Sains Malaysiana 41(8)(2012):
961–967
Antifungal Susceptibility Patterns Among Candida Species
Isolated from
Blood at Universiti Kebangsaan Malaysia Medical Centre
(Corak Kerentanan Antikulat di Kalangan SpesiesCandida yang dipencil daripada
Darah di Pusat Perubatan Universiti Kebangsaan Malaysia)
Siti Umairah Binti Hamid, Sharon Tan, Siti Nurwani Binti Ahmad Ridzuan, Mohd Syazwan Bin
Che Seman, Ramliza Binti Ramli & Tzar Mohd Nizam Bin Khaithir*
Department of Medical
Microbiology and Immunology, Faculty of Medicine
Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak
56000 Cheras Kuala Lumpur, Malaysia
Diserahkan: 13
October 2011 / Diterima: 15 March 2012
ABSTRACT
Many challenges arise in candidaemia treatment which involves emergence of
antifungal resistance. New species have been identified due to improved methods
of detection and some are resistant to commonly prescribed antifungal agents
such as fluconazole and amphotericin B. Therefore, the objective of the study
was to observe any changes in the susceptibility patterns and distribution of Candida species. This cross sectional study was conducted at the Department
of Medical Microbiology and Immunology in UKMMC, a tertiary teaching hospital. One hundred and fifty one
data were collected from the department’s laboratory records from January 2008
to December 2010. The yeasts were identified using ID32C carbohydrate
assimilation tests whilst the antifungal susceptibility test was performed
using Sensititre® YeastOne®
broth microdilution method. Antifungal agents tested
included amphotericin B, fluconazole, itraconazole, voriconazole, 5-flucytosine and caspofungin.
Out of 151 blood isolates, 47 (31.1%) were Candida albicansand 104 (68.9%) were non-albicansCandida species. Candida tropicalishas
surpassed C. albicansas the
most commonly isolated Candida species from blood. Overall susceptibility (as
compared to 2005-2006 data in brackets) to caspofungin was 99.3% (n/a), 5-flucytosine 97.4% (98%), amphotericin B 94.7% (100%), voriconazole 92.7% (98%), fluconazole 86.8% (90%) and itraconazole 39.1% (40%). In conclusion, although the
isolates were generally still susceptible to amphotericin B and fluconazole,
resistance to these drugs is increasing.
Keywords: Antifungal
resistance; antifungal susceptibility; Candida; candidaemia
ABSTRAK
Banyak cabaran timbul dalam rawatan kandidemia melibatkan kemunculan kerintangan antikulat. Spesies baru telah dikenal pasti selaras dengan penambahbaikan kaedah pengenalpastian dan sebahagiannya adalah rintang terhadap antikulat yang biasa diberi seperti flukonazol dan amfoterisin B. Oleh itu, tujuan kajian ini adalah untuk memerhati sebarang perubahan dalam corak-corak kerentanan dan taburan spesiesCandida. Kajian keratan rentas ini telah dilakukan di Jabatan Mikrobiologi dan Imunologi Perubatan di PPUKM, sebuah hospital pengajar tertier. Data telah dikumpul daripada rekod makmal jabatan dari Januari 2008 hingga Disember 2010. Yis-yis telah dikenal pasti dengan menggunakan ujian asimilasi karbohidrat ID32C manakala ujian kerentanan antikulat telah dilakukan dengan kaedah pencairan kaldu mikro Sensititre® YeastOne®. Agen-agen antikulat yang diuji termasuk amfoterisin B, flukonazol, itrakonazol, vorikonazol,
5-flusitosin dan kaspofungin. Daripada 151 isolat darah, 47
(31.1%) adalah Candida albicansdan 104
(68.9%) adalah spesies bukan-albicans Candida. Candida tropicalis telah mengatasiC. albicans sebagai spesisCandida yang paling kerap dipencil daripada darah. Kerentanan keseluruhan (dibandingkan dengan data
2005-2006 dalam kurungan) terhadap kaspofungin adalah 99.3% (n/a), 5-flukitosin 97.4% (98%), amfotericin B 94.7% (100%), vorikonazol 92.7% (98%), flukonazol 86.8% (90%) dan itrakonazol 39.1% (40%). Kesimpulannya, walaupun isolat-isolat secara umumnya masih rentan terhadap amfoterisin B dan flukonazol, kerintangan terhadap ubatan ini semakin bertambah.
Kata kunci: Candida; Kandidemia; kerentanan antikulat; kerintangan antikulat
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*Pengarang surat-menyurat; email: tzarmohdnizam@yahoo.com
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