Affiliation:
1. Medical Microbiology Division, Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa
Abstract
ABSTRACT
An international program of surveillance of bloodstream infections (BSI) in the United States, Canada, and Latin America detected 306 episodes of candidemia in 34 medical centers (22 in the United States, 6 in Canada, and 6 in Latin America) in 1997 and 328 episodes in 34 medical centers (22 in the United States, 5 in Canada, and 7 in Latin America) in 1998. Of the 634 BSI, 54.3% were due to
Candida albicans
, 16.4% were due to
C. glabrata
, 14.9% were due to
C. parapsilosis
, 8.2% were due to
C. tropicalis
, 1.6% were due to
C. krusei
, and 4.6% were due to other
Candida
spp. The percentage of BSI due to
C. albicans
decreased very slightly in the United States between 1997 and 1998 (56.2 to 54.4%;
P
= 0.68) and increased in both Canada (52.6 to 70.1%;
P
= 0.05) and Latin America (40.5 to 44.6%;
P
= 0.67).
C. glabrata
was the second most common species observed overall, and the percentage of BSI due to
C. glabrata
increased in all three geographic areas between 1997 and 1998.
C. parapsilosis
was the third most prevalent BSI isolate in both Canada and Latin America, accounting for 7.0 and 18.5% of BSI, respectively. Resistance to fluconazole (MIC, ≥64 μg/ml) and itraconazole (MIC, ≥1.0 μg/ml) was observed infrequently in both 1997 (2.3 and 8.5%, respectively) and 1998 (1.5 and 7.6%, respectively). Among the different species of
Candida
, resistance to fluconazole and itraconazole was observed in
C. glabrata
and
C. krusei
, whereas isolates of
C. albicans
,
C. parapsilosis
, and
C. tropicalis
were all highly susceptible to both fluconazole (98.9 to 100% susceptible) and itraconazole (96.4 to 100% susceptible). Isolates from Canada and Latin America were generally more susceptible to both triazoles than U.S. isolates were. Continued surveillance appears necessary to detect these important changes.
Publisher
American Society for Microbiology
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology
Cited by
311 articles.
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