Investigation of the antifungal susceptibility of candida strains isolated from immune suppressed patients, with e-test method

2. ABSTRACTInvestigation of the Antifungal Susceptibility of Candida Strains Isolated fromImmune Suppressed Patients, with E test MethodIt is well-known that Candida cause a considerable mortality via leadinginvasive and disseminated-systemic infections in the patients whose immune-suppressed or in poor clinic condition. In this study, it was aimed to investigatetyping of Candida species that were isolated from various clinic samples frominpatients whose immune-suppressed or in poor clinic condition and also todetermine the antifungal susceptibility of these isolates. During the study, a total 46Candida were isolated from urine (6), sputum (6), blood (11), wound (4),endotracheal aspirate (7), nasopharynx (3), catheter (7) and stool (2) samples of 39febrile neutropenic patients and 7 patients with poor clinic condition in intensivecare units. Typing of the Candida isolates were carried out with API ID 32 C (bioMérieux) kits. Of the strains included in to the study, 24 (52.1%) were identified asCandida albicans, five (10.8%) were Candida krusei, seven (15.2 %) were Candidatropicalis, four (8.6 %) were Candida glabrata, three (6.5 %) were Candidaparapsilosis and three (6.5%) were Candida guillermondii. In the susceptibilityassay with E test, 2.1% of the isolates were found resistant to amphotericin B, 21.7% to ketoconazole and fluconazole, 17.3 % to voriconazole, 23.9% to itraconazoleand 6.5 % to flucytosine. The MIC50 and MIC90 values of the most active antifungal,amphotericin B, were determined as 0.019 and 0.75 μg/ml, respectively; and theMIC50 and MIC90 values of the least active antifungal, itraconazole, weredetermined as 0.032 and 16 μg/ml, orderly.3Due to development of the medicine, the target patient population ofCandida which is an opportunistic pathogen, is progressively augmented, and by thetime, it is observed that the prevalence of the invasive candida infections are beingincreased. Therefore, to successfully treat the serious infections caused by Candidain the patients at high risk, typing of the Candida should be routinely performed andantifungal susceptibility of these strains should be investigated with a reliablemethod, regularly.Key-Words: Candida strains, amphotericin B, voriconazole, ketoconazole,ıtraconazole, fluconazole, flucytosine, antifungal susceptibility.4