Species distribution and antifungal susceptibility of invasive Candida isolates from Canadian hospitals: results of the CANWARD 2011-16 study

被引：28

作者：

Fuller, Jeff ^{[1
,2
]}

Dingle, Tanis C. ^{[3
,4
]}

Bull, Amy ^{[3
]}

Shokoples, Sandy ^{[3
]}

Laverdiere, Michel ^{[5
]}

Baxter, Melanie R. ^{[6
]}

Adam, Heather J. ^{[6
,7
]}

Karlowsky, James A. ^{[6
,7
]}

Zhanel, George G. ^{[6
]}

Hoban, Daryl J.

Nichol, Kimberly A.

Lagace-Wiens, Philippe R. S.

Walkty, Andrew

Blondeau, J. ^{[8
]}

Slinger, R. ^{[9
]}

Davidson, R. ^{[10
]}

Zhanel, G. ^{[11
]}

Hoban, D. ^{[11
]}

Delport, J. ^{[12
]}

Ellis, C. ^{[13
]}

Laverdiere, M. ^{[14
]}

Loo, V ^{[15
,16
]}

Poutanen, S. ^{[17
]}

Fuller, J. ^{[18
]}

Roscoe, D. ^{[19
]}

Desjardins, M. ^{[20
]}

Matukas, L. ^{[21
]}

Goyette, M. ^{[22
]}

Lee, C. ^{[23
]}

Carignan, A. ^{[24
]}

Bergevin, M. ^{[25
]}

Pelletier, R. ^{[26
]}

机构：

[1] Western Univ, Schulich Sch Med & Dent, Dept Pathol & Lab Med, London, ON N6A 5C1, Canada

[2] London Hlth Sci Ctr, Div Microbiol, 800 Commissioners Rd E, London, ON N6A 5W9, Canada

[3] Alberta Hlth Serv, Prov Lab, 8440-112 St, Edmonton, AB T6G 2B7, Canada

[4] Univ Alberta, Dept Lab Med & Pathol, Edmonton, AB T6G 2B7, Canada

[5] Hop Maison Neuve Rosemont, Dept Med Microbiol & Infect Dis, Montreal, PQ H1T 2M4, Canada

[6] Univ Manitoba, Max Rady Coll Med, Dept Med Microbiol Infect Dis, Room 543-745 Bannatyne Ave, Winnipeg, MB R3E 0J9, Canada

[7] Diagnost Serv, Clin Microbiol, MS673-820 Sherbrook St, Winnipeg, MB R3A 1R9, Canada

[8] Royal Univ Hosp, Saskatoon, SK, Canada

[9] Childrens Hosp Eastern Ontario, Ottawa, ON, Canada

[10] Queen Elizabeth 2 Hlth Sci Ctr, Halifax, NS, Canada

[11] Hlth Sci Ctr, Winnipeg, MB, Canada

[12] London Hlth Sci Ctr, London, ON, Canada

[13] South East Hlth Care Corp, Moncton, NB, Canada

[14] Hop Maison Neuve Rosemont, Montreal, PQ, Canada

[15] Montreal Gen Hosp, Montreal, PQ, Canada

[16] Royal Victoria Hosp, Montreal, PQ, Canada

[17] Univ Hlth Network, Mt Sinai Hosp, Toronto, ON, Canada

[18] Univ Alberta Hosp, Edmonton, AB, Canada

[19] Vancouver Hosp, Vancouver, BC, Canada

[20] Ottawa Hosp, Ottawa, ON, Canada

[21] St Michaels Hosp, Toronto, ON, Canada

[22] CHRTR Pavillon Ste Marie, Trois Rivieres, PQ, Canada

[23] St Josephs Hosp, Hamilton, ON, Canada

[24] Ctr Hosp Univ Sherbrooke, Sherbrooke, PQ, Canada

[25] Cite Sante, Laval, PQ, Canada

[26] Hotel Dieu Quebec, Quebec City, PQ, Canada

来源：

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY | 2019年 / 74卷

关键词：

ESCMID-ASTERISK GUIDELINE; BLOOD-STREAM INFECTIONS; ECHINOCANDIN RESISTANCE; ALLIANCE(R) REGISTRY; CASPOFUNGIN MICS; FKS MUTATIONS; SURVEILLANCE; EPIDEMIOLOGY; MANAGEMENT; OUTCOMES;

D O I：

10.1093/jac/dkz287

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: Understanding the epidemiology of invasive Candida infections is essential to patient management decisions and antifungal stewardship practices. This study characterized the species distribution and antifungal susceptibilities of prospectively collected isolates of Candida species causing bloodstream infections (BSIs) in patients admitted to tertiary care hospitals located in 14 cities across 8 of the 10 Canadian provinces between 2011 and 2016. Methods: Antifungal susceptibility testing was performed by broth microdilution using CLSI methods, breakpoints and epidemiological cut-off values. DNA sequencing of fks loci was performed on all echinocandin-non-susceptible isolates. Results: Candida albicans (49.6%), Candida glabrata (20.8%) and Candida parapsilosis complex (12.0%) were the most common species out of 1882 isolates associated with BSIs. Candida tropicalis (5.2%), Candida krusei (4.3%), Candida dubliniensis (4.1%), Candida lusitaniae (1.4%) and Candida guilliermondii (1.1%) were less frequently isolated. Between 2011 and 2016, the proportion of C. albicans significantly decreased from 60.9% to 42.1% (P=0.0001) while that of C. glabrata significantly increased from 16.4% to 22.4% (P=0.023). C. albicans (n=934), C. glabrata (n=392) and C. parapsilosis complex (n=225) exhibited 0.6%, 1.0% and 4.9% resistance to fluconazole and 0.1%, 2.5% and 0% resistance to micafungin, respectively. Mutations in fks hot-spot regions were confirmed in all nine micafungin non-susceptible C. glabrata. Conclusions: Antifungal resistance in contemporary isolates of Candida causing BSIs in Canada is uncommon. However, the proportion of C. glabrata isolates has increased and echinocandin resistance in this species has emerged. Ongoing surveillance of local hospital epidemiology and appropriate antifungal stewardship practices are necessary to preserve the utility of available antifungal agents.

