Background: The precise identification of yeasts and their antifungal sensitivity is a key factor in the choice of a suitable drug for treatment and prevention of fungal infections. Objectives: The aim of the present study was to determine in vitro susceptibility of clinical Candida albicans isolates to nine antifungal agents. Methods: A total of 61 C. albicans isolates were tested. Antifungal susceptibility was evaluated by determination of minimum inhibitory concentrations (MIC). Results: Fifty C. albicans isolates were susceptible to nine antifungal agents. The remaining 11 yeasts were resistant to one or more antifungals. All C. albicans were susceptible to amphotericin B with MICs 0.25 to 1 µg/mL and exhibited sensitivity to 5-fluorocytosine with MIC90 of 0.125 µg/mL. The MIC50 and MIC90 of fluconazole were 0.5 and 32 µg/mL, whereas the MIC50 and MIC90 of voriconazole were considerably lower-0.0078 and 2 µg/mL. The isolates showed susceptibility to echinocandins with MIC90 of micafungin, anidulafungin and caspofungin of 0.015, 0.031, and 0.125 µg/mL, respectively. Of particular interest was detection of seven C. albicans isolates, which expressed a high-level resistance to all azoles and one of them was also resistant to echinocandins. Conclusions: In conclusion, detection of resistance in C. albicans, which is a species typically susceptible to antifungals, is of great importance for clinical practice.
Background: Emerging non-albicans Candida (NAC) species are a major threat because of their intrinsic or acquired resistance to routinely applied antifungal agents. Objectives: The purpose of our study was to reveal in vitro activity of nine antifungal agents against NAC isolates. Methods: A total of 67 NAC (27 Candida glabrata, 10 C. tropicalis, 6 C. krusei, 6 C. parapsilosis, 4 C. lusitaniae, 4 C. lipolytica, etc.) were identified and tested. The antifungal susceptibility was estimated on the basis of minimum inhibitory concentrations (MIC). Results: Overall, 13 species were determined, of which C. glabrata was the most common (40.3%), followed by C. tropicalis (14.9%), C. krusei, and C. parapsilosis (8.9 % each). Forty-nine NAC isolates (73.13%) demonstrated decreased susceptibility to one or more antifungals, and 18 of them were resistant to all azoles. Out of 27 C. glabrata, 12 (44.4%) were resistant to fluconazole with MICs: 32 - >128 µg/mL and 15 (55.6%) were intermediate with MICs: 8 - 16 µg/mL Non-albicans Candida revealed a good susceptibility to echinocandins. Amphotericin B resistance was found in 5.97% of the isolates. Of particular interest was the detection of 6 (8.95%) multidrug-resistant NAC, which expressed resistance to azoles and echinocandins and/or amphotericin B. Conclusions: About one-fourth of the studied NAC were resistant to all azoles. These findings as well as the detection of several multidrug-resistant isolates determine the necessity of susceptibility testing of clinically important yeast isolates and control of the antifungal drugs in our hospital.
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