Background: Candida species are among the most common fungal pathogens in ICU
patients. Candida albicans was the predominant species, but a shift toward non-albicans
Candida species has been recently observed. Objectives: To detect the prevalence of
different Candida species and determine their antifungal susceptibility profile in ICU
patients using phenotypic methods, the Vitek 2 system compared with CHROMagar
Candida agar and a genotypic method; PCR-RFLP. Methodology: Various clinical
samples were collected from 248 ICU patients in Sohag University Hospital from the
period between September 2014 and May 2015. Samples were cultured on CHROMagar
Candida agar. Results were compared with those of Vitek 2 system and confirmed by
PCR- RFLP method and antifungal susceptibility profiles were analyzed by disc diffusion
and Vitek 2 antifungal susceptibility tests. Results: The study revealed an overall
isolation rate of Candida species among ICU patients was 29 % by PCR-RFLP. Candida
albicans was the most frequent species isolated (40.3%). Non- albicans Candida species
including Candida tropicalis (22.2%), Candida glabrata (18%), Candida krusei
(12.5%), C. parapsilosis (4.2%), C. dubliniensis (1.4%) and Candida guilliermondii
(1.4%) were also isolated. The sensitivity of vitek 2 with regard to correct identification
of Candida species was 96%; the specificity was 100 % , also CHROMagar Candida
agar enable the correct identification with sensitivity 89% , specificity 100 %. Vitek 2
antifungal susceptibility tests results were found to be an accurate method as it was
compared with the disc diffusion method for fluconazole, voriconazole and amphotracin
B. Conclusion: CHROMagar Candida agar supported by Vitek 2 system is a valuable
method for identification of common Candida species, these methods are easy to interpret
and give rapid results in comparison with the expensive PCR-RFLP method. Although
amphotericin B and fluconazole are widely used in clinical practice, there was no evidence
of enhanced resistance. Moreover, voriconazole could be used in treatment of fluconazoleresistant
Candida species.