Susceptibility pattern of Candida albicans isolated from Iranian patients to antifungal agents

Authors

  • Ahmad Shamsizadeh Jundishapur Infectious and Tropical Diseases Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Ali Hosseininasab Department of Pediatrics, Kerman University of Medical Sciences, Kerman, Iran
  • Hadis Jafarian Professor Alborzi Clinical Microbiology Research Center, Nemazi Hospital, Zand Ave., Shiraz, Iran
  • Hamid Badali Department of Medical Mycology and Parasitology, Invasive Fungi Research Centre (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  • Hossein Mirhendi Department of Medical Mycology and Parasitology, School of Public Health and Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
  • Jafar Soltani Department of Pediatrics, Besat Tertiary Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
  • Kambiz Diba Cellular and Molecular Research Center, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
  • Mohammad Javad Najafzadeh Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  • Parisa Badiee Professor, Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Rasoul Mohammadi Department of Medical Parasitology and Mycology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract:

Background and Purpose: Candidiasis is a major fungal infection, and Candida albicans is the major cause of infections in humans. The Clinical and Laboratory Standards Institute (CLSI) developed new breakpoints for antifungal agents against C. albicans. In this multi-center study, we aimed to determine the drug susceptibility profile of C. albicans, isolated from Iranian population according to new species-specific CLSI. Materials and Methods: Clinical samples were cultured on Sabouraud dextrose agar and were incubated at room temperature for seven days. The isolates were transferred to Professor Alborzi Clinical Microbiology Research Center, Shiraz, Iran. C. albicans were identified by using API 20C AUX system. Broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) of amphotericin B, caspofungin, voriconazole, fluconazole, posaconazole, itraconazole, and ketoconazole, based on CLSI document M27-S4 and new breakpoints for some azoles and caspofungin. Results: Overall, 397 C. albicans were isolated from patients admitted to ten university hospitals in Iran. The MIC90 of the isolates to amphotericin B, caspofungin, voriconazole, fluconazole, posaconazole, itraconazole, and ketoconazole were 0.125, 0.125, 0.125, 1, 0.064, 0.5, and 0.125 μg/ml, and rates of resistance were 0.5%, 0.3%, 3.8%, 2.8%, and 2.5% for amphotericin B, caspofungin, voriconazole, fluconazole, and itraconazole, respectively. Conclusion: According to our data, fluconazole is the drug of choice for management of patients at risk for systemic candidiasis throughout the region, since it is cost-effective with low side effects.

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Journal title

volume 2  issue None

pages  24- 29

publication date 2016-03

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