Trends in frequency and in vitro susceptibilities to antifungal agents, including voriconazole and anidulafungin, of Candida bloodstream isolates.: Results from a six-year study (1996-2001)

The frequency of isolation and antifungal susceptibility patterns to established and two new antifungal agents were determined for 218 Candida spp isolates causing bloodstream infection from 1996 to 2001. Overall, 41.7% of the candidemias were due to C. albicans, followed by C. parapsilosis (22%), C. tropicalis (16.1%), C. glabrata (11.9%), C. krusei (6%) and miscellaneous Candida spp (2.3%). Isolates of C. albicans C. parapsilosis and C. tropicalis (80% of isolates) were highly susceptible to fluconazole (94 to 100% at less than or equal to 8 mug/ml) and voriconazole (97 to 100% at less than or equal to 1 mug/ml). By comparison with the newer agents itraconazole was less active (77 to 97% at less than or equal to 0.12 mug/ml). Only 77% and 15% of C. glabrata isolates were inhibited by fluconazole at less than or equal to 8 mug/ml and itraconazole at less than or equal to 0.12 mug/ml, respectively. Voriconazole showed a remarkable in vitro potency against C. glabrata as well as C. krusei isolates (100% at less than or equal to 1 mug/ml). Anidulalfungin was very active against Candida spp isolates (MIC90: less than or equal to 0.5 mug/ml), except C. parapsilosis (MIC90: 4 mug/ml) and two C. guilliermondii isolates (MIC: greater than or equal to 32 mug/ml). (C) 2003 Elsevier Inc. All rights reserved.