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Epidemiological characteristics of Candida species colonizing oral and rectal sites of Jordanian infants.doc

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Epidemiological characteristics of Candida species colonizing oral and rectal sites of Jordanian infants

Issaetal.BMCPediatrics2011,11:79 /1471-2431/11/79 RESEARCH ARTICLE OpenAccess EpidemiologicalcharacteristicsofCandidaspecies colonizingoralandrectalsitesofJordanian infants ShireenYIssa1,EmanFBadran2,KamalFAkl2andAsemAShehabi1* Abstract Background:ThereisevidencethatCandidacolonizationcontributestoincreasinginvasionofcandidiasisin hospitalizedneonates.FewstudiesinvestigatedtheepidemiologyandriskfactorsofCandidacolonizationamong hospitalizedandnon-hospitalizedinfants.Thisprospectivestudyinvestigatedthemajorepidemiological characteristicsofCandidaspeciescolonizingoralandrectalsitesofJordanianinfants. Methods:Infantsagedoneyearorlesswhowereexaminedatthepediatricsoutpatientclinicorhospitalizedat theJordanUniversityHospital,Amman,Jordan,wereincludedinthisstudy.Cultureswabswerecollectedfromoral andrectalsitesandinoculatedonSabourauddextroseagar.AllCandidaisolateswereconfirmedbytheRemel RapIDyeastplussystem,andfurtherinvestigatedforspecificvirulencefactorsandantifungalsusceptibilityMIC usingE-test.GenotypingofC.albicansisolateswasdeterminedusingrandomamplifiedpolymorphicDNA(RAPD) analysismethod. Results:Atotalof61/492(12.4%)infantswerecolonizedwithCandidaspeciesbyeithertheiroral/rectalsitesor both.Rectalcolonizationwassignificantlymoredetectedthanoralcolonization(64.6%verses35.4%),particularly amonghospitalizedinfantsagedmorethanonemonth.Thepatternandratesofcolonizationwereasfollows:C. albicanswasthecommonestspeciesisolatedfrombothsitesandaccountedfor67.1%ofallisolates,followedby C.kefyr(11.4%),eachC.tropicalisandC.glabrata(8.9%)andC.parapsilosis(3.8%). AvariousratesofCandidaisolatesprovedtosecreteputativevirulencefactorsinvitro;asparatylproteinase, phospholipaseandhemolysin.C.albicanswereassociatedsignificantly(P0.05)withtheseenzymesthanother Candidaspecies.AllCandidaisolatesweresusceptibletoamphotericinBandcaspofungin,whereas97%ofCandida speciesisolatesweresusceptibletofluconazoleusingE-test. Thegeneticsimilarityof53C.albicansisolatesasdemonstratedbydendrogramrevealed