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. 2016 Feb 20;9(2):e28666.
doi: 10.5812/jjm.28666. eCollection 2016 Feb.

In Vitro Susceptibility and Trailing Growth Effect of Clinical Isolates of Candida Species to Azole Drugs

Kamiar Zomorodian  1 , Azadeh Bandegani  2 , Hossein Mirhendi  3 , Keyvan Pakshir  1 , Navvab Alinejhad  2 , Ali Poostforoush Fard  4
Affiliations

In Vitro Susceptibility and Trailing Growth Effect of Clinical Isolates of Candida Species to Azole Drugs

Kamiar Zomorodian et al. Jundishapur J Microbiol. .

Abstract

Background: Emergence of resistance to respective antifungal drugs is a primary concern for the treatment of candidiasis. Hence, determining antifungal susceptibility of the isolated yeasts is of special importance for effective therapy. For this purpose, the clinical laboratory standard institute (CLSI) has introduced a broth microdilution method to determine minimum inhibitory concentration (MIC). However, the so-called "Trailing effect" phenomenon might sometimes pose ambiguity in the interpretation of the results.

Objectives: The present study aimed to determine the in vitro susceptibility of clinical isolates of Candida against azoles and the frequency of the Trailing effect.

Materials and methods: A total of 193 Candida isolates were prospectively collected and identified through the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Using a broth microdilution test, according to the guidelines of CLSI M27-A3, antifungal susceptibilities of the isolated yeasts against Fluconazole (FLU), Itraconazole (ITR), Ketoconazole (KET) and Voriconazole (VOR) were assessed. Moreover, trailing growth was determined when a susceptible MIC was incubated for 24 hours, and turned into a resistant one after 48 hours of incubation.

Results: Among the tested antifungal drugs in this study, the highest rate of resistance was observed against ITR (28.5%) followed by VOR (26.4%), FLU (20.8%) and KET (1.5%). The trailing effect was induced in 27 isolates (14.0%) by VOR, in 26 isolates (13.5%) by ITR, in 24 isolates (12.4%) by FLU, and in 19 isolates (9.8%) by KET.

Conclusions: The monitoring of antifungal susceptibilities of Candida species isolated from clinical sources is highly recommended for the efficient management of patients. Moreover, the trailing effect should be taken into consideration once the interpretation of the results is intended.

Keywords: Antifungal Susceptibility; Candida; Trailing Effect.

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References

    1. Zomorodian K, Haghighi NN, Rajaee N, Pakshir K, Tarazooie B, Vojdani M, et al. Assessment of Candida species colonization and denture-related stomatitis in complete denture wearers. Med Mycol. 2011;49(2):208–11. doi: 10.3109/13693786.2010.507605. - DOI - PubMed
    1. Wanke B, Lazera Mdos S, Nucci M. Fungal infections in the immunocompromised host. Mem Inst Oswaldo Cruz. 2000;95 Suppl 1:153–8. - PubMed
    1. Schelenz S, Abdallah S, Gray G, Stubbings H, Gow I, Baker P, et al. Epidemiology of oral yeast colonization and infection in patients with hematological malignancies, head neck and solid tumors. J Oral Pathol Med. 2011;40(1):83–9. doi: 10.1111/j.1600-0714.2010.00937.x. - DOI - PubMed
    1. Alangaden GJ. Nosocomial fungal infections: epidemiology, infection control, and prevention. Infect Dis Clin North Am. 2011;25(1):201–25. doi: 10.1016/j.idc.2010.11.003. - DOI - PubMed
    1. Brissaud O, Guichoux J, Harambat J, Tandonnet O, Zaoutis T. Invasive fungal disease in PICU: epidemiology and risk factors. Ann Intensive Care. 2012;2(1):6. doi: 10.1186/2110-5820-2-6. - DOI - PMC - PubMed

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