Ann Clin Microbiol.  2017 Sep;20(3):53-62. 10.5145/ACM.2017.20.3.53.

Trend of Prevalence and Antifungal Drug Resistance of Candida Species Isolated from Candidemia Patients at a Tertiary Care Hospital During Recent Two Decades

• Kim D
• Hwang GY
• Yoo G
• Kim J
• Uh Y

• KMID: 2424231
• DOI: http://doi.org/10.5145/ACM.2017.20.3.53

Abstract

BACKGROUND
Candidemia has increased with an increasing number of people in the high risk group and so has become more important. This study was conducted to investigate the isolation rate of Candida species from candidemia patients and the change in rate of antifungal resistance.
METHODS
At a single tertiary care hospital, 1,120 blood cultures positive for Candida species from 1997 to 2016 were investigated according to date of culture, gender, age, and hospital department.
RESULTS
During the investigation period, the number of candidemia patients increased from 14 in 1997 to 84 in 2016. The most common organism identified during the two decades was Candida albicans (40.8%), followed by Candida parapsilosis (24.1%), Candida tropicalis (13.2%), and Candida glabrata (12.8%). C. glabrata was relatively common in females (45.5%) compared to males. The age group 40-89 years was more frequently infected than other age groups, and the most frequent isolates according to age group were C. albicans in neonate (66.7%), C. parapsilosis in 1-9-year-olds (41.7%), and C. glabrata in those aged ≥60 years (range; 13.3%-20.0%). According to the visited departments, C. albicans, C. glabrata, and Candida haemulonii were more common in medical departments, while C. parapsilosis was more common in surgical departments. In the antifungal susceptibility test, a rising trend of azole resistance among C. albicans and C. glabrata was observed in recent years.
CONCLUSION
In this study, it was confirmed that the isolation rate of Candida species in blood is different by age, gender, and hospital department, and the distribution of isolated Candida species changed over time. The resistance patterns of antifungal agents are also changing, and continuous monitoring and proper selection of antifungal agents are necessary.

Keyword

Antifungal drug resistance; Blood culture; Candida species; Candidemia; Isolation rate

MeSH Terms

Antifungal Agents
Candida albicans
Candida glabrata
Candida tropicalis
Candida*
Candidemia*
Danazol
Drug Resistance, Fungal*
Female
Hospital Departments
Humans
Infant, Newborn
Male
Prevalence*
Tertiary Healthcare*
Antifungal Agents
Danazol

Figure

• 

  Fig. 1. Isolation rate of Candida species in patients with candidemia during two decades (1997–2016). *Others includes Candida famata, Candida guilliermondii, Candida utilis, Candida haemulonii, Candida sake, Candida krusei, Candida intermedia, Candida globosa, Candida lipolytica, Candida sphaerica, Candida silvicola, Candida lusitaniae, Candida melibiosica, and Candida species. Abbreviations: CAL, Candida albicans; CPA, Candida parapsilosis; CTR, Candida tropicalis; CGL, Candida glabrata.

• 

  Fig. 2. Resistance rate of C. albicans and C. glabrata for fluconazole and voriconazole during recent 7 years (2010–2016).

Reference

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