Journal Article

The European Confederation of Medical Mycology (ECMM) survey of candidaemia in Italy: <i>in vitro</i> susceptibility of 375 <i>Candida albicans</i> isolates and biofilm production

Anna Maria Tortorano, Anna Prigitano, Emanuela Biraghi and Maria Anna Viviani

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 56, issue 4, pages 777-779
Published in print October 2005 | ISSN: 0305-7453
Published online September 2005 | e-ISSN: 1460-2091 | DOI:
The European Confederation of Medical Mycology (ECMM) survey of candidaemia in Italy: in vitro susceptibility of 375 Candida albicans isolates and biofilm production

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Objectives: To investigate the in vitro antifungal susceptibility pattern of 375 Candida albicans bloodstream isolates recovered during the European Confederation of Medical Mycology survey of candidaemia performed in Lombardia, Italy and to test the ability to form biofilm.

Methods: In vitro susceptibility to flucytosine, fluconazole, itraconazole, posaconazole, voriconazole and caspofungin was performed by broth microdilution following the NCCLS guidelines. Biofilm production was measured using the XTT reduction assay in 59 isolates selected as representative of different patterns of susceptibility to flucytosine and azoles.

Results: MICs (mg/L) at which 90% of the strains were inhibited were ≤0.25 for flucytosine, 0.25 for caspofungin, 4 for fluconazole and 0.06 for itraconazole, voriconazole and posaconazole. Flucytosine resistance was detected in five isolates and was associated with serotype B in 2/29 and serotype A in 3/346. Resistance to fluconazole was detected in 10 isolates; nine of these exhibited reduced susceptibility to the other azoles. Among the 10 patients with fluconazole-resistant C. albicans bloodstream infection, only one, an AIDS patient, had been previously treated with fluconazole. Biofilm production was observed in 23 isolates (39%) and was significantly associated with serotype B. No relationship was detected with the pattern of antifungal susceptibility.

Conclusions: Resistance is uncommon in C. albicans isolates recovered from blood cultures, while biofilm production is a relatively frequent event. Periodic surveillance is warranted to monitor the incidence of in vitro antifungal resistance as well as of biofilm production.

Keywords: flucytosine; caspofungin; azoles; voriconazole; posaconazole

Journal Article.  1757 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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