High prevalence of itraconazole resistance among Candida parapsilosis isolated from Iran

سال انتشار: 1398
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 149

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شناسه ملی سند علمی:

JR_CUMM-5-3_008

تاریخ نمایه سازی: 11 آذر 1402

چکیده مقاله:

Background and Purpose: Candida parapsilosis isolates usually have a low minimum inhibitory concentration (MIC) against azoles. Although Candida parapsilosis isolates usually have low MICs against azoles, recent studies candida invasive infections due to azole resistant-C. parapsilosis isolates . Regarding this, the main aim of this study was to determine the susceptibility pattern of Iranian clinical C. parapsilosis against available azole antifungal drugs. Materials and Methods: This study was conducted on ۱۰۵ previously-identified isolates of C. parapsilosis sensu stricto. For the purpose of the study, the isolates were subjected to antifungal susceptibility testing against fluconazole (FLZ), itraconazole (ITZ), voriconazole (VRZ), and two new azole drugs, namely luliconazole (LUZU) and lanoconazole (LZN). The broth microdilution reference method adopted in this study was according to the Clinical & Laboratory Standards Institute M۲۷-A۳ and M۲۷-S۴ documents. Results: According to the results, ۸۹% (n=۹۴) of C. parapsilosis isolates showed a MIC of ≥ ۱ μg/ml, indicating resistance against ITZ. Multi-azole resistance was observed in ۳.۸% of the isolates. In addition, LUZU and LZN demonstrated the highest efficacy with the MIC۵۰ values of ۰.۵ and ۱ μg/ml, respectively. Conclusion: The majority of the isolates showed high MIC values against ITZ. This may have been associated with the long-term ITZ prophylaxis/therapy in patients infected with candidiasis. Hence, the adoption of an appropriate antifungal agent is a crucial step for starting the treatment. Background and Purpose: Although Candida parapsilosis isolates have usually low MICs against azoles but recent study confirmed Candida –related invasive infections due to azoles resistance C. parapsilosis isolates. The main aim of this study was to determine the susceptibility pattern of Iranian clinical C. parapsilosis against available azolesantifungal drugs. .Material and Methods: One hundred and five previously-identified isolates of C. parapsilosis sensu stricto were subjected to antifungal susceptibility testing against fluconazole, itraconazole, voriconazole and two new azole drugs, loliconazole and lanoconazole using the broth microdilution reference method according to CLSI M۲۷-A۳ and M۲۷-S۴ document.Results: Eighty nine percent (n=۹۴) of C. parapsilosis isolates showed MIC ≥ ۱µg/ml which indicated resistance against itraconazole. Multi-azoles resistances were observed in ۳.۸% of the isolates. Loliconazole and lanoconazole demonstrated the highest efficacy with MIC۵۰ values of ۰.۵ and ۱µg/ml, respectively.Conclusion: The majority of the isolates showed high MIC values against Itraconazole. It may associated with the long term Itraconazole prophylaxis/therapy in patients Infected with candidasis. Hence, choosing the appropriate antifungal is the crucial step for starting treatment.

نویسندگان

Fozieh Hassanmoghadam

Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran

Tahere Shokohi

Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran

Mohammad Taghi Hedayati

Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran

Narges Aslani

Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

Iman Haghani

Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

Mojtaba Nabili

Faculty of Medicine, Sari Branch, Islamic Azad University, Sari, Iran

Ensieh Lotfali

Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Amirhossein Davari

Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran

Maryam Moazeni

Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran

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