Objectives: Candidaemia is one of the commonest nosocomial blood stream infection and is associated with high mortality. Antifungal treatment ranges from conventional amphotericin B to the new echinocandins. Azole agents provide an alternative choice where oral formulation is available. Fluconazole and voriconazole has been used in the treatment of candidaemia for several years, thus, it is important to monitor for the trend of antifungal resistance. In this study, we aimed to investigate the in vitro activity of fluconazole and voriconazole against invasive Candida albicans isolates in patients with candidaemia from 2001 to 2005 in Hong Kong. Methods: Non-duplicate Candida albicans isolates collected from candidaemic patients from 2001-Oct 2005 were tested against fluconazole and voriconazole in accordance to the NCCLS (CLSI) standard M44-A by disk diffusion method. Fluconazole susceptibility results were interpreted according to NCCLS (CLSI) criteria. Voriconazole susceptibility results were interpreted according to Pfaller et al. (Pfaller MA, Boyken L, MesserSA, Tendolkar S, Hollis RJ, Diekema DJ. Comparison of Results of Voriconazole Disk Diffusion Testing for Candida Species with Results from a Central Reference Laboratory in the ARTEMIS Global Antifungal surveillance Program. J Clin Microbiol 2005; 43, 5208-5213). Tests were done in duplicates. Results: A total of 73 Candida albicans isolates were collected over the 5-year period. Among which, 12 isolates were collected from 2001, 15 isolates from 2002, 17 isolates from both 2003 and 2004, 12 isolates from 2005 (up to and including October 2005). Only two isolates (2.7%): one from 2003, one from 2004, showed resistance to fluconazole. None of the isolates showed resistance to voriconazole. Conclusion: Fluconazole and voriconazole are active against invasive Candida albicans isolates. They remain as appropriate choices for patients who can be considered for oral azole agents. For fluconazole, even after many years of extensive usage, resistance rate remain low.
Full conference title:
16th European Congress of Clinical Microbiology and Infectious Diseases
- ECCMID 16th (2006)