Browsing by Author "Lo, Hsiu-Jung"

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An emerging issue of mixed yeast cultures
(2014-08-01)
Yang, Yun-Liang
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Chu, Wen-Li
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Lin, Chih-Chao
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Tsai, Sheng-Hua
;
Chang, Te-Pin
Background: Different yeast species have different susceptibilities to commonly prescribed antifungal drugs. Thus, it is important to accurately determine the species of pathogenic yeasts, especially when more than one species are in a specimen. Methods: Clinically significant yeast isolates were collected via the Taiwan Surveillance of Antimicrobial Resistance of Yeasts from July to September in 2010. The identifications of isolates were assessed in the core laboratory at the National Health Research Institutes. Results: Of the 1127 isolates recovered, 1088 were of Candida genus, accounting for 96.53% of the total isolates, followed by Cryptococcus (15, 1.33%), Trichosporon (12, 1.06%), Kodamaea (4, 0.35%), Pichia (4, 0.35%), and three others. In all, 38 out of 1116 (3.4%) specimens had mixed yeast cultures. One ascites specimen had three species, Candida albicans, Candida glabrata, and Candida tropicalis. In the remaining 37 specimens, 16 had a combination of C. albicans and C. glabrata, eight C. albicans and C. tropicalis, five C. glabrata and C. tropicalis, three Candida krusei and C. tropicalis, and five with different combinations. Conclusion: The high prevalence of cultures with mixed yeasts may be an emerging issue. Thus, to determine mixed yeast cultures in the same specimen, we highly recommend CHROMagar Candida medium to culture yeast isolates directly from the specimen. Copyright (C) 2013, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. All rights reserved.
Are we ready for the global emergence of multidrug-resistant Candida auris in Taiwan?
(2018-06-01)
Lu, Po-Liang
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Liu, Wei-Lun
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Lo, Hsiu-Jung
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Wang, Fu-Der
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Ko, Wen-Chien
Candida auris is a recently identified multi-resistant Candida species, first reported in Japan in 2009, and poses a serious global health threat. Lack of awareness of this new Candida species and difficulties with laboratory identification have impacted significantly on outbreak detection and management, and compromised patient outcome. Accordingly, there is an urgent need to raise awareness of healthcare personnel to this emerging pathogen and determine its prevalence, impact, and challenges to the Taiwan healthcare system. Enhanced laboratory testing strategies are needed to differentiate C. auris from other Candida species to provide accurate diagnosis and implement control measures early enough to prevent hospital outbreaks. In this report, we review the key epidemiological, microbiological and clinical characteristics of C. auris and provide the results of a multicenter surveillance study of C. auris in Taiwan. We also conducted a web-based survey to determine awareness of the medical community to C. auris and the capability of Taiwanese hospital laboratories to identify this microorganism. C. auris has not yet been isolated from humans in Taiwan, but the unique features of this microorganism and its ability to reach across international boundaries justify the importance of these initiatives in Taiwan.(C) 2017, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license.
Association between fluconazole susceptibility and genetic relatedness among Candida tropicalis isolates in Taiwan
(2007-05-01)
Wang, Jang-Shiun
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Li, Shu-Ying
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Yang, Yun-Liang
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Chou, Hsiao-Hui
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Lo, Hsiu-Jung
Among the 162 Candida tropicalis isolates Collected in the Taiwan Surveillance of Antimicrobial Resistance of Yeasts in 1999, 23 (14.2%) had fluconazole MICs >= 64 mg l(-1), and thus fulfilled the definition of resistance. Random amplified polymorphic DNA assay showed that all 23 fluconazole-resistance C. tropicalis isolates collected from different hospitals around Taiwan were closely related. Two distinct pulsotypes associated with fluconazole susceptibility were identified when these 23 resistant isolates, along with 13 susceptible ones, were analysed by PFGE.
Characterization of Candida Species from Different Populations in Taiwan
(2011-08-01)
Yang, Yun-Liang
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Hsieh, Li-Yun
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Wang, An-Huei
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Lo, Hsiu-Jung
;
生物科技學系
The opportunistic Candida species existing as part of commensal microbiota in humans are usually the etiological agents causing infections. We investigated whether isolates collected from different age groups, hospital units, and sources have distinct characteristics. A total of 913 isolates comprising 395 Candida albicans, 230 Candida tropicalis, 202 Candida glabrata, 62 Candida parapsilosis, 13 Candida krusei, and 11 of other six species were analyzed. Urine was the most common source (41.2%), followed by sputum (16.3%), blood (15.2%), and others (27.3%). Candida albicans and C. parapsilosis were more prevalent in the working group [from 19 to 65 years], whereas C. tropicalis and C. glabrata were more prevalent in the elder one (a parts per thousand yen 66 years). We found that the age of patients and the source of isolates affect the distribution of species. On the other hand, the drug susceptibility of isolates was associated with fungal species and whether patients were hospitalized.
