ИСТИНА

Objective : To determine the place of fungal infections, caused by Candida spp ., in taxonomic structure of microorganisms, causing infections in cancer patients. Methods : 4532 bacterial and fungal strains were isolated from all pathological biomaterials from oncological patients during the last 12 months (2016- 2017). The place of Candida spp. among most “problematic” (including multidrug- resistant) microorganisms: K. pneumoniae, E. coli, P. aeruginosa, A. baumannii,, S. aureus, Enterococcus spp .) was determined. These microorganisms were isolated most often from 993 biomaterials, including blood/IV catheter (n = 96), urine (n = 322), wounds (n = 304), sputum/bronchoscopic materials (n = 271). The identification was carried out on MS Maldi Tof. Duplicates were excluded. Results : K. pneumoniae was isolated in 15.3% of all strains (680/4532), E. coli —1.7% (81/4532), P. aeruginosa —8.0% (366/4532), A. baumannii —7.3% (331/4532), S. aureus —9.6% (433/4532), Enterococci ( E. faecium + E. faecalis ) - 9.9% (452/4532), Candida spp.—9.0% (410/4532), other—39.2%. The frequency of isolation of enterococci, S. aureus and Candida spp . was almost the same (9.0- 9.9%, the difference is non- significant)) and they occupied the 2 nd to the 4 th place after K. pneumoniae . In bloodstream infections Candida spp. was the predominant pathogen (22.9%), followed by E. coli (16.8%), enterococci (15.6%), K. pneumoniae (14.6%), P. aeruginosa (11.5%), A. baumannii (9.3%), S. aureus (9.3%). The taxonomic structure of Candida spp ., isolated from the blood, was as follows: C. parapsilosis (51.1%), C. albicans (21.5%), C. guilliermondi (7.4%), C. krusei (3.5%), C. glabrata (3.2%) and C. tropicalis (2.6%). The other Candida species occurred at a frequency of less than 1%. In urinary tract infections (UTI) and respiratory tract infections (RTI) Candida spp was more often isolated than other microorganisms as well (30.7% in UTI and 29.5% in RTI), followed by gram- negative rods (12- 14% and 17- 20%, respectively). In RTI Candida spp . was more often isolated in association with bacteria, supposing possible colonization. In wound infections Candida spp. was isolated in 10.9%, A. baumannii - in 11.5%, K. pneumoniae —in 24.0% and enterococci—in 28.2%. Conclusion : When analyzing the taxonomic structure of infectious complications in cancer patients, it was revealed that Candida spp. occupied the 2 nd —the 4 th place along with enterococci and Staphylococcus aureus . In bloodstream infections Candida spp . occupied the first place ( C. parapsilosis predominates), being associated with a large number of catheter- associated infections. Candida spp is also leading in UTI and lower RTI. In the latter case, Candida spp. was isolated in association with bacteria and this, most likely, was colonization, but not the true causative agent of infection.