Pfaller M A, Diekema D J, Colombo A L, Kibbler C, Ng K P, Gibbs D L, Newell V A
Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
J Clin Microbiol. 2006 Oct;44(10):3578-82. doi: 10.1128/JCM.00863-06.
Candida rugosa is a fungus that appears to be emerging as a cause of infection in some geographic regions. We utilized the extensive database of the ARTEMIS DISK Antifungal Surveillance Program to describe the geographic and temporal trends in the isolation of C. rugosa from clinical specimens and the in vitro susceptibilities of 452 isolates to fluconazole and voriconazole. C. rugosa accounted for 0.4% of 134,715 isolates of Candida, and the frequency of isolation increased from 0.03% to 0.4% over the 6.5-year study period (1997 to 2003). C. rugosa was most common in the Latin American region (2.7% versus 0.1 to 0.4%). Decreased susceptibility to fluconazole (40.5% susceptible) was observed in all geographic regions; however, isolates from Europe and North America were much more susceptible (97 to 100%) to voriconazole than those from other geographic regions (55.8 to 58.8%). C. rugosa was most often isolated from blood and urine in patients hospitalized at the Medical and Surgical inpatient services. Notably, bloodstream isolates were the least susceptible to both fluconazole and voriconazole. C. rugosa should be considered, along with the established pathogens Candida krusei and Candida glabrata, as a species of Candida with reduced susceptibility to the azole antifungal agents.
皱落假丝酵母菌是一种在某些地理区域似乎正逐渐成为感染源的真菌。我们利用ARTEMIS DISK抗真菌监测项目的广泛数据库，来描述从临床标本中分离出皱落假丝酵母菌的地理和时间趋势，以及452株分离株对氟康唑和伏立康唑的体外敏感性。皱落假丝酵母菌占134715株假丝酵母菌分离株的0.4%，在6.5年的研究期（1997年至2003年）内，分离频率从0.03%增至0.4%。皱落假丝酵母菌在拉丁美洲地区最为常见（2.7%，而其他地区为0.1%至0.4%）。在所有地理区域均观察到对氟康唑的敏感性降低（40.5%敏感）；然而，来自欧洲和北美的分离株对伏立康唑的敏感性（97%至100%）远高于其他地理区域的分离株（55.8%至58.8%）。皱落假丝酵母菌最常从内科和外科住院患者的血液和尿液中分离得到。值得注意的是，血流分离株对氟康唑和伏立康唑的敏感性最低。皱落假丝酵母菌应与已明确的病原菌克鲁斯假丝酵母菌和光滑假丝酵母菌一起，被视为对唑类抗真菌药物敏感性降低的假丝酵母菌菌种。
