title: Species distribution and susceptibility to azole antifungals of Candida bloodstream isolates from eight university hospitals in Korea.
abstract: OBJECTIVE
  The incidence of Candida bloodstream infections (BSI) has increased over the past two decades. The rank order of occurrence and the susceptibility to antifungals of the various Candida species causing BSI are important factors driving the establishment of empirical treatment protocols; however, very limited multi-institutional data are available on Candida bloodstream isolates in Korea.
  
  
  METHODS
  We investigated the susceptibility to azole antifungals and species distribution of 143 Candida bloodstream isolates recovered from eight university hospitals over a six-month period. Minimal inhibitory concentrations (MICs) of fluconazole, itraconazole, and voriconazole for each isolate were determined by the broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI).
  
  
  RESULTS
  The Candida species recovered most frequently from the blood cultures was C. albicans (49%), followed by C. parapsilosis (22%), C. tropicalis (14%), and C. glabrata (11%). The MIC ranges for the Candida isolates were 0.125 to 64 microg/mL for fluconazole, 0.03 to 2 microg/mL for itraconazole, and 0.03 to 1 microg/mL for voriconazole. Overall, resistance to fluconazole was found in only 2% of the Candida isolates (3/143), while the dose-dependent susceptibility was found in 6% (8/143). The resistance and dose-dependent susceptibility of itraconazole were found in 4% (6/143) and 14% (20/143) of the isolates, respectively. All bloodstream isolates were susceptible to voriconazole (MIC, < or = 1 microg/mL).
  
  
  CONCLUSIONS
  Our findings show that C. albicans is the most common cause of Candida-related BSI, followed by C. parapsilosis, and that the rates of resistance to azole antifungals are still low among bloodstream isolates in Korea.
authors.affiliation: Department of Laboratory Medicine, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju 501-757, Korea.
authors.forename: Jin-Sol
authors.initials: JS
authors.lastname: Lee
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Shin
authors.forename: Kyungwon
authors.initials: K
authors.lastname: Lee
authors.forename: Mi-Na
authors.initials: MN
authors.lastname: Kim
authors.forename: Bo-Moon
authors.initials: BM
authors.lastname: Shin
authors.forename: Young
authors.initials: Y
authors.lastname: Uh
authors.forename: Wee-Gyo
authors.initials: WG
authors.lastname: Lee
authors.forename: Hye Soo
authors.initials: HS
authors.lastname: Lee
authors.forename: Chulhun L
authors.initials: CL
authors.lastname: Chang
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Myung Geun
authors.initials: MG
authors.lastname: Shin
authors.forename: Soon Pal
authors.initials: SP
authors.lastname: Suh
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Ryang
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D001393:Azoles / Q000494:pharmacology*; D016470:Bacteremia / Q000382:microbiology*; D002175:Candida / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D002177:Candidiasis / Q000382:microbiology*; D025141:Drug Resistance, Fungal; D015725:Fluconazole / Q000494:pharmacology; D006785:Hospitals, University; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D011743:Pyrimidines / Q000494:pharmacology; D014230:Triazoles / Q000494:pharmacology; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D001393:Azoles; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; D015725:Fluconazole; D065819:Voriconazole