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    Title: Clinical manifestations of candidemia caused by uncommon Candida species and antifungal susceptibility of the isolates in a regional hospital in Taiwan, 2007-2014
    Authors: Liu, Wei-Lun
    Lai, Chih-Cheng
    Li, Ming-Chi
    Wu, Chi-Jung
    Ko, Wen-Chien
    Hung, Yi-Li
    Hung-Jen Tang(湯宏仁)
    Hsueh, Po-Ren
    Contributors: Fu Jen Catholic Univ Hosp, Dept Emergency & Crit Care Med
    Fu Jen Catholic Univ, Coll Med
    Chi Mei Med Ctr, Dept Intens Care Med
    Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Internal Med
    Natl Cheng Kung Univ Hosp, Ctr Infect Control
    Natl Hlth Res Inst, Natl Inst Infect Dis & Vaccinol
    Cathay Gen Hosp, Dept Pediat
    Chi Mei Med Ctr, Dept Internal Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Natl Taiwan Univ, Natl Taiwan Univ Hosp, Dept Lab Med
    Natl Taiwan Univ, Natl Taiwan Univ Hosp, Dept Internal Med
    Keywords: Candidemia
    Uncommon candida species
    Healthcare-associated infection
    Antifungal susceptibility testing
    Date: 2019-08
    Issue Date: 2020-07-29 13:48:44 (UTC+8)
    Publisher: ELSEVIER TAIWAN
    Abstract: Objective: This retrospective study investigated clinical manifestations of candidemia caused by uncommon Candida species and antifungal susceptibility of the isolates in a regional hospital in Taiwan. Methods: The uncommon Candida species was initially defined as Candida species other than C. albicans, C. tropicalis, C. glabrata complex, C. parapsilosis complex and C. krusei. All uncommon Candida isolates were identified and confirmed by molecular methods. In vitro susceptibility testing of the uncommon Candida species to nine antifungal agents was conducted using the broth microdilution method with the Sensititre YeastOne (SYO) system (Trek Diagnostic Systems, Ltd., East Grimstead, UK). Results: Twenty-one patients, comprising 11 males and 10 females with a median age of 69 years, were recruited. Cancer (n = 11) was the most common underlying disease, 19 (90.5%) cases had prior antibiotic exposure, and only two patients had prior antifungal use. The overall in-hospital mortality rate was 38.1% (n = 8). C. guilliermondii (n = 11) was the most common pathogen, followed by C. curvata (n = 3). C. guilliermondii isolates exhibited relatively high rates of azole minimum inhibitory concentrations (MICs) above epidemiological cut-off values (ECVS), whereas C. pelliculosa and C. lusitaniae isolates all remained susceptible to azoles. All three C. curvata isolates had high caspofungin (>8 mg/L) and fluconazole MICs (8 mg/L) and could be defined as multidrug-resistant. Conclusions: Uncommon Candida species frequently exhibit high rates of non-susceptibility to antifungals. Identification of all Candida isolates at the species level from blood samples is of value for treatment. Copyright (C) 2017, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.
    Relation: Journal of Microbiology Immunology and Infection, v.52, n.4, pp.612-619
    Appears in Collections:[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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