Species Distribution and Antifungal Susceptibilities of Candida Species Isolated From Blood Culture.

Abstract

Introduction Candidaspecies (spp.) are among the leading agents of bloodstream infections. Candidemias are a major cause of morbidity and mortality. Having an understanding of Candida epidemiology and antifungal susceptibility patterns in each center is crucial in guiding the management of candidemia.In this study, the species distribution and antifungal susceptibility of Candida spp. isolated from blood culture at the University of Health Sciences, Bursa Yuksek Ihtisas Training & Research Hospital were examined and the first data on the epidemiology of candidemia in our center were presented. Methods A total of 236 Candida strains isolated from blood cultures in our hospital over a four-year period were analyzed and their antifungal susceptibilities were studied retrospectively. Strains were identified at the species complex (SC) level by the germ tube test, morphology in cornmeal-tween 80 medium, and the automated VITEK 2 Compact (bioMérieux, Marcy-l'Étoile, France) system. Antifungal susceptibility tests were performed on VITEK 2 Compact (bioMérieux, Marcy-l'Étoile, France) system. The susceptibilities of the strains to fluconazole, voriconazole, micafungin, and amphotericin B were determined according to Clinical and Laboratory Standards Institute (CLSI) guidelines and epidemiologic cut-off values. Results Of theCandida (C.)strains, 131 wereC. albicans(55.5%), 40 wereC. parapsilosisSC (16.9%), 21 wereC. tropicalis(8.9%), 19 wereC. glabrataSC (8.1%), eight wereC. lusitaniae(3.4%), seven wereC. kefyr(3.0%), six wereC. krusei(2.6%), two wereC. guilliermondii(0.8%) and two wereC. dubliniensis(0.8%). Amphotericin B resistance was not detected inCandidastrains. Micafungin susceptibility was 98.3%, and fourC. parapsilosisSCstrains (10%) were intermediate (I) to micafungin. Fluconazole susceptibility was 87.2%. Apart fromC. kruseistrains which intrinsically resistant to fluconazole, threeC. parapsilosis(7.5%), oneC. glabrataSC (5.3%) strain were resistant (R) to fluconazole, and oneC. lusitaniae(12.5%) strain was wild-type (WT). Voriconazole susceptibility ofCandidastrains was 98.6%. TwoC. parapsilosisSC strains were I to voriconazole, while one strain was R. Conclusion In this study, the first epidemiological data of candidemia agents in our hospital were presented. It was determined that rare and naturally resistant species did not cause any problem in our center yet.C. parapsilosisSC strains showed decreased susceptibility to fluconazole, whereasCandidastrains were highly susceptible to the four antifungals tested. Close monitoring of these data will help guide the treatment of candidemia.