Clinical manifestations of candidemia caused by uncommon Candida species and antifungal susceptibility of the isolates in a regional hospital in Taiwan, 2007-2014

doi:10.1016/j.jmii.2017.08.007

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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 Azotes Echinocandin
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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