Comparison of Human and Soil Candida tropicalis Isolates with Reduced Susceptibility to Fluconazole
(2012-04-05)
Yang, Yun-Liang
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Lin, Chih-Chao
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Chang, Te-Pin
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Lauderdale, Tsai-Ling
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Chen, Hui-Ting
Infections caused by treatment-resistant non-albicans Candida species, such as C. tropicalis, has increased, which is an emerging challenge in the management of fungal infections. Genetically related diploid sequence type (DST) strains of C. tropicalis exhibiting reduced susceptibility to fluconazole circulated widely in Taiwan. To identify the potential source of these wildly distributed DST strains, we investigated the possibility of the presence in soil of such C. tropicalis strains by pulsed field gel electrophoresis (PFGE) and DST typing methods. A total of 56 C. tropicalis isolates were recovered from 26 out of 477 soil samples. Among the 18 isolates with reduced susceptibility to fluconazole, 9 belonged to DST149 and 3 belonged to DST140. Both DSTs have been recovered from our previous studies on clinical isolates from the Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) program. Furthermore, these isolates were more resistant to agricultural azoles. We have found genetically related C. tropicalis exhibiting reduced susceptibility to fluconazole from the human hosts and environmental samples. Therefore, to prevent patients from acquiring C. tropicalis with reduced susceptibility to azoles, prudent use of azoles in both clinical and agricultural settings is advocated.
Distribution and antifungal susceptibility of Candida species isolated from different age populations in Taiwan
(2006-05-01)
Yang, Yun-Liang
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Cheng, Hsiao-Hsu
;
Lo, Hsiu-Jung
;
生物科技學系
;
Department of Biological Science and Technology
A total of 3926 yeast isolates were isolated from 24 hospitals participating in the Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) from July to September 2002. Candida albicans (69.1%) was the most common species, followed by Candida tropicalis (12.9%), Candida glabrata (8.3%), Candida parapsilosis (2.7%), Candida krusei (0.6%), and others (6.4%). To study the distribution and antifungal susceptibility of Candida species according to sources and patient ages, we have collected and analyzed the clinical data of 861 isolates. Of those 861 isolates, urine was the most common source (40%) followed by sputum (22.1%), blood (13.5%), central venous catheter (5.5%), wound (5.2%), and others (13.7%). With increasing age, we observed a significant increase in the percentage of isolates from urine (P = 0.00005) and a parallel reduction from blood (P = 0.009). As expected, more elder patients were hospitalized than younger ones (P = 0.05). In total, 2.7% and 1.9% of isolates were resistant to amphotericin B and fluconazole, respectively. Antifungal susceptibilities of isolates from different age groups were not significantly different.
Distribution and drug susceptibilities of Candida species causing candidemia from a medical center in central Taiwan
(2013-12-01)
Chang, Te-Pin
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Ho, Mao-Wang
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Yang, Yun-Liang
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Lo, Pai-Chang
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Lin, Pei-Sheng
Invasive fungal infections have increased significantly in the past few decades because of the increase in high-risk populations. To investigate the distribution and drug susceptibilities of such infections, we analyzed all 152 Candida isolates causing candidemia from 2004 to 2006 at the China Medical University Hospital, a medical center in central Taiwan. Candida albicans was the most common species, accounting for 52.6 % of the isolates, followed by C. tropicalis (19.7 %), C. parapsilosis (14.5 %), C. glabrata (8.6 %), C. guilliermondii (3.9 %), and C. pelliculosa (0.7 %). All isolates were susceptible to amphotericin B, anidulafungin, micafungin, and voriconazole according to minimum inhibitory concentrations (MICs) after a 24-h incubation; 0.7 %, 6.6 %, and 7.9 % of isolates were resistant to amphotericin B, fluconazole, and voriconazole, respectively, after 48-h incubation. Both C. albicans and C. parapsilosis had high degrees of agreement for azoles between 24- and 48-h incubation periods, whereas C. glabrata (38.5-46.2 %) and C. tropicalis (56.7-63.3 %) did not. The majority of the isolates with high azole MICs displayed a trailing growth phenotype. Hence, the MICs of different drugs after 24-h incubation may be considered for prognosis of candidemia.
