Isolation of Candida species from the bronchoalveolar lavage in patients with pulmonary diseases

Definite diagnosis of Candida pneumonia remains a problem in medicine. Although, isolation of Candida spp. from the bronchoalveolar lavage is not diagnostic by itself, it may be helpful in early diagnosis of pulmonary candidiasis in immunocompromised or critically ill patients and prompt antifungal therapy.

In a cross- sectional study, bronchoalveolar lavage was obtained from 144 patients with pulmonary diseases and different predisposing factors. All specimens were examined by direct microscopy and inoculated on CHOROM agar candida plates. Corn-meal agar medium and API 20C diagnostic kit also were used for identification of different stains of Candida.

Candida spp. was isolated from 74 (51.3%) specimens. The most common isolated species was Candida albicans with frequency of 69.7%, followed by C.glabrata (20.2%), C.kefyr (5.6%), C.krusei (2.25) and C.tropicalis (1.2%). Hypercolonization (≥103 CFU/mL) was found in 10 patients.

This report implies the high frequency (30.3%) of non- albicans Candida spp. isolated from respiratory tract, necessity the application of other diagnostic methods and following up the patients. Less susceptibility of non- albicans Candida spp. to present anti- fungal drugs must be noted and hypercolonization of respiratory tract with Candida spp. should be considered as a initiating factor for invasive candidiasis.