Table 1.
Species distribution and antifungal susceptibilities of 829 Candida bloodstream isolates from 370 ICU and 437 non-ICU patients in 11 hospitals over a two-year period.
| Species | No (%) of Isolates | No. (%) Fluconazole Resistance 1 | No. (%) Micafungin Resistance 1 | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Total | ICU | Non-ICU | Total | ICU | Non-ICU | Total | ICU | Non-ICU | |
| C. albicans | 353 (42.6) | 156 (40.7) | 197 (44.2) | 1 (0.3) | 0 (0.0) | 1 (0.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. glabrata | 159 (19.2) | 65 (17.0) | 94 (21.1) | 10 (6.3) | 6 (9.2) | 4 (4.3) | 1 (0.6) | 1 (1.5) | 0 (0.0) |
| C. tropicalis | 156 (18.8) | 89 (23.2) 2 | 67 (15.0) | 2 (1.3) | 1 (1.1) | 1 (1.5) | 1 (0.6) | 0 (0.0) | 1 (1.5) |
| C. parapsilosis | 112 (13.5) | 49 (12.8) | 63 (14.1) | 4 (3.6) | 4 (8.2) 2 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. krusei | 15 (1.8) | 10 (2.6) | 5 (1.1) | 15 (100) | 10 (100) | 5 (100) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. lusitaniae | 9 (1.1) | 5 (1.3) | 4 (0.9) | 1 (11.1) | 1 (20.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. guilliermondii | 8 (1.0) | 1 (0.3) | 7 (1.6) | 1 (12.5) | 1 (100) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| C. dubliniensis | 1 (0.1) | 1 (0.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | - | 0 (0.0) | 0 (0.0) | - |
| Others 3 | 16 (1.9) | 7 (1.8) | 9 (2.0) | NA | NA | NA | NA | NA | NA |
| Total | 829 (100) 4 | 383 (100) | 446 (100) | 34 (4.2) | 23 (6.1) 2 | 11 (2.5) | 2 (0.2) | 1 (0.3) | 1 (0.2) |
Abbreviations: ICU, intensive care unit; NA, non-applicable. 1 Total proportion of isolates for which the MICs exceed the current Clinical and Laboratory Standards Institute (CLSI) species-specific breakpoints or epidemiological cutoff values [18,19,20]. Total resistance to fluconazole was evident in 4.2% (34/813), 6.1% (23/376), and 2.5% (11/437) of the total, ICU, and non-ICU isolates, respectively; resistance to micafungin was evident in 0.2% (2/813), 0.3% (1/376), and 0.2% (1/437) of the total, ICU, and non-ICU isolates, respectively. 2 p-value < 0.05, ICU vs. non-ICU. 3 Other Candida species, for which CLSI breakpoints or epidemiological cutoff values are absent, include 7 isolates (2 C. haemulonii, 2 C. pelliculosa, 1 C. fabianii, 1 C. lipolytica, and 1 C. utilis) from ICU patients and 9 isolates (2 C. intermedia, 2 C. orthopsilosis, 1 C. haemulonii, 1 C. pelliculosa, 1 C. auris, 1 C. metapsilosis, and 1 C. norvegensis) from non-ICU patients. 4 A total of 829 non-duplicate Candida bloodstream isolates from 807 patients. Only one Candia species was recovered from 786 patients, but more than two different Candida species were recovered from 21 patients (9 C. albicans + C. glabrata, 3 C. albicans + C. tropicalis, 2 C. tropicalis + C. krusei, 1 C. albicans + C. guilliermondii, 1 C. albicans + C. lusitaniae + C. intermedia, 1 C. albicans + C. dublinensis, 1 C. tropicalis + C. glabrata, 1 C. tropicalis + C. lusitaniae, 1 C. glabrata + C. parapsilosis, and 1 C. glabrata + C. guilliermondii).