Table 3.
Invasive Candida species from Pakistan (188 isolates): frequencies and antifungal susceptibility profiles Caspofungin represents echinocandin susceptibilities (caspofungin, anidulafungin, micafungin). The uncommon Candida species included C. pelliculosa, C. viswanathii, C. utilis, C. kefyr, C. rugosa, C. fabianii and two novel Candida species.
| Species | n (%) | Antifungal | MIC range (µg ml−1) |
MIC50 (µg ml−1) |
MIC90 (µg ml−1) |
Resistant/non wild-type (%) |
|---|---|---|---|---|---|---|
| C. tropicalis | 61 (32.5) | Caspofungin | 0.015–0.12 | 0.03 | 0.06 | 0.0 |
| Fluconazole | 0.25–1.0 | 0.5 | 0.5 | 0.0 | ||
| Voriconazole | 0.015–0.12 | 0.015 | 0.06 | 0.0 | ||
| Itraconazole | 0.03–1.0 | 0.5 | 1.0 | 19.7 | ||
| Amphotericin B | 0.047–0.75 | 0.25 | 0.38 | 0.0 | ||
| C. albicans | 38 (20.2) | Caspofungin | 0.15–0.06 | 0.03 | 0.06 | 0.0 |
| Fluconazole | 0.12–2.0 | 0.25 | 1.0 | 0.0 | ||
| Voriconazole | 0.008–0.12 | 0.015 | 0.06 | 0.0 | ||
| Itraconazole | 0.06–0.5 | 0.12 | 0.25 | 23.7 | ||
| Amphotericin B | 0.012–0.125 | 0.064 | 0.094 | 0.0 | ||
| C. parapsilosis | 28 (15.0) | Caspofungin | 0.06–1.0 | 0.25 | 0.5 | 0.0 |
| Fluconazole | 0.25–4.0 | 0.5 | 1.0 | 0.0 | ||
| Voriconazole | 0.008–0.12 | 0.015 | 0.06 | 0.0 | ||
| Itraconazole | 0.06–0.5 | 0.12 | 0.5 | 0.0 | ||
| Amphotericin B | 0.016–0.125 | 0.06 | 0.125 | 0.0 | ||
| C. metapsilosis | 4 (2.1) | Caspofungin | 0.12–0.25 | – | – | – |
| Fluconazole | 1.0–2.0 | – | – | – | ||
| Voriconazole | 0.015 | – | – | – | ||
| Itraconazole | 0.12–0.5 | – | – | – | ||
| Amphotericin B | 0.032–0.38 | – | – | – | ||
| C. orthopsilosis | 3 (1.6) | Caspofungin | 0.12–0.25 | – | – | 0.0 |
| Fluconazole | 0.5 | – | – | 0.0 | ||
| Voriconazole | 0.015–0.03 | – | – | 0.0 | ||
| Itraconazole | 0.12–0.25 | – | – | – | ||
| Amphotericin B | 0.012–0.047 | – | – | – | ||
| C. glabrata | 20 (10.6) | Caspofungin | 0.03–0.5 | 0.03 | 0.06 | 5.0 |
| Fluconazole | 1.0–256.0 | 8.0 | 64.0 | 15.0 | ||
| Voriconazole | 0.06–4.0 | 0.25 | 1.00 | 5.0 | ||
| Itraconazole | 0.25–>16.0 | 0.5 | 1.3 | 10.0 | ||
| Amphotericin B | 0.06–0.5 | 0.25 | 0.5 | 0.0 | ||
| C. guilliermondii | 13 (6.9) | Caspofungin | 0.03–0.5 | 0.5 | 0.5 | 0.0 |
| Fluconazole | 2.0–4.0 | 2.0 | 4.0 | 0.0 | ||
| Voriconazole | 0.03–0.12 | 0.06 | 0.125 | 0.0 | ||
| Itraconazole | 0.25–1.0 | 0.5 | 0.5 | 0.0 | ||
| Amphotericin B | 0.016–0.064 | 0.03 | 0.06 | 0.0 | ||
| C. krusei | 4 (2.1) | Caspofungin | 0.12–0.25 | – | – | 0.0 |
| Fluconazole | 4.0–32.0 | – | – | 100.0 | ||
| Voriconazole | 0.12–0.25 | – | – | 0.0 | ||
| Itraconazole | 0.25–1.0 | – | – | 0.0 | ||
| Amphotericin B | 0.38–0.75 | – | – | 0.0 | ||
| C. lusitaniae | 4 (2.1) | Caspofungin | 0.25–0.5 | – | – | 0.0 |
| Fluconazole | 0.25–0.5 | – | – | 0.0 | ||
| Voriconazole | <0.008–0.008 | – | – | 0.0 | ||
| Itraconazole | 0.25–0.5 | – | – | 0.0 | ||
| Amphotericin B | 0.016–0.064 | – | – | 0.0 | ||
| Uncommon | 13 (6.9) | Caspofungin | 0.015–1.0 | 0.06 | 0.5 | – |
| Candida species | ||||||
| Fluconazole | 0.25–8.0 | 1.0 | 4.0 | –* | ||
| Voriconazole | <0.008–0.25 | 0.03 | 0.25 | – | ||
| Itraconazole | 0.03–0.5 | 0.5 | 0.5 | – | ||
| Amphotericin B | 0.016–0.5 | 0.094 | 0.5 | – |
*
One C. pelliculosa isolate was categorized as non-wild-type in respect to fluconazole, as the MIC of fluconazole fell beyond the wild-type range.