Species Distribution and Antifungal Susceptibilities of Candida Species Isolated From Blood Culture

Introduction species (spp.) are among the leading agents of bloodstream infections. Candidemias are a major cause of morbidity and mortality. Having an understanding of epidemiology and antifungal susceptibility patterns in each center is crucial in guiding the management of candidemia. In this study, the species distribution and antifungal susceptibility of spp. isolated from blood culture at the University of Health Sciences, Bursa Yuksek Ihtisas Training & Research Hospital were examined and the first data on the epidemiology of candidemia in our center were presented. Methods A total of 236 strains isolated from blood cultures in our hospital over a four-year period were analyzed and their antifungal susceptibilities were studied retrospectively. Strains were identified at the species complex (SC) level by the germ tube test, morphology in cornmeal-tween 80 medium, and the automated VITEK 2 Compact (bioMérieux, Marcy-l'Étoile, France) system. Antifungal susceptibility tests were performed on VITEK 2 Compact (bioMérieux, Marcy-l'Étoile, France) system. The susceptibilities of the strains to fluconazole, voriconazole, micafungin, and amphotericin B were determined according to Clinical and Laboratory Standards Institute (CLSI) guidelines and epidemiologic cut-off values. Results Of the strains, 131 were (55.5%), 40 were SC (16.9%), 21 were (8.9%), 19 were SC (8.1%), eight were (3.4%), seven were (3.0%), six were (2.6%), two were (0.8%) and two were (0.8%). Amphotericin B resistance was not detected in strains. Micafungin susceptibility was 98.3%, and four SC strains (10%) were intermediate (I) to micafungin. Fluconazole susceptibility was 87.2%. Apart from strains which intrinsically resistant to fluconazole, three (7.5%), one SC (5.3%) strain were resistant (R) to fluconazole, and one (12.5%) strain was wild-type (WT). Voriconazole susceptibility of strains was 98.6%. Two SC strains were I to voriconazole, while one strain was R. Conclusion In this study, the first epidemiological data of candidemia agents in our hospital were presented. It was determined that rare and naturally resistant species did not cause any problem in our center yet. SC strains showed decreased susceptibility to fluconazole, whereas strains were highly susceptible to the four antifungals tested. Close monitoring of these data will help guide the treatment of candidemia.