The frequency of isolation and the susceptibility to antifungals of Candida species in a large academic hospital: three-year surveillance
Abstract number: 1734_182
Ghezzi M.C., Raponi G., Mancini C.
Objective: The pattern of Candida species commonly isolated in various clinical settings is continuously changing. Purpose of this study was to analyse the frequency of isolation of different species of Candida and the variation of their susceptibility to antifungals, during a three years surveillance study.
Methods:Candida species were isolated from clinical samples of patients hospitalised at the ``Azienda Policlinico Umberto I'' Academic Hospital of Rome, Italy during three years (20032005). Strains were identified by germ tube test and by API 32C®. The susceptibility testing was performed by Sensitre Yeast One® test on clinically based request, and the results were interpreted according to the manufacturer's and CLSI guidelines.
Results: A total of 3022 strains of Candida were identified during the study period. The specie most frequently isolated was C. albicans (83.9%) followed by C. glabrata (7.8%), C. tropicalis (5.1%) and other Candida species (4.2%). The frequency of isolation of C. albicans steadily decreased during the study period, starting from 90% in 2003 to 80% during 2004 and 2005. Instead, the isolation of C. glabrata and C. tropicalis doubled in the same period from 4.5% to 9.5% and from 2.2% to 4.8% respectively. Antifungal tests were performed on 110 strains isolated from blood stream (50.9%), lower respiratory tract (26.3%), wounds (16.4%) and urinary tract (6.4%). C. albicans showed very low frequency of resistant isolates, with 3 strains in 2004 and one in 2005 resistant to at least one antifungal. Conversely, C. glabrata showed low susceptibility to itraconazole (18%), to fluconazole (59%), and, to a lower extent, to amphotericin B (88.3%) and to voriconazole (94%). Furthermore, the number of C. glabrata strains resistant to at least one antifungal steadily increased from 0 in 2003 to 10 strains in 2005.
Conclusions: The results of this study indicated that the pattern of Candida species isolated during the years varied in our clinical setting, showing an increasing incidence of non-albicans species, particularly C. glabrata and C. tropicalis. The susceptibility data evidenced that strains of C. albicans were highly susceptible to the test drugs, together with an increasing rate of C. glabrata strains resistant to antifungals. The usage of azoles in the prophylaxis of fungal infections in our hospital probably influenced the diffusion of non-albicans species, some of which are frequently resistant to these drugs.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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