Geographic variation in the frequency of isolation and fluconazole and voriconazole susceptibilities of Candida glabrata: An assessment from the ARTEMIS DISK Global Antifungal Surveillance Program

Michael A. Pfaller, Daniel J. Diekema, David L. Gibbs, Vance A. Newell, Richard Barton, Hu Bijie, Jacques Bille, Shan Chwen Chang, Maria da Luz Martins, Adriano Duse, Danuta Dzierzanowska, David Ellis, Jorge Finquelievich, Ian Gould, Deniz Gur, Anwar Hoosen, Kyungwon Lee, Nada Mallatova, Michele Mallie, NG Kee PengGeorge Petrikos, Axel Santiago, Jan Trupl, Ann Marie VanDen Abeele, Jeannette Wadula, Mussaret Zaidi

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Geographic differences in frequency and azole resistance among Candida glabrata may impact empiric antifungal therapy choice. We examined geographic variation in isolation and azole susceptibility of C. glabrata. We examined 23 305 clinical isolates of C. glabrata during ARTEMIS DISK global surveillance. Susceptibility testing to fluconazole and voriconazole was assessed by disk diffusion, and the results were grouped by geographic location: North America (NA) (2470 isolates), Latin America (LA) (2039), Europe (EU) (12 439), Africa and the Middle East (AME) (728), and Asia-Pacific (AP) (5629). Overall, C. glabrata accounted for 11.6% of 201 653 isolates of Candida and varied as a proportion of all Candida isolated from 7.4% in LA to 21.1% in NA. Decreased susceptibility (S) to fluconazole was observed in all geographic regions and ranged from 62.8% in AME to 76.7% in LA. Variation in fluconazole susceptibility was observed within each region: AP (range, 50-100% S), AME (48-86.9%), EU (44.8-88%), LA (43-92%), and NA (74.5-91.6%). Voriconazole was more active than fluconazole (range, 82.3-84.2% S) with similar regional variation. Among 22 sentinel sites participating in ARTEMIS from 2001 through 2007 (84 140 total isolates, 8163 C. glabrata), the frequency of C. glabrata isolation increased in 14 sites and the frequency of fluconazole resistance (R) increased in 11 sites over the 7-year period of study. The sites with the highest cumulative rates of fluconazole R were in Poland (22% R), the Czech Republic (27% R), Venezuela (27% R), and Greece (33% R). C. glabrata was most often isolated from blood, normally sterile body fluids and urine. There is substantial geographic and institutional variation in both frequency of isolation and azole resistance among C. glabrata. Prompt species identification and fluconazole susceptibility testing are necessary to optimize therapy for invasive candidiasis.

Original languageEnglish
Pages (from-to)162-171
Number of pages10
JournalDiagnostic Microbiology and Infectious Disease
Volume67
Issue number2
DOIs
Publication statusPublished - 2010 Jun 1

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Candida glabrata
Fluconazole
Latin America
Azoles
Middle East
North America
Candida
Invasive Candidiasis
Geographic Locations
Venezuela
Far East
Voriconazole
Czech Republic
Greece
Body Fluids
Poland
Urine

