title: Antifungal susceptibility of 1000 Candida bloodstream isolates to 5 antifungal drugs: results of a multicenter study conducted in São Paulo, Brazil, 1995-2003.
abstract: We evaluated all Candida sp. bloodstream isolates obtained from patients admitted to 4 tertiary care hospitals between 1995 and 2003 in the city of São Paulo, Brazil. Susceptibility to amphotericin B, 5-fluorocytosine, fluconazole (FCZ), itraconazole (ITZ), and voriconazole (VCZ) was determined using the Clinical Laboratory Standards Institute broth microdilution method. We tested a total of 1000 strains, including 400 strains of Candida albicans (40%), 243 of Candida tropicalis (24.3%), 238 of Candida parapsilosis (23.8%), 44 of C. glabrata (4.4%), 30 of Candida guilliermondii (3%), and 25 of Candida rugosa (2.5%). Only 1.9% of the strains tested were susceptible in a dose-dependent manner, and 0.2% of them were resistant to FCZ. Almost 100% of the strains were susceptible to VCZ. Despite that azole resistance was a rare finding, a trend toward increased resistance among C. rugosa strains to FCZ and ITZ was noted.
authors.affiliation: Division of Infectious Diseases, Universidade Federal de São Paulo, SP 04023-062, Brazil.
authors.forename: Daniel Archimedes
authors.initials: DA
authors.lastname: da Matta
authors.forename: Leila Paula
authors.initials: LP
authors.lastname: de Almeida
authors.forename: Antônia Maria
authors.initials: AM
authors.lastname: Machado
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Azevedo
authors.forename: Elisa Junko Ura
authors.initials: EJ
authors.lastname: Kusano
authors.forename: Norma Fracalanza
authors.initials: NF
authors.lastname: Travassos
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Salomão
authors.forename: Arnaldo Lopes
authors.initials: AL
authors.lastname: Colombo
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D001393:Azoles / Q000494:pharmacology; D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification*; D002177:Candidiasis / Q000382:microbiology; D025141:Drug Resistance, Fungal; D016469:Fungemia / Q000382:microbiology*; D006761:Hospitals; D006801:Humans; D008826:Microbial Sensitivity Tests
chemical_list: D000935:Antifungal Agents; D001393:Azoles