Species distribution and susceptibility to azole antifungals of Candida bloodstream isolates from eight university hospitals in Korea

Jin Sol Lee, Jong Hee Shin, Kyungwon Lee, Mi Na Kim, Bo Moon Shia, Young Uh, Wee Gyo Lee, Hye Soo Lee, Chulhun L. Chang, Soo Hyun Kim, Myung Geun Shin, Soon Pal Suh, Dong Wook Ryang

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Abstract

Purpose: The incidence of Candida bloodstream infections (BSI) has increased over the past two decades. The rank order of occurrence and the susceptibility to antifungals of the various Candida species causing BSI are important factors driving the establishment of empirical treatment protocols; however, very limited multi-institutional data are available on Candida bloodstream isolates in Korea. Materiasl and Methods: We investigated the susceptibility to azole antifungals and species distribution of 143 Candida bloodstream isolates recovered from eight university hospitals over a six-month period. Minimal inhibitory concentrations (MICs) of fluconazole, itraconazole, and voriconazole for each isolate were determined by the broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI). Results: The Candida species recovered most frequently from the blood cultures was C albicans (49%), followed by C parapsilosis (22%), C tropicalis (14%), and C. glabrata (11%). The MIC ranges for the Candida isolates were 0.125 to 64 μg/mL, for fluconazole, 0.03 to 2 μg/mL for itraconazole, and 0.03 to 1 μg/mL for voriconazole. Overall, resistance to fluconazole was found in only 2% of the Candida isolates (3/143), while the dose-dependent susceptibility was found in 6% (8/ 143). The resistance and dose-dependent susceptibility of itraconazole were found in 4% (6/143) and 14% (20/143) of the isolates, respectively. All bloodstream isolates were susceptible to voriconazole (MIC,≤ 1 μg/mL). Conclusion: Our findings show that C albicans is the most common cause of Candida-related BSI, followed by C. parapsilosis, and that the rates of resistance to azole antifungals are still low among bloodstream isolates in Korea.

Original languageEnglish
Pages (from-to)779-786
Number of pages8
JournalYonsei medical journal
Volume48
Issue number5
DOIs
Publication statusPublished - 2007 Jan 1

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Azoles
Korea
Candida
Itraconazole
Fluconazole
Infection
Clinical Protocols
Incidence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Lee, Jin Sol ; Shin, Jong Hee ; Lee, Kyungwon ; Kim, Mi Na ; Shia, Bo Moon ; Uh, Young ; Lee, Wee Gyo ; Lee, Hye Soo ; Chang, Chulhun L. ; Kim, Soo Hyun ; Shin, Myung Geun ; Suh, Soon Pal ; Ryang, Dong Wook. / Species distribution and susceptibility to azole antifungals of Candida bloodstream isolates from eight university hospitals in Korea. In: Yonsei medical journal. 2007 ; Vol. 48, No. 5. pp. 779-786.
@article{a0d12d3742044e97bf75e2812cd2cb49,
title = "Species distribution and susceptibility to azole antifungals of Candida bloodstream isolates from eight university hospitals in Korea",
abstract = "Purpose: The incidence of Candida bloodstream infections (BSI) has increased over the past two decades. The rank order of occurrence and the susceptibility to antifungals of the various Candida species causing BSI are important factors driving the establishment of empirical treatment protocols; however, very limited multi-institutional data are available on Candida bloodstream isolates in Korea. Materiasl and Methods: We investigated the susceptibility to azole antifungals and species distribution of 143 Candida bloodstream isolates recovered from eight university hospitals over a six-month period. Minimal inhibitory concentrations (MICs) of fluconazole, itraconazole, and voriconazole for each isolate were determined by the broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI). Results: The Candida species recovered most frequently from the blood cultures was C albicans (49{\%}), followed by C parapsilosis (22{\%}), C tropicalis (14{\%}), and C. glabrata (11{\%}). The MIC ranges for the Candida isolates were 0.125 to 64 μg/mL, for fluconazole, 0.03 to 2 μg/mL for itraconazole, and 0.03 to 1 μg/mL for voriconazole. Overall, resistance to fluconazole was found in only 2{\%} of the Candida isolates (3/143), while the dose-dependent susceptibility was found in 6{\%} (8/ 143). The resistance and dose-dependent susceptibility of itraconazole were found in 4{\%} (6/143) and 14{\%} (20/143) of the isolates, respectively. All bloodstream isolates were susceptible to voriconazole (MIC,≤ 1 μg/mL). Conclusion: Our findings show that C albicans is the most common cause of Candida-related BSI, followed by C. parapsilosis, and that the rates of resistance to azole antifungals are still low among bloodstream isolates in Korea.",
author = "Lee, {Jin Sol} and Shin, {Jong Hee} and Kyungwon Lee and Kim, {Mi Na} and Shia, {Bo Moon} and Young Uh and Lee, {Wee Gyo} and Lee, {Hye Soo} and Chang, {Chulhun L.} and Kim, {Soo Hyun} and Shin, {Myung Geun} and Suh, {Soon Pal} and Ryang, {Dong Wook}",
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doi = "10.3349/ymj.2007.48.5.779",
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Lee, JS, Shin, JH, Lee, K, Kim, MN, Shia, BM, Uh, Y, Lee, WG, Lee, HS, Chang, CL, Kim, SH, Shin, MG, Suh, SP & Ryang, DW 2007, 'Species distribution and susceptibility to azole antifungals of Candida bloodstream isolates from eight university hospitals in Korea', Yonsei medical journal, vol. 48, no. 5, pp. 779-786. https://doi.org/10.3349/ymj.2007.48.5.779

