Typing of candida species isolated from patients in hospital as an infectious agent and evaluation of their susceptibility to antifungal drugs with e-test method

Many factors such as epidemiologic factors, risk factors, mortality, new agents, the difficulty of diagnosis, treatment costs, and development of resistance to antifungal agents contribute to increased importance of invasive Candida infections.Between April 2009 and April 2011, all patients who were followed up for diagnosis of candidemia and/or invasive Candida infections at Medical School Hospital of Firat University were included in this study, regardless of department. Patients were evaluated in respect to age, gender, risk factors predisposing to the formation of invasive Candida infections, related clinics which followed up patients, distributions of invasive Candida infection attacks according to the systems. Isolated Candida strains were idendified by germ tube test and API ID 32 C identification system and their antifungal susceptibility were tested with E-test method.Fortynine (44,1%) of 111 patients with invasive Candida infections were followed up at intensive care ünit and the remaining 62 (55,9 %) patients were followed up at the other departments. The mean age was 54,8±20,8 years, 64 (57,7%) patients were male and 47 (42,3%) patients were female. The most common risk factors for invasive Candida infections were identified as use of broad-spectrum antibiotics (92,8%), presence of central venous catheter (57,7%), and presence of urinary catheter at patients (55%). The most commonly isolated Candida species among 111 patients with Candida infections was Candida albicans (45,9%) followed by Candida parapsilosis (19,8%), Candida tropicalis (9,9%) and Candida glabrata (7,2%). Other Candida species were isolated from 17,2% of cases. Itraconazole resistance for Candida albicans and for non-albicans species at antifungal susceptibility tests was 5,8% and 28,3%, respectively, and fluconazole resistance for Candida albicans and for non-albicans species was 5,8% and 20%, respectively, amphotericin B resistance for Candida albicans and non-albicans species was 1,9% and 1,6%, respectively. There was no voriconazole resistance in Candida albicans, while this resistance was found as 10% for non-albicans species. The higest resistance was found against itraconazole followed by fluconazole. In our study, the resistance against voriconazole and amphotericin B were found at very low rates, while there was no resistance against caspofungin.Key words: Invasive Candida infections, Candida species, antifungal susceptibility