In Vitro Susceptibility of Candida Species to Four Antifungal Agents Assessed by the Reference Broth Microdilution Method

Abstract

This study was performed to determine the distribution of Candida species isolated from the blood cultures of the patients hospitalized in our hospital and to investigate their antifungal susceptibility. Candida strains were identified at species level by using classical methods and API ID 32C (bioMerieux, France) identification kits. The susceptibility of the strains to amphotericin B, fluconazole, voriconazole, and caspofungin was evaluated by using the reference broth microdilution method in document M27-A3 of the Clinical and Laboratory Standards Institute. Of the 111 Candida strains isolated, 47.7% were identified as C. albicans and 52.3% as non-albicans Candida strains. The MIC ranges were 0.03–1 μg/mL for amphotericin B, 0.125–≥64 μg/mL for fluconazole, 0.03–16 μg/mL for voriconazole, and 0.015–0.25 μg/mL for caspofungin. All Candida strains were susceptible to amphotericin B and caspofungin. 10.8% isolates were resistant to fluconazole and 8.1% isolates were dose-dependent susceptible. While 0.9% isolate was resistant to voriconazole, 0.9% isolate was dose-dependent susceptible. In our study, C. albicans and C. parapsilosis were the most frequently encountered agents of candidemia and it was detected that voriconazole with a low resistance rate might also be used with confidence in the treatment of infections occurring with these agents, primarily besides amphotericin B and caspofungin.

Candida profiles and antifungal resistance evolution over a decade in Lebanon

“…This is in accord with most studies from our region [12][13][14][15][16][17][18][19][20][21][22][23][24] and from different parts of the world [31,34,35], where all Candida isolates exhibited high susceptibility to amphotericin B, with MICs of up to 1 mg/L. In contrast, the majority of the isolates in our study showed high levels of resistance (35%-79%) to itraconazole.…”

“…Nonetheless, data concerning the profile and antifungal susceptibility of Candida spp. are relatively few in some Arab countries [12][13][14][15][16][17][18][19] and other countries in the region [20][21][22][23][24]. In Lebanon, only one study exists, which was published 17 years ago [25]; thus, this subject warrants an update.…”

Antifungal susceptibility, risk factors and treatment outcomes of patients with candidemia at a university hospital in Saudi Arabia

“…Antifungal susceptibility is highly important for management of patients with candidemia. The results of this study showed that all isolated Candida species were susceptible to amphotericin B, which is in agreement with the results of many other studies [24][25]. However, the increased usage of antifungal agents may contribute to increased occurrence of resistance in some Candida species more than others [26].…”

“…Eksi et al [24] in Turkey, found that 47.7% of their isolates from candidemia cases were C. albicans, followed by C. parapsilosis (36.9%) and other Candida species represented by 15.4%. Chi et al [7] in Taiwan, reported that C. albicans represented 43.5%, meanwhile, non-albicans spp.…”

Antifungal Susceptibility and Risk Factors in Patients with Candidemia

“…In the study by Eksi et al [26] conducted in our region, Candida species were typed and tested for antifungal susceptibility. However, since the risk factors were not evaluated in this study, our study becomes prominent as the first one to take these factors into consideration.…”