Distribution and Antifungal Susceptibility of Candida species Isolated from Clinical Specimens during the Past Six Years

Shin, Jeong Hwan; Kim, Hye Ran; Lee, Jeong Nyeo

Abstract

BACKGROUND: The epidemiology of Candida species isolated from nonsterile as well as normally sterile sites is important because colonization of the former may precede invasive Candida infections.
METHODS
We investigated the epidemiology and antifungal susceptibility of Candida species recovered in Busan Paik Hospital during the past 6 years and compared these results according to the type of specimens.
RESULTS
Among the 2364 strains, C. albicans (53.8%) was the most frequently isolated, followed by C. tropicalis (17.5%), and C. guilliermondii (10.0%). Non-albicans Candida species were more prevalent in normally sterile sites (P<0.001); the prevalence of C. tropicalis and C. parapsilosis was significantly higher in normally sterile than in nonsterile sites (P<0.001). The prevalence of C. parapsilosis was higher in blood, intravenous catheter tips, and ear discharge, whereas C. tropicalis was more frequently isolated from urine. C. guilliermondii was the most frequently isolated from bronchial washings. The susceptibilities of Candida species to 5-flucytosine, amphotericin B, nystatin, miconazole, econazole, and ketoconazole were 98.3, 99.3, 99.7, 94.9, 86.3, and 94.5%, respectively. The susceptibilities of the organisms from normally sterile sites were lower than those from nonsterile sites.
CONCLUSION
The distribution of Candida species differed among various types of specimens, especially those from normally sterile versus nonsterile sites. We assume that the frequency of infections of exogenous origin is high. We presume that the candidemia of C. parapsilosis is associated with the use of central venous catheter and that C. parapsilosis is acquired from exogenous sources.