Epidemiology and antifungal susceptibility of candidemia isolates of non-albicans Candida species from cancer patients

Emerg Microbes Infect. 2017 Oct 11;6(10):e87. doi: 10.1038/emi.2017.74.

Abstract

Candidemia is a growing concern worldwide, and its species distribution has shifted toward non-albicans Candida in recent decades, especially in patients with malignancy. This study aimed to update the epidemiology and antifungal susceptibility of non-albicans candidemia isolates from the cancer patients. Adult cancer patients with non-albicans candidemia were recruited, and clinical data were retrospectively collected from five medical centers in Taiwan from 1 July 2011 to 30 June 2014. In vitro susceptibility was determined by the broth dilution method using a Sensititre YeastOne system and interpreted according to the guidelines of the Clinical and Laboratory Standards Institute. A total of 346 episodes of non-albicans candidemia were identified in cancer patients. Candida tropicalis was the most common species (n=145, 41.9%) and had the highest resistance rate to fluconazole (n=17, 13.9%) among all the preserved isolates, including C. tropicalis, Candida glabrata and Candida parapsilosis. A higher Charlson comorbidity index, non-albicans candidemia due to C. tropicalis, neutropenia and septic shock were independent predictors of 28-day mortality. In conclusion, the species distribution and antifungal susceptibility of non-albicans candidemia isolates in our study differed from those in Western countries, providing useful information about local epidemiology for the selection of empirical antifungal agents for cancer patients.

Publication types

  • Multicenter Study

MeSH terms

  • Antifungal Agents / pharmacology*
  • Candida / classification
  • Candida / drug effects*
  • Candida / isolation & purification
  • Candidemia / complications
  • Candidemia / epidemiology
  • Candidemia / microbiology*
  • Candidemia / mortality
  • Drug Resistance, Fungal
  • Female
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / microbiology
  • Retrospective Studies
  • Risk Factors
  • Taiwan / epidemiology

Substances

  • Antifungal Agents