[Mycological analysis of clinical materials of patients receiving total parenteral nutrition].

The most frequent etiological factors of fungal infections in patients receiving total parenteral nutrition (TPN) belong to Candida genus of the yeastlike fungi. In the TPN patients the several infectious complications can develop: venous catheter infection, catheter candidemia (fungemia), fungal endocarditis or fungal ophtalmitis. The capability of hydrolytic (proteolytic, lipolytic) enzymes secretion as well as biofilm formation on artificial surfaces are the most important factors of fungal strains pathogenity. In the study from clinical materials of 37 patients receiving total parenteral nutrition 31 strains of Candida glabrata (56.4%), 13 strains of Candida albicans (23.6%), 3 Candida tropicalis strains, 2 Candida krusei strains, 2 Candida lusitaniae strains and 1 strain of Candida inconspicua were identified. The phenotypic analysis of isolated strains were performed using API YM (bioMerieux) tests for the enzymatic activity determination. Simultaneously the proteolytic and lipolytic activity analysis were performed. Candida albicans isolates secreted 10 out of 19 enzymes and Candida glabrata 7. The secretion of proteases was demonstrated in 12 C. albicans strains. All Candida glabrata isolates from examined and from control group secreted proteolitic enzymes. Candida glabrata is the dominant species in clinical materials of patients receiving total parenteral nutrition. The numerous isolation of C. glabrata from clinical materials of patients receiving total parenteral nutrition might be connected with the selection of azole resistant strains and also to ability of creatin biofilm on the biomaterial surfaces.