Comparison of Clinical Laboratory Standards Institute (CLSI) Microdilution Method and VITEK 2 Automated Antifungal Susceptibility System for the Determination of Antifungal Susceptibility of Candida Species

Background: In this study, our aim was to identify and isolate Candida species from patients admitted in ICU,s of our hospital and to determine their susceptibilities to various antifungal agents so as to find the local resistance pattern and guide for empirical treatment.Methods: In our study 37 strains of candida were isolated (4 Candida albicans, 33 Non-albicans Candida strains). Candida species were identified by conventional, biochemical and molecular methods. Antifungal susceptibility tests for amphotericin B, fluconazole, itraconazole, ketoconazole and voriconazole were performed with broth microdilution method and E- tests as described by National Committee for Clinical Laboratory Standards (NCCLS).Results: Out of 37 Candida strains, the most prevalent species were C. tropicalis (43.2%), C. parapsilosis (24.3%), C. krusei (16.2%), C. albicans (10.8%), and C. glabrata (2.7%). Among all strains four strains (10.8 %) were resistant, two Candida albicans where found resistant to fluconazole one Candida krusei and one Candida parapsilosis were found to be resistant to all azoles.Conclusions: Candidemia continues to be associated with substantial morbidity and mortality and non albicans Candida species are the commonly isolated pathogen from those patients admitted in tertiary care hospitals in Indian scenario. Thus, it is imperative to perform antifungal susceptibility to select appropriate and effective antifungal therapy.

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Comparison of the VITEK 2 antifungal susceptibility system with Etest using clinical isolates of Candida species

Revista Iberoamericana de Micología ◽

10.1016/j.riam.2016.12.002 ◽

2017 ◽

Vol 34 (3) ◽

pp. 171-174 ◽

Cited By ~ 4

Author(s):

Wadha Alfouzan ◽

Tahani Al-Enezi ◽

Ebteehal AlRoomi ◽

Vayalil Sandhya ◽

Rachel Chandy ◽

...

Keyword(s):

Candida Species ◽

Antifungal Susceptibility ◽

Clinical Isolates ◽

Vitek 2

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Molecular diagnosis and antifungal resistance and biofilm production profiles among Candida species isolated from immunocompromised patients at Menoufia University Hospitals

10.51429/ejmm29305 ◽

2020 ◽

Vol 29 (3) ◽

pp. 37-45

Author(s):

Mabrouk M Ghonaim ◽

Azza Z. Labeeb ◽

Alyaa I. Eliwa ◽

Eman H. Salem

Keyword(s):

Candida Species ◽

Biofilm Formation ◽

Antifungal Susceptibility ◽

High Sensitivity ◽

Antifungal Resistance ◽

Common Source ◽

Immunocompromised Patients ◽

University Hospitals ◽

Biofilm Production ◽

Vitek 2

Background: Accurate and rapid identification of Candida species is necessary for proper diagnosis and treatment of candidiasis due to emergences of drug-resistant strains especially among immunocompromised patients. Objectives: Identification of Candida clinical isolates to the species level using different phenotypic and molecular methods. Biofilm-forming ability and antifungal resistance were also studied. Methodology: Sixty-nine Candida strains were isolated from 220 immunocompromised patients. Identification was performed using chromogenic Candida agar, VITEK 2 system and multiplex polymerase chain reaction (PCR). Biofilm formation was detected by the tube method and antifungal susceptibility was tested using the VITEK2 system. Results: The most common source of Candida isolates was from urine (33.3%) and ICUs (56.6%). VITEK 2 system detected 9 spp.: C. albicans (34.8%), C. tropicalis (21.7%), C. famata (8.7%), C. lusitaniae (7.2%), C. cruzi (7.2%), C. ciferri (5.8%), C. dubliniensis (5.8%), C. parapsilosis (5.8 %) and C. glabrata. Candida isolates showed high resistance to flucytocine (49.3%), and high sensitivity to fluconazole, micafungin, voriconazole and caspofungin (88.4%, 81.2% and 81.2 % respectively). Only 30.4% of all Candida isolates were biofilm producers. There was a positive relationship between antifungal resistance and biofilm formation among Candida isolates. Conclusion: C. albicans was the predominant species. Chromogenic Candida agar and VITEK 2 system were valuable tests compared to PCR in speciation of Candida isolates. Antifungal susceptibility was significantly related to biofilm production and its evaluation is important for proper treatment..

