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Candida infection diagnosis: evaluation of Candida species identification and characterization of susceptibility profile

BACKGROUND: Invasive infections by Candida are an important cause of morbidity and mortality. The successful treatment of these infections depends on the identification of the species and on the sensitivity pattern to antifungal agents. A quick and specific diagnosis is essential to introduce appropriate therapy. OBJECTIVES: Assess different diagnostic methods to determine Candida species and evaluate the sensitivity pattern to different antifungal agents among the identified ones. MATERIAL AND METHODS: The identification of Candida species present in samples of different biological materials was conducted through CHROMagar® Candida culture and Nested-PCR. The sensitivity pattern was assessed using Etest®. RESULTS: The culture of samples on CHROMagar® revealed 50% Candida albicans, 20.8% Candida tropicalis, 2.4% Candida krusei, and 26.9% other undetermined species. Samples of Candida albicans and Candida tropicalis were identified through CHROMagar® and N-PCR. Species that were not determined through CHROMagar® were characterized as Candida parapsilosis by N-PCR. Resistance to fluconazole, 5-fluocytosine was detected, respectively, in Candida krusei and Candida tropicalis samples. Both Candida albicans and Candida tropicalis samples showed resistance to itraconazole. DISCUSSION: The methods applied are easily reproducible and highly specific, which allows complementary diagnosis. The determination of the susceptibility profile by Etest® enables the early introduction of specific treatment. CONCLUSION: The growing appearance of Candida species resistant to azole confirms the importance of monitoring possible changes in the distribution of pathogenic species and in the sensitivity pattern.

Diagnosis of Candida spp.; Antifungal susceptibility; Multidrug resistance


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