caspofungin-non-susceptible candida orthopsilosis isolated from onychomycosis in iran

background: although  candida albicans  remains the most common fungal isolate from clinical specimens, many studies have detected a shift towards non-albicans  candida species. despite worrying clinical pictures associated with latter species , there is little information regarding its susceptibility patterns against currently available antifungal agents, with only a small number of strains having been studied. methods: we evaluated the in vitro antifungal susceptibilities of clinical isolates of c. orthopsilosis already identified by two-steps pcr-rflp and reconfirmed by sequence analysis of entire its rdna region, to six antifungal drugs. results: the resulting mic 50 and mic 90 for all strains (n=18) were in increasing order, as follows: posaconazole (0.016 & 0.063 μg/ml); itraconazole (0.031 & 0.125 μg/ml); amphotericin b (0.5 & 1 μg/ml); fluconazole (0.25 & 0.5 μg/ml) and caspofungin (4 & 8 μg/ml). a uniform pattern of the mic ranges was seen for amphotericin b, fluconazole, itraconazole, and posaconazole, while a widest range and the highest mics were observed for caspofungin. conclusion: although we emphasis on the careful species designation of the clinical isolates of candida , the antifungal susceptibility patterns of these clinically important organisms may have an application in clinical and epidemiological setting and deserve the implementation of local surveillance programs to monitor.