title: Regional data analysis of Candida non-albicans strains collected in United States medical sites over a 6-year period, 2006-2011.
abstract: Limited data are available on temporal and geographic variation of occurrence and antifungal resistance of non-C. albicans Candida species (non-CA-CSP) from the USA. The objective of this study was to evaluate the occurrence and antifungal resistance of 1694 isolates of non-CA-CSP collected during the period 2006-2011. Isolates were recovered in 33 hospitals located in four regions: Northcentral, North-east, South-east and West and tested using CLSI reference broth microdilution methods. Non-CA-CSP represented 55.6% of all Candida. C. glabrata was most predominant (39-42% of non-CA-CSP). Infections due to C. glabrata, C. krusei and C. dubliniensis increased over the 6 years. Anidulafungin (3.6%) and caspofungin (5.7%) resistance were prominent among C. glabrata from the North-east and West regions respectively. Resistance to micafungin was detected in 2.0% and 2.9% of C. glabrata from the West and North-east regions respectively. Echinocandin resistance was low, except for C. dubliniensis. Azole resistance was most prominent among C. glabrata from the South-east (13.6% fluconazole R) and the West (18.0%). Cross-resistance among three tested azoles was observed in C. glabrata from all regions. Whereas differences in species distribution and antifungal R varied across geographic regions, there was little evidence of temporal increase in resistance to azoles or echinocandins in the monitored non-CA-CSP.
authors.affiliation: JMI Laboratories, North Liberty, IA, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pfaller
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Jones
authors.forename: Mariana
authors.initials: M
authors.lastname: Castanheira
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology; D002175:Candida / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D002177:Candidiasis / Q000453:epidemiology / Q000382:microbiology*; D025141:Drug Resistance, Fungal; D006761:Hospitals; D008826:Microbial Sensitivity Tests; D014481:United States
chemical_list: D000935:Antifungal Agents
keywords: Non-albicans Candida; antifungal resistance; surveillance