National Institutes of Infectious Diseases and Vaccinology, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli, 350, Taiwan.
J Infect Chemother. 2013 Dec;19(6):1065-71. doi: 10.1007/s10156-013-0623-8. Epub 2013 Jun 4.
Invasive fungal infections have increased significantly in the past few decades because of the increase in high-risk populations. To investigate the distribution and drug susceptibilities of such infections, we analyzed all 152 Candida isolates causing candidemia from 2004 to 2006 at the China Medical University Hospital, a medical center in central Taiwan. Candida albicans was the most common species, accounting for 52.6% of the isolates, followed by C. tropicalis (19.7%), C. parapsilosis (14.5%), C. glabrata (8.6%), C. guilliermondii (3.9%), and C. pelliculosa (0.7%). All isolates were susceptible to amphotericin B, anidulafungin, micafungin, and voriconazole according to minimum inhibitory concentrations (MICs) after a 24-h incubation; 0.7%, 6.6%, and 7.9% of isolates were resistant to amphotericin B, fluconazole, and voriconazole, respectively, after 48-h incubation. Both C. albicans and C. parapsilosis had high degrees of agreement for azoles between 24- and 48-h incubation periods, whereas C. glabrata (38.5-46.2%) and C. tropicalis (56.7-63.3%) did not. The majority of the isolates with high azole MICs displayed a trailing growth phenotype. Hence, the MICs of different drugs after 24-h incubation may be considered for prognosis of candidemia.
在过去的几十年中，由于高危人群的增加，侵袭性真菌感染显著增加。为了研究这些感染的分布和药物敏感性，我们分析了 2004 年至 2006 年中国医科大学附属医院（台湾中部的一家医疗中心）所有 152 株引起念珠菌血症的念珠菌分离株。白色念珠菌是最常见的物种，占分离株的 52.6%，其次是热带念珠菌（19.7%）、近平滑念珠菌（14.5%）、光滑念珠菌（8.6%）、季也蒙念珠菌（3.9%）和乳脂念珠菌（0.7%）。根据 24 小时孵育后的最小抑菌浓度（MIC），所有分离株均对两性霉素 B、阿尼达霉素、米卡芬净和伏立康唑敏感；经过 48 小时孵育，分别有 0.7%、6.6%和 7.9%的分离株对两性霉素 B、氟康唑和伏立康唑耐药。白色念珠菌和近平滑念珠菌在 24 小时和 48 小时孵育期间对唑类药物的一致性较高，而光滑念珠菌（38.5-46.2%）和热带念珠菌（56.7-63.3%）则不一致。大多数高唑类 MIC 分离株表现出滞后生长表型。因此，24 小时孵育后不同药物的 MIC 可用于预测念珠菌血症的预后。
