title: Antifungal susceptibility of bloodstream Candida isolates in Sfax hospital: Tunisia.
abstract: Invasive candidiasis has emerged as an important nosocomial infection, causing significant morbidity and mortality especially among critically ill patients. The aim of our study was to determine specie distribution and resistance profiles of Candida species isolated from blood cultures.
  
  
  METHODS
  We conducted a retrospective study of all episodes of candidemia diagnosed in our laboratory from January 2006 to May 2009. The susceptibility to antifungal agents of all Candida isolates was tested by using a Sensititre(®) YeastOne panel.
  
  
  RESULTS
  A total of 130 Candida isolates were recovered from blood cultures. Candida tropicalis was the most frequent specie (37.7%), followed by C. albicans (22.3%), C. glabrata (19.2%), and C. parapsilosis (12.2%). All the isolates were inhibited by ≤1 μg/ml of amphotericin B and ≤2 μg/ml of caspofungin. For fluconazole, 7.3% of clinical isolates were resistant. It was most active against C. parapsilosis (100% susceptible), C. albicans (95.8% susceptible), and C. tropicalis (94% susceptible). All of the fluconazole-susceptible isolates were susceptible to voriconazole, as were 83.3% of the fluconazole-susceptible-dose-dependent isolates. Among fluconazole-resistant isolates, 85.7% were susceptible to voriconazole.
  
  
  CONCLUSIONS
  In our institution, C. tropicalis was the most frequent specie isolated from the bloodstream. Caspofungin had an excellent in vitro activity against Candida isolates and was the drug of choice among fluconazole-resistant isolates.
authors.affiliation: Laboratory of Parasitic and Fungal Molecular Biology, Medicine School, 3029 Sfax, Tunisia.
authors.forename: A
authors.initials: A
authors.lastname: Sellami
authors.forename: H
authors.initials: H
authors.lastname: Sellami
authors.forename: S
authors.initials: S
authors.lastname: Néji
authors.forename: F
authors.initials: F
authors.lastname: Makni
authors.forename: S
authors.initials: S
authors.lastname: Abbes
authors.forename: F
authors.initials: F
authors.lastname: Cheikhrouhou
authors.forename: H
authors.initials: H
authors.lastname: Chelly
authors.forename: M
authors.initials: M
authors.lastname: Bouaziz
authors.forename: B
authors.initials: B
authors.lastname: Hammami
authors.forename: M
authors.initials: M
authors.lastname: Ben Jemaa
authors.forename: S
authors.initials: S
authors.lastname: Khaled
authors.forename: A
authors.initials: A
authors.lastname: Ayadi
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects*; D058387:Candidemia / Q000097:blood / Q000453:epidemiology / Q000382:microbiology*; D000077336:Caspofungin; D025141:Drug Resistance, Fungal; D054714:Echinocandins / Q000494:pharmacology; D005260:Female; D015725:Fluconazole / Q000494:pharmacology; D006801:Humans; D055666:Lipopeptides; D008297:Male; D008826:Microbial Sensitivity Tests; D011743:Pyrimidines / Q000494:pharmacology; D012189:Retrospective Studies; D014230:Triazoles / Q000494:pharmacology; D014416:Tunisia / Q000453:epidemiology; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; D015725:Fluconazole; D000077336:Caspofungin; D065819:Voriconazole