title: In vitro susceptibilities of bloodstream isolates of Candida spp.: results from a multicenter active surveillance program in Andalusia.
abstract: 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.
authors.affiliation: Servicio de Microbiología, Hospital de Valme, Seville, Spain. florezalia@yahoo.es
authors.forename: Carmen
authors.initials: C
authors.lastname: Flórez
authors.forename: Estrella
authors.initials: E
authors.lastname: Martín-Mazuelos
authors.forename: Maite
authors.initials: M
authors.lastname: Ruiz
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Cisneros
authors.forename: Marta
authors.initials: M
authors.lastname: Herrero
authors.forename: M Victoria
authors.initials: MV
authors.lastname: García
authors.forename: Ma Victoria
authors.initials: MV
authors.lastname: García
authors.forename: Manuel
authors.initials: M
authors.lastname: Márquez
authors.forename: José
authors.initials: J
authors.lastname: Porras
authors.forename: Patricia
authors.initials: P
authors.lastname: Martín
authors.forename: Carmen
authors.initials: C
authors.lastname: Gamero
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Castón
mesh_terms: 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
chemical_list: D000935:Antifungal Agents