Susceptibilidad in vitro de las especies de Candida a los antifúngicos en el Hospital de Especialidades del Centro Médico Nacional de Occidente

Antecedentes: la administración indiscriminada de los antifúngicos ha seleccionado cepas de Candida resistentes a los mismos. Objetivo: estudiar la susceptibilidad in vitro de Candida a los antifúngicos en el Hospital de Especialidades del Centro Médico Nacional de Occidente. Material y método: estudio descriptivo y retrospectivo que incluyó cultivos de aspirado bronquial y hemocultivos con crecimiento de Candida durante el año 2012. Se determinaron concentraciones inhibitorias mínimas para anfotericina B, fluconazol, itraconazol, ketoconazol, voriconazol y fluorocitosina por el método Sensititre YeastOne®. Resultados: se incluyeron 156 cultivos (82.6% de aspirado bronquial y 17.4% hemocultivos) con 160 aislamientos de siete especies: C. albicans 83 (51.9%), C. tropicalis 39 (24.37%), C. glabrata 21 (13.1%), C. parapsilosis 7 (4.4%), C. krusei 7 (4.4%), C. guilliermondii 2 (1.3%) y C. kefyr 1 (0.5%). A la anfotericina mostraron resistencia C. kefyr (100%), C. albicans (6.1%) y C. glabrata (4.8%). Al fluconazol tuvieron resistencia C. krusei (28.6%), C. glabrata (9.5%) y C. albicans (6.1%). Al voriconazol mostraron resistencia C. albicans (6%) y C. tropicalis (2.6%). Al ketoconazol tuvieron resistencia C. krusei (28.6%), C. glabarata (23.8%), C albicans (14.5%) y C. tropicalis (2.6%). A la fluorocitosina tuvieron resistencia C. albicans (3.6%) y C. tropicalis (2.6%). Al itraconazol tuvieron resistencia C. glabrata (38.1%), C. krusei (28.6%), C. albicans (8.4%) y C. tropicalis (5.1%). Conclusiones: similar a lo reportado en otros estudios, existen especies de Candida resistentes a los antifúngicos en el Hospital de Especialidades del Centro Médico Nacional de Occidente; es importante realizar estudios de susceptibilidad a los antifúngicos para tomar mejores decisiones terapéuticas y disminuir costos. Palabras clave: antifúngicos, Candida, susceptibilidad, resistencia, anfotericina B, fluconazol, itraconazol, ketoconazol, voriconazol, fluorocitosina.

Palabras clave: antifúngicos, Candida, susceptibilidad, resistencia, anfotericina B, fluconazol, itraconazol, ketoconazol, voriconazol, fluorocitosina

Background: The widespread use of antifungals has selected resistant Candida strains to antifungals. Objective: To study the in vitro susceptibility of Candida to antifungal agents at the Western National Medical Center (WNMC) Specialty Hospital (SH), Mexico. Material and method: A descriptive and retrospective study included bronchial aspirate and blood cultures with Candida development during 2012. Minimum inhibitory concentrations were determined for amphotericin B, fluconazole, itraconazole, ketoconazole, voriconazole and fluorocytosine by the Sensititre YeastOne method. Results: Were included 156 cultures (82.6% were bronchial aspirate cultures and 17.4% were blood cultures) with 160 isolates of 7 species: C. albicans 83 (51.9%), C. tropicalis 39 (24.37%), C. glabrata 21 (13.1%), C. parapsilosis 7 (4.4%), C. krusei 7 (4.4%), C. guilliermondii 2 (1.3%) and C. kefyr 1 (0.5%). To amphotericin we found resistance in C. kefyr (100%), C. albicans (6.1%) and C. glabrata (4.8%). To fluconazole we found resistance in C. krusei (28.6%), C. glabrata (9.5%) and C. albicans (6.1%). To voriconazole we found resistance in C. albicans (6%) and C. tropicalis (2.6%). To ketoconazole we found resistance in C. krusei (28.6%), C. glabarata (23.8%), C. albicans (14.5%) and C. tropicalis (2.6%). To fluorocytosine we found resistance in C. albicans (3.6%) and C. tropicalis (2.6%). To itraconazole we found resistance in C. glabrata (38.1%), C. krusei (28.6%), C. albicans (8.4%) and C. tropicalis (5.1%). Conclusion: Similar to that reported in other studies, there are resistant Candida species to antifungal agents in the WNMC-SH, it is important to study antifungal susceptibility to take better treatment decisions and reduce costs. Key words: antifungal, Candida, susceptibility, resistance, amphotericin B, fluconazole, itraconazole, ketoconazole, voriconazole, fluorocytosine.

Keywords: Candida, antifungal, susceptibility, resistance, amphotericin B, fluconazole, itraconazole, ketoconazole, voriconazole, fluorocytosine