Evaluation of Susceptibility of Candida species to Six Antifungal Drugs in Iraqi Specimens
Abstract
Introduction: Candida spp. has become increasingly resistant to antifungal drugs, with elevated MIC levels causing a negative medical impact and increasing the number of patients at risk of candidiasis. According to the
CDC, about 7% of Candida blood samples show reduced susceptibility to fluconazole. Monitoring the antifungal resistance profile of Candida spp. is vital, as non-Albicans species may limit treatment options.
Objective: Evaluate the antifungal effectiveness against clinical Candida spp. isolates of six antifungals: amphotericin B, fluconazole, voriconazole, itraconazole, caspofungin, and 5-fluorocytosine.
Methods: 100 samples were collected from various clinical samples at the National Centre of Teaching Laboratories in Baghdad, Iraq, from May to December 2023. The effectiveness of six antifungals (fluconazole
(FLC), itraconazole (ITR), voriconazole (VRC), amphotericin B (AMB), caspofungin (CAS), and 5-fluorocytosine (5-FC)) was tested using the MA120 Automated ID and AST System (Render) according to CLSI
standards.
Results: Out of 100 isolates, nine Candida species were identified: C. albicans (54%), C. glabrata (20%), C. dubliniensis (10%), C. tropicalis (6%), C. krusei (5%), C. parapsilosis (2%), and C. rugosa, C. lusitaniae, and C. kyfer (each 1%). The non-susceptible rates to the six antifungals were: 5-FC (42%), FLC (21% intermediate, 9% resistant), AMB (11%), ITR (8%), VRC (6%), CAS (4% intermediate, 1% resistant).
Conclusion: We observed increased resistance rates to 5-FC, FLC, ITR, AMB, and VRC, but not to caspofungin. C. albicans showed a high 5-FC non-WT phenotype (72%) with elevated MIC values, while C. glabrata had a 7% non-WT rate against AMB. C. tropicalis and C. parapsilosis revealed limited susceptibility to azoles.
How to cite this article:
Al-Ameri A D, zghair A S, Al-Nuaimi N B , Adbdul
Ghani N M, Naman T Z, Fadhil J Z . Evaluation
of Susceptibility of Candida species to Six
Antifungal Drugs in Iraqi Specimens.
DOI: https://doi.org/10.24321/0019.5138.202432
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