The epidemiology of non-Candida yeast isolated from blood: The Asia Surveillance Study
Journal
Mycoses
Journal Volume
62
Journal Issue
2
Pages
112
Date Issued
2019-02-01
Author(s)
Lin, Shang Yi
Lu, Po Liang
Tan, Ban Hock
Chakrabarti, Arunaloke
Yang, Jui Hsuan
Patel, Atul K.
Li, Ruo Yu
Watcharananan, Siriorn P.
Liu, Zhengyin
Chindamporn, Ariya
Tan, Ai Ling
Sun, Pei Lun
Hsu, Li Yin
Xu, Ying Chun
Wang, Hui
Sun, Zi Yong
Wang, Lan Lan
Lu, Juan
Yang, Qing
Zhang, Qiang Qiang
Shao, Hai Feng
Liao, Kang
Woo, Patrick C.Y.
Marak, Rungmei S.K.
Kindo, Anupma Jyoti
Wu, Chieh Liang
Ho, Mao Wang
Wang, Lih Shinn
Riengchan, Pattaya
the Asia Fungal Working Group (AFWG)
Abstract
© 2018 The Authors. Mycoses Published by Blackwell Verlag GmbH Background: Current guidelines recommend echinocandins as first-line therapy for candidemia. However, several non-Candida yeast are non-susceptible to echinocandins (echinocandin non-susceptible yeast, ENSY), including Cryptococcus, Geotrichum, Malassezia, Pseudozyma, Rhodotorula, Saprochaete, Sporobolomyces and Trichosporon. In laboratories that are not equipped with rapid diagnostic tools, it often takes several days to identify yeast, and this may lead to inappropriate presumptive use of echinocandins in patients with ENSY fungemia. The aim of this study was to determine the distribution of ENSY species during a 1-year, laboratory surveillance programme in Asia. Methods: Non-duplicate yeast isolated from blood or bone marrow cultures at 25 hospitals in China, Hong Kong, India, Singapore, Taiwan and Thailand were analysed. Isolates were considered to be duplicative if they were obtained within 7 days from the same patient. Results: Of 2155 yeast isolates evaluated, 175 (8.1%) were non-Candida yeast. The majority of non-Candida yeast were ENSY (146/175, 83.4%). These included Cryptococcus (109 isolates), Trichosporon (23), Rhodotorula (10) and Malassezia (4). The proportion of ENSY isolates (146/2155, 6.7%) differed between tropical (India, Thailand and Singapore; 51/593, 8.6%) and non-tropical countries/regions (China, Hong Kong and Taiwan; 95/1562, 6.1%, P = 0.038). ENSY was common in outpatient clinics (25.0%) and emergency departments (17.8%) but rare in intensive care units (4.7%) and in haematology-oncology units (2.9%). Cryptococcus accounted for the majority of the non-Candida species in emergency departments (21/24, 87.5%) and outpatient clinics (4/5, 80.0%). Conclusions: Isolation of non-Candida yeast from blood cultures was not rare, and the frequency varied among medical units and countries.
Subjects
candidemia | echinocandin | fungemia | presumptive therapy | yeast
candidemia; echinocandin; fungemia; presumptive therapy; yeast
SDGs
Other Subjects
Article; Asia; blood culture; bone marrow culture; China; disease surveillance; emergency ward; Filobasidiella; fungemia; fungus isolation; Hong Kong; human; India; intensive care unit; Kodamaea; Malassezia; nonhuman; Ogataea angusta; outpatient department; priority journal; Rhodotorula; Singapore; species distribution; Taiwan; Thailand; Trichosporon; Wickerhamomyces anomalus; Yarrowia lipolytica; blood; bone marrow; classification; cross-sectional study; epidemiological monitoring; fungemia; hospital; isolation and purification; microbiology; prevalence; yeast; Asia; Blood; Bone Marrow; Cross-Sectional Studies; Epidemiological Monitoring; Fungemia; Hospitals; Humans; Prevalence; Yeasts
Publisher
WILEY
Type
journal article