title: Distribution of fluconazole-resistant Candida bloodstream isolates among hospitals and inpatient services in Israel.
abstract: The emergence of fluconazole-resistant Candida (FRC) is worrisome, but little is known about susceptibility patterns in different nosocomial settings. We prospectively analysed Candida bloodstream isolates in 18 medical centres in Israel (six tertiary-care and 12 community hospitals). The study included 444 episodes of candidaemia (450 patient-specific isolates, 8.5% fluconazole-resistant). Institutional FRC bloodstream infection rates correlated with annual inpatient days, and were strongly associated with the presence and activity of haematology/oncology services. Infection with Candida krusei and fluconazole-resistant Candida glabrata occurred exclusively in hospitals with >600 beds. These findings suggest that empirical antifungal strategies should be tailored to the nosocomial setting.
authors.affiliation: Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel. ronenba@tasmc.health.gov.il
authors.forename: R
authors.initials: R
authors.lastname: Ben-Ami
authors.forename: G
authors.initials: G
authors.lastname: Rahav
authors.forename: H
authors.initials: H
authors.lastname: Elinav
authors.forename: I
authors.initials: I
authors.lastname: Kassis
authors.forename: I
authors.initials: I
authors.lastname: Shalit
authors.forename: T
authors.initials: T
authors.lastname: Gottesman
authors.forename: O
authors.initials: O
authors.lastname: Megged
authors.forename: M
authors.initials: M
authors.lastname: Weinberger
authors.forename: P
authors.initials: P
authors.lastname: Ciobotaro
authors.forename: P
authors.initials: P
authors.lastname: Shitrit
authors.forename: G
authors.initials: G
authors.lastname: Weber
authors.forename: A
authors.initials: A
authors.lastname: Paz
authors.forename: D
authors.initials: D
authors.lastname: Miron
authors.forename: I
authors.initials: I
authors.lastname: Oren
authors.forename: J
authors.initials: J
authors.lastname: Bishara
authors.forename: C
authors.initials: C
authors.lastname: Block
authors.forename: N
authors.initials: N
authors.lastname: Keller
authors.forename: D P
authors.initials: DP
authors.lastname: Kontoyiannis
authors.forename: M
authors.initials: M
authors.lastname: Giladi
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects* / Q000302:isolation & purification; D041221:Candida glabrata; D058387:Candidemia / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology*; D025141:Drug Resistance, Fungal; D005260:Female; D015725:Fluconazole / Q000494:pharmacology*; D006761:Hospitals; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole