International surveillance of bloodstream infections due to Candida species:: Frequency of occurrence and in vitro susceptibilities to fluconazole, ravuconazole, and voriconazole of isolates collected from 1997 through 1999 in the SENTRY antimicrobial surveillance program
International surveillance of bloodstream infections due to Candida species:: Frequency of occurrence and in vitro susceptibilities to fluconazole, ravuconazole, and voriconazole of isolates collected from 1997 through 1999 in the SENTRY antimicrobial surveillance program
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DOI：
10.1128/jcm.39.9.3254-3259.2001
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发表时间：
2001-09-01
影响因子：
9.4
通讯作者：
Messer, SA
中科院分区：
文献类型：
--
作者：
Pfaller, MA;Diekema, DJ;Messer, SA
1997 年至 1999 年美国、加拿大、拉丁美洲和欧洲的血流感染 (BSI) 监测计划 (SENTRY) 在 71 个医疗中心检测到 1,184 例念珠菌血症（美国 32 例、欧洲 23 例、拉丁美洲 9 例、加拿大 7 例）。总体而言，55% 的酵母 BSI 是由白色念珠菌引起的，其次是光滑念珠菌和近光滑念珠菌 (15%)、热带念珠菌 (9%) 和杂念珠菌属。 (6%)。在美国，45% 的念珠菌血症是由非念珠菌引起的。白色念珠菌种。 C. glabrata (21%) 是最常见的非 C. glabrata。美国的白色念珠菌种类，以及非念珠菌的比例。拉丁美洲的白色念珠菌 BSI 最高 (55%)。在加拿大，白色念珠菌占 BSI 的 60%，在欧洲占 58%。 C. parapsilosis 是最常见的非 C. parapsilosis。拉丁美洲 (25%)、加拿大 (16%) 和欧洲 (17%) 的白色念珠菌种类。白色念珠菌、近平滑念珠菌和热带念珠菌的分离株均对氟康唑高度敏感（小于或等于 8 微克/毫升时为 97% 至 100%）。同样，这些物种中的97％至100％被小于或等于1μg/ml的雷夫康唑（抑制50％的浓度[MIC50]，0.007至0.03μg/ml）或伏立康唑（MIC50，0.007至0.06μg/ml）抑制。雷伐康唑和伏立康唑对光滑念珠菌的活性均显着高于氟康唑（（MIC（90）分别为 0.5 至 1.0 微克/毫升 vs 16 至 32 微克/毫升）。在三年期间注意到光滑念珠菌对氟康唑敏感性增加的趋势。对氟康唑敏感的光滑念珠菌分离株的百分比从 2017 年的 48% 增加到1997 年至 1999 年，MIC(50) 从 16 微克/毫升降至 4 微克/毫升，在美洲（57% 至 84% 易感）和欧洲（22% 至 80% 易感）中发现了类似的趋势，加拿大分离株通常比美国和欧洲分离株更易感。并提出其他问题，这些问题只能通过此处报告的类型的持续监测和临床研究（哨兵计划）来回答。
A surveillance program (SENTRY) of bloodstream infections (BSI) in the United States, Canada, Latin America, and Europe from 1997 through 1999 detected 1,184 episodes of candidemia in 71 medical centers (32 in the United States, 23 in Europe, 9 in Latin America, and 7 in Canada). Overall, 55% of the yeast BSIs were due to Candida albicans, followed by Candida glabrata and Candida parapsilosis (15%), Candida tropicalis (9%), and miscellaneous Candida spp. (6%). In the United States, 45% of candidemias were due to non-C. albicans species. C. glabrata (21%) was the most common non-C. albicans species in the United States, and the proportion of non-C. albicans BSIs was highest in Latin America (55%). C. albicans accounted for 60% of BSI in Canada and 58% in Europe. C. parapsilosis was the most common non-C. albicans species in Latin America (25%), Canada (16%), and Europe (17%). Isolates of C. albicans, C. parapsilosis, and C. tropicalis were all highly susceptible to fluconazole (97 to 100% at less than or equal to8 mug/ml). Likewise, 97 to 100% of these species were inhibited by less than or equal to1 mug/ml of ravuconazole (concentration at which 50% were inhibited [MIC50], 0.007 to 0.03 mug/ml) or voriconazole (MIC50, 0.007 to 0.06 mug/ml). Both ravaconazole and voriconazole were significantly more active than fluconazole against C. glabrata ((MIC(90)s of 0.5 to 1.0 mug/ml versus 16 to 32 mug/ml, respectively). A trend of increased susceptibility of C.. glabrata to fluconazole was noted over the three-year period. The percentage of C. glabrata isolates susceptible to fluconazole increased from 48% in 1997 to 84% in 1999, and MIC(50)s decreased from 16 to 4 mug/ml. A similar trend was documented in both the Americas (57 to 84% susceptible) and Europe (22 to 80% susceptible). Some geographic differences in susceptibility to triazole were observed with Canadian isolates generally more susceptible than isolates from the United States and Europe. These observations suggest susceptibility patterns and trends among yeast isolates from BSI and raise additional questions that can be answered only by continued surveillance and clinical investigations of the type reported here (SENTRY Program).