Candida guilliermondii, an opportunistic fungal pathogen with decreased susceptibility to fluconazole: Geographic and temporal trends from the ARTEMIS DISK antifungal surveillance program

M. A. Pfaller, D. J. Diekema, M. Mendez, C. Kibbler, P. Erzsebet, S. C. Chang, D. L. Gibbs, V. A. Newell, Jorge Finquelievich, Nora Tiraboschi, David Ellis, Dominique Frameree, Annemarie van den Abeele, Jean Marc Senterre, Arnaldo Colombo, Robert Rennie, Steve Sanche, Bijie Hu, Yingchun Xu, Yingyuan ZhangNan Shan Zhong, Pilar Rivas, Angela Restrepo, Catalina Bedout, Ricardo Vega, Matilde Mendez, Nada Mallatova, Stanislava Dobiasova, Julio Ayabaca, Jeannete Zurita, M. Mallie, E. Candolfi, W. Fegeler, A. Haase, G. Rodloff, W. Bar, V. Czaika, George Petrikos, Erzsébet Puskás, Ilona Doczi, Mestyan Gyula, Radka Nikolova, Uma Banerjee, Nathan Keller, Vivian Tullio, Gian Carlo Schito, Giacomo Fortina, Gian Piero Testore, Domenico D'Antonio, Giorgio Scalise, Pietro Martino, Graziana Manno, Kee Peng, Celia Alpuche, Jose Santos, Eduardo Rodriguez Noriega, Mussaret Zaidi, Jacques F.G.M. Meis, Egil Lingaas, Danuta Dzierzanowska, Waclaw Pawliszyn, Mariada Luz Martins, Luis Albuquerque, Laura Rosado, Rosa Velho, Jose Amorim, Vera N. Ilina, Olga I. Kretchikova, Galina A. Klyasova, Sