A 3-year study of resistance of Candida pathogens obtained from patients with fungaemia with emphasis on new antifungal agents
Abstract number: p1228
Koutsoukou A., Stylianakis A., Tsiplakou S., Tachtatzis M., Tsakona E., Vourtsi A., Sideri A.
The aim of the present study was to examine the resistance of Candida species to amphotericin-B, fluconazole, itraconazole, 5-flucytocine and to the new antifugal agents voriconazole and caspofungin.
152 non duplicated Candida species, isolated from blood cultures (Bactec, Becton Dickinson) over a 3 year period (20032005), were identified and MIC values were determined. Identification was performed by VITEK II automated system (Biomerieux) and confirmed by the API 20C AUX (Biomerieux). MICs for amphotericin-B, fluconazole, itraconazole and 5- flucytocine were determined by ATB fungus 2 (Biomerieux). For the new agents voriconazole and caspofungin, MICs were defined by E-test (AB Biodisk, Solna, Sweden) and confirmed by broth microdilution method, according to NCCLS criteria (document M 27-A).
Candida parapsilosis was the predominant species (64%) followed by Candida albicans (24%), Candida tropicalis (8%), Candida glabrata (2%), Candida krusei (1%). 77 (50%) strains were resistant to itraconazole 44 (33%) strains were resistant to fluconazole, 7 (5%) strains were resistant to 5-flucytocine while no strain was found resistant to amphotericin-B. The MICs of caspofugin were between 0.252 mg/ml and the MICs of voriconazole were less than 1 mg/ml. Only 2 strains of Candida parapsilosis had MICs higher than 2 mg/ml to voriconazole and would be classified as resistant to the drug.
Our findings show that fungemia in our hospital is caused mainly by Candida parapsilosis. Moreover Candida blood stream infections had high-rates of resistance to itraconazole and fluconazole in contrast to voriconazole. All Candida strains were susceptible to caspofungin. Also, no resistance was observed to amphotericin-B which remains the more active antifungal agent in common use.
|Session name:||XXIst ISTH Congress|
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