Antifungal susceptibility of Candida spp. isolates from blood cultures in a five-year period (1997-2001)

INTRODUCTION. This retrospective study investigates the incidence of candidemia and antifungal susceptibility of Candida spp. isolates from blood cultures performed in the period from January 1997 to December 2001. METHODS. Amphotericin B, fluconazole, itraconazole and flucytosine minimal inhibitory concentrations (MICs) were determined using the Sensititre(R) YeastOne broth microdilution assay for the 53 isolates detected in the study period: C. parapsilosis (22), C. albicans (19), C. glabrata (5), C. krusei (3), C. tropicalis (2) and C. guilliermondii (2). RESULTS. The incidence of candidemia was 0.25 episodes per 1000 admissions in the period studied. C. parapsilosis was present in 41.5% of cases, followed by C. albicans (35.8%), C. glabrata (9.4%), C. krusei (5.5%), C. tropicalis (3.7%) and C. guilliermondii (3.7%). Isolation of C. parapsilosis was significantly associated with the neonatal and pediatric ICU. None of the isolates presented an amphotericin B MIC > 1 mug/ml. All the C. krusei isolates were resistant to fluconazole. Itraconazole resistance and dose-dependent fluconazole susceptibility was found in 80% of C. glabrata isolates. Only one C. parapsilosis isolate was resistant to flucytosine. CONCLUSIONS. The incidence of candidemia in our hospital was low. C. parapsilosis was the most common species and was associated With neonatal and pediatric ICUs. Fluconazole and itraconazole resistance was only found among C. krusei and C. glabrata isolates, which accounted for 15% of the total Candida spp. isolated from blood cultures in our hospital.