUTI) is dependent on the site of infection, the underlying disease of the patient, and the pharmacokinetics/pharmacodynamics (PK/PD) of the agent. This study aimed to perform a review of antifungal therapy for CUTI.Materials and methods: Data was obtained by a search for full-text articles in Medline, PubMed, Embase, Scopus, Web of Science, Science Direct, Google Scholar, Magiran, Irandoc, and Iran Medex published from 1994 until 2016. The search keywords included urinary tract INFECTIONS, CANDIDA species, diagnosis, and treatment.Results: Fluconazole is the drug of choice for prophylaxis and treatment of CUTI due to low toxicity, high solubility, and wide tissue distribution. Although flucytosine is concentrated in urine and has potent activity against CANDIDA species, treatment is restricted because of its toxicity and expansion of resistance when it is used alone. In addition, amphotericin B is an active drug against most CANDIDA species (except resistant C. krusei strains). Other azoles and echinocandins are not effective for treating CUTI due to the minimum excretion of the active compound into the urine. However, a localized renal infection followed by blood spreading might be treated by echinocandins because of its effective tissue concentrations.Conclusion: We presented diagnostic tests and treatment protocols of CUTI, but new surveillance protocols and diagnostic strategies for control and prevention of CUTI in critically ill patients are essential.

Background: INFECTIONS caused by opportunistic yeasts such as CANDIDA species, Trichosporon, Rhodotorula and Saccharomyces have increased in immunocompromised patients and their identification is crucial as intrinsic and acquired resistance of some yeast species to antifungal agents are on the rise. The aim of this study was to identify the organisms to the species level in order to suggest accurate and effective antifungal therapies.Methods: In this study that carried out in Tehran, Iran in 2009, 200 patients with yeast infection were medically examined and clinical specimens were prepared for direct examination and culture on Sabouraud dextrose agar. Subsequently, the isolated yeast colonies were identified using various tests including culture on Corn Meal agar with Tween 80, CHROMagar CANDIDA and casein agar. For the definite identification of organisms some biochemical tests were done based on carbohydrate assimilation by RapID Yeast Plus System kit, and, finally, a molecular method, PCR-RFLP, using Hpa II enzyme, was performed for the remaining unknown yeast species.Results: A total of 211 yeast isolates were identified in 200 patients with yeast INFECTIONS. The most frequent isolated yeasts were CANDIDA albicans, 124 (58.77%), followed by CANDIDA parapsilosis, 36 (17.06%), CANDIDA tropicalis, 17 (8.06%), CANDIDA glabrata, 13 (6.16%), CANDIDA krusei, 8 (3.79%), CANDIDA guilliermondii, 2 (0.96%), Trichosporon, 3 (1.14%), Rhodotorula, 1 (0.47%), Saccaromyces cerevisiae, 1 (0.47%) and other yeast species, 6 (2.84%).Conclusion: Nail candidiasis was the most prevalent type of yeast infection in the patients and CANDIDA albicans was the most frequent isolated species from all clinical specimens.