Species Distribution and Susceptibilities to Azoles of Candida Species Including C. tropicalis in a Tertiary Burn Center

Background: Candida species are the fourth leading cause of nosocomial bloodstream infections and have one of the highest mortality rates among nosocomial pathogens. C. tropicalis has been reported to be one of the leading Candida species other than C. albicans to cause Candida infection in patients who have malignancy, diabetes mellitus, and burn. This study was designed to determine whether burn might influence the species distribution and susceptibilities of azoles against clinical isolates of Candida species including C. tropicalis. Methods: A total 372 Candida isolates from various samples in a tertiary burn center were studied, and the MICs of Candida isolates to fluconazole, itraconazole, and voriconazole were tested by broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI) M27-A2. A comparison was made between Candida isolates from burn patients and non-burn patients. Results: The percentages of C. albicans, C. tropicalis, C. parapsilosis and C. glabrata isolates from burn patients and non-burn patients were 42.3% and 64.2% (P=0.000), 35.7% and 21.6% (P=0.002), 11.9% and 7.8%, and 10.1% and 6.4%, respectively. Decreased susceptibilities to fluconazole, itraconazole, and voriconazole were observed more frequently in burn patients (4.76%, 19.05%, and 0.60%, respectively) than non-burn patients (2.45%, 14.22%, and 0%, respectively). Conclusion: The results of this study suggest that burn may lead to influence the species distribution and susceptibilities to azoles of Candida species. (Korean J Clin Microbiol 2010;13:79-84)