Authors
1
Professor, Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2
Department of Medical Mycology and Parasitology, Invasive Fungi Research Centre (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
3
Cellular and Molecular Research Center, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
4
Department of Pediatrics, Yasuj University of Medical Sciences, Yasuj, Iran
5
Department of Pediatrics, Kerman University of Medical Sciences, Kerman, Iran
6
Professor Alborzi Clinical Microbiology Research Center, Nemazi Hospital, Zand Ave., Shiraz, Iran
7
Department of Medical Parasitology and Mycology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
8
Department of Medical Mycology and Parasitology, School of Public Health and Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
9
Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
10
Jundishapur Infectious and Tropical Diseases Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
11
Department of Pediatrics, Besat Tertiary Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
Abstract
Background and Purpose: Candidiasis is a major fungal infection, and Candida albicans is the major cause of infections
in humans. The Clinical and Laboratory Standards Institute (CLSI) developed new breakpoints for antifungal agents
against C. albicans. In this multi-center study, we aimed to determine the drug susceptibility profile of C. albicans,
isolated from Iranian population according to new species-specific CLSI.
Materials and Methods: Clinical samples were cultured on Sabouraud dextrose agar and were incubated at room temperature for seven days. The isolates were transferred to Professor Alborzi Clinical Microbiology Research Center, Shiraz,
Iran. C. albicans were identified by using API 20C AUX system. Broth microdilution method was used to determine
the minimum inhibitory concentrations (MICs) of amphotericin B, caspofungin, voriconazole, fluconazole, posaconazole,
itraconazole, and ketoconazole, based on CLSI document M27-S4 and new breakpoints for some azoles and caspofungin.
Results: Overall, 397 C. albicans were isolated from patients admitted to ten university hospitals in Iran. The MIC90
of the isolates to amphotericin B, caspofungin, voriconazole, fluconazole, posaconazole, itraconazole, and ketoconazole
were 0.125, 0.125, 0.125, 1, 0.064, 0.5, and 0.125 μg/ml, and rates of resistance were 0.5%, 0.3%, 3.8%, 2.8%, and 2.5%
for amphotericin B, caspofungin, voriconazole, fluconazole, and itraconazole, respectively.
Conclusion: According to our data, fluconazole is the drug of choice for management of patients at risk for systemic
candidiasis throughout the region, since it is cost-effective with low side effects.
Keywords
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