標題: Antifungal susceptibility of invasive Candida bloodstream isolates from the Asia-Pacific region
作者: Tan, Thean Yen
Hsu, Li Yang
Alejandria, Marissa M.
Chaiwarith, Romanee
Chinniah, Terrence
Chayakulkeeree, Methee
Choudhury, Saugata
Chen, Yen Hsu
Shin, Jong Hee
Kiratisin, Pattarachai
Mendoza, Myrna
Prabhu, Kavitha
Supparatpinyo, Khuanchai
Tan, Ai Ling
Xuan Thi Phan
Thi Thanh Nga Tran
Gia Binh Nguyen
Mai Phuong Doan
Van An Huynh
Su Minh Tuyet Nguyen
Thanh Binh Tran
Hung Van Pham
交大名義發表
National Chiao Tung University
關鍵字: fluconazole;susceptibility testing;echinocandin;antifungal resistance;microbiology;candidemia
公開日期: Jul-2016
摘要: Bloodstream infections caused by Candida species are of increasing importance and associated with significant mortality. We performed a multi-centre prospective observational study to identify the species and antifungal susceptibilities of invasive bloodstream isolates of Candida species in the Asia-Pacific region. The study was carried out over a two year period, involving 13 centers from Brunei, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Identification of Candida species was performed at each study center, and reconfirmed at a central laboratory. Susceptibility testing was performed using a commercial broth dilution panel (Sensititre YeastOne YST-010, Thermofisher, United Kingdom) with susceptibility categorisation (S = susceptible, S-DD = susceptible dose-dependent) applied using breakpoints from the Clinical Laboratory Standards Institute. Eight hundred and sixty-one Candida isolates were included in the study. The most common species were C. albicans (35.9%), C. tropicalis (30.7%), C. parapsilosis (15.7%), and C. glabrata (13.6%). Non-albicans species exceeded C. albicans species in centers from all countries except Taiwan. Fluconazole susceptibility was almost universal for C. albicans (S = 99.7%) but lower for C. tropicalis (S = 75.8%, S-DD = 6.1%), C. glabrata (S-DD = 94.9%), and C. parapsilosis (S = 94.8%). Echinocandins demonstrated high rates of in vitro susceptibility (S> 99%) against C. albicans, C. tropicalis, and C. parapsilosis. This study demonstrates that non-albicans species are the most common isolates from bloodstream infections in most countries in the Asia-Pacific region, with C. tropicalis as the predominant species. Because of the prevalence of reduced susceptibility to fluconazole in non-albicans species, the study indicates that echinocandins should be the antifungal of choice in clinically unstable or high-risk patients with documented candidemia.
URI: http://dx.doi.org/10.1093/mmy/myv114
http://hdl.handle.net/11536/133895
ISSN: 1369-3786
DOI: 10.1093/mmy/myv114
期刊: MEDICAL MYCOLOGY
Volume: 54
Issue: 5
起始頁: 471
結束頁: 477
Appears in Collections:Articles