EVALUATION OF SUSCEPTIBILITY PATTERNS OF COMMONLY USED ANTIFUNGAL MEDICATIONS AGAINST CANDIDA AURIS.AT ROBERT KAIRUKI HOSPITAL, TANZANIA
Keywords:
antifungal, Candida auris, susceptibility, clinical breakpoint, antimicrobial resistance, antifungal susceptibilityAbstract
Background: Antifungal resistance in Candida auris raises the morbidity and mortality rates among immunosuppressed patients globally. Information regarding antimicrobial susceptibility testing trends of Candida auris is scarce in local contexts. Gaining insight into the antifungal susceptibility profile of Candida auris is essential for its management and treatment. This study evaluated the antifungal susceptibility testing results of Candida auris against fluconazole,
amphotericin, ketoconazole, and caspofungin.
Methods: A total of eleven samples of Candida auris, confirmed through both clinical and laboratory methods according to standard procedures, were analyzed for their antifungal susceptibility patterns against fluconazole, amphotericin, ketoconazole, and caspofungin at Robert Kairuki Hospital in the Dar es Salaam region of Tanzania. The evaluation of antifungal susceptibility for the Candida auris strains was conducted following the guidelines outlined in the Clinical and Laboratory Standards Institute (CLSI) document M27-A3.
Results: Candida auris isolates showed sensitive or full resistance to the tested antifungals. The rates of resistance in Candida auris against fluconazole, amphotericin, ketoconazole, and caspofungin were 76%, 50%, 23%, and 5%, respectively. Caspofungin was the drug that showed the highest susceptibility among all antifungals tested. `
Conclusions: Antifungal resistance of Candida auris to commonly prescribed antifungals such as fluconazole was alarmingly high while very low resistance rate was observed against amphotericin, caspofungin and ketoconazole.
Recommendation: The study recommends the need for comprehensive national control programs to combat antifungal resistance. Also, method-specific resistance breakpoints should be devised for accurate antifungal susceptibility testing (AST) of clinical Candida auris isolates for proper patient management.
