The Investigation of the Susceptibility of Candida Species to Fluconazole, Voriconazole, and Amphotericin B by Disc Diffusion and the Microdilution Method

Öz

In this study, we aimed to investigate the antifungal susceptibility profile of Candida isolates obtained in our hospital with two methods. A total of 200 Candida isolates were obtained from samples of patients in various departments of our hospital. Identification of each strain was performed using conventional (germ tube formation, microscopic morphology in corn meal-Tween 80 agar), and commercial kit API 20C (Biomerieux, France). MIC values of fluconazole (FLU), voriconazole (VORI), and amphotericin B (AMB) were evaluated according to Clinical Laboratory Standards Institute broth microdilution and disk diffusion (DD) method. Totally isolated 200 Candida species were identified as 100 C. albicans, 25 C. glabrata, 7 C. krusei, 43 C. parapsilosis, and 25 C. tropicalis. All isolates were susceptible to VORI. High resistance rate (22,5%) was detected for AMB antifungal by reference microdilution method. Between two methods, the best categorical ratio was calculated as VORI (99%), FLU (84.9%), and AMB (72,5%) respectively. Voriconazole exhibited better activity in vitro than fluconazole, even in isolates fluconazole resistant and disk diffusion method can be considered as alternative antifungal sensitivity method for VORI.

Anahtar Kelimeler

• Broth microdilution
• Antifungal susceptibility
• Antifungal

Candida türlerinin flukonazol, vorikonazol, amfoterisin B'ye karşı duyarlılıklarının disk difüzyon ve mikrodilüsyon yöntemiyle araştırılması

Öz

Bu çalışmada hastanemizde izole edilen Candida türlerinin iki farklı yöntemle antifungal duyarlılıklarının incelenmesi amaçlanmıştır. Hastanemizde çeşitli departmanlardan gelen klinik örneklerden toplam 200 Candida türü izole edildi. Bu türler geleneksel yöntem (germ tüp oluşturma, corn-meal tween 80  besiyerinde  mikroskobik görünüm) ve ticari kit API 20C (Biomerieux, France) ile tanımlandı. Bu türlerin flukonazol (FLU), vorikonazol (VORI), amfoterisin B (AMB) antifungal minimum inhibisyon konsantrasyonu (MIK) değerleri Clinical and Laboratory Standards Institute sıvı mikrodilüsyon ve disk-difüzyon (DD) yöntemine göre değerlendirildi. İzole edilen 200 Candida türü; 100 C. albicans, 25 C. glabrata, 7 C. krusei, 43 C. parapsilosis ve 25 C. tropicalis olarak tanımlandı. Bütün Candida izolatları VORI ‘ye karşı duyarlı bulundu. Yüksek direnç (%22,5) oranı referans mikrodilüsyon yöntemi ile AMB antifungaline karşı tespit edilidi. İki yöntem arasında en iyi kategorik oran sırası ile VORI (%99), FLU (%84,9) ve AMB (%72,5) olarak hesaplandı.Vorikonazol, flukonazole dirençli izolatlarda bile in vitro olarak flukonazolden daha iyi aktivite göstermiştir. Ek olarak disk difüzyon yöntemi VORI için alternatif antifungal duyarlılık yöntemi olarak değerlendirilebilir.

Anahtar Kelimeler

• Antifungal duyarlılık
• Antifungal
• Sıvı Mikrodilüsyon

Kaynakça

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