Identification and antifungal susceptibility of Candida species isolated from bloodstream infections in Konya, Turkey

Background: In this study, our aim was to identify Candida species isolated from bloodstream infections and to determine their susceptibilities to various antifungal agents to demonstrate the local resistance profiles and to guide empirical treatment for clinicians. Methods: Two hundred Candida isolates (95Candida albicans, 105 non-albicans Candida strains) were included in the study. Candida species were identified by conventional, biochemical and molecular methods. Antifungal susceptibility tests for amphotericin B, fluconazole, voriconazole, posaconazole, caspofungin and anidulafungin were performed with broth microdilution method according to the Clinical and Laboratory Standards Institute M27-A3 document. Results: Of the 200 Candida strains, the most prevalent species were C. albicans (47.5%), Candida glabrata (18.0%) and Candida parapsilosis complex (14.0%). All Candida species except for three (1.5%) Candida kefyr strains were susceptible to amphotericin B. Only one (2.8%) C. glabrata was resistant to fluconazole (MIC ≥ 64 μg/ml), and the others (97.2%) exhibited dose-dependent susceptibility. All species, but C. glabrata strains, were susceptible to fluconazole. Resistance to voriconazole, posaconazole, caspofungin and anidulafungin was not detected in any strain. Conclusion:Candida albicans were susceptible to all antifungal drugs. Three C. kefyr strains were resistant to amphotericin B. Only one C. glabrata was resistant to fluconazole. All the strains were susceptible to voriconazole, posaconazole, caspofungin and anidulafungin. In vitro antifungal susceptibility tests should be performed to select of appropriate and effective antifungal therapy, and monitor the development of resistance.