Species distribution and susceptibility to azole antifungals of Candida bloodstream isolates from eight university hospitals in Korea. / Lee, Jin Sol; Shin, Jong Hee; Lee, Kyungwon; Kim, Mi Na; Shia, Bo Moon; Uh, Young; Lee, Wee Gyo; Lee, Hye Soo; Chang, Chulhun L.; Kim, Soo Hyun; Shin, Myung Geun; Suh, Soon Pal; Ryang, Dong Wook.

In: Yonsei medical journal, Vol. 48, No. 5, 01.01.2007, p. 779-786.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Species distribution and susceptibility to azole antifungals of Candida bloodstream isolates from eight university hospitals in Korea

AU - Lee, Jin Sol

AU - Shin, Jong Hee

AU - Lee, Kyungwon

AU - Kim, Mi Na

AU - Shia, Bo Moon

AU - Uh, Young

AU - Lee, Wee Gyo

AU - Lee, Hye Soo

AU - Chang, Chulhun L.

AU - Kim, Soo Hyun

AU - Shin, Myung Geun

AU - Suh, Soon Pal

AU - Ryang, Dong Wook

PY - 2007/1/1

Y1 - 2007/1/1

N2 - Purpose: The incidence of Candida bloodstream infections (BSI) has increased over the past two decades. The rank order of occurrence and the susceptibility to antifungals of the various Candida species causing BSI are important factors driving the establishment of empirical treatment protocols; however, very limited multi-institutional data are available on Candida bloodstream isolates in Korea. Materiasl and Methods: We investigated the susceptibility to azole antifungals and species distribution of 143 Candida bloodstream isolates recovered from eight university hospitals over a six-month period. Minimal inhibitory concentrations (MICs) of fluconazole, itraconazole, and voriconazole for each isolate were determined by the broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI). Results: The Candida species recovered most frequently from the blood cultures was C albicans (49%), followed by C parapsilosis (22%), C tropicalis (14%), and C. glabrata (11%). The MIC ranges for the Candida isolates were 0.125 to 64 μg/mL, for fluconazole, 0.03 to 2 μg/mL for itraconazole, and 0.03 to 1 μg/mL for voriconazole. Overall, resistance to fluconazole was found in only 2% of the Candida isolates (3/143), while the dose-dependent susceptibility was found in 6% (8/ 143). The resistance and dose-dependent susceptibility of itraconazole were found in 4% (6/143) and 14% (20/143) of the isolates, respectively. All bloodstream isolates were susceptible to voriconazole (MIC,≤ 1 μg/mL). Conclusion: Our findings show that C albicans is the most common cause of Candida-related BSI, followed by C. parapsilosis, and that the rates of resistance to azole antifungals are still low among bloodstream isolates in Korea.

AB - Purpose: The incidence of Candida bloodstream infections (BSI) has increased over the past two decades. The rank order of occurrence and the susceptibility to antifungals of the various Candida species causing BSI are important factors driving the establishment of empirical treatment protocols; however, very limited multi-institutional data are available on Candida bloodstream isolates in Korea. Materiasl and Methods: We investigated the susceptibility to azole antifungals and species distribution of 143 Candida bloodstream isolates recovered from eight university hospitals over a six-month period. Minimal inhibitory concentrations (MICs) of fluconazole, itraconazole, and voriconazole for each isolate were determined by the broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI). Results: The Candida species recovered most frequently from the blood cultures was C albicans (49%), followed by C parapsilosis (22%), C tropicalis (14%), and C. glabrata (11%). The MIC ranges for the Candida isolates were 0.125 to 64 μg/mL, for fluconazole, 0.03 to 2 μg/mL for itraconazole, and 0.03 to 1 μg/mL for voriconazole. Overall, resistance to fluconazole was found in only 2% of the Candida isolates (3/143), while the dose-dependent susceptibility was found in 6% (8/ 143). The resistance and dose-dependent susceptibility of itraconazole were found in 4% (6/143) and 14% (20/143) of the isolates, respectively. All bloodstream isolates were susceptible to voriconazole (MIC,≤ 1 μg/mL). Conclusion: Our findings show that C albicans is the most common cause of Candida-related BSI, followed by C. parapsilosis, and that the rates of resistance to azole antifungals are still low among bloodstream isolates in Korea.

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JO - Yonsei Medical Journal

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