title: Epidemiology and antifungal susceptibilities of Candida spp. to six antifungal agents: results from a surveillance study on fungaemia in Germany from July 2004 to August 2005.
abstract: OBJECTIVE
  Data on fungal infections occurring in Germany are rare to date. The aim of the present study was to survey the epidemiological situation in Germany, to provide data on the susceptibility of the fungal isolates to antifungals.
  
  
  METHODS
  Five hundred and sixty-one Candida isolates were collected from primarily sterile sites of patients from July 2004 to August 2005 with the aid of a nationwide established laboratory network, MykolabNet-D. The MICs of amphotericin B, flucytosine, fluconazole, itraconazole, voriconazole and caspofungin were determined using the microdilution reference procedure M27-A2 of the CLSI.
  
  
  RESULTS
  Candida albicans was the most frequently isolated species (58.5%), followed by Candida glabrata (19.1%), Candida parapsilosis (8.0%) and Candida tropicalis (7.5%). In contrast, the isolation rate of Candida krusei (1.4%) was low. Candida kefyr appeared as a new pathogen in this profile. Amphotericin B revealed excellent activity, with only three resistant isolates (0.5%). A total of 25 isolates (4.5%) showed resistance against flucytosine. All 25 isolates were identified as C. tropicalis indicating a peculiarity within German isolates. The resistance rate of all tested isolates to fluconazole and to itraconazole was 3.7% and 17.6%, respectively. According to the provisional breakpoints, two isolates (0.4%) were tested as resistant to voriconazole. Caspofungin was active against the majority of isolates where an intrinsic resistance is unknown.
  
  
  CONCLUSIONS
  This latest German survey of isolates from patients with fungaemia demonstrates a favourable situation with respect to antifungal susceptibilities for the antifungal substances tested.
authors.affiliation: Institute of Medical Microbiology, National Reference Centre for Systemic Mycoses, University Clinics, Göttingen, Germany. mborg@gwdg.de
authors.forename: Margarete
authors.initials: M
authors.lastname: Borg-von Zepelin
authors.forename: Luisa
authors.initials: L
authors.lastname: Kunz
authors.forename: Reinhard
authors.initials: R
authors.lastname: Rüchel
authors.forename: Utz
authors.initials: U
authors.lastname: Reichard
authors.forename: Michael
authors.initials: M
authors.lastname: Weig
authors.forename: Uwe
authors.initials: U
authors.lastname: Gross
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects*; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D025141:Drug Resistance, Fungal; D005260:Female; D016469:Fungemia / Q000453:epidemiology* / Q000382:microbiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011159:Population Surveillance; D012737:Sex Factors
chemical_list: D000935:Antifungal Agents