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Study of Virulence Markers and Antifungal Susceptibility by Vitek-2 in Various Candida Species Isolated from Cases of Vulvovaginal Candidiasis

International Journal of Current Microbiology and Applied Sciences ◽

10.20546/ijcmas.2017.612.416 ◽

2017 ◽

Vol 6 (12) ◽

pp. 3593-3605 ◽

Cited By ~ 1

Author(s):

Rafat Siddiqi ◽

D.K. Mendiratta ◽

Atul Rukadikar ◽

Sandhya Gadre

Keyword(s):

Candida Species ◽

Antifungal Susceptibility ◽

Vulvovaginal Candidiasis ◽

Virulence Markers ◽

Vitek 2

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Antifungal susceptibility profiles of otomycosis etiological agents in Ahvaz, Iran

Current Medical Mycology ◽

10.18502/cmm.6.2.2696 ◽

2020 ◽

Author(s):

Maral Gharaghani ◽

Marzieh Halvaeezadeh ◽

Gholam Ali Jalaee ◽

Simin Taghipour ◽

Neda Kiasat ◽

...

Keyword(s):

Aspergillus Niger ◽

Candida Species ◽

Geometric Mean ◽

Antifungal Susceptibility ◽

Morphological Characteristics ◽

Aspergillus Species ◽

Great Activity ◽

Minimum Effective Concentration ◽

Microdilution Method ◽

Physiological Tests

Background and Purpose: Otomycosis is a secondary ear fungal infection among predisposed individuals in humid conditions. Aspergillus species are the most common etiologic agents of this infection. Several ototopical antifungals are currently used for the treatment of this disease; however, recurrence and treatment failure are usually observed in some cases. Regarding this, the present study was conducted to investigate the antifungal activity of caspofungin, azoles, and terbinafine against the isolated agents of otomycosis. Materials and Methods: This study was conducted on the specimens collected from 90 patients with otomycosis. The samples were cultured on Sabouraud dextrose agar and identified based on morphological characteristics, physiological tests, and microscopic features. Furthermore, the microdilution method was used for antifungal susceptibility testing according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Finally, the minimum inhibitory concentration (MIC) and minimum effective concentration (MEC) ranges, MIC/MEC50, MIC/MEC90, and geometric mean (GM) MIC/MEC were calculated for the isolates. Results: According to the results, 77 patients with otomycosis were positive for different Aspergillus (88.3%) and Candida (11.7%) species. Aspergillus niger complex (n=36) was found to be the most common agent, followed by A. flavus, A. terreus, and A. nidulans complexes. Furthermore, epidemiological cutoff values (ECVs) were lower than those presented by the CLSI for itraconazole and caspofungin in 98.5% and 42.6% of Aspergillus species, respectively. Terbinafine exhibited a great activity against Aspergillus species, while fluconazole revealed a low activity against both Aspergillus species. Based on the results, 77.8% of Candida species were resistant to caspofungin; however, miconazole and econazole had low MIC ranges. Conclusion: Aspergillus niger and A. flavus complexes were identified as the most common agents accounting for 85.7% of the isolates. In addition, terbinafine was identified as the best antifungal for both Aspergillus and Candida species. Moreover, tested azoles had relatively low MICs, whereas most of the isolates had the MIC values beyond the caspofungin ECVs.

