alexa Species Identification and Antifungal Susceptibility of Candida Bloodstream Isolates from 2 Population-based Surveillance in Two US Cities: 2008-2011
Pathology

Pathology

Journal of Clinical & Experimental Pathology

Author(s): Shawn R Lockhart, Naureen Iqbal, Angela M Ahlquist, Carol B Bolden, Tom Chiller

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Between 2008 and 2011, population-based candidemia surveillance was conducted in Atlanta, GA and Baltimore, MD. Surveillance had been previously performed in Atlanta in 1992-1993 and in Baltimore in 1998-2000, making this the first population-based candidemia surveillance conducted over multiple time points in the US. From 2,675 identified cases of candidemia in the current surveillance, 2,329 Candida isolates were collected. Candida albicans no longer comprised the majority of isolates but remained the most frequently isolated species (38%), followed by C. glabrata (29%), C. parapsilosis (17%) and C. tropicalis (10%). The species distribution has changed over time; in both Atlanta and Baltimore the proportion of C. albicans decreased and the proportion of C. glabrata increased, while the proportion of C. parapsilosis increased in Baltimore only. There were 98 multi-species episodes, with C. albicans and C. glabrata the most frequently encountered combination. The new species-specific CLSI Candida MIC breakpoints were applied to these data. With the exception of C. glabrata (11.9% resistant), resistance to fluconazole was very low (2.3% for C. albicans, 6.2% for C.tropicalis and 4.1% for C. parapsilosis). There was no change in the proportion of fluconazole resistance between surveillance periods. Overall echinocandin resistance was low (1%) but was higher for C. glabrata isolates, ranging from 2.1% resistant to caspofungin in Baltimore to 3.1% resistant to anidulafungin in Atlanta. Given the increase at both sites and the higher echinocandin resistance, C. glabrata should be closely monitored in future surveillance.

This article was published in J. Clin. Microbiol. and referenced in Journal of Clinical & Experimental Pathology

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