A multicenter study of antifungal use and species distribution and antifungal susceptibilities of candida isolates in South Korea

Ju Hyeon Shin, Eun Jeong Won, Soo Hyun Kim, Jong Hee Shin, Dain Lee, Dong Hyun Lee, Young Ah Kim, Jongyoun Yi, Jeong Hwan Shin, Kyeong Seob Shin, Seok Hoon Jeong

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Candidiasis control should include monitoring the epidemiology and resistance to various antifungal agents. In this study, the researchers investigated the Candida species recovered from clinical specimens at particular geographic areas or hospitals. Objective: The present study is geared toward the evaluation of antifungal drug usage at Korean hospitals in 2016. It is also essential that species distribution and antifungal susceptibilities of Candida isolates should be looked into to provide important data that can help devise therapeutic strategies to control the disease. Methods: Systemic antifungal agent usage over a one-year period was investigated at 10 Korean hospitals. Identification and antifungal susceptibility tests were performed on clinical isolates of the Candida species, which were collected over a three-month period. Results: The total antifungal usage in each hospital ranged from 7.7 to 158.9 defined daily doses (DDDs) per 1,000 patient days. Fluconazole was most commonly used (37.1%), followed by amphotericin B (30.6%), itraconazole (9.7%), echinocandins (8.8%), voriconazole (7.5%), and posaconazole (6.3%), respectively. Among 274 Candida isolates, C. albicans was the most frequently recovered (51.1%), followed by C. glabrata (15.7%), C. tropicalis (15.0%), and C. parapsilosis (13.5%), respectively. Through the application of either species-specific clinical breakpoints or epidemiological cutoff values to Candida isolates, the non-susceptibility rates to fluconazole, voriconazole, amphotericin B, and micafungin were found in 20.7%, 5.6%, 0%, and 0% of isolates, respectively. Conclusion: This nationwide multicenter study showed that total antifungal use varied considerably according to each hospital. Non-susceptibility to fluconazole should be further monitored, considering the drug's frequent use in Korea.

Original languageEnglish
Pages (from-to)10-16
Number of pages7
JournalJournal of Mycology and Infection
Volume25
Issue number1
DOIs
Publication statusPublished - 2021

Bibliographical note

Funding Information:
This work was supported by the research fund of Korea Centers for Disease Control and Prevention [2017E44004-00] and the Basic Science Research Program through the NationalResearchFoundationofKorea(NRF)fundedbythe MinistryofEducation(NRF-2019R1C1C1004605;NRF-2019-M3E5D1A02067953).

All Science Journal Classification (ASJC) codes

  • Infectious Diseases

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