Tahereh Shokohi - Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Hamid Badali - Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Nasrin Amirrajab - Department of Medical Laboratory Sciences, School of Paramedicine/Infectious & Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Mohammad Reza Ataollahi - Department of Medical Microbiology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
Seyyed Amin Kouhpayeh - Department of Pharmacology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
Mohammad Hosein Afsarian - Department of Medical Microbiology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran

Background and Purpose: Candida albicans is the most common causative agent of candidiasis. Candidiasis management is dependent on the immune status of the host, severity of disease, and the choice of antifungal drug. Antifungals, specifically triazoles, are widely administered for the treatment of invasive fungal infections. Herein, we aimed to evaluate the in vitro susceptibility of C. albicans isolates to fluconazole (FLZ), itraconazole (ITZ), voriconazole (VRZ), amphotericin B (AMB), and Caspofungin (CAS). Materials and Methods: A total of ۴۴ clinical strains of C. albicans were collected from ۳۶ patients admitted to four hospitals in Mazandaran Province, Iran. The in vitro antifungal susceptibility testing was performed based on the Clinical and Laboratory Standards Institute methods. Results: Generally, ۳۴ isolates were susceptible to all the five antifungal drugs, while four isolates were susceptible or susceptible dose-dependent (SDD) and six isolates were SDD or resistant to these antifungals. The lowest minimum inhibitory concentration (MIC; ۰.۰۱۶ μg/ml) belonged to AMB and the highest MIC was for FLZ (۱۶ μg/ml). The lowest MIC۵۰ (۰.۰۶۳ μg/ml) was related to ITZ and the lowest MIC۹۰ (۰.۲۵ μg/ml) pertained to CAS; in addition, the highest MIC۵۰ (۱ μg/ml) and MIC۹۰ (۴ μg/ml) were for FLZ. Four of the isolates showed resistance to both FLZ and VRZ, separately, and five isolates were resistant to ITZ. Caspofungin showed potent activity against more than ۹۵% of the C. albicans isolates. Conclusion: Overall, we reported ۹.۱% resistance to FLZ and VRZ, ۱۱.۳% resistance to ITZ and AMB, and ۴.۶% resistance to caspofungin. Our finding is in agreement with previous observations proposing that C. albicans isolates develop resistance to some antifungal drugs such as FLZ since they are widely used as prophylaxis.

Antifungal agents, candida albicans, In vitro susceptibility testing