Multidrug resistance to fluconazole, amphotericin B and antiseptic miramistin in Candida spp. isolated from patients with various pathology in region of Crimea

To overcome spreading of multidrug resistance to antimycotics in yeast fungi using combination therapy, it is necessary to monitor the sensitivity of clinical fungal isolates to antifungal drugs and antiseptics. The aim of this work was to study multidrug resistance to fluconazole (FLU), amphotericin B (AMB) and antiseptic miramistin (MST) in Candida fungi isolated from patients with various pathologies in Crimea in 2010-2016. Material and methods. The sensitivity of 25 clinical isolates of fungi species C. albicans, C. dubliniensis, C. parapsilosis, C. lusitaniae, C. tropicalis, C. famata, C. guillermondii, C. kefir and C. krusei to FLU, AMB and MST was determined by using disk diffusion method, serial dilution method, and quantitative suspension test according to the rate of inactivation of fungi, respectively. Results. 72% of isolates were resistant to FLU, 20% – to AMB, and 32% of isolates – to MST. 20% of fungal isolates belonging to the Non-albicans type were susceptible to all drugs tested. 40% of isolates were resistant to one drug. 40% of isolates were poly-resistant. C. albicans resistant to FLU and AMB or FLU and MST accounted for 20% of isolates. The isolates of C. dubliniensis and C. lusitaniae were resistant to FLU and MST, and one isolate of C. krusei was resistant to AMB and MST. One C. tropicalis isolate was resistant to all the drugs. Conclusion. In a significant part of the yeast fungi, circulating in Crimean patients, multidrug resistance to FLU, AMB and MST antiseptic is widespread. In 36% of fungal isolates, the poly-resistance spectra included resistance to two drugs and partially overlapped: to FLU and AMB – 2 isolates, to FLU and MST – 6 isolates, to AMB and miramistin – one isolate. One isolate of C. tropicalis showed resistance to all three drugs, which indicates the risk of further broadening the spectrum of multidrug resistance in pathogenic yeasts.