1887

Abstract

The antifungal susceptibilities of 159 clinical isolates of species from patients with invasive candidiasis in Kuala Lumpur Hospital, Malaysia, were determined against amphotericin B, fluconazole, voriconazole, itraconazole and caspofungin. The most common species were (71 isolates), (42 isolates), (27 isolates) and (12 isolates). The susceptibility tests were carried out using an E-test. The MIC breakpoints were based on Clinical Laboratory Standards Institute criteria. Amphotericin B and voriconazole showed the best activities against all the isolates tested, with MIC values of ≤1 µg ml for all major species. Only one isolate was resistant to amphotericin B, and all the isolates were susceptible to voriconazole. In total, six isolates were resistant to fluconazole, comprising two isolates of , two of , one and one , and all of these isolates showed cross-resistance to itraconazole. The MIC of itraconazole was highest for and . Caspofungin was active against most of the isolates except for five isolates of . The MIC of caspofungin against was 3 µg ml. In conclusion, amphotericin B remains the most active antifungal agent against most species except for . Voriconazole is the best alternative for fluconazole- or itraconizole-resistant isolates. Although five of the isolates showed resistance to caspofungin, more clinical correlation studies need to be carried out to confirm the significance of these findings. Currently, despite the increase in usage of antifungals in our hospitals, especially in the management of febrile neutropenia patients, the antifungal-resistance problem among clinically important isolates in Kuala Lumpur Hospital is not yet worrying. However, continued antifungal-susceptibility surveillance needs to be conducted to monitor the antifungal-susceptibility trends of species and other opportunistic fungal pathogens.

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2011-09-01
2019-12-12
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