title: Species distribution and antifungal susceptibility of Candida bloodstream isolates in a tertiary medical center in Israel.
abstract: To evaluate the species distribution and antifungal susceptibility of Candida isolates in a tertiary institution in Israel, all consecutive isolates of Candida spp. recovered from blood during the last 2 years were studied. The isolates were identified by the germ tube test and the API ID 32C test (bioMérieux, Marcy l'Etoile, France). MICs of antifungal agents were determined by the E test. Candida albicans was the most commonly isolated species, accounting for 44% (63/142) of the isolates, followed by Candida tropicalis (25%; 35/142), Candida parapsilosis (20%; 29/142), Candida glabrata (10%; 14/142), and Candida krusei (0.7%; 1/142). All isolates were sensitive to amphotericin B and voriconazole. Resistance to fluconazole (using a high MIC of >/=256 microg/ml) was found in 1.6% of C. albicans isolates, in 3.4% of C. parapsilosis isolates, and in 21.4% of C. glabrata isolates. Resistance to itraconazole was detected in 3.2% of C. albicans isolates, in 2.9% of C. tropicalis isolates, in 3.4% of C. parapsilosis isolates, and in 93% of C. glabrata isolates. Disparities in species distribution and antifungal susceptibility of Candida isolates from the institute studied versus Candida isolates from other centers and countries are described. The findings emphasize the need for continuous surveillance and further clinical investigational studies.
authors.affiliation: Department of Clinical Microbiology, Rabin Medical Center, Beilinson Campus, and Sackler School of Medicine, Tel-Aviv University, Petach-Tikva, 49100, Israel.
authors.forename: Z
authors.initials: Z
authors.lastname: Samra
authors.forename: M
authors.initials: M
authors.lastname: Yardeni
authors.forename: N
authors.initials: N
authors.lastname: Peled
authors.forename: J
authors.initials: J
authors.lastname: Bishara
mesh_terms: D000046:Academic Medical Centers; D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology; D002175:Candida / Q000187:drug effects* / Q000302:isolation & purification; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification; D041221:Candida glabrata / Q000187:drug effects / Q000302:isolation & purification; D041022:Candida tropicalis / Q000187:drug effects / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology*; D025141:Drug Resistance, Fungal; D015725:Fluconazole / Q000494:pharmacology; D016469:Fungemia / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007557:Israel; D017964:Itraconazole / Q000494:pharmacology; D011743:Pyrimidines / Q000494:pharmacology; D013045:Species Specificity; D014230:Triazoles / Q000494:pharmacology; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole; D065819:Voriconazole