Antifungal Susceptibility of Candida albicans Isolates at a Tertiary Care Hospital in Bulgaria

Abstract

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.

Antifungal Susceptibility of Non-albicans Candida Species in A Tertiary Care Hospital, Bulgaria

“…As is well known, azole resistance is more common in NAC as compared to C. albicans (9). The results from Bulgarian trials confirmed these observations (16,17,29). In the current study, C. glabrata showed MIC 50 and MIC 90 of fluconazole 16 and > 128 µg/mL, until voriconazole MIC 50 and MIC 90 were considerably lower -0.25 and 8 µg/mL.…”