Abstract
Multicenter data on in vitro susceptibility of Candida bloodstream isolates to echinocandin antifungal agents is still lacking in South Korea. We performed a prospective multicenter study to determine the species distribution of Candida bloodstream isolates and their susceptibility to five antifungal agents, including caspofungin and micafungin. A total of 639 isolates were collected from 20 tertiary hospitals between September 2006 and August 2007. Antifungal susceptibilities were determined through the use of the CLSI broth microdilution method M27-A3. The overall species distribution was as follows; Candida albicans (38%), Candida parapsilosis (26%), Candia tropicalis (20%), Candida glabrata (11%), and miscellaneous Candida species (5%). Although C. parapsilosis and miscellaneous Candida species were less susceptible to both echinocandins, all 639 isolates were susceptible to both caspofungin and micafungin (MIC, ≤ 2 μg/ml). Nearly all isolates (99.7%) had a MIC ≤ 1 μg/ml to amphotericin B. Resistance to fluconazole and voriconazole was found in 0.8% and 0.3%, respectively, among all Candida isolates, with C. glabrata and C. krusei isolates displaying the greatest level of resistance. This is the largest multicenter candidemia study conducted in South Korea and shows that non-C. albicans Candida species, including C. parapsilosis, constitutes over 60% of all Candida species isolates recovered from the bloodstream. In addition, the rates of resistance to all five antifungals, including two echinocandins, are still low among bloodstream isolates in South Korea.
Acknowledgments
The Korean Study Group for Candidemia is represented by Jong Hee Shin, Sook-In Jung, Hee-Chang Jang (Chonnam National University Hospital, Gwangju, Korea), Soo Hyun Kim, Kyung-Hwa Park (Hwasun Chonnam National University Hospital, Hwasun), Jae-Hoon Song, Kyong Ran Peck, Doo Ryeon Chung (Samsung Medical Center, Seoul), Eui-Chong Kim (Seoul National University Hospital, Seoul), Kyungwon Lee, Seok Hoon Jeong (Severance Hospital, Seoul), Mi-Na Kim (Asan Medical Center, Seoul), Joon-Sup Yeom (Kangbuk Samsung Hospital, Seoul), Choon Kwan Kim (Seoul Veterans Hospital, Seoul), Hyun Kyun Ki (Konkuk University Hospital, Seoul), Jun Seong Son (Kyunghee University Hospital, Seoul), Mi-Kyung Lee (Chung-Ang University Hospital, Seoul), Young Uh (Wonju Christian Hospital, Wonju), Yeon-Sook Kim (Chungnam National University Hospital, Daejon), Hye Soo Lee (Chonbuk National University Hospital, Jeonju), Shin-Woo Kim, Hyun Ha Chang (Kyungbook National University Hospital, Daegu), Hyuck Lee, Dong Sik Jung (Dong-A University Hospital, Busan), Chi Sook Moon (Busan-Paik Hospital, Busan), Seong Yeol Ryu (Dongsan Medical Center, Daegu), Sang Taek Heo (Gyeongsang National University Hospital, Jinju), and Sang Yop Shin (Cheju National University Hospital, Jeju).
Funding
This study was supported by a research grant from the IISP of MSD Korea (CCD-MSG-02). The opinions expressed in this paper are those of the authors and do not necessarily represent those of MSD Korea.
Declaration of interest: None.
Ethical approval: Not required.
This paper was first published online on Early Online on 15 April 2010.