Voriconazole and fluconazole susceptibility of Candida isolates

An adapted NCCLS M27-A method was used to evaluate the activity of voriconazole (VRC) and fluconazole (FLC) against 295 Candida isolates collected from 189 patients (including isolates from deep sites). Isolates included 186 C. albicans, 54 C. glabrata, 27 C. tropicalis, 14 C. parapsilosis, 6 C. krusei, 6 C. lusitaniae, 1 C. lypolytica and 1 C. sake. Forty-two isolates had reduced susceptibility to FLC (MIC >8 mg/L); 83.3% of these had VRC MICs ≤2 mg/L (9 of 11 C. albicans, 18 of 19 C. glabrata, 6 of 6 C. krusei, 2 of 2 C. lusitaniae and 0 of 4 C. tropicalis), including 60% of isolates collected from deep-seated infections. These results suggested that in the era of azole resistance, VRC has a promising antifungal activity for serious infections with Candida spp., including most species with low susceptibility to FLC and uncommonly isolated species.