Fruits as the vehicle of drug resistant pathogenic yeasts
(2017-09-01)
Lo, Hsiu-Jung
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Tsai, Sheng-Hua
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Chu, Wen-Li
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Chen, Yin-Zhi
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Zhou, Zi-Li
Objective: We investigated the diversity and drug susceptibility of pathogenic yeasts on fruit surfaces. Method: Fruits were purchased from supermarkets and washed with buffer. The pellets were re-suspended in medium after centrifugation. The cell suspensions were plated onto CHROMagar Candida medium. Yeasts were identified by ribosomal DNA sequencing and their drug susceptibilities were determined by broth microdilution assay. Results: Of 184 isolates, comprised of 55 species, from 22 different types of fruits, 29 species, including Candida famata, Candida fermentati, Candida guilliermondii, Candida intermedia, Candida krusei, Candida orthopsilosis, Candida parapsilosis, Candida pelliculosa, Candida tropicalis, and others have been reported to cause diseases in humans. In addition to C. krusei, intrinsically resistant to fluconazole, all Rhodotorula and Rhodosporidium species were resistant to fluconazole. One each of C. tropicalis isolate was belonged to diploid sequence type (DST)149 and DST225, genotypes also detected in isolates from humans. Furthermore, the DST225 isolate was less susceptible to azole drugs. The susceptibilities to azole drugs for clinical and agricultural usage were associated to each other. Conclusion: It is important to be aware of the existence of pathogenic yeasts, especially drug-resistant ones, on the fruit surfaces, a potential route for pathogenic yeasts to be transmitted to humans. (C) 2017 Published by Elsevier Ltd on behalf of The British Infection Association.
Genotype analysis based on intergenic spacer 1 sequences of Trichosporon asahii collected in Taiwan
(2013-11-01)
Yang, Yun-Liang
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Liu, Yi-Wen
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Chen, Hui-Ting
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Tsai, Moan-Shane
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Chu, Wen-Li
Among 32 Trichosporon asahii isolates collected in four rounds of the Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) studies, conducted in 1999, 2002, 2006, and 2010, five different intergenic spacer 1 (IGS1) genotypes were detected. Genotype 1 was the most common (43.8%), followed by genotypes 3 (28.1%), 7 (12.5%), 5 (9.4%), and 4 (6.3%). Interestingly, genotype 7 was more prevalent in Taiwan than in other areas (P = 0.01); while we did not find a significant association between IGS1 genotype and susceptibility to antifungal drugs, we did note that the majority of isolates of T. asahii were susceptible to both fluconazole and voriconazole, consistent with previous reports. A higher proportion of isolates (P = 0.05) collected in 2010 (4/12, 33.3%) had high amphotericin B MICs (>= 2 mg/l) than those collected in the previous three TSARYs (1/21, 5%). Hence, the new data of genotypes and drug susceptibilities in the present study may contribute to the epidemiology of T. asahii
Loss of Heterozygosity of FCY2 Leading to the Development of Flucytosine Resistance in Candida tropicalis
(2011-06-01)
Chen, Yen-Ning
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Lo, Hsiu-Jung
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Wu, Chia-Chen
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Ko, Hui-Ching
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Chang, Te-Pin
As fluconazole resistance becomes an emerging issue for treating infections caused by Candida tropicalis, searching for alternative becomes a prominent task. In the present study, 97 clinical isolates of C. tropicalis were tested for the susceptibilities to flucytosine (5FC) with the Etest method. Although only one isolate was resistant to 5FC, 30 susceptible isolates could produce resistant progeny after exposure to the drug. Interestingly, 22 of these 30 clinical isolates had a heterozygous G/T at the 145th position on FCY2, encoding purine-cytosine permease, whereas their progeny recovered from within the inhibitory ellipses had homozygous T/T, resulting in null alleles for both copies of the gene and produced only truncated proteins, effecting the 5FC resistance. Furthermore, we found that two major fluconazole-resistant clinical clones, diploid sequence type 98 (DST98) and DST140, had a homozygous G/G at the 145th position, and neither was able to produce 5FC-resistant progeny within the inhibitory ellipses. Hence, strains of C. tropicalis containing heterozygous alleles may develop 5FC resistance readily, whereas those with homozygous G/G wild-type alleles can be treated with 5FC. Subsequently, a combination of 5FC and another antifungal drug is applicable for treating infections of C. tropicalis.
