Antifungal Susceptibility of Candida albicans Isolates at a Tertiary Care Hospital in Bulgaria

background: the precise identification of yeasts and their antifungal sensitivity is a key factor in the choice of a suitable drug for treatment and prevention of fungal infections.objectives: the aim of the present study was to determine in vitro susceptibility of clinical candida albicans isolates to nine antifungal agents.methods: a total of 61 c. albicans isolates were tested. antifungal susceptibility was evaluated by determination of minimum inhibitory concentrations (mic).results: fifty c. albicans isolates were susceptible to nine antifungal agents. the remaining 11 yeasts were resistant to one or more antifungals. all c. albicans were susceptible to amphotericin b with mics 0.25 to 1 μg/ml and exhibited sensitivity to 5-fluorocytosine with mic90 of 0.125 μg/ml. the mic50 and mic90 of fluconazole were 0.5 and 32 μg/ml, whereas the mic50 and mic90 of voriconazole were considerably lower - 0.0078 and 2 μg/ml. the isolates showed susceptibility to echinocandins with mic90 of micafungin, anidulafungin and caspofungin of 0.015, 0.031, and 0.125 μg/ml, respectively. of particular interest was detection of seven c. albicans isolates, which expressed a high-level resistance to all azoles and one of them was also resistant to echinocandins.conclusions: in conclusion, detection of resistance in c. albicans, which is a species typically susceptible to antifungals, is of great importance for clinical practice.