The relationship between antifungal usage and antifungal susceptibility in clinical isolates of Candida

A multicenter Korean study

Soo Hyun Kim, Jong Hee Shin, Eui Chong Kim, Kyungwon Lee, Mi Na Kim, Won Gil Lee, Young Uh, Hye Soo Lee, Mi Kyung Lee, Seokhoon Jeong, Sook In Jung, Kyung Hwa Park, Jin Sol Lee, Myung Geun Shin, Soon Pal Suh, Dong Wook Ryang

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

There have been very few multicenter studies of the relationship between the use of antifungals and resistance to them. We investigated the antifungal susceptibility of 1,301 clinical isolates of Candida collected from nine Korean hospitals during a 3-month period in 2006 to explore the existence of this type of relationship. Antifungal usage in the preceding year, defined as the daily dose per 1,000 patient days (DDD/1,000 PD), was calculated for each hospital. Resistance to fluconazole, itraconazole, and amphotericin B was detected in 2, 9, and 0.2% of the isolates, respectively. The MIC50/MIC90 values were 0.03/0.125 mg/L for voriconazole, 0.06/0.25 mg/l for caspofungin, and 0.03/0.125 mg/l for micafungin. The total usage of systemic antifungals varied considerably among the nine hospitals, ranging from 6.1 to 96.2 DDD/1,000 PD. No relationship was found between the use of fluconazole (MIC ≥ 64 mg/l) or itraconazole (MIC ≥ 1 mg/ l) and resistance in the Candida species (P > 0.05). However, significant correlations were found between the percentage of Candida isolates that were non-susceptible to fluconazole (MIC ≥ 16 mg/l) and fluconazole usage (r = 0.733, P = 0.025) or total antifungal usage (r = 0.767, P = 0.016).

Original languageEnglish
Pages (from-to)296-304
Number of pages9
JournalMedical Mycology
Volume47
Issue number3
DOIs
Publication statusPublished - 2009 Aug 17

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Fluconazole
Candida
Multicenter Studies
Dichlorodiphenyldichloroethane
Itraconazole
caspofungin
Amphotericin B

All Science Journal Classification (ASJC) codes

  • Infectious Diseases

Cite this

Kim, Soo Hyun ; Shin, Jong Hee ; Kim, Eui Chong ; Lee, Kyungwon ; Kim, Mi Na ; Lee, Won Gil ; Uh, Young ; Lee, Hye Soo ; Lee, Mi Kyung ; Jeong, Seokhoon ; Jung, Sook In ; Park, Kyung Hwa ; Lee, Jin Sol ; Shin, Myung Geun ; Suh, Soon Pal ; Ryang, Dong Wook. / The relationship between antifungal usage and antifungal susceptibility in clinical isolates of Candida : A multicenter Korean study. In: Medical Mycology. 2009 ; Vol. 47, No. 3. pp. 296-304.
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title = "The relationship between antifungal usage and antifungal susceptibility in clinical isolates of Candida: A multicenter Korean study",
abstract = "There have been very few multicenter studies of the relationship between the use of antifungals and resistance to them. We investigated the antifungal susceptibility of 1,301 clinical isolates of Candida collected from nine Korean hospitals during a 3-month period in 2006 to explore the existence of this type of relationship. Antifungal usage in the preceding year, defined as the daily dose per 1,000 patient days (DDD/1,000 PD), was calculated for each hospital. Resistance to fluconazole, itraconazole, and amphotericin B was detected in 2, 9, and 0.2{\%} of the isolates, respectively. The MIC50/MIC90 values were 0.03/0.125 mg/L for voriconazole, 0.06/0.25 mg/l for caspofungin, and 0.03/0.125 mg/l for micafungin. The total usage of systemic antifungals varied considerably among the nine hospitals, ranging from 6.1 to 96.2 DDD/1,000 PD. No relationship was found between the use of fluconazole (MIC ≥ 64 mg/l) or itraconazole (MIC ≥ 1 mg/ l) and resistance in the Candida species (P > 0.05). However, significant correlations were found between the percentage of Candida isolates that were non-susceptible to fluconazole (MIC ≥ 16 mg/l) and fluconazole usage (r = 0.733, P = 0.025) or total antifungal usage (r = 0.767, P = 0.016).",
author = "Kim, {Soo Hyun} and Shin, {Jong Hee} and Kim, {Eui Chong} and Kyungwon Lee and Kim, {Mi Na} and Lee, {Won Gil} and Young Uh and Lee, {Hye Soo} and Lee, {Mi Kyung} and Seokhoon Jeong and Jung, {Sook In} and Park, {Kyung Hwa} and Lee, {Jin Sol} and Shin, {Myung Geun} and Suh, {Soon Pal} and Ryang, {Dong Wook}",
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Kim, SH, Shin, JH, Kim, EC, Lee, K, Kim, MN, Lee, WG, Uh, Y, Lee, HS, Lee, MK, Jeong, S, Jung, SI, Park, KH, Lee, JS, Shin, MG, Suh, SP & Ryang, DW 2009, 'The relationship between antifungal usage and antifungal susceptibility in clinical isolates of Candida: A multicenter Korean study', Medical Mycology, vol. 47, no. 3, pp. 296-304. https://doi.org/10.1080/13693780802291445

