Table 2. Susceptibility profile of Candida spp. isolated from blood cultures in 1995-2009. Detection of non-susceptible isolates based on the breakpoints from CLSI M27-A3 and species-specific clinical breakpoints from CLSI M27-S4.
Species | N | ATF* | MIC (µg/mL) | CLSI M27-A3 Breakpoints (n) | CLSI M27-S4 Breakpoints (n) | ||||
---|---|---|---|---|---|---|---|---|---|
Range | MIC 50% | MIC 90% | R | SDD/I | R | SDD/I | |||
C. parapsilosis | 197 | AMB | 0.06-0.5 | 0.125 | 0.25 | 0 | 0 | -- | -- |
FLZ | 0.125-4.0 | 1.0 | 4.0 | 0 | 0 | 0 | 14 | ||
ITZ | 0.03-0.5 | 0.125 | 0.5 | 0 | 0 | -- | -- | ||
5FC | 0.03-16.0 | 0.5 | 2.0 | 0 | 1 | -- | -- | ||
VOR | 0.03-0.5 | 0.125 | 0.25 | 0 | 0 | 0 | 7 | ||
CAS | 0.03-2.0 | 0.5 | 2.0 | 0 | 0 | 0 | 0 | ||
C. albicans | 151 | AMB | 0.06-1.0 | 0.25 | 0.5 | 0 | 0 | -- | -- |
FLZ | 0.125-4.0 | 0.25 | 4.0 | 0 | 0 | 0 | 15 | ||
ITZ | 0.015-1.0 | 0.25 | 0.5 | 3 | 0 | -- | -- | ||
5FC | 0.03-4.0 | 1.0 | 4.0 | 0 | 0 | -- | -- | ||
VOR | 0.015-0.5 | 0.125 | 0.5 | 0 | 0 | 0 | 4 | ||
CAS | 0.03-0.5 | 0.125 | 0.25 | 0 | 0 | 0 | 0 | ||
C. tropicalis | 41 | AMB | 0.125-1.0 | 0.125 | 0.5 | 0 | 0 | -- | -- |
FLZ | 0.25-32.0 | 2.0 | 8.0 | 0 | 1 | 3 | 8 | ||
ITZ | 0.03-2.0 | 0.125 | 0.5 | 1 | 0 | -- | -- | ||
5FC | 0.125-4.0 | 1.0 | 4.0 | 0 | 0 | -- | -- | ||
VOR | 0.03-2.0 | 0.25 | 0.5 | 0 | 0 | 2 | 5 | ||
CAS | 0.03-0.25 | 0.06 | 0.25 | 0 | 0 | 0 | 0 | ||
C. glabrata | 15 | AMB | 0.125-0.5 | 0.5 | 1.0 | 0 | 0 | -- | -- |
FLZ | 0.5-64.0 | 8.0 | 32.0 | 1 | 5 | 1 | 14 | ||
ITZ | 0.03-2.0 | 0.5 | 1.0 | 4 | 3 | -- | -- | ||
5FC | 0.125-16.0 | 4.0 | 16.0 | 0 | 4 | -- | -- | ||
VOR | 0.06-4.0 | 0.5 | 2.0 | 2 | 0 | -- | -- | ||
CAS | 0.06-0.5 | 0.125 | 0.25 | 0 | 0 | 0 | 3 | ||
C. guilliermondii | 7 | AMB | 0.125-0.25 | 0.25 | 0.25 | 0 | 0 | -- | -- |
FLZ | 0.5-4.0 | 2.0 | 4.0 | 0 | 0 | -- | -- | ||
ITZ | 0.03-0.5 | 0.06 | 0.5 | 0 | 0 | -- | -- | ||
5FC | 0.06-1.0 | 0.5 | 1.0 | 0 | 0 | -- | -- | ||
VOR | 0.06-0.25 | 0.06 | 0.06 | 0 | 0 | -- | -- | ||
CAZ | 0.03-0.25 | 0.06 | 0.06 | 0 | 0 | 0 | 0 | ||
C. lusitaniae | 7 | AMB | 0.125-0.5 | 0.5 | 0.5 | 0 | 0 | -- | -- |
FLZ | 0.25-4.0 | 2.0 | 2.0 | 0 | 0 | -- | -- | ||
ITZ | 0.03-0.5 | 0.5 | 0.5 | 0 | 0 | -- | -- | ||
5FC | 0.25-2.0 | 0.5 | 2.0 | 0 | 0 | -- | -- | ||
VOR | 0.06-0.25 | 0.25 | 0.25 | 0 | 0 | -- | -- | ||
CAS | 0.06-0.5 | 0.125 | 0.25 | 0 | 0 | -- | -- | ||
C. krusei | 4 | AMB | 0.125-0.5 | 0.25 | 0.5 | 0 | 0 | -- | -- |
FLZ | 4.0-8.0 | 8.0 | 8.0 | 4** | 0 | 4** | 0 | ||
ITZ | 0.25-1.0 | 0.5 | 0.5 | 1 | 3 | -- | -- | ||
5FC | 0.25-2.0 | 0.5 | 2.0 | 0 | 0 | -- | -- | ||
VOR | 0.06-0.25 | 0.25 | 0.25 | 0 | 0 | 0 | 0 | ||
CAS | 0.06-0.5 | 0.125 | 0.25 | 0 | 0 | 0 | 0 |
(*) AMB = amphotericin B; FLZ = fluconazole; ITZ = itraconazole; 5FC = flucytosine; VOR = voriconazole; CAS = caspofungin; (**) C. krusei are assumed to be intrinsically resistant to fluconazole; (--) breakpoints not provided by CLSI documents M27-S4 and M27-A3.