Abstract
BackgroundAntifungal susceptibility testing is a subject of interest in the field of medical mycology. The aim of the present study were the distributions and antifungal susceptibility patterns of various Candida species isolated from colonized and infected immunocompromised patients admitted to ten university hospitals in Iran.MethodsIn totally, 846 Candida species were isolated from more than 4000 clinical samples and identified by the API 20 C AUX system. Antifungal susceptibility testing was performed by broth microdilution method according to CLSI.ResultsThe most frequent Candida species isolated from all patients was Candida albicans (510/846). The epidemiological cutoff value and percentage of wild-type species for amphotericin B and fluconazole in Candida albicans, Candida tropicalis, Candida glabrata and Candida krusei were 0.5 μg/ml (95%) and 4 μg/ml (96%); 1 μg/ml (95%) and 8 μg/ml (95%); 0.5 μg/ml (99%) and 19 μg/ml (98%); and 4 μg/ml (95%) and 64 μg/ml (95%), respectively. The MIC90 and epidemiological cutoff values to posaconazole in Candida krusei were 0.5 μg/ml. There were significant differences between infecting and colonizing isolates of Candida tropicalis in MIC 90 values of amphotericin B, and isolates of Candida glabrata in values of amphotericin B, caspofungin, and voriconazole (P < 0.05).ConclusionsOur findings suggest that the susceptibility patterns of Candida species (colonizing and infecting isolates) in immunocompromised patients are not the same and acquired resistance was seen in some species.
Highlights
Antifungal susceptibility testing is a subject of interest in the field of medical mycology
In the present study, the distributions and antifungal susceptibility patterns of various Candida species isolated from infected and colonized immunocompromised patients admitted to 10 university hospitals in Iran were reported using Clinical and Laboratory Standards Institute (CLSI) species-specific clinical breakpoints and epidemiological cutoff values (ECV)
The most frequent Candida species isolated from the patients was C. albicans (Table 2)
Summary
Antifungal susceptibility testing is a subject of interest in the field of medical mycology. The Clinical and Laboratory Standards Institute (CLSI) developed new Candida species-specific clinical breakpoints for some antifungal agents, like fluconazole, voriconazole, and echinocandins [5, 6]. Use of such breakpoints can change the previously known Candida species sensitivity impact patterns and the management of the patients. In the present study, the distributions and antifungal susceptibility patterns of various Candida species isolated from infected and colonized immunocompromised patients admitted to 10 university hospitals in Iran were reported using CLSI species-specific clinical breakpoints and epidemiological cutoff values (ECV)
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