Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
J Antimicrob Chemother. 2013 Nov;68(11):2632-5. doi: 10.1093/jac/dkt214. Epub 2013 Jun 13.
This study was intended to analyse the clinical characteristics and outcomes of patients with infections due to Candida guilliermondii complex and evaluate in vitro susceptibilities of the isolates.
We searched the Mycology Database of the National Taiwan University Hospital and identified patients with infections due to C. guilliermondii complex from 2001 to 2010. Isolates were identified to species level by two yeast identification systems and restriction fragment length polymorphism of the riboflavin synthetase gene. MICs of nine antifungal agents were determined using the Sensititre YeastOne system (Trek Diagnostic Systems) and were interpreted by breakpoints (BPs) for three echinocandins and epidemiological cut-off values (ECVs) for the other agents.
Fifty-two patients with infections due to C. guilliermondii complex were evaluated. The majority (90%, n = 47) of the isolates were C. guilliermondii, followed by Candida fermentati (10%, n = 5). Among them, 42 (81%) were isolated from blood cultures. Among the 52 patients, 27 (52%) had underlying malignancy and 15 (29%) had undergone abdominal surgery. The 30 day mortality rates among patients with C. guilliermondii and C. fermentati infections were 45% and 60%, respectively. Among C. guilliermondii isolates, 98%, 100% and 98% were susceptible to caspofungin, micafungin and anidulafungin, respectively, by BPs. Nearly all (96%-100%) C. guilliermondii isolates belonged to wild-type for the other agents by ECVs. All five C. fermentati were susceptible to three echinocandins and belonged to wild-type for the other agents.
The currently used antifungal agents exhibited good in vitro activities against C. guilliermondii complex isolates.
本研究旨在分析感染假丝酵母菌复合群的患者的临床特征和结局，并评估分离株的体外药敏情况。
我们检索了台湾大学医院真菌数据库，并从 2001 年至 2010 年期间确定了感染假丝酵母菌复合群的患者。通过两种酵母鉴定系统和核黄素合成酶基因的限制性片段长度多态性，将分离株鉴定到种的水平。使用 Sensititre YeastOne 系统（Trek 诊断系统）测定 9 种抗真菌药物的 MIC，并根据 3 种棘白菌素的折点（BP）和其他药物的流行病学临界值（ECV）进行解释。
评估了 52 例感染假丝酵母菌复合群的患者。大多数（90%，n=47）分离株为假丝酵母菌，其次为假丝酵母菌（10%，n=5）。其中，42 株（81%）来自血培养。在 52 例患者中，27 例（52%）有恶性肿瘤，15 例（29%）接受过腹部手术。假丝酵母菌和假丝酵母菌感染患者的 30 天死亡率分别为 45%和 60%。根据 BP，假丝酵母菌分离株对卡泊芬净、米卡芬净和阿尼芬净的敏感性分别为 98%、100%和 98%。根据 ECV，几乎所有（96%-100%）假丝酵母菌分离株对其他药物均属于野生型。5 株假丝酵母菌均对 3 种棘白菌素敏感，且对其他药物均属于野生型。
目前使用的抗真菌药物对假丝酵母菌复合群分离株表现出良好的体外活性。
