Some characteristics of invasive candidiasis pathogens.

Abstract

e14084 Background: The purpose of the study was to determine the etiology of invasive candidiasis (IC) and investigate in vitro activity of caspofungin and azoles for blood isolates of Candida fungi. Methods: We performed a multidisciplinary prospective study of isolates of patients with clinical signs of IC obtained in intensive care units (ICU), oncohematology and oncology departments of hospitals in Rostov-on-Don and Rostov region in 2012-2015. Candida fungi were identified using MALDI-TOF MS; interpretation was performed according to CLSI 2012, M27-S4 criteria. Sensitivity testing was performed using the Sensititre system (Trek Diagnostic Systems, England). Results: 92 Candida isolates were obtained from blood culture: C.albicans - 31.5% (29) and non-albicans - 68.5% (63), including C.tropicalis 30.2% (19), C.parapsilosis 28.6% (18), C.glabrata 19.0% (12), C.krusei 15.9% (10) and C.guilliermondii 6.3% (4). C. albicans were found mostly in oncological departments (44%) compared with ICU – 30% (р=0.003) and departments of oncohematology – 26%. The table demonstrates comparative activities of caspofungin, fluconasole and voriconasole (susceptible – S, intermediate – I, resistant – R) in % to Candida spp. Conclusions: Candida non albicans prevailed among IC pathogens (68.5%), which could be associated with the use of azole antifungal agents for prophylaxis and empirical therapy. Dominating isolates showed decreased activity to caspofungin and azoles. Acquired resistance to azoles was noted for C. parapsilosis and C. albicans. All cases of invasive candidiasis require susceptibility testing for caspofungin and azoles before starting therapy with these agents. [Table: see text]