Species distribution and resistance profile to antifungal agents of Candida bloodstream infections in ICU-patients. Emergence of voriconazole resistance
Abstract number: P1801
Stylianakis A., Papaioannou V., Tsiplakou S., Pantazis E., Merianos I., Zoumpouloglou F., Koutsoukou A.
Objectives: To study the Candida species caused fungaemia in ICU-patients and their in vitro resistance profile to commonly used antifungal agents.
Methods: during a two year time period (20052007) we examined 84 fungal isolates recovered from positive blood cultures of equal numbered patients hospitalised in the three ICUs of our hospital.
The yeasts were differentiated by using germ-tube test and by the automated system VITEK 2 (Biomerieux, France). Sensitivity testing was performed by the system Fungus 3 (Biomerieux, France) and confirmed by the determination of MIC values of the examined antifungal agents by E-test strips (AB Biodisk, Solna, Sweden) in accordance to the manufacturer's recommendations. MICs were noted after 24 h of incubation. MICs (mg/L) at which 90% of the strains were inhibited were 1 for amphotericin B, 32 for 5-flucytosine, 8 for fluconazole and 0.25 for voriconazole.
Results: The more often encountered species was Candida parapsilosis n = 55 (65.5%), followed by C. albicans n = 17 (20.2%), C. glabrata n = 5 (5.9%), C. famata n = 4 (4.6%), C. lusitaniae n = 2 (2.3%) and C. utilis n = 1 (1.2%).
No resistance to amphotericin B was observed to any kind of Candida spp. The resistance level of the examined fungal isolates to fluconazole was 14.3%, to itraconazole 19% and to 5-flucytosine 51.3%. The second year two (2.3%) C. albicans isolates were found resistant to voriconazole, for the first time in our hospital and one isolate of C. albicans with decreased sensitivity (dose-depended) to the same antifungal agent.
Conclusion: The most prevalent isolated species recovered from blood stream infections of ICU-patients was Candida parapsilosis. Resistance to voriconazole emerged for the first time in our hospital making the treatment of fungal infections due to C. albicans species, more difficult. Amphotericin B remains an agent with very good activity for the treatment of Candida blood stream infections.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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