The relationship between antifungal usage and antifungal susceptibility in clinical isolates of Candida : A multicenter Korean study. / Kim, Soo Hyun; Shin, Jong Hee; Kim, Eui Chong; Lee, Kyungwon; Kim, Mi Na; Lee, Won Gil; Uh, Young; Lee, Hye Soo; Lee, Mi Kyung; Jeong, Seokhoon; Jung, Sook In; Park, Kyung Hwa; Lee, Jin Sol; Shin, Myung Geun; Suh, Soon Pal; Ryang, Dong Wook.

In: Medical Mycology, Vol. 47, No. 3, 17.08.2009, p. 296-304.

Research output: Contribution to journalArticle

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T1 - The relationship between antifungal usage and antifungal susceptibility in clinical isolates of Candida

T2 - A multicenter Korean study

AU - Kim, Soo Hyun

AU - Shin, Jong Hee

AU - Kim, Eui Chong

AU - Lee, Kyungwon

AU - Kim, Mi Na

AU - Lee, Won Gil

AU - Uh, Young

AU - Lee, Hye Soo

AU - Lee, Mi Kyung

AU - Jeong, Seokhoon

AU - Jung, Sook In

AU - Park, Kyung Hwa

AU - Lee, Jin Sol

AU - Shin, Myung Geun

AU - Suh, Soon Pal

AU - Ryang, Dong Wook

PY - 2009/8/17

Y1 - 2009/8/17

N2 - There have been very few multicenter studies of the relationship between the use of antifungals and resistance to them. We investigated the antifungal susceptibility of 1,301 clinical isolates of Candida collected from nine Korean hospitals during a 3-month period in 2006 to explore the existence of this type of relationship. Antifungal usage in the preceding year, defined as the daily dose per 1,000 patient days (DDD/1,000 PD), was calculated for each hospital. Resistance to fluconazole, itraconazole, and amphotericin B was detected in 2, 9, and 0.2% of the isolates, respectively. The MIC50/MIC90 values were 0.03/0.125 mg/L for voriconazole, 0.06/0.25 mg/l for caspofungin, and 0.03/0.125 mg/l for micafungin. The total usage of systemic antifungals varied considerably among the nine hospitals, ranging from 6.1 to 96.2 DDD/1,000 PD. No relationship was found between the use of fluconazole (MIC ≥ 64 mg/l) or itraconazole (MIC ≥ 1 mg/ l) and resistance in the Candida species (P > 0.05). However, significant correlations were found between the percentage of Candida isolates that were non-susceptible to fluconazole (MIC ≥ 16 mg/l) and fluconazole usage (r = 0.733, P = 0.025) or total antifungal usage (r = 0.767, P = 0.016).

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