Abstract:
Candida species are responsible for a wide spectrum of infections in man. They can be
isolated from most sites of a human body. These mycoses are most common in
immunocompromised patients as opportunistic infections. Azoles have been used in
treatment, prophylaxis and currently as maintenance therapy for candidiasis in these
patients. The aim of the study was to characterize Candida species from clinical sources
and determine their susceptibilities to azoles in Kenya. The study was conducted in 2009
in a mycology laboratory at Kenya Medical Research Institute (KEMRI). A total of 50
isolates of Candida were characterized and correctly identified to species level by germ
tube test, Pal’s agar, Chromogenic agar Candida, corn meal agar and Analytical Profile
Index (API 20C AUX). 45 isolates were identified as Candida albicans, 1 as Candida
glabrata, 1 as Candida famata and 3 as Candida parapsilosis. Susceptibilities of
Candida species to fluconazole, posaconazole, itraconazole and clotrimazole were
determined using Epsilometer-test and disc diffusion method. Their Minimum Inhibitory
Concentrations (MIC’s) were correlated. In Epsilometer test, 78% of Candida species
were susceptible to clotrimazole and posaconazole, 60% to fluconazole and 50% to
itraconazole. In disc diffusion method, 92% Candida species were susceptible to
clotrimazole, 74% to itraconazole, 78% to posaconazole and 46% to fluconazole. There
were no significant differences in susceptibility between E-test and disc diffusion
methods for clotrimazole, itraconazole and posaconazole which had low significance
levels (p<0.002). Fluconazole had the greatest difference between the two methods
(p=0.002) and a kappa value of 0.329. There is emerging fungal resistance to fluconazole and itraconazole therefore further investigations on fungal resistance and
rational use of antifungal drugs is necessary.
