In vitro susceptibilities of bloodstream isolates of Candida spp.: results from a multicenter active surveillance program in Andalusia.
OBJECTIVE
The aim of this study was to determine the antifungal drug susceptibilities of Candida bloodstream isolates in Andalusia, obtained through a multicenter active laboratory-based surveillance between October 2005 and September 2006.


METHODS
One hundred and ninety-seven Candida isolates were collected. The MICs of amphotericin B, fluconazole, itraconazole and voriconazole were established using the Sensititre YeastOne panel. The MICs of posaconazole and caspofungin were determined by Etest.


RESULTS
C. albicans was the most frequently isolated species (49.2%), followed by C. parapsilosis (17.3%), C. tropicalis (15.2%), C. glabrata (13.7%) and C. krusei (3.6%). All strains were inhibited at MICs of </=1 mg/L of amphotericin B and 98.5% of isolates were inhibited at MICs of < or = 1 mg/L of posaconazole. A total of 8 isolates (4.1%) were classified as resistant to fluconazole (MIC > or = 64 mg/L) and 7 (3.6%) were considered resistant to itraconazole (MIC > or = 1 mg/L). All the isolates were susceptible to voriconazole and caspofungin.


CONCLUSIONS
In our study C. krusei and C. glabrata were identified in over 18% of cases of candidemia. Most clinical isolates of these species are resistant or susceptible-dose-dependent to fluconazole but susceptible to voriconazole and caspofungin. These agents must be used in the empiric treatment of candidemia rather than fluconazole.
Flórez
Carmen
C
Servicio de Microbiología, Hospital de Valme, Seville, Spain. florezalia@yahoo.es
Martín-Mazuelos
Estrella
E
Ruiz
Maite
M
Cisneros
José Miguel
JM
Herrero
Marta
M
García
M Victoria
MV
García
Ma Victoria
MV
Márquez
Manuel
M
Porras
José
J
Martín
Patricia
P
Gamero
Carmen
C
Castón
Juan José
JJ
D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects* / Q000302:isolation & purification; D002177:Candidiasis / Q000453:epidemiology / Q000382:microbiology*; D025141:Drug Resistance, Fungal; D026141:Drug Resistance, Multiple, Fungal; D016469:Fungemia / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D066298:In Vitro Techniques; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D013030:Spain / Q000453:epidemiology; D013045:Species Specificity
D000935:Antifungal Agents