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Value of antifungal susceptibility testing in recurrent vulvovaginal Candidiasis by Non -Albicans Candida

10.51429/ejmm30120 ◽

2021 ◽

Vol 30 (1) ◽

pp. 161-167

Author(s):

Ghada A. Mokhtar ◽

Mohamed Sh. Ramadan ◽

Shymaa Yahia

Keyword(s):

Amphotericin B ◽

Candida Species ◽

Antifungal Susceptibility ◽

High Sensitivity ◽

Common Species ◽

Vulvovaginal Candidiasis ◽

Recurrent Vulvovaginal Candidiasis ◽

Sensitivity Pattern ◽

Vaginal Swabs ◽

Vitek 2

Background: Vulvovaginal candidiasis (VVC) is regarded as a prevalent vaginal infection and mainly results from Candida albicans. Nevertheless, there has recently been a prominent shift in candidiasis etiology regarding non-albicans Candida (NAC) species with achieving importance. For women with more than three episodes annually are described as recurrent vulvovaginal candidiasis (RVVC). Objectives: To isolate, speciate, and determine the value of antifungal sensitivity pattern of candida species isolated from patients developed (RVVC). Methodology: High vaginal swabs (HVS) were taken from patients with RVVC and cultured on ordinary mycological media. Any significant candida growth was identified and speciated by VITEK 2 system. Their antifungal sensitivity was done by disc diffusion approach governed by CLSI guidelines. Results: A total of 110 Candida species from 250 high vaginal swabs were isolated. Among all candida species isolated from patients with RVCC, C.albicanis accounts for 44% while NAC accounts for 56% with C.glabrata most common species isolated. Voriconazole, amphotericin B, and nystatin showed high sensitivity rates (92 %, 89%, and 84% respectively) on all candida species (C.albicans and NAC) isolated from patients with RVVC. Conclusion: In RVCC there is increase in NAC (56%) with C.glabrata most common species isolated. Voriconazole, Nystatin, and amphotericin B have the best antifungal activity against all spp.

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Distribution and antifungal susceptibility of candida species isolated from blood culture

Journal of the Pakistan Medical Association ◽

10.47391/jpma.1464 ◽

2021 ◽

pp. 1-12

Author(s):

Selim Gorgun ◽

Melek Bilgin ◽

Suleyman Sirri Kilic ◽

Admin

Keyword(s):

Candida Species ◽

Antifungal Susceptibility ◽

Tube Formation ◽

Resistance Rate ◽

Blood Cultures ◽

Dilution Method ◽

Ethical Approval ◽

Immunosuppressed Patients ◽

Training And Research ◽

Vitek 2

Abstract Objective: The aim of this study is to determine the distribution of samples exhibiting Candida growth among the blood cultures, and the antifungal susceptibility. Methods: The retrospective study was conducted in Samsun Training and Research Hospital, Samsun, Turkey from January to December, 2018 and comprised immunosuppressed patients with sepsis. Ethical approval was obtained and consent was taken from all patients. Yeast growths were typed by means of colony morphology, germ tube formation and the VITEK 2 system. Their susceptibilities tests were determined using the same automatized system. Resistance strains were also tested using the dilution method. Results: Of the 50 patients, 19(38%) were females and 31(62%) were males. The overall mean age was 60.84 ± 22.05 years. 31 (62%) of the samples were received from intensive care units, 14 (28%) from the palliative care unit, and five from other inpatients. In our study, most common among our isolates was C. albicans, and C. parapsiosis was most common among non-albicans species. Resistance to antifungals was observed in 28% of Candida isolates. Of the total isolates, %10 were found to be naturally resistant to fluconazole, 8% to voriconazole, 4% to flucytosine, and amphotericin B. The high resistance rate for fluconazole in Candida species is noteworthy. The findings obtained through both the dilution method and the automatized system were consistent. Continuou....

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Candida Isolates From Blood and Other Normally Sterile Foci From ICU Patients: Determination of Epidemiology, Antifungal Susceptibility Profile and Evaluation of Associated Risk Factors

Frontiers in Public Health ◽

10.3389/fpubh.2021.779590 ◽

2021 ◽

Vol 9 ◽

Author(s):

Bo Wang ◽

Xinlong He ◽

Feng Lu ◽

Yajuan Li ◽

Yuerong Wang ◽

...

