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Antifungal susceptibility patterns of Candida isolates recovered from bloodstream infections: a 3-year study

Abstract number: 1734_173

Kopsari K., Zarkotou O., Avramioti V., Chrysos G., Gianneli D.

Objectives: To determine the prevalence of candidaemia in bloodstream infections (BSIs), to define the species distribution among candida isolates and to evaluate the antifungal susceptibility profiles.

Methods: During a 3-year period (11/03–10/06) a total of 1263 episodes of BSIs were studied. The blood cultures were incubated in BACTEC 9240 Automated Blood Culture System (Becton and Dickinson). The identification of candida isolates to species level was based on Fungichrom kit (International Microbio, France), until April 2006. The isolates recovered after April 2006 were identified to species level by VITEK 2 Compact automated system (bioMérieux). The antifungal susceptibility testing was performed by a colorimetric microdilution method (Sensititre YeastOne Test Panel, UK) which is based on NCCLS M-27-A2 standards and gives MIC results for 6 common antifungal agents: amphotericin B, fluconazole, itraconazole, ketoconazole, flucytosine and voriconazole. The breakpoints for azoles and flucytosine were those suggested by NCCLS. The strains with MICs >1 for ampotericin B and voriconazole were considered resistant.

Results: During the study period a total of 58 episodes of candidaemia in 56 patients were identified. Candidaemias accounted for 4.6% of BSIs (58/1263) and 5.8% of the patients (56/964) developed BSI due to candida species. The majority of candidaemias were observed in ICU-patients (33/56) followed by surgical patients (14/56). The species distribution study proved a clear predominance of Candida albicans (40/58 isolates, 69%). The most prevalent among non-albicans species was Candida parapsilosis (9/58, 15.5%). All candida isolates were susceptible to amphotericin B. Susceptibility to all antifungals tested was detected in 46.6% of the strains. Resistance to fluconazole and itraconazole was observed in 15.5% and 17.2% of the isolates respectively, while 6.9 and 15.5% of them were susceptible dose-dependent. The resistance rate to voriconazole was 13.8%. Resistance to all azoles tested was detected in 5 Candida albicans and one Candida glabrata isolate.

Conclusions:Candida albicans prevails among fungal isolates in candidaemias in our hospital. The necessity of surveillance for detecting trends in species distribution and antifungal susceptibility patterns is emphasized by the increasing incidence of resistance to antifungals.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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