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Identification rate and susceptiblity of Candida isolates from blood cultures

Abstract number: P2179

Dagwadordsch U., Dosa E., Doczi I., Wilhelms D., Nagy E., Kekulé A.S.

Objective: The incidence of invasive candidiasis has increased over the past 2 decades and it is an important cause of complications and death in hospitalised patients. Due to the life-threatening nature of these infections and increasing drug resistances, susceptibility testing of Candida spp. has crucial importance. During a 2-year period (2005–2007), Candida infections were analysed in two institutions, the 1208-bed University Hospital in Halle, Germany, and the 1240-bed University Hospital in Szeged, Hungary.

Methods: Results of 41.423 blood culture samples were reviewed. The samples had been analysed by BacT/ALERT® 3D (bioMérieux) and BACTEC™ (BD) automated systems in Halle and Szeged, respectively. The maximum incubation time was 10 days. All positive samples were microscopically examined by Gram stain. For the identification of Candida species, we used CHROMagar®Candida (MAST DIAGNOSTICA/BD, rice agar, Auxacolor 2 (Sanofi Diagnostics Pasteur), ID 32 C and the VITEK® 2 YST card (bioMérieux).

In vitro antifungal activities of amphotericin B, flucytosine, fluconazole, itraconazole, voriconazole, posaconazole, caspofungin and anidulafungin were investigated by Etest® (AB Biodisk).

Results: Of the examined blood culture samples (1–13 samples/patient, mean 3 samples/patient), 16.7% were positive for bacteria and/or fungi. The most prevalent isolates were aerobic bacteria, found in 91% of the positive cultures. Candida spp. were detected in 172 patients. They constituted the second most common isolates, with a mean isolation frequency of 6.3%. Anaerobic bacteria were found in 2.7% of the positive cultures.

Most specimens positive for Candida spp. were received from intensive care units, from patients with cancer, organ transplants, burns and surgical infections. The most prevalent species was C. albicans (55.8% of isolates). From each of the 172 patients positive for Candida spp., one representative isolate was referred to further investigation. All tested isolates were sensitive to amphotericin B, voriconazole and posaconazole. Only one isolate of C. albicans and 6 isolates of C. parapsilosis displayed decreased susceptibilities to both caspofungin and anidulafungin (MIC > 1 mg/mL).

Conclusion: The new antifungals posaconazole and anidulafungin have excellent in vitro activities against invasive isolates of Candida spp.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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