Activities of fluconazole and voriconazole against bloodstream isolates of Candida glabrata and Candida krusei: a 14-year study in a Spanish tertiary medical centre.

The aim of this study was to evaluate the in vitro activities of voriconazole and fluconazole against Candida glabrata and Candida krusei isolated from blood during a 14-year period (1990-2003) at the tertiary care hospital of Cruces (Barakaldo, Spain). The in vitro activities of fluconazole and voriconazole against 28 isolates of C. glabrata and 15 isolates of C. krusei were determined by the Clinical and Laboratory Standards Institute disk diffusion method. Of the 28 C. glabrata isolates tested, 24 (85.7%) were susceptible (S) to fluconazole, 2 (7.1%) were susceptible dose-dependent (S-DD) and 2 (7.1%) were resistant (R). All C. krusei isolates were classified as R to fluconazole. Resistance to voriconazole was observed in one isolate each of C. glabrata (3.6%) and C. krusei (6.7%), and one isolate of each species was S-DD. These results were confirmed by the Sensititre YeastOne and Etest methods, with good comparative results. Voriconazole was very active in vitro against C. glabrata and C. krusei blood isolates and the resistance observed was not related to the introduction of voriconazole in the therapeutic schedule of the hospital. These facts support the usefulness of voriconazole as a therapeutic tool for candidaemia caused by these species.