Regional data analysis of Candida non-albicans strains collected in United States medical sites over a 6-year period, 2006-2011

Mycoses. 2014 Oct;57(10):602-11. doi: 10.1111/myc.12206. Epub 2014 May 26.

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.

Keywords: Non-albicans Candida; antifungal resistance; surveillance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifungal Agents / pharmacology
  • Candida / classification
  • Candida / drug effects
  • Candida / genetics
  • Candida / isolation & purification*
  • Candidiasis / epidemiology
  • Candidiasis / microbiology*
  • Drug Resistance, Fungal
  • Hospitals
  • Microbial Sensitivity Tests
  • United States

Substances

  • Antifungal Agents