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In Vitro Activity of Caspofungin Against Fluconazole-Resistant Candida Species Isolated From Clinical Samples in Iran Publisher



Shekari Ebrahim Abad H1 ; Zaini F1 ; Kordbacheh P1 ; Mahmoudi M2 ; Safara M1 ; Mortezaee V1
Authors
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Authors Affiliations
  1. 1. Department of Parasitology and Mycology, School of Public Health, Institute of Public Health Researches, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Source: Jundishapur Journal of Microbiology Published:2015


Abstract

Background: Candida spp. is the most common organisms involved in fungal infections in the high risk patients. It causes the greatest number of invasive candidiasis. Fluconazole is effective in treating mucosal candidiasis. However, resistance to fluconazole and other azoles antifungal drugs is an important clinical problem to treat candidiasis. Caspofungin is more effective against Candida species such as some azoles-resistant isolates. Objectives: The current study aimed to investigate the susceptibilities of clinical fluconazole-resistant and fluconazole - susceptible dose-dependent Candida species to caspofungin. Materials and Methods: In the Minimum Inhibitory Concentration (MIC) test, 207 Candida species and other yeasts isolated from Iranian patients (each isolated from a high-risk patient) were evaluated. The yeasts were differentiated by standard mycological methods, CHROM agar Candida, and verified byAPI20CAUX. In vitro susceptibilities were determined using Broth Micro Dilution (BMD) method described in the Clinical Laboratory Standards Institute M27-A3. MICs were noted after 24 and 48 hours of incubation. Results: The most frequently isolated species were Candida albicans (52.2%), C. glabrata (24.6%), followed by C. tropicalis (7.7%) and C. krusei (3.4%). MICs of caspofungin against 87% of C. albicans and 90% of C. glabrata and C. tropicalis isolates were 2 jig/mL and for C. krusei were 4 jg/mL, respectively. The results revealed that only 20 out of 207 isolates (9.7%) were non-sensitive to caspofungin. Caspofungin non-susceptible isolates were isolated from the patients with cancer, diabetes and AIDS; and not in the species isolated from patients with other underlying diseases. Conclusions: Caspofungin appears more effective in vitro against Iranian fluconazole-resistant Candida isolates and some other yeasts. © 2015, Ahvaz Jundishapur University of Medical Sciences.
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