Abstract
Over a three years period, 472 Candida isolates were
obtained from specimens of patients hospitalized either in
?at risk?, Bone Marrow Transplant Unit and Intensive Care
Unit, or in conventional wards, Pneumological Divisions of
the ?Binaghi? Hospital of Cagliari (Italy). Antifungal susceptibility
profile to amphotericin B, voriconazole, fluconazole
and ketoconazole was determined. Candida albicans was the
predominant species while Candida krusei was the most frequent
non-albicans species. C. krusei was significantly more
common among Bone Marrow Transplant Unit and Intensive
Care Unit than Pneumological Divisions patients (17.9%
and 14.1% vs. 6.0%; p inf. 0.05). No significant differences
were observed when the same distribution was analysed with
regard to the other Candida species or when Bone Marrow
Transplant Unit and Intensive Care Unit were compared. The
profiles of susceptibility to the antifungal drugs among isolates
from the different hospital wards showed no significant
differences, even though most of MIC values were higher
for Intensive Care Unit isolates compared to those for Bone
Marrow Transplant Unit and Pneumological Divisions. For C.
albicans isolates, amphotericin B was the more efficient antifungal
(97.7% S), while fluconazole (6.1% R [Resistant] and
2.6% SDD [Susceptible Dose Dependent]) and ketoconazole
(4.1% R and 3.2% SDD) showed the lowest activity. Voriconazole
was the more efficient antimycotic for C. krusei (96.7%
S) and Candida glabrata (100% S [Sensible]) isolates.
This study has shown a significantly higher presence of nonalbicans
Candida in at risk wards as well as a decreased susceptibility
to the older azoles (ketoconazole and fluconazole)
among C. albicans isolates.