引用

页码：48 / 54

页数：7

共 44 条

[1] Prevalence of antimicrobial resistant pathogens from blood cultures from Canadian hospitals: results of the CANWARD 2007-2009 study [J].

Adam, Heather J. ;

DeCorby, Melanie ;

Rennie, Robert ;

Karlowsky, James A. ;

Hoban, Daryl J. ;

Zhanel, George G. .

DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2011, 69 (03) :307-313

[2] Increasing Echinocandin Resistance in Candida glabrata: Clinical Failure Correlates With Presence of FKS Mutations and Elevated Minimum Inhibitory Concentrations [J].

Alexander, Barbara D. ;

Johnson, Melissa D. ;

Pfeiffer, Christopher D. ;

Jimenez-Ortigosa, Cristina ;

Catania, Jelena ;

Booker, Rachel ;

Castanheira, Mariana ;

Messer, Shawn A. ;

Perlin, David S. ;

Pfaller, Michael A. .

CLINICAL INFECTIOUS DISEASES, 2013, 56 (12) :1724-1732

[3] Epidemiological changes with potential implication for antifungal prescription recommendations for fungaemia: data from a nationwide fungaemia surveillance programme [J].

Arendrup, M. C. ;

Dzajic, E. ;

Jensen, R. H. ;

Johansen, H. K. ;

Kjaeldgaard, P. ;

Knudsen, J. D. ;

Kristensen, L. ;

Leitz, C. ;

Lemming, L. E. ;

Nielsen, L. ;

Olesen, B. ;

Rosenvinge, F. S. ;

Roder, B. L. ;

Schonheyder, H. C. .

CLINICAL MICROBIOLOGY AND INFECTION, 2013, 19 (08) :E343-E353

[4] Echinocandin resistance: an emerging clinical problem? [J].

Arendrup, Maiken C. ;

Perlin, David S. .

CURRENT OPINION IN INFECTIOUS DISEASES, 2014, 27 (06) :484-492

[5] National Surveillance of Fungemia in Denmark (2004 to 2009) [J].

Arendrup, Maiken Cavling ;

Bruun, Brita ;

Christensen, Jens Jorgen ;

Fuursted, Kurt ;

Johansen, Helle Krogh ;

Kjaeldgaard, Poul ;

Knudsen, Jenny Dahl ;

Kristensen, Lise ;

Moller, Jens ;

Nielsen, Lene ;

Rosenvinge, Flemming Schonning ;

Roder, Bent ;

Schonheyder, Henrik Carl ;

Thomsen, Marianne K. ;

Truberg, Kjeld .

JOURNAL OF CLINICAL MICROBIOLOGY, 2011, 49 (01) :325-334

[6] Heteroresistance to Fluconazole Is a Continuously Distributed Phenotype among Candida glabrata Clinical Strains Associated with In Vivo Persistence [J].

Ben-Ami, Ronen ;

Zimmerman, Offer ;

Finn, Talya ;

Amit, Sharon ;

Novikov, Anna ;

Wertheimer, Noa ;

Lurie-Weinberger, Mor ;

Berman, Judith .

MBIO, 2016, 7 (04)

[7] FKS Mutant Candida glabrata: Risk Factors and Outcomes in Patients With Candidemia [J].

Beyda, Nicholas D. ;

John, Julie ;

Kilic, Abdullah ;

Alam, Mohammad J. ;

Lasco, Todd M. ;

Garey, Kevin W. .

CLINICAL INFECTIOUS DISEASES, 2014, 59 (06) :819-825

[8] Canadian clinical practice guidelines for invasive candidiasis in adults [J].

Bow, Eric J. ;

Evans, Gerald ;

Fuller, Jeff ;

Laverdiere, Michel ;

Rotstein, Coleman ;

Rennie, Robert ;

Shafran, Stephen D. ;

Sheppard, Don ;

Carle, Sylvie ;

Phillips, Peter ;

Vinh, Donald C. .

CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY, 2010, 21 (04) :E122-E150

[9]

Castanheira M, 2017, ANTIMICROB AGENTS CH, V61, DOI [10.1128/AAC.00906-17, 10.1128/aac.00906-17]

[10] Antifungal susceptibility patterns of a global collection of fungal isolates: results of the SENTRY Antifungal Surveillance Program (2013) [J].

Castanheira, Mariana ;

Messer, Shawn A. ;

Rhomberg, Paul R. ;

Pfaller, Michael A. .

DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2016, 85 (02) :200-204

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