antifungal susceptibility of non-albicans candida species in a tertiary care hospital, bulgaria

Background: emerging non-albicans candida (nac) species are a major threat because of their intrinsic or acquired resistance to routinely applied antifungal agents.objectives: the purpose of our study was to reveal in vitro activity of nine antifungal agents against nac isolates.methods: a total of 67 nac (27 candida glabrata, 10 c. tropicalis, 6 c. krusei, 6 c. parapsilosis, 4 c. lusitaniae, 4 c. lipolytica, etc.) were identified and tested. the antifungal susceptibility was estimated on the basis of minimum inhibitory concentrations (mic).results: overall, 13 species were determined, of which c. glabrata was the most common (40.3%), followed by c. tropicalis (14.9%), c. krusei, and c. parapsilosis (8.9 % each). forty-nine nac isolates (73.13%) demonstrated decreased susceptibility to one or more antifungals, and18 of themwere resistant to all azoles. out of 27 c. glabrata, 12 (44.4%) were resistant to fluconazole with mics: 32 - >128 µg/ml and 15 (55.6%) were intermediate with mics: 8 - 16 µg/ml non-albicans candida revealed a good susceptibility to echinocandins. amphotericin b resistance was found in 5.97% of the isolates. of particular interest was the detection of 6 (8.95%) multidrug-resistant nac, which expressed resistance to azoles and echinocandins and/or amphotericin b.conclusions: about one-fourth of the studied nac were resistant to all azoles. these findings as well as the detection of several multidrug-resistant isolates determine the necessity of susceptibility testing of clinically important yeast isolates and control of the antifungal drugs in our hospital.