Abstract
BackgroundThe spectrum of yeasts and their antifungal susceptibility profile are poorly known and treatment of fungal disease has remained empirical. The aim of this study is to determine the spectrum and antifungal susceptibility profile of yeasts particularly of Candida species.MethodsA descriptive study on the composition of Candida species and antifungal susceptibility profile were conducted from January 2018 to September 2018. Clinical samples collected from different sites were cultured on Sabouraud dextrose agar and incubated for an appropriate time. Identification of yeast isolates and their antifungal susceptibility profile were determined by the VITEK 2 compact system. Descriptive statistics such as frequency and percentage of Candida species were calculated using SPSS version 20.ResultsOf 209 yeasts recovered, 104(49.8%), 90 (43.1%), 15(7.2%) were C. albicans, non albicans Candida species, and other yeasts, respectively. Among non albicans Candida species, Candida krusei was the commonest isolate. Of other yeast groups, 66.7% was represented by Cryptococcus laurentii. Regardless of Candida species identified, 85.6, 3.9, and 10.5% of the isolates were susceptible, intermediate, and resistant to fluconazole, respectively. C krusei was 100% resistant to the drug. Voriconazole demonstrated the greatest antifungal activity against Candida isolates in which 99.4% of Candida isolates were susceptible. The susceptibility and the resistance rate of Candida isolate to both caspofungin and micafungin were the same being 96 and 4% respectively. However, micafungin was more potent than caspofungin. The susceptibility, resistant, and intermediate rates of yeasts against flucytosine were, 86.2, 6.6, and 7.2%, respectively.ConclusionsThe present study demonstrated the distribution of Candida species in different clinical specimens where the isolation rate of non-albicans Candida species was comparable to Candida albicans. The high resistance rate of C. krusei to fluconazole and flucytosine may demonstrate that the treatment of candidiasis empirically is questionable.
Highlights
The spectrum of yeasts and their antifungal susceptibility profile are poorly known and treatment of fungal disease has remained empirical
In the last few decades, several studies reported that there has been a progressive shift from a predominance of C. albicans to non-albicans Candida species (NAC) such as C. tropicalis, C. glabrata and C. krusei [4–6]
Our result was in line with that of Bitew and Abebaw [17] and Mohndas and Ballal [19], but in contradiction with many other studies where C. glabrata or C. tropicalis was reported as a 2nd predominant NAC species [16, 18–20, 22, 23, 25–29]
Summary
The spectrum of yeasts and their antifungal susceptibility profile are poorly known and treatment of fungal disease has remained empirical. The aim of this study is to determine the spectrum and antifungal susceptibility profile of yeasts of Candida species. Candida species are the most common cause of fungal infections, leading to a range of life-threatening invasive diseases such as blood stream candidiasis to non-lifethreatening mucocutaneous candidiasis such as genitourinary candidiasis, vulvovaginal candidiasis, and oropharyngeal candidiasis [1]. They are an important cause of superficial mycosis such as onychomycosis. NAC species have been reported to be a major cause of fungal opportunistic infection [7, 8]. Excessive use of broad-spectrum antibiotics, metabolic disorders, and the emergence of AIDS are among the various contributing factors for an increase in opportunistic fungal infections [9–12]
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