Species Identification and Antifungal Susceptibility Testing of Candida Bloodstream Isolates from Population-Based Surveillance Studies in Two US Cities from 2008 to 2011
Species Identification and Antifungal Susceptibility Testing of Candida Bloodstream Isolates from Population-Based Surveillance Studies in Two US Cities from 2008 to 2011
复制标题
DOI：
10.1128/jcm.01283-12
复制
发表时间：
2012-11-01
影响因子：
9.4
通讯作者：
Chiller, Tom
中科院分区：
文献类型：
--
作者：
Lockhart, Shawn R.;Iqbal, Naureen;Chiller, Tom
2008年至2011年期间，在佐治亚州亚特兰大和马里兰州巴尔的摩进行了基于人群的念珠菌血症监测。此前曾于1992年至1993年在亚特兰大和1998年至2000年在巴尔的摩进行过监测，这是美国首次在多个时间点进行的基于人群的念珠菌血症监测。从目前监测的2,675例念珠菌血症中，收集了2,329株念珠菌。白色念珠菌不再构成大多数分离株，但仍然是最常见的分离菌种（38%），其次是光滑念珠菌（29%）、近平滑念珠菌（17%）和热带念珠菌（10%）。随着时间的推移，物种分布发生了变化;在亚特兰大和巴尔的摩，C.白色念珠菌的比例下降，C. glabrata菌株的比例增加，而C.近平滑分离株仅在巴尔的摩增加。共发现98个多种类群，其中C.白色念珠菌和念珠菌。glabrata是最常见的组合。将新的种属特异性CLSI念珠菌MIC折点应用于这些数据。除C.光滑念珠菌（11.9%）对氟康唑的耐药率很低（2.3%）。白色念珠菌占6.2%; tropicalis和C.近平滑）。氟康唑耐药率在两个监测期之间无变化。总体棘白菌素耐药性较低（1%的分离株），但对C。glabrata分离株，范围从巴尔的摩的2.1%卡泊芬净耐药分离株到亚特兰大的3.1%阿尼芬净耐药分离株。考虑到两个位点的增加和棘白菌素抗性的提高，C。在未来的监测中应密切监测光滑。
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 to 1993 and in Baltimore in 1998 to 2000, making this the first population-based candidemia surveillance conducted over multiple time points in the United States. 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 Candida glabrata (29%), Candida parapsilosis (17%), and Candida tropicalis (10%). The species distribution has changed over time; in both Atlanta and Baltimore the proportion of C. albicans isolates decreased, and the proportion of C. glabrata isolates increased, while the proportion of C. parapsilosis isolates increased in Baltimore only. There were 98 multispecies 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% of isolates 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% of isolates) but was higher for C. glabrata isolates, ranging from 2.1% isolates resistant to caspofungin in Baltimore to 3.1% isolates 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.