P055 Antifungal resistance of clinical Candida albicans isolates in Iran: asystematic review and meta-analysis

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objective Antifungal susceptibility patterns of Candida infections can play an essential and decisive role in the treatment outcome. The present systematic review and meta-analysis aimed to investigate the drug susceptibility pattern of Iranian clinical Candida albicans isolates to antifungal drugs (azoles, polyenes, and echinocandins). Method Six electronic databases including ‘PubMed,’ ‘Scopus,’ ‘Web of Science,’ ‘IranDoc’, ‘SID’, ‘Magiran’ were searched from May 2000 to June 2021. Results The susceptibility of 6322 C. albicans strains from 19 967 patients against 14 antifungal drugs was evaluated according to Clinical and Laboratory Standards Institute (CLSI) methods. The pooled prevalence of antifungal resistance ranged from 0 to 26%. The lowest resistance levels among azoles were observed in luliconazole with a frequency of 0% and voriconazole of 3.94% [95% confidence interval (CI), 2.24%-6.09%]. An increase in trend of itraconazole (7%-16.65%), voriconazole (1.4%-6.52%), and amphotericin B resistance (7.5%-9.11%) among C. albicans strains since 2006 in Iran, while a decreasing trend was observed in fluconazole resistance (23.42%-14.42%). Conclusion Due to the resistance of C. albicans species to common antifungal drugs, antifungal stewardship strategy combining therapeutic drug monitoring to reduce the emergence of resistant multi-drug Candida species.