Clinical features of patients with infections caused by candida guilliermondii and candida fermentati and antifungal susceptibility of the isolates at a medical centre in taiwan, 2001-10

Abstract

Objectives: This studywas intended to analyse the clinical characteristicsandoutcomes of patients with infections due to Candida guilliermondii complex and evaluate in vitro susceptibilities of the isolates. Methods:We searched the Mycology Database of the National Taiwan University Hospital and identified patients with infections due to C. guilliermondii complex from2001 to 2010. Isolateswere 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. Results: 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. Conclusions: The currently used antifungal agents exhibited good in vitro activities against C. guilliermondii complex isolates. ? e Author.Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. ? The Author 2013. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.