title: [Species distribution and susceptibility pattern of Candida spp.: the importance to survey also strains isolated from the community].
abstract: BACKGROUND
  The most of the surveillance studies has been conducted in hospitalized patients with invasive infections. Recently, new clinical breakpoints (CBPs) have been proposed for antifungal susceptibility testing and epidemiological cutoffs (ECVs).
  
  
  OBJECTIVE
  To evaluate species distribution and susceptibility pattern of Candida spp. obtained from in and outpatients in a period of 6 months.
  
  
  METHODS
  The isolates (n=223) came from vaginal discharge (51.6%), lower respiratory tract (24.7%), urine (20.2%), wounds (1.8%), blood (0.9%), peritoneal fluid (0.4%) and nails (0.4%).
  
  
  RESULTS
  The species distribution was C. albicans 84.8% (n: 189), C. glabrata 7.6% (n: 17), C. tropicalis 2.7% (n: 6), C. parapsilosis 2.2% (n: 5), C. kefyr 0.9% (n: 2) and others 1.8% (C. krusei, C. lusitanie, C. guilliermondii, C. intermedia) (n: 4). The susceptibility dose dependence (SDD) and resistance were 3.2% for fluconazole and 2.2% for voriconazole. The most of SDD and resistant strains were isolated from ambulatory patients. Also, a higher percentage of MICs over the new CBPs and ECVs were found in strains from ambulatory patients and especially in C. glabrata isolates to caspofungin.
  
  
  CONCLUSIONS
  Taking into consideration that most of the invasive infections are caused by strains from the endogenous microbiota, and that there is a resistant population of Candida spp. in the community, should be important to include in surveillance studies strains isolated from ambulatory patients.
authors.affiliation: Escuela de Tecnología Médica, Universidad Mayor, Santiago, Chile.
authors.forename: Claudio
authors.initials: C
authors.lastname: Alburquenque
authors.forename: Sebastián
authors.initials: S
authors.lastname: Beltrán
authors.forename: Roberto
authors.initials: R
authors.lastname: Olivares
authors.forename: Mary A
authors.initials: MA
authors.lastname: Falconer
authors.forename: José
authors.initials: J
authors.lastname: Amaro
authors.forename: Marisol
authors.initials: M
authors.lastname: Fuentes
authors.forename: Cecilia V
authors.initials: CV
authors.lastname: Tapia
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification; D017714:Community-Acquired Infections / Q000382:microbiology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008826:Microbial Sensitivity Tests
chemical_list: D000935:Antifungal Agents