Candida krusei, a multidrug-resistant opportunistic fungal pathogen:: Geographic and temporal trends from the ARTEMIS DISK Antifungal Surveillance Program, 2001 to 2005
Candida krusei, a multidrug-resistant opportunistic fungal pathogen:: Geographic and temporal trends from the ARTEMIS DISK Antifungal Surveillance Program, 2001 to 2005
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DOI：
10.1128/jcm.01915-07
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发表时间：
2008-02-01
影响因子：
9.4
通讯作者：
Veselov, A.
中科院分区：
文献类型：
--
作者：
Pfaller, M. A.;Diekema, D. J.;Veselov, A.
克柔念珠菌是众所周知的血液恶性肿瘤患者和移植受者的真菌病原体。使用 ARTEMIS 抗真菌监测计划数据库，我们描述了从临床标本中分离克柔念珠菌的地理和时间趋势，以及通过 CLSI（以前称为 NCCLS）纸片扩散测试确定的 3,448 个分离株对伏立康唑的体外敏感性。此外，我们报告了通过 CLSI 肉汤微量稀释方法测定的克柔梭菌血流感染分离株对两性霉素 B（304 株）、氟胞嘧啶（254 株）、阿尼芬净（121 株）、卡泊芬净（300 株）和米卡芬净（102 株）的体外敏感性。隔离的地理差异很明显；捷克共和国的隔离频率最高（7.6%），印度尼西亚、韩国和泰国的隔离频率最低（0 至 0.3%）。总体而言，83% 的分离株对伏立康唑敏感，范围从拉丁美洲的 74.8% 到北美的 92.3%。克柔梭菌最常见于血液肿瘤科服务，其中只有 76.7% 的分离株对伏立康唑敏感。从 2001 年到 2005 年，没有证据表明克柔梭菌对伏立康唑的耐药性增加。注意到对两性霉素 B（90% 分离株被抑制的 MIC [MIC90]，4 μg/ml）和氟胞嘧啶（MIC90，16 μg/ml）的敏感性降低，而 100% 分离株被抑制
Candida krusei is well known as a fungal pathogen for patients with hematologic malignancies and for transplant recipients. Using the ARTEMIS Antifungal Surveillance Program database, we describe geographic and temporal trends in the isolation of C. krusei from clinical specimens and the in vitro susceptibilities of 3,448 isolates to voriconazole as determined by CLSI (formerly NCCLS) disk diffusion testing. In addition, we report the in vitro susceptibilities of bloodstream infection isolates of C. krusei to amphotericin B (304 isolates), flucytosine (254 isolates), anidulafungin (121 isolates), caspofungin (300 isolates), and micafungin (102 isolates) as determined by CLSI broth microdilution methods. Geographic differences in isolation were apparent; the highest frequency of isolation was seen for the Czech Republic (7.6%) and the lowest for Indonesia, South Korea, and Thailand (0 to 0.3%). Overall, 83% of isolates were susceptible to voriconazole, ranging from 74.8% in Latin America to 92.3% in North America. C. krusei was most commonly isolated from hematology-oncology services, where only 76.7% of isolates were susceptible to voriconazole. There was no evidence of increasing resistance of C. krusei to voriconazole from 2001 to 2005. Decreased susceptibilities to amphotericin B (MIC at which 90% of isolates were inhibited [MIC90], 4 mu g/ml) and flucytosine (MIC90, 16 mu g/ml) were noted, whereas 100% of isolates were inhibited by