Naslov
Species Distribution and Antifungal Susceptibility Profile of Candida species and Cryptococcus neoformans isolates : Two Years of Croatian Surveillance

Autori
Mlinarić-Missoni, Emilija ; Vazić-Babić, Verica ; Missoni, Eduard

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstracts of the 4th Trends in Medical Mycology ; u: Mycoses 52 (2009) (S1) 1-137 ; Poster Presentations 29-123 / - , 2009, 29-30

Skup
Trends in Medical Mycology (4 ; 2009)

Mjesto i datum
Atena, Grčka, 18.10.2009. - 21.10.2009

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Candida species; Cryptococcus neoformans; clinical isolates; antifungal susceptibilities; Croatia

Sažetak
Objectiveswere to conduct a prospective surveillance of species distribution and in vitro susceptibility to 5-fluorocitosine (5-FC), amphotericin B (AMB), fluconazole (FLU), itraconazole (ITR), and voriconazole (VOR) among Candida species and Cryptococcus neoformans isolates associated with deep–seated and disseminated infections during a 24 month-period in patients from seven Croatian medical institutions. From January 2007 to December 2008, we are able to collect a total of 685 yeast isolates: 650 (95%) isolates of 13 Candida species and 35 (5%) isolates of C. neoformans from five tertiary care hospitals, one general hospital and Croatian National Institute of Public Health (CNIPH). The isolates were collected at the individual study sites and were sent to the National Reference Laboratory for systemic mycoses (in CNIPH) for identification and susceptibility testing. Yeast isolates were identified by ID 32 C (BioMerieux) and classical methods. Antifungal susceptibility profile of isolates was determined by ATB FUNGUS 3 (BioMerieux) microdilution methods following the manufacturer's instructions. MIC readings were performed visually and the results were interpreted according to the CLSI recommendations. The collection included 115 (16.8%) bloodstream or CSF isolates of Candida species and C. neoformans and 570 (83.2%) isolates of Candida species from other clinical samples (BAL, sputum, urine, aspirates, drainage swabs, stools). Candida species distribution was as follows: C. albicans 360 (55%), C. glabrata 110 (17%), C. parapsilosis 63 (10%), C. krusei 35 (5%), C. tropicalis 25 (4%) and the other Candida species 57 (9%). Only 0.3% C. albicans and 8.6% C. krusei isolates were resistant to 5-FC. All Candida species and C. neoformans isolates were sensitive to AMB. Isolates of C. albicans, C. tropicalis, and C. neoformans were all susceptible to FLU, whereas 82.5% C. glabrata, 88.9% C. parapsilosis, 0% C. krusei, and 97.8% of the other tested Candida species isolates were susceptible to this antifungal agent. Intermediate susceptibility and resistance against ITR were found for 68.2% C. glabrata, 31.7% C. parapsilosis, 94.3% C. krusei, and 20% of the other tested Candida species isolates. Resistance to VOR was detected in 4 (11.4%) C. krusei isolates. The results of the two years of Croatian antifungal susceptibility surveillance showed the existence of different frequency of isolation pattern and antifungal susceptibility profile in yeast isolates among institutions. C. albicans account for approximately one-half of all clinical isolates, and the most (99.7%) of our C. albicans isolates remained susceptible to all antifungal drug tested. We were able to demonstrate that in Croatia most non-albicans Candida species are represented by C. glabrata, C. parapsilosis, C. krusei, and C. tropicalis isolates still susceptible to 5-FC, AMB and VOR. Conversely, non-albicans Candida spp. isolates have higher intermediate and resistance rates to FLU and ITR, the second generation of systemic triazoles. The overall susceptibility of C. neoformans isolates was 100% for all antifungals tested. However, continuous surveillance programs are needed in order to identify possible changes in the species distribution and antifungal susceptibility patterns of yeasts, particularly after increasing the use of triazoles in Croatian hospitals.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Javno zdravstvo i zdravstvena zaštita

Napomena
DOI: 10.1111/j.1439-0507.2009.01782.x

POVEZANOST RADA