Antifungal Activity of Fluconazole, Itraconazole, Voriconazole Amphotericin B and Caspofungin against Candida parapsilosis Blood Isolates
Stephanie Villalobos-Castro, Daniela Jaikel-Víquez, Diego Ortiz-Solano, Luis Enrique Chaves-González and Norma T Gross
Journal Title:Acta Scientific Microbiology
Candida albicans is considered the most frequent etiological agent of candidemia worldwide. However, in the last decades there has been a rise in non-albicans Candida spp. causing candidemia. For example, in some Latin American countries Candida parapsilosisis replacing C. albicans as the main species isolated from blood samples. There is also an emerging concern regarding the decrease in susceptibility of non-albicans Candida spp. to first-line antifungals. In Costa Rica, there is limited information about this emerging problem. Thus, the objective of the present investigation was to study the susceptibility pattern of C. parapsilosis blood isolates to flu-conazole, itraconazole, voriconazole, caspofungin and amphotericin B. Sixty-nine isolates collected from three Type A hospitals were studied. The isolates are part of the Fungal collection of the School of Microbiology, University of Costa Rica. Two reference methods were used to determine antifungal susceptibility. The EUCAST was performed for the azoles and amphotericin B. The end-points for caspofungin are not established by the EUCAST, thus the CLSI method was used instead. Results showed that 29% of the isolates were resistant to fluconazole, 25% to voriconazole, 6% to itraconazole and 3% to caspofungin. As to amphotericin no resistance was found; however, it is noteworthy that 42% of the isolates had minimal inhibitory concentrations of 1 μg ml-1, the upper limit to be considered as sensible. In conclusion, these results highlight the importance of vigilance programs for susceptibility testing of C. parapsilosis involved in candidemia in Costa Rica.