Species distribution and antifungal susceptibility of Candida bloodstream isolates in a tertiary teaching hospital, Saudi Arabia

Ahmed Albarrag


Background: Candida species are considered a major cause of nosocomial bloodstream infections worldwide with an increase in isolation of non-albicans Candida species. The purposee of the study was to evaluate the species distribution and antifungal susceptibility profiles of Candida species recovered from blood in a tertiary teaching hospital in Saudi Arabia during a 5-year period (2010- 2014).

Material/methods: Candida species recovered from blood cultures during a 5-year period (2010- 2014) were included. All isolates were identified to species level by the germ tube test and the ‪API 20 C AUX ‬(bioMerieux). Antifungal susceptibility of Candida isolates to amphotericin B, fluconazole, voriconazole, caspofungin, and 5-flucytosine was evaluatedd using Sensititre YeastOne and the MIC breakpoints for resistance were based on CLSI.

Results: A total of 167 isolates of Candida species were recovered during the study period. Candida albicans was the predominant species (30.5 %), followed by Candida glabrata (24.5 %), Candida parapsilosis (19.8 %), Candida tropicalis (19.1 %), Candida krusei (2.4 %) and other species (1.8%). All isolates were susceptible to amphotericin B and only two isolates, one C. tropicalis and one C. glabrata exhibited an MIC for amphotericin B of >1 mg/L. Resistance to fluconazole was observed in 5.9 % of C. albicans, 5% in C. glabrata and 15.2 % of C. parapsilosis. Most of the isolates were susceptable to voriconazole. Resistance was detected in C. albicans (3.9%), C. glabrata (2.5%) and C. parapsilosis (3%). For C. trpoicals (9.4%) and C. parapsilosis (9.1%) were susceptible dose dependent (SDD). Resistance to caspofungin was observed in C. glabrata (5%), C. krusei (25%) and C. albicans (1.96%). 15% of C. glabrata and 6% of C. parapsilosis were intermediate.

Conclusions: High rate of Non-C. albicans species was observed which constituted 69.5 % of the isolates. Although the rates of resistance were low, a considerable number of isolates were classified as SDD or intermediate for fluconazole and caspofungin respectively. Therefore, continuously surveillance of species distribution and antifungal susceptibility patterns of yeasts is needed.



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26th European Congress of Clinical Microbiology and Infectious Diseases
    • ECCMID 26th (2016)