Keyword(s):

Risk Factors ◽

Molecular Mechanisms ◽

Antifungal Susceptibility ◽

Resistance Mechanism ◽

Lavage Fluid ◽

Icu Patients ◽

Multiple Risk Factors ◽

Microdilution Method ◽

Associated Risk Factors

Background: The clinical diagnosis and therapy for ICU patients with invasive candidiasis are challenged by the changes of Candida community composition and antimicrobial resistance. The epidemiology and drug sensitivity of candidiasis in ICU as well as its risk factors and drug resistance mechanism were investigated.Methods: In the present study, 115 patients in ICU were recruited from June 2019 through July 2020. Among them, 83 Candida isolates were identified with MALDI-TOF mass spectrometry. The susceptibility to antifungals was measured by microdilution method. The molecular mechanisms of azole-resistant Candida tropicalis were explored by sequencing, and their outcomes were explicitly documented.Results:Candida glabrata and C. tropicalis were the predominant non-C. albicans Candida. The specimen sources were mainly urine, bronchoalveolar lavage fluid and blood. The age, length of hospitalization, tracheotomy, diabetes and concomitant bacterial infection were the main risk factors for candidiasis. The majority of Candida species exhibited susceptibility to antifungals. However, certain C. tropicalis were frequently resistant to azoles. The polymorphism of the ERG11 in C. tropicalis was likely associated with azole resistance.Conclusion: The multiple risk factors for candidiasis in ICU patients need to be considered. Certain C. tropicalis exhibit resistance to azoles likely due to the ERG11 gene polymorphism.

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Spectrum of candidal species isolated from neonates admitted in an Intensive Care Unit of teaching hospital of Kashmir, North India

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_1_18 ◽

2018 ◽

Vol 10 (03) ◽

pp. 255-259 ◽

Cited By ~ 3

Author(s):

Asifa Nazir ◽

Talat Masoodi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Candida Species ◽

Neonatal Intensive Care ◽

Life Support ◽

Antifungal Susceptibility ◽

Preterm Births ◽

North India ◽

Sensitivity Testing ◽

Vitek 2

ABSTRACT BACKGROUND: Candidal infections are an important cause of morbidity and mortality in Neonatal Intensive Care Unit. Neonatal candidiasis is increasing in frequency, mainly because of increase in the survival of babies with low-birth weight, preterm births, advancement in medical field, life support systems, relative immunodeficiency, and extensive use of broad-spectrum antibiotics. Over the past few decades, there has been a progressive shift from the predominance of Candida albicans to nonalbicans Candida species. AIMS AND OBJECTIVES: The objective of the current study was to know the prevalence of nonalbicans candidemia in neonates and their antifungal susceptibility pattern. Materials and Methods: In this study, a total of 424 samples from clinically diagnosed septicemic neonates were included. Identification of Candida isolates from these samples as well as their antifungal sensitivity testing was performed with Vitek 2 Compact (Biomerieux France) using Vitek 2 cards for identification of yeast and yeast-like organisms (ID-YST cards). Results: A total of 246/424 (58.01%) cases were blood culture positive. Out of these, 80/246 samples tested positive for candidemia (32.5%). Candida tropicalis (13.8%) was the predominant species isolated among the non-albicans Candida followed by Candida krusei (4.8%), Candida parapsilosis (3.2%), Candida guilliermondii (2.8%), and Candida dubliniensis (2.0%). We found an increase in the antifungal drug resistance, especially for the azole group of drugs, both in C. albicans and non-albicans Candida species. All the isolates were uniformly sensitive to micafungin, voriconazole, and caspofungin. Conclusions: Candidemia in neonates is an ominous prognostic sign and is an important entity in our region. The present study highlights the mycological shift of Candida species in neonatal candidemia with a preponderance of nonalbicans Candida species.

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