ABSTRACT

In recent years an increase of the incidence of Candida infections caused mainly by C. albicans strains especially in high risk inpatients with neoplasms, decreased immunity, bums and after treatment with multiple antibiotics has been observed. Candida organisms are parti­cularly dangerous for newborns being responsible for about 30% of septicaemia cases in newborns in intensive care units. Fungal infections can be endogenous in origin but exogenous infection sources occur in hospitals. The cause of the latter are errors in aseptic management and insufficiently disinfected medical instruments and equipment. The purpose of the study was a comparison of the sensitivity to disinfectants of C. albicans belonging to two laboratory strains C. albicans PZH and C. albicans ATCC 10231 used for the determination of concentrations of two disinfectants used. Besides that, this sensitivity was determined in 14 strains isolated from the patients and one from the circuit of dialysis solution supply to artificial kidney. The study was carried out by the qualitative suspension method, in which the cells in the fluid were subjected to the action of disinfectants, and by the carrier method in which the cells of the microorganisms were present on the surface of metal cylinders. By the suspension method the sensitivity was determined to chloramine T in concentrations from 5.0% to 0.001%, formalin from 10.0% to 0.25%, glutaraldehyde from 2.0% to 0.1%, Septyl from 3.5% to 0.25%. The exposure time was 5, 10, 15, 30 and 60 minutes. The tested strains differed in their sensitivity to the disinfectants used. The greatest interstrain differences were observed in the sensitivity to chloramine T. The highest concentrations were tolerated by the strains isolated from the patients and from the artificial kidney circuit as well as by the standard strain ATCC 10231. In the 10-minute exposure time accepted by us as comparison standard these strains were 200-time less susceptible to chloramine than the standard C. albicans PZH strain. Two strain isolated from the patients were tenfold as sensitivive. The sensitivity to the remaining tested disinfectants showed less evident differences. The sensitivity of the strains from the patients to formalin was similar to that of the standard PZH strain. A similar sensitivity was found to Septyl, with the exception of the strain from the artificial kidney circuit which was sevenfold less sensitive than the PZH strain. In the case of glutaraldehyde 9 strains from the patients and the ATCC 10231 strain were two or four times less sensitive than the PZH strain. No cross-sensitivity or tolerance to the disinfectants were noted in the study. Both standard strains were similarly sensitive to formalin, but the ATCC 10231 strain was less sensitive to Septyl, glutaraldehyde and chloramine T. In the experiment by the carrier method the effect was evidenced of the surface on the action of disinfectants. This was particularly evident in the case of chloramine T. Even in sensitive strains the disinfection parameters (concentration and exposure time) were significantly higher than in the suspension method. The least sensitive strains survived the effect of 5°h chloramine during 2 hours of exposure. Septyl in the working concentration 2.5% at 10-minute exposure time disinfected all carriers with the exception of that carrying the strain isolated from the artificial kidney circuit, which survived 15% Septyl exposure during 10 minutes. The disinfectant Aldesan (2% glutaraldehyde) and formalin 8% killed all fungi during 10 minutes. The study shows that the sensitivity of C. albicans strains to disinfectants varies. For the assessment of the fungicidal action of disinfectants the standard test ATCC 10231 should be used since its sensitivity was similar to that of most strains from the patients and medical equipment. For the determination of the parameters of disinfectants the carrier method should be used since it takes into account the surface effect on the action of these disinfectants.