title: Clinical features of patients with infections caused by Candida guilliermondii and Candida fermentati and antifungal susceptibility of the isolates at a medical centre in Taiwan, 2001-10.
abstract: OBJECTIVE
  This study was intended to analyse the clinical characteristics and outcomes of patients with infections due to Candida guilliermondii complex and evaluate in vitro susceptibilities of the isolates.
  
  
  METHODS
  We searched the Mycology Database of the National Taiwan University Hospital and identified patients with infections due to C. guilliermondii complex from 2001 to 2010. Isolates were identified to species level by two yeast identification systems and restriction fragment length polymorphism of the riboflavin synthetase gene. MICs of nine antifungal agents were determined using the Sensititre YeastOne system (Trek Diagnostic Systems) and were interpreted by breakpoints (BPs) for three echinocandins and epidemiological cut-off values (ECVs) for the other agents.
  
  
  RESULTS
  Fifty-two patients with infections due to C. guilliermondii complex were evaluated. The majority (90%, n = 47) of the isolates were C. guilliermondii, followed by Candida fermentati (10%, n = 5). Among them, 42 (81%) were isolated from blood cultures. Among the 52 patients, 27 (52%) had underlying malignancy and 15 (29%) had undergone abdominal surgery. The 30 day mortality rates among patients with C. guilliermondii and C. fermentati infections were 45% and 60%, respectively. Among C. guilliermondii isolates, 98%, 100% and 98% were susceptible to caspofungin, micafungin and anidulafungin, respectively, by BPs. Nearly all (96%-100%) C. guilliermondii isolates belonged to wild-type for the other agents by ECVs. All five C. fermentati were susceptible to three echinocandins and belonged to wild-type for the other agents.
  
  
  CONCLUSIONS
  The currently used antifungal agents exhibited good in vitro activities against C. guilliermondii complex isolates.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Chien-Yuan
authors.initials: CY
authors.lastname: Chen
authors.forename: Shang-Yi
authors.initials: SY
authors.lastname: Huang
authors.forename: Jih-Luh
authors.initials: JL
authors.lastname: Tang
authors.forename: Woei
authors.initials: W
authors.lastname: Tsay
authors.forename: Ming
authors.initials: M
authors.lastname: Yao
authors.forename: Bo-Sheng
authors.initials: BS
authors.lastname: Ko
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Chou
authors.forename: Hwei-Fang
authors.initials: HF
authors.lastname: Tien
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification; D002177:Candidiasis / Q000382:microbiology* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016533:Mycological Typing Techniques; D012150:Polymorphism, Restriction Fragment Length; D012189:Retrospective Studies; D013624:Taiwan; D055815:Young Adult
chemical_list: D000935:Antifungal Agents
keywords: candidaemia; drug resistance; in vitro antifungal susceptibility; malignancy; outcomes