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Pfaller, Michael A. ; Diekema, Daniel J. ; Gibbs, David L. ; Newell, Vance A. ; Barton, Richard ; Bijie, Hu ; Bille, Jacques ; Chang, Shan Chwen ; da Luz Martins, Maria ; Duse, Adriano ; Dzierzanowska, Danuta ; Ellis, David ; Finquelievich, Jorge ; Gould, Ian ; Gur, Deniz ; Hoosen, Anwar ; Lee, Kyungwon ; Mallatova, Nada ; Mallie, Michele ; Peng, NG Kee ; Petrikos, George ; Santiago, Axel ; Trupl, Jan ; VanDen Abeele, Ann Marie ; Wadula, Jeannette ; Zaidi, Mussaret. / Geographic variation in the frequency of isolation and fluconazole and voriconazole susceptibilities of Candida glabrata : An assessment from the ARTEMIS DISK Global Antifungal Surveillance Program. In: Diagnostic Microbiology and Infectious Disease. 2010 ; Vol. 67, No. 2. pp. 162-171.
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abstract = "Geographic differences in frequency and azole resistance among Candida glabrata may impact empiric antifungal therapy choice. We examined geographic variation in isolation and azole susceptibility of C. glabrata. We examined 23 305 clinical isolates of C. glabrata during ARTEMIS DISK global surveillance. Susceptibility testing to fluconazole and voriconazole was assessed by disk diffusion, and the results were grouped by geographic location: North America (NA) (2470 isolates), Latin America (LA) (2039), Europe (EU) (12 439), Africa and the Middle East (AME) (728), and Asia-Pacific (AP) (5629). Overall, C. glabrata accounted for 11.6{\%} of 201 653 isolates of Candida and varied as a proportion of all Candida isolated from 7.4{\%} in LA to 21.1{\%} in NA. Decreased susceptibility (S) to fluconazole was observed in all geographic regions and ranged from 62.8{\%} in AME to 76.7{\%} in LA. Variation in fluconazole susceptibility was observed within each region: AP (range, 50-100{\%} S), AME (48-86.9{\%}), EU (44.8-88{\%}), LA (43-92{\%}), and NA (74.5-91.6{\%}). Voriconazole was more active than fluconazole (range, 82.3-84.2{\%} S) with similar regional variation. Among 22 sentinel sites participating in ARTEMIS from 2001 through 2007 (84 140 total isolates, 8163 C. glabrata), the frequency of C. glabrata isolation increased in 14 sites and the frequency of fluconazole resistance (R) increased in 11 sites over the 7-year period of study. The sites with the highest cumulative rates of fluconazole R were in Poland (22{\%} R), the Czech Republic (27{\%} R), Venezuela (27{\%} R), and Greece (33{\%} R). C. glabrata was most often isolated from blood, normally sterile body fluids and urine. There is substantial geographic and institutional variation in both frequency of isolation and azole resistance among C. glabrata. Prompt species identification and fluconazole susceptibility testing are necessary to optimize therapy for invasive candidiasis.",
author = "Pfaller, {Michael A.} and Diekema, {Daniel J.} and Gibbs, {David L.} and Newell, {Vance A.} and Richard Barton and Hu Bijie and Jacques Bille and Chang, {Shan Chwen} and {da Luz Martins}, Maria and Adriano Duse and Danuta Dzierzanowska and David Ellis and Jorge Finquelievich and Ian Gould and Deniz Gur and Anwar Hoosen and Kyungwon Lee and Nada Mallatova and Michele Mallie and Peng, {NG Kee} and George Petrikos and Axel Santiago and Jan Trupl and {VanDen Abeele}, {Ann Marie} and Jeannette Wadula and Mussaret Zaidi",
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Pfaller, MA, Diekema, DJ, Gibbs, DL, Newell, VA, Barton, R, Bijie, H, Bille, J, Chang, SC, da Luz Martins, M, Duse, A, Dzierzanowska, D, Ellis, D, Finquelievich, J, Gould, I, Gur, D, Hoosen, A, Lee, K, Mallatova, N, Mallie, M, Peng, NGK, Petrikos, G, Santiago, A, Trupl, J, VanDen Abeele, AM, Wadula, J & Zaidi, M 2010, 'Geographic variation in the frequency of isolation and fluconazole and voriconazole susceptibilities of Candida glabrata: An assessment from the ARTEMIS DISK Global Antifungal Surveillance Program', Diagnostic Microbiology and Infectious Disease, vol. 67, no. 2, pp. 162-171. https://doi.org/10.1016/j.diagmicrobio.2010.01.002

Geographic variation in the frequency of isolation and fluconazole and voriconazole susceptibilities of Candida glabrata : An assessment from the ARTEMIS DISK Global Antifungal Surveillance Program. / Pfaller, Michael A.; Diekema, Daniel J.; Gibbs, David L.; Newell, Vance A.; Barton, Richard; Bijie, Hu; Bille, Jacques; Chang, Shan Chwen; da Luz Martins, Maria; Duse, Adriano; Dzierzanowska, Danuta; Ellis, David; Finquelievich, Jorge; Gould, Ian; Gur, Deniz; Hoosen, Anwar; Lee, Kyungwon; Mallatova, Nada; Mallie, Michele; Peng, NG Kee; Petrikos, George; Santiago, Axel; Trupl, Jan; VanDen Abeele, Ann Marie; Wadula, Jeannette; Zaidi, Mussaret.

In: Diagnostic Microbiology and Infectious Disease, Vol. 67, No. 2, 01.06.2010, p. 162-171.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Geographic variation in the frequency of isolation and fluconazole and voriconazole susceptibilities of Candida glabrata

T2 - An assessment from the ARTEMIS DISK Global Antifungal Surveillance Program

AU - Pfaller, Michael A.

AU - Diekema, Daniel J.

AU - Gibbs, David L.

AU - Newell, Vance A.

AU - Barton, Richard

AU - Bijie, Hu

AU - Bille, Jacques

AU - Chang, Shan Chwen

AU - da Luz Martins, Maria

AU - Duse, Adriano

AU - Dzierzanowska, Danuta

AU - Ellis, David

AU - Finquelievich, Jorge

AU - Gould, Ian

AU - Gur, Deniz

AU - Hoosen, Anwar

AU - Lee, Kyungwon

AU - Mallatova, Nada

AU - Mallie, Michele

AU - Peng, NG Kee

AU - Petrikos, George

AU - Santiago, Axel

AU - Trupl, Jan

AU - VanDen Abeele, Ann Marie

AU - Wadula, Jeannette

AU - Zaidi, Mussaret

PY - 2010/6/1

Y1 - 2010/6/1

N2 - Geographic differences in frequency and azole resistance among Candida glabrata may impact empiric antifungal therapy choice. We examined geographic variation in isolation and azole susceptibility of C. glabrata. We examined 23 305 clinical isolates of C. glabrata during ARTEMIS DISK global surveillance. Susceptibility testing to fluconazole and voriconazole was assessed by disk diffusion, and the results were grouped by geographic location: North America (NA) (2470 isolates), Latin America (LA) (2039), Europe (EU) (12 439), Africa and the Middle East (AME) (728), and Asia-Pacific (AP) (5629). Overall, C. glabrata accounted for 11.6% of 201 653 isolates of Candida and varied as a proportion of all Candida isolated from 7.4% in LA to 21.1% in NA. Decreased susceptibility (S) to fluconazole was observed in all geographic regions and ranged from 62.8% in AME to 76.7% in LA. Variation in fluconazole susceptibility was observed within each region: AP (range, 50-100% S), AME (48-86.9%), EU (44.8-88%), LA (43-92%), and NA (74.5-91.6%). Voriconazole was more active than fluconazole (range, 82.3-84.2% S) with similar regional variation. Among 22 sentinel sites participating in ARTEMIS from 2001 through 2007 (84 140 total isolates, 8163 C. glabrata), the frequency of C. glabrata isolation increased in 14 sites and the frequency of fluconazole resistance (R) increased in 11 sites over the 7-year period of study. The sites with the highest cumulative rates of fluconazole R were in Poland (22% R), the Czech Republic (27% R), Venezuela (27% R), and Greece (33% R). C. glabrata was most often isolated from blood, normally sterile body fluids and urine. There is substantial geographic and institutional variation in both frequency of isolation and azole resistance among C. glabrata. Prompt species identification and fluconazole susceptibility testing are necessary to optimize therapy for invasive candidiasis.

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