Susceptibility patterns of Candida species recovered from Canadian intensive care units.
OBJECTIVE
The objective of this study was to determine the speciation and susceptibility patterns of Candida species recovered from Canadian intensive care units (ICUs) during a 1-day point-prevalence study on fungal colonization/infection in Canadian ICUs.


METHODS
Blood, urine, respiratory tract, rectal, and wound fungal cultures were performed for 357 patients present at any time during a single-day 24-hour period in 35 Canadian ICUs. Comparative in vitro activities of amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, micafungin, anidulafungin, and aminocandin were determined.


RESULTS
Four hundred fifteen yeasts (409 Candida species and 6 non-Candida yeasts) were recovered. Almost 50% of the patients were found to have positive respiratory tract or rectal cultures. Candida albicans accounted for 72% of the Candida species isolated, followed by Candida glabrata (16%), Candida tropicalis (5%), Candida parapsilosis (3%), Candida krusei (2%), and other Candida species or nonspeciated isolates (2%). Minimum inhibitory concentrations (milligrams per liter) at which 90% of the strains were inhibited were 0.06 for micafungin as well as anidulafungin, 0.12 for voriconazole, 0.25 for itraconazole, posaconazole, as well as aminocandin, 1 for amphotericin B, and 4 for fluconazole. Only 4% of the isolates were resistant to fluconazole and/or itraconazole.


CONCLUSIONS
Candida albicans is the predominant species colonizing Canadian ICU patients. Overall, the triazoles, both older and new compounds, and the echinocandins have excellent in vitro antifungal activities against Candida species recovered from Canadian ICUs patients.
Laverdiere
Michel
M
University of Montreal, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada H1T 2M4. laverdim@courrier.umontreal.ca
Labbé
Annie-Claude
AC
Restieri
Christiane
C
Rotstein
Coleman
C
Heyland
Daren
D
Madger
Sheldon
S
Stewart
Thomas
T
D000935:Antifungal Agents / Q000494:pharmacology*; D002170:Canada / Q000453:epidemiology; D002175:Candida / Q000145:classification* / Q000187:drug effects; D002177:Candidiasis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002478:Cells, Cultured; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D025141:Drug Resistance, Fungal; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence
D000935:Antifungal Agents