Species level identification and antifungal susceptibility of yeasts isolated from various clinical specimens and evaluation of Integral System Yeasts Plus

It is essential to use easy, standard, cost-effective and accurate methods for identification and susceptibility testing of yeasts in routine practice. This study aimed to establish the species distribution and antifungal susceptibility of yeast isolates and also to evaluate the performance of the c...

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Bibliographic Details
Published in:The New microbiologica 2012-07, Vol.35 (3), p.327-334
Main Authors: Bicmen, Can, Doluca, Mine, Gulat, Sinem, Gunduz, Ayriz T, Tuksavul, Fevziye
Format: Article
Language:English
Subjects:
Amphotericin B
Amphotericin B - pharmacology
Candida - classification
Candida - drug effects
Candida - isolation & purification
Candida albicans
Colorimetry - methods
Drug Resistance, Multiple, Fungal
Fluconazole - pharmacology
Flucytosine - pharmacology
Humans
Itraconazole - pharmacology
Microbial Sensitivity Tests - methods
Microbial Sensitivity Tests - standards
Pyrimidines - pharmacology
Reagent Kits, Diagnostic - standards
Reproducibility of Results
ROC Curve
Sensitivity and Specificity
Triazoles - pharmacology
Voriconazole
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Summary:It is essential to use easy, standard, cost-effective and accurate methods for identification and susceptibility testing of yeasts in routine practice. This study aimed to establish the species distribution and antifungal susceptibility of yeast isolates and also to evaluate the performance of the colorimetric and commercially available Integral System Yeasts Plus (ISYP). Yeast isolates (n=116) were identified by conventional methods and ISYP. Antifungal susceptibility testing was performed by the microdilution method according to the standards of CLSI M27-A3 and ISYP. Candida albicans (50%) was the most common species isolated, followed by C. parapsilosis (25%) (mostly in blood samples). According to the CLSI M27-S3 criteria, resistance rates for amphotericin B, flucytosine, fluconazole, itraconazole, and voriconazole were 0%, 0%, 4.6%, 4.5% and 1.8%, respectively. Resistance for miconazole (MIC >1 mg/L) was found as 17.9%. Sixty-two (53.4%) of the isolates which were analyzed by ISYP showed disagreement with those identified by the conventional methods and API ID 32C identification kit or a specific identification code could not be assigned by ISYP. The performance of ISYP could be indicated as low for all antifungal drugs tested according to the ROC analysis (AUC: 0.28-0.56). As the current version of ISYP displays a poor performance, it is recommended to use the other commercial systems whose results are approved as reliable and in agreement with those of the reference methods in identification and susceptibility testing of yeasts.
ISSN:1121-7138