The Effectiveness of Antifungal Agents Against Yeasts of Candida Genus Isolated in Moscow Region

Background. Current problems in the treatment of candidiasis include changes in the sensitivity of yeasts to antifungal agents, often used for the purpose of prevention, and changes in the spectrum of leading etiological agents.

Aim. Analysis of changes in the antimicotic effectiveness against Candida isolated from clinical and natural materials during 2014–2019 in Moscow.

Materials and methods. Antibiotic sensitivity of 186 isolates (75 clinical, 128 natural) of Candida species: C.albicans, C.parapsilosis, C.glabrata, C.krusei (Pichia kudriavzevii), C.intermedia, C.tropicalis, C.lusitaniae (Clavispora lusitaniae), C.guilliermondii (Meyerozyma guilliermondii), was determined by disc-diffusion method.

Results. The incidence among clinical isolates isolated in 2014: C.albicans (23.53%), C.tropicalis (20.59%), C.guilliermondii (20.58%), C.parapsilosis (17.65%), C.glabrata (17.65%); in 2019: C.parapsilosis (21.95%), C.albicans (17.07%), C.tropicalis (12.19%), C.guilliermondii (12.19%), C.krusei (9.76%), C.glabrata (9.76%), C.lusitaniae (9.76%), C.intermedia (7.32%). Incidence among natural isolates isolated in 2014: C.parapsilosis (29.17%), C.guilliermondii (25.0%), C.glabrata (16.67%), C.albicans (16.67%), C.tropicalis (12.5%); in 2016–2018: C.lusitaniae (14.94%), C.tropicalis (14.94%), C.glabrata (13.79%), C.intermedia (13.79%), C.parapsilosis (11.5%), C.guilliermondii (11.5%), C.krusei (10.34%), C.albicans (9.2%). 70.59% and 17.07% of clinical isolates demonstrated sensitivity to fluconazole in 2014 and 2019, respectively; 100% and 80.49% — to clotrimazole, 94.12% and 58.54% — to intraconazole, 97.06% and 73.17% — to nystatin, 100% and 75.61% — to amphotericin B. 70.83% of natural isolates isolated in 2014 were sensitive to all antimicotic agents. 26.44% were sensitive to fluconazole, 66.67% to clotrimazole, 43.68% to intraconazole, 48.28% to nystatin, 63.22% of the natural isolates isolated in 2016–2018 to amphotericin B.

Conclusion. During five years of observation, the antimicotic sensitivity decreased by 19.51–53.52% for clinical isolates of Candida genus and by 4.16–44.39% for natural isolates. It is possible that the spread of resistance among these yeasts is influenced by co-evolutionary processes occurring within the community of microorganisms under the influence of anthropogenic factors.

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