الفهرس 
Candida SpeciesOnly 14 pages are availabe for public view
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Abstract
Background: Candidiasis is one of the most common nosocomial infections with a high mortality rate. This led to the wide use of azoles in the prophylaxis and treatment of candidiasis. As a result, drug resistance has emerged among Candida species. Bot the CLSI and the EUCAST established species-specific clinical break points for common Candida species-antifungal drugs combinations testing. This mandates the need for species identification for accurate interpretation of AFST. The aim of our current study was to assess the usefulness of chromogenic media for Candida spp. identification and for agar dilution using different antifungals with multiple concentrations in comparison to VITEK® 2 (bioMérieux) (Reference Method).
Methods: This cross-sectional study was conducted on 160 Candida isolates collected from specimens of clinically relevant patients with Candida infection from different sites. Specimens were submitted to the Central Microbiology Laboratory of Ain Shams University Hospitals from February 2020 to February 2021.
Results: The identification results of the Candida species by the VITEK-2 system and Brilliance Candida agar for our 160 isolates were in an almost perfect agreement (KAPPA= 0.9) with each other. Our results showed high prevalence of C. tropicalis among the isolated specimens with its predominance among urine specimens. AFST using fluconazole showed 88.5% susceptible , 7.6% SDD and 3.8% resistant. While for Voriconazole 95.0% were susceptible, 4.4% were intermediate, and 0.6% were resistant. Concerning Micafungin, 98.8% and 1.3% were susceptible and resistant, respectively.
Conclusion: The chromogenic media showed good identification results when compared with VITEK-2 identification. AFST using agar dilution method by Brilliance Candida agar media showed good agreement (KAPPA= 0.63) with Fluconazole susceptibility results obtained by the VITEK-2 system. However, there was a poor agreement (KAPPA= 0.07) and (KAPPA= 0.004) between the antifungal susceptibility testing for Voriconazole and Micafungin using the VITEK-2 system and the agar dilution method.