The sensitivity of Candida spp. Isolated from blood with fluconazole remains stable

Azole antifungals are the most commonly used group of antimycotics, due to their high activity against fungi of the genus Candida (fluconazole) and Aspergillus (itraconazole). Fluconazole is the most commonly used drug for the treatment of both superficial and invasive forms of candidiasis. Prolonged use of fluconazole is associated with a risk of selecting resistant strains of Candida fungi.

The May issue of the Journal of Antimicrobial Chemotherapy published data from a prospective study on the level of resistance to fluconazole in strains of Candida spp. Isolated from the blood during the period from 1994 to 2000. in Taiwan.

A total of 1,095 candidaemia episodes were analyzed. The most common causative agents were C. albicans (50.4%), C. tropicalis (20.5%), C. parapsilosis (14.2%) and C.glabrata (12.0%). Fluconazole consumption from 1991 to 2000 increased by almost 10 times, from 0.5-1 g to 9-10 g per 1000 bed-days, respectively. Susceptibility to fluconazole was determined by the disc diffusion method in 552 strains. The frequency of isolation of resistant strains was 0.7%. In 1994-1995. and in 1999-2000 The sensitivity to this antifungal drug was respectively 94% and 97% of the isolated strains (p = 0.06). Mortality rates in patients with nosocomial candidaemia were 43.2% in 1994-95. and 25% in 2000 (p = 0.005).

Thus, despite an increase in the incidence of nosocomial fungal infections and an increase in the consumption of fluconazole from 1994 to 2000, there was no decrease in the sensitivity to this antifungal drug in the Candidaspp. Isolated from blood. It is possible that the results obtained are partly associated with a low frequency of C.krusei and C.glabrata.