title: Antifungal susceptibilities of Candida isolates causing bloodstream infections at a medical center in Taiwan, 2009-2010.
abstract: We used the Sensititre YeastOne (SYO) method (Trek Diagnostic Systems) to determine the MICs of nine antifungal agents against 474 nonduplicate blood Candida isolates. The MIC results were interpreted according to updated clinical breakpoints (CBPs) recommended by the Clinical and Laboratory Standards Institute (CLSI; document M27-S4) or epidemiology cutoff values (ECVs). The rates of fluconazole susceptibility were 99.2% (234/236) in Candida albicans, 86.7% (85/98) in C. tropicalis, and 97.7% (42/43) in C. parapsilosis. Among the 77 isolates of C. glabrata, 90.9% showed dose-dependent susceptibility (S-DD) to fluconazole. Nearly all isolates of C. albicans, C. parapsilosis, and C. krusei were susceptible to voriconazole; however, rates of voriconazole susceptibility were 78.6% in C. tropicalis. Few isolates of C. albicans (n = 5; 2.1%) and C. glabrata (n = 3; 3.9%), no isolates of C. parapsilosis, C. krusei, and C. guilliermondii, but 62.2% (n = 51) of C. tropicalis isolates were non-wild type for posaconazole susceptibility. For itraconazole susceptibility, 98.3% of C. albicans isolates were wild type, and 3.9% (n = 3) of C. glabrata isolates were non-wild type. Almost all of the isolates tested (>97% for all species) were susceptible to both micafungin and anidulafungin. All isolates tested were found to be wild type for amphotericin B susceptibility, with MICs of <1 μg/ml. Further evaluation is needed to establish CBPs of antifungal agents by the 24-h SYO method for the management of patients with candidemia or other invasive candida infections.
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yu-Tsung
authors.initials: YT
authors.lastname: Huang
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Chia-Ying
authors.initials: CY
authors.lastname: Liu
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Chun-Hsing
authors.initials: CH
authors.lastname: Liao
authors.affiliation: Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Kuei-Pin
authors.initials: KP
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Wang-Huei
authors.initials: WH
authors.lastname: Sheng
authors.affiliation: Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan hsporen@ntu.edu.tw.
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects*; D058387:Candidemia / Q000097:blood* / Q000453:epidemiology / Q000382:microbiology*; D003428:Cross Infection / Q000382:microbiology; D004305:Dose-Response Relationship, Drug; D006402:Hematologic Diseases / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents
references.citation: J Microbiol Immunol Infect. 2013 Dec;46(6):463-8
references.pmid: 23010536
references.citation: J Clin Microbiol. 2012 Dec;50(12):3952-9
references.pmid: 23035204
references.citation: J Clin Microbiol. 2010 Jan;48(1):52-6
references.pmid: 19923478
references.citation: J Clin Microbiol. 2004 Feb;42(2):718-21
references.pmid: 14766842
references.citation: Int J Antimicrob Agents. 2012 Dec;40(6):533-8
references.pmid: 23006521
references.citation: Curr Opin Crit Care. 2010 Oct;16(5):445-52
references.pmid: 20711075
references.citation: Antimicrob Agents Chemother. 2013 Dec;57(12):5836-42
references.pmid: 24018263
references.citation: Antimicrob Agents Chemother. 2014;58(4):1897-906
references.pmid: 24395235
references.citation: J Antimicrob Chemother. 2014 Jan;69(1):162-7
references.pmid: 24004860
references.citation: Diagn Microbiol Infect Dis. 2011 Jul;70(3):330-43
references.pmid: 21546199
references.citation: J Microbiol Immunol Infect. 2011 Dec;44(6):461-6
references.pmid: 21576041
references.citation: Clin Microbiol Infect. 2008 Feb;14(2):136-40
references.pmid: 18042196
references.citation: J Formos Med Assoc. 2009 Jun;108(6):443-51
references.pmid: 19515624
references.citation: Antimicrob Agents Chemother. 2005 Feb;49(2):512-7
references.pmid: 15673726
references.citation: J Clin Microbiol. 2011 Feb;49(2):630-7
references.pmid: 21159940
references.citation: J Clin Microbiol. 2012 Sep;50(9):2846-56
references.pmid: 22740712
references.citation: J Clin Microbiol. 2007 Mar;45(3):698-706
references.pmid: 17202279
references.citation: J Clin Microbiol. 2012 Jun;50(6):2040-6
references.pmid: 22461672
references.citation: J Clin Microbiol. 2012 Dec;50(12):3921-6
references.pmid: 23015676
references.citation: Int J Antimicrob Agents. 2012 Oct;40(4):349-53
references.pmid: 22819796
references.citation: J Clin Microbiol. 2011 Nov;49(11):3800-4
references.pmid: 21900519
references.citation: Antimicrob Agents Chemother. 2008 Aug;52(8):2919-22
references.pmid: 18458136
references.citation: Antimicrob Agents Chemother. 2012 May;56(5):2518-23
references.pmid: 22314534
references.citation: Diagn Microbiol Infect Dis. 2011 Jan;69(1):45-50
references.pmid: 21146713
references.citation: Int J Antimicrob Agents. 2009 Sep;34(3):205-9
references.pmid: 19409759
references.citation: Drug Resist Updat. 2011 Jun;14(3):164-76
references.pmid: 21353623
references.citation: J Clin Microbiol. 2010 May;48(5):1782-6
references.pmid: 20220169
references.citation: J Microbiol Immunol Infect. 2014 Apr;47(2):95-103
references.pmid: 23063082