2018, Cilt 48, Sayı 1, Sayfa(lar) 038-044 |
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Investigation of In Vitro Susceptibility of Non-albicans Candida Species Isolated from Clinical Specimens to Fluconazole, Itraconazole, Voriconazole by Reference Broth Microdilution Method: Application of New Species-Specific Clinical Breakpoints and Epidemiological Cutoff Values |
Gülşen HAZIROLAN |
Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara |
Keywords: Non-albicans Candida, fluconazole, itraconazole, voriconazole, antifungal susceptibility profile |
Objective: The aim of this study was to determine in vitro
antifungal susceptibility profiles of the most frequently isolated
non-albicans Candida species to fluconazole, itraconazole and
voriconazole in our hospital.
Material and Methods: Non-albicans Candida species isolated
from the clinical specimens of patients who were hospitalized in
Ankara Training and Research Hospital between January 2013
and June 2016 were included in the study. Isolates were identified
by conventional methods and MALDI-TOF MS. In vitro antifungal
susceptibilities of isolates were determined by Clinical and
Laboratory Standards Institute (CLSI, M27-A3) reference broth
microdilution method (BMD). Minimal inhibitor concentration
values were evaluated with new species- specific clinical
breakpoints and epidemiological cut-off values.
Results: The species distribution of the isolates were as follows;
C. glabrata (n=37), C. parapsilosis (n=24), C. krusei (n=24),
C. tropicalis (n=14), C. lusitaniae (n=13), C. kefyr (n= 10),
C. guilliermondii (n=2) and C. dubliniensis (n=2). It was
determined that two of C. glabrata isolates were resistant to
fluconazole and one C. parapsilosis isolate was dose dependent
susceptible to fluconazole, one C. parapsilosis and one
C. tropicalis isolates were non-wild type to itraconazole, one
C. krusei and two C. parapsilosis isolates were voriconazole
intermediate, and two C. glabrata, five C. kefyr and three
C. lusitaniae isolates were non-wild type to voriconazole.
Conclusion: In our study, 126 non- albicans Candida isolates
were tested for in vitro antifungal susceptibility profiles, two
isolates were detected as resistant to triazole and 12 isolates were
evaluated as non-wild type to triazoles. No cross- resistance was
observed for tiazoles in these isolates. These data emphasize the
necessity of performing antifungal susceptibility tests for nonalbicans
Candida isolates at each center in order to direct the
treatment properly.
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