İnvaziv infeksiyonlardan izole edilen kandida türlerinin flukonazol, vorikonazol, amfoterisin B duyarlılıklarının mikrodilüsyon ve tıme kill yöntemi (zamana bağlı öldürme kinetiği) ile araştırılması

In this study we classified candida species derived from patient's blood, urine, ETA catheter and sputum specimens who has invasive infection by using conventional systems and commercial clasification kits. We determinated isolated MIC values of 100 C. albicans strain for tree antifungal medication (fluconazole, voriconazole and amphotericin B) by using microdilution, standard method recommended by CLSI. We indicated fluconazole, voriconazole and amphotericin B resistant and sensitive strains depending upon microdiluation results and for 10 strains of theese which has different MIC values we invastigated fungistatic or fungicidal activities of drugs in different dilutions by using time kill method. We determinated MIC range as 0,125-64 ?g/ml and MIC 50/90 value as 1 /16 ?g/ml of 100 Candida albicans strains for fluconazole by microdilution method. We founded that 82 strains are fluconazole sensitive, 10 strains are dose-dependent sensitive and 8 strains are resistant. We determinated MIC range as 0,03-4 ?g/ml and MIC 50/90 value as 0,06 /1 ?g/ml of same strains for Voriconazole. We founded that 95 strains are voriconazole sensitive, 2 strains are dose-dependent sensitive and 3 strains are resistant. We determinated MIC range as 0,125-1 ?g/ml and MIC 50/90 value as 0,5/0,5 ?g/ml for Amphotericin B. No amphotericin B resistance observed in Candida albicans strains. We observed that fluconazole and voriconazole have fungistatic affect in 1,2,4 times consantrations of MIC, amphotericin B has fungistatic affect in quarter, half consantrations and fungicide affect in 1,2,4 times consantrations of MIC by time kill method and determined that amphotericin B has more rapid affect in higher consantrations. In conclusion, inconsistent results presents resistance ranges in azoles can be lower essentially. We think that time kill method is adequate for research studies but not practical in rutin. However, we also think that supoorting results of in vitro studies by clinic researches will help us determinig sensitivity ranges and developing adequate dose strategies.