Table 2.
In vitro antifungal susceptibility of Candida species isolated from surgical patients with candidemia
| Species | Antifungal agent | MIC (μg/ml) | No. (%) of isolates by new CBPsa | ||||
|---|---|---|---|---|---|---|---|
| (n = 172) | Ranges | MIC50 | MIC90 | S | SDD / I | R | |
| C. albicans (n = 58) | Fluconazole | ≤0.5–16 | ≤1 | 4 | 50 (86.2%) | 6 (10.3%) | 2 (3.4%) |
| Voriconazole | ≤0.03- ≤ 4 | 0.06 | ≤1 | 49 (84.5%) | 3 (5.2%) | 6 (10.3%) | |
| Itraconazole | 0.062–1 | ≤0.125 | 0.25 | NA | NA | NA | |
| Amphotericin B | ≤0.25–1 | ≤0.5 | 0.5 | 58 (100%) | 0 | 0 | |
| C. parapsilosis (n = 74) | Fluconazole | ≤0.5–8 | ≤1 | ≤4 | 65 (87.8%) | 8 (10.8%) | 1 (1.4%) |
| Voriconazole | ≤0.03–0.25 | ≤0.06 | 0.125 | 72 (97.3%) | 2 (2.7%) | 0 | |
| Itraconazole | ≤0.062–0.25 | ≤0.125 | 0.125 | 72 (97.3%) | 0 | 2 (2.7%) | |
| Amphotericin B | ≤0.25–1 | ≤0.5 | 0.5 | 74 (100%) | 0 | 0 | |
| C. glabrata (n = 19) | Fluconazole | ≤1–16 | 4 | 16 | 0 | 19 (100%) | 0 |
| Voriconazole | ≤0.06–0.5 | 0.125 | 0.25 | NA | NA | NA | |
| Itraconazole | ≤0.125–1 | 0.25 | 1 | NA | NA | NA | |
| Amphotericin B | ≤0.25–1 | ≤0.5 | 0.5 | 19 (100%) | 0 | 0 | |
| C. tropicalis (n = 14) | Fluconazole | ≤1–32 | 1 | 16 | 11 (78.6%) | 1 (7.1%) | 2 (14.3%) |
| Voriconazole | ≤0.06–4 | 0.06 | 0.5 | 12 (85.7%) | 1 (7.1%) | 1 (7.1%) | |
| Itraconazole | ≤0.125–8 | 0.125 | 1 | 10 (71.4%) | 0 | 4 (28.6%) | |
| Amphotericin B | ≤0.25–0.5 | ≤0.5 | 0.5 | 14 (100%) | 0 | 0 | |
| C. kruseib (n = 1) | Fluconazole | 64 | 0 | 0 | 1 (100%) | ||
| Voriconazole | 0.5 | 1 (100%) | 0 | 0 | |||
| Itraconazole | 1 | NA | NA | NA | |||
| Amphotericin B | 1 | 1 (100%) | 0 | 0 | |||
| Others (n = 6) | Fluconazole | ≤1–16 | ≤2 | 16 | NA | NA | NA |
| Voriconazole | ≤0.06–2 | ≤0.06 | 2 | NA | NA | NA | |
| Itraconazole | ≤0.125–1 | 0.125 | 1 | NA | NA | NA | |
| Amphotericin B | ≤0.5–0.5 | ≤0.5 | 0.5 | NA | NA | NA | |
a Specific clinical breakpoints (CBPs) for Candida susceptibility to fluconazole and voriconazole were determined following CLSI [14], while CBPs for susceptibility of Candida against itraconazole and amphotericin B were obtained from EUCAST [15]; b Minimum inhibitory concentration (MIC) 50 and MIC 90 values were not calculated for antifungal drugs against C. krusei owing to the small number of C. krusei case. Isolates of C. krusei are assumed to be intrinsically resistant to fluconazole. S, susceptible; I, intermediate; SDD, susceptible-dose dependent; R, resistant; NA, non-applicable;