Abstract:

Objective: Widespread and repeated use of azoles for prophylaxis or therapy has led to the development of resistance in Candida albicans (C.albicans) species. In this study, it was aimed to determine the in vitro resistance rates of C.albicans isolates isolated from sterile body fluid cultures to fluconazole, itroconazole and voriconazole. Material and Methods: Fifty one C.albicans species isolated from sterile body fluid cultures of patients hospitalized in various clinics between January 2020 and April 2021 were included in the study. Species-level identification was assessed using conventional methods and the BD Phoenix 100 (BD, USA) automated identification system. Antifungal susceptibility testing was performed by microdilution method using RPMI medium containing 2% glucose. For the triazoles fluconazole, itroconazole and voriconazole, the concentration in the well at which turbidity was reduced significantly (≥50%) was determined as the MIC50 value. C.albicans ATCC 90028 was used as control strain. Results: Eighty-eight point two percent (n=45) of C.albicans isolates were isolated from samples taken from intensive care units. Twenty-six (50.9%) of the samples were taken from female patients with a mean age of 68.6±18.29 years, and 25 (49%) from male patients with a mean age of 62.22±21.08 years. Of the isolates, 48 (94.1%) was identified from blood, 1 (1.96%) cerebrospinal fluid, 1(1.96%) sterile body fluid, 1(1.96%) peritoneal fluid culture. According to the antifungal susceptibility test results; 7 (12.2%) of the species were resistant to fluconazole, 14 (27.4%) to itroconazole, and 2 (3.9%) to 5 (9.8%) voriconazole. Cross-resistance was detected in a total of 6 (11.7%) samples. Conclusion: In addition to resistance to triazoles, cross-resistance was also detected against other azoles in C.albicans isolates. Therefore, antifungal susceptibility test results should be taken into account for appropriate treatment.

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