Antifungal Susceptibility Profile and Predominance of non-Candida albicans Isolates in Bloodstream Yeasts Isolated from Peruvian Patients

Ref ID: 18738

Author:

B. Bustamante, PhD – Medical Doctor 1, M. A. Martins, MD – Senior Researcher 2, L. X. Bonfietti, MD – Research assistant 2, M. W. Szeszs, PhD – Senior Researcher 2, J. Jacobs, PhD – Senior Researcher 3, M. S. C. Melhem, PhD – Researcher2;

Author address:

1Instituto de Medicina Tropical Alexander von Humboldt-Univ. Peruana Cayetano Heredia, Lima, Peru, 2Instituto Adolfo Lutz, Sao Paulo, Brazil, 3Central Lab. of Clinical Biology, Dept. of Clinical Sci. Instituto de Medicina Tropical Prince Leopold,, Am

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: Up to now, there are no large studies in Peru that provide data of the candidemia agents. Methods: Bloodstream isolates (BSI) from 9 hospitals (Lima, Peru) were identified, and tested for their antifungal susceptibility (AST). We tested 163 isolates identified by the API 20C AUX ® . PCR and PCR-RFLP assays were used to discriminate criptic species. AST for fluconazole (FCZ), anidulafungin and voriconazole (VCZ) against Candida isolates, was performed by M27-A3 method (CLSI). AST for amphotericin B (AMB) was determined by Etest® method. Results: The distribution of species was as follows: C. albicans (59; 36.2%), C. parapsilosis (43;26.4%), C. tropicalis (41; 25.2%), C. glabrata (10; 6.2%), C.guilliermondii (5; 3.1%), C. krusei and C. famata one isolate each (1; 0.6%), Pichia anomala (2; 1.2%) and Trichosporon mucoides (1; 0.6%). None isolate of C. dubliniensis, C. metapsilosis, C. orthopsilosis, C. bracarensis or C. nivariensis was found. C. albicans isolates showed to be susceptible to all drugs, except for a single strain against anidulafungin (MIC 1 mg/L). We found 3 isolates of C. tropicalis resistant to anidulafungin (MIC 1-2mg/L) and other three isolates VCZ-resistant (MIC 0.25 mg/L). Among C. parapsilosis isolates we observed resistance to AMB (3; 7%), FCZ (1; 2.3%) and VCZ (1; 2.3%). High VCZ-MICs (0.25 mg/L) for one isolate of C. glabrata (1%) were observed. Anidulafungin has low activity (MIC 1 mg/L) against 2 (40%) isolates of C. guilliermondii and for the single Trichosporon mucoides isolate (MIC 16 mg/L). Conclusions: This is the largest candidemia study conducted in Peru and shows that non-C. albicans constitutes 62% of candidemia agents. The rates of resistance to tested drugs, including anidulafungin are still low among BSI.

Abstract Number: M-311

Conference Poster: y

Conference Year: 2012

Link to conference website: NULL

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