An Evaluation Of The Susceptibility Of Candida Species To Fluconazole And Itraconazole In The Urban Area Of Wuhan City

Background and Objective: With the development of medical technology and the change in the disease spectrum, the number of critical patients and immunosuppressed patients increased in recent years. The candidiasis often occur in these kinds of people. Though great progress have got in the research and development of new antifungal drugs, fluconazole and itraconazole are often used as empirical therapy to control fungal infection. These two drugs have been applied to clinical use for about 20 years. There is a growing number of publications described the shift in the infection pathogen from Candida albican to non-albicans species and the serious resistance of Candida to these agents, but there are no data in the urban area of Wuhan city. Our aim in this project is to find out the spectrum of isolated pathogenic Candida species and investigate the susceptibility of Candida speciese to fluconazole and itraconazole.Methods: All the Candida strains were isolated form the three large general hospitals in Wuhan urban (Renmin hospital of Wuhan University, Zhongnan hospital of Wuhan University and Tongji hospital of Huazhong University of Science and Technology) from October, 2003 to April, 2004. All the strains were identified by the automatic microbial analysis machine and kept at -70℃. Susceptibility testing was performed using a yeast disk diffusion method and microdilution method respectively. Both of them were approved by National Committee for Clinical Laboratory Standards (NCCLS).Results: 186 strains of Candida were isolated, of which Candida albicans accounted for 67.2% of all the isolates; C. tropicalis, C. glabrata, C. krusei and C. Portugal accounted for 15.6%, 15.1%, 1.6%, 0.5% respectively. The isolation frequency of Candida albicans, C .glabrata, C. tropicalis in Renmin hospital of Wuhan University were 68.3%, 10%, 20% respectively; in Zhongnan hospital of Wuhan University were 80.9%, 4.2%, 14.9% respectively and in Tongji hospital of Huazhong University of Science and Technology were 58.2%, 25.3%, 12.7%. The total susceptibility rates of the 111 isolates to fluconazole and itraconazole were 90.1% and 88.3% respectively, while the susceptibility rates of Candida albicans, C. glabrata and C.tropicalis to fluconazole and itraconazole were 97.4% and 96.1%, 58.8% and 52.9%, 100% and 100% respectively.Conclusions: Candida albicans were the most frequent organisms isolated in Wuhan urban. Fluconazole and itraconazole were quite effective to Candida albicans and C. tropicalis, but less effective to C. glabrata. Clinical laboratory should identify the isolates to species and do the microbial sensitivity tests. It will be more helpful for clinicians to treat the Candida infection.