Mixed yeast infections in Taiwan
(2018-08-01)
Yang, Yun-Liang
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Chu, Wen-Li
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Lin, Chih-Chao
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Zhou, Zi-Li
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Chen, Pei-Ning
Clinically significant yeast isolates were collected via Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) in 2014, and mixed infections were investigated. Among 44 out of 1092 specimens containing multiple species, 17, 11, 5, 3, and 8 were from urine, sputum, blood, ascites, and 6 others, respectively. There predominant combinations of mixed infection were 14 Candida albicans/Candida glabrata, 13 C. albicans/Candida tropicalis, and 9 C. glabrata/C. tropicalis. Furthermore, we also detected fluconazole resistant isolates Candida norvegensis and Candida krusei. Hence, it is important to accurately identify the species with different drug susceptibilities when they are in the same specimen.
Ndt80p is involved in L-sorbose utilization through regulating SOU1 in Candida albicans
(2015-01-01)
Lo, Hsiu-Jung
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Chu, Wen-Li
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Liou, Ci-Hong
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Huang, Szu-Hsuan
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Khoo, Kay-Hooi
Ndt80p, a known transcriptional factor, regulates various targets involved in stress responses, filamentous growth, and virulence in Candida albicans. Potential targets of Ndt80p have been identified at the transcriptional level. The present study was conducted to identify genes regulated by Ndt80p from the protein level. We found that the levels of Ahp1p, Fma1p, Hsp21p, Rfa2p, Snz1p, Sod1p, Soul p, Trp99p, orf19.251, orf19.1862, and orf19.5620, were affected by the null mutation of NDT80 by two-dimensional polyacrylamide gel-electrophoresis analysis. Among the 11 proteins, all but Sou1p and Rfa2p are suggested to be involved in known functions of Ndt80p. Here, we demonstrate that Ndt80p plays a role in t-sorbose utilization through regulating SOU1 in C. albicans. (C) 2014 Elsevier GmbH. All rights reserved.
Oropharyngeal Colonization of HIV-Infected Outpatients in Taiwan by Yeast Pathogens
(2010-07-01)
Yang, Yun-Liang
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Hung, Chien-Ching
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Wang, An-Huei
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Tseng, Fan-Chen
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Leaw, Shiang Ning
Among 234 isolates comprising 26 different Candida species colonizing the oropharynx of 181 (54.3% of 399 surveyed) HIV-infected outpatients, 27 (11.7%) were fluconazole resistant. Antibacterial treatment was associated with increased rates of yeast colonization, while antiretroviral therapy and pneumococcal vaccination protected patients from yeast colonization.
Predisposing factors for oropharyngeal colonization of yeasts in human immunodeficiency virus-infected patients: A prospective cross-sectional study
(2013-04-01)
Lin, Jiun-Nong
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Lin, Chih-Chao
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Lai, Chung-Hsu
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Yang, Yun-Liang
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Chen, Hui-Ting
Background: Oropharyngeal candidiasis continues to be a major opportunistic infection in human immunodeficiency virus (HIV)-infected patients. The objectives of this study were to investigate the prevalence, associated factors, and microbiologic features for oropharyngeal yeast colonization in HIV-infected patients. Methods: From October to December 2009, consecutive HIV-infected patients older than 18 years were recruited in this study. Demographic information, underlying conditions, and clinical histories were collected. Oropharyngeal swab cultures for yeasts and antifungal drug susceptibilities of the isolates were performed. Results: Of the 105 HIV-infected patients, 54 (51.4%) were colonized with yeasts, including 11 patients (20.4%) with more than one species. Among the 68 isolates, Candida albicans accounted for 73.5%, followed by Candida tropicalis (5.9%), Candida glabrata (5.9%), and Candida dubliniensis (4.4%). There were 7.5% and 6% Candida isolates resistant to fluconazole and voriconazole, respectively. All of the Candida isolates were susceptible to amphotericin B. A higher prevalence of yeast colonization was noted in patients with a CD4 cell count <= 200 cells/mu L (p = 0.032). Multivariate regression analysis showed that intravenous drug use was an independent associated factor for oropharyngeal yeast colonization (odds ratio, 5.35; 95% confidence interval, 1.39-20.6; p = 0.015), as well as protease inhibitor-containing anti-retroviral therapy (odds ratio, 3.59; 95% confidence interval, 1.41-9.12; p = 0.007). Conclusion: Despite previous studies showing that protease inhibitors decreased Candida adhesion to epithelial cells in vitro, the current study found protease inhibitor-containing anti-retroviral therapy predisposed to oropharyngeal yeast colonization in HIV-infected patients. Copyright (C) 2012, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. All rights reserved.
Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus colonization among human immunodeficient virus-infected outpatients in Taiwan: oral Candida colonization as a comparator
(2017-01-01)
Wu, Chi-Jung
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Ko, Wen-Chien
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Ho, Mao-Wang
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Lin, Hsi-Hsun
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Yang, Yun-Liang
Human immuodeficency virus (HIV)-infected patients receiving highly active antiretroviral therapy (HAART) and community-associated methicillin-resistant Staphylococcus aureus (CAMRSA) have increased in recent years in Taiwan. This study was undertaken to determine the prevalence of and risk factors for nasal and oral S. aureus and MRSA colonization among contemporary HIV-infected populations. Clinical variables for S. aureus and MRSA colonization among HIV-infected outpatients from three hospitals were analyzed and compared with those for oral Candida colonization. Genetic characteristics of MRSA isolates were analyzed. A total of 714 patients were screened for nasal S. aureus colonization, and a subset of 457 patients were also screened for oral S. aureus colonization. Of all patients, 79.4% were receiving HAART, and their mean CD4 count was 472 cells/mm(3). The colonization rates in the oral cavity, nasal cavity, and at either site were 18.8%, 31.7%, and 36.8%, respectively, for S. aureus, and 3.1%, 4.4%, and 5.5%, respectively, for MRSA. These rates were all much lower than the previously reported rate of oral Candida colonization (52.4%). By multivariate analysis, a suppressed viral load (< 200 copies/mL) protected against oral S. aureus, MRSA, and Candida colonization, and recent use of antibacterial agents protected against oral and nasal S. aureus colonization. Recent incarceration increased the risk of nasal MRSA colonization, while recent hospitalization, tuberculosis, older age, and intravenous drug use increased the risk of oral Candida colonization. Candida spp. did not augment S. aureus or MRSA colonization in the oral cavity. Most of the 41 MRSA isolates recovered belonged to the SCCmec IV/pvl-negative (51.2%) and VT/pvl-positive (26.8%) ST59 local prevalent CA-MRSA clones. Distinct carriage rates demonstrated here suggested that mucosal immunity against colonization might differ in terms of microbes and sites. A decreased risk in oral carriage of MRSA and Candida might be a benefit of HAART.
Rep1p negatively regulating MDR1 efflux pump involved in drug resistance in Candida albicans
(2009-09-01)
Chen, Chia-Geun
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Yang, Yun-Liang
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Tseng, Kuo-Yun
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Shih, Hsin-I
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Liou, Ci-Hong
Overexpression of MDR1 efflux pump is a major mechanism contributing to drug resistance in Candida albicans, the most common human fungal pathogen. To elucidate the regulatory pathway of drug resistance, we have identified a negative regulator of MDR1 and named it Regulator of Efflux Pump 1 (REP1). Overexpression of REPI in Saccharomyces cerevisiae increased susceptibility to fluconazole. Furthermore, null mutations on REP1 decreased the susceptibility to antifungal drugs in C albicans resulting from increased expression of MDR1 mRNA. Hence, Rep1p is involved in drug resistance by negatively regulating MDR1 in C albicans. (c) 2009 Elsevier Inc. All rights reserved.
Serum repressing efflux pump CDR1 in Candida albicans
(2006-07-13)
Yang, Yun-Liang
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Lin, Yi-Hsuan
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Tsao, Ming-Yang
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Chen, Chia-Geun
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Shih, Hsin-I
Background: In the past decades, the prevalence of candidemia has increased significantly and drug resistance has also become a pressing problem. Overexpression of CDR1, an efflux pump, has been proposed as a major mechanism contributing to the drug resistance in Candida albicans. It has been demonstrated that biological fluids such as human serum can have profound effects on antifungal pharmacodynamics. The aim of this study is to understand the effects of serum in drug susceptibility via monitoring the activity of CDR1 promoter of C. albicans. Results: The wild-type C. albicans cells ( SC5314) but not the cdr1/cdr1 mutant cells became more susceptible to the antifungal drug when the medium contained serum. To understand the regulation of CDR1 in the presence of serum, we have constructed CDR1 promoter-Renilla luciferase ( CDR1p-RLUC) reporter to monitor the activity of the CDR1 promoter in C. albicans. As expected, the expression of CDR1p-RLUC was induced by miconazole. Surprisingly, it was repressed by serum. Consistently, the level of CDR1 mRNA was also reduced in the presence of serum but not N-acetyl-D-glucosamine, a known inducer for germ tube formation. Conclusion: Our finding that the expression of CDR1 is repressed by serum raises the question as to how does CDR1 contribute to the drug resistance in C. albicans causing candidemia. This also suggests that it is important to re-assess the prediction of in vivo therapeutic outcome of candidemia based on the results of standard in vitro antifungal susceptibility testing, conducted in the absence of serum.
Species distribution and drug susceptibilities of Candida isolates in TSARY 2010
(2013-06-01)
Yang, Yun-Liang
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Chen, Hui-Ting
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Lin, Chih-Chao
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Chu, Wen-Li
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Lo, Hsiu-Jung
Susceptibilities to antifungal drugs of 1083 Candida isolates collected in Taiwan Surveillance of Antimicrobial Resistance of Yeasts in 2010 were determined. There were 422 (39%) C albicans, 270 (24.9%) C tropicalis, 258 (23.8%) C glabrata, 87 (8%) C. parapsilosis, 18 (1.7%) C. krusei, and 28 (2.6%) of 13 other species. In the present study, we have applied species-specific clinical breakpoints for common species and epidemiological cutoff values for rare species. We found that majority of isolates were susceptible to tested drugs. A total of 15, 3, 2, and 0 isolates were not susceptible to fluconazole, voriconazole, amphotericin B, and anidulafungin, respectively. We found that three of the four fluconazole non-susceptible C albicans isolates were resistant to voriconazole. Hence, there is an issue of cross-resistance among azole-type drugs. (C) 2013 Elsevier Inc. All rights reserved.
Susceptibilities to amphotericin B and fluconazole of Candida species in Taiwan Surveillance of Antimicrobial Resistance of Yeasts 2006
(2008-06-01)
Yang, Yun-Liang
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Wang, An-Huei
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Wang, Chih-Wei
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Cheng, Wei-Ting
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Li, Shu-Ying
Susceptibilities to amphotericin B and fluconazole of 964 Candida isolates collected in Taiwan Surveillance of Antimicrobial Resistance of Yeasts in 2006 were determined. There were 419 (43.5%) Candida albicans, 246 (25.5%) Candida tropicalis, 211 (21.9%) Candida glabrata, 62 (6.4%) Candida parapsilosis, 14 (1.5%) Candida krusei, and 12 (1.2%) others. Interestingly, 16 of the 17 amphotericin B-resistant isolates were non-albicans Candida species. The resistant rate to amphotericin B has decreased from 2.5% in 2002 to 1.8% in 2006. On the other hand, there were 132 C. tropicalis, 14 C. krusei, 10 C. albicans, and 9 C. glabrata isolates that had MICs to fluconazole >= 64 mu g/mL. The prevalence of isolates with such high MICs was significantly higher than that in 2002 (17.1% versus 1.9%). Our results further indicate that most of the isolates with MICs to fluconazole >= 64 mu g/mL exhibited the "trailing" phenomenon. (C) 2008 Elsevier Inc. All rights reserved.
The distribution and drug susceptibilities of clinical Candida species in TSARY 2014
(2016-12)
Zhou, Zi-Li
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Lin, Chih-Chao
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Chu, Wen-Li
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Yang, Yun-Liang
;
Lo, Hsiu-Jung
The species distribution and drug susceptibilities of 1106 Candida isolates collected in Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) in 2014 were determined. Candida albicans is still the dominant species, accounting for 35.9%, followed by 28.3% C. glabrata, 26.6% C. tropicalis, 5.2% C. parapsilosis, 1.0% C. krusei, and 3.0% of 13 other species. Interestingly, the prevalence of candidemia caused by C. glabrata in the present study is significantly higher than that in previous three surveys (39/220 vs. 54/471, P = 0.025). We found that 31 (2.8%), 24 (2.2%), 1 (0.09%), and 0 isolates were resistant to fluconazole, voriconazole, anidulafungin, and amphotericin B, respectively. There is a significant increase in fluconazole (P = 0.00002) and voriconazole (P = 0.00006) resistant rates when compared to the isolates collected in 2010. Importantly, all the 24 voriconazole resistant isolates identified were also resistant to fluconazole. Hence, cross-resistance among azole-type drugs is an emerging issue for managing fungal infections. (C) 2016 Published by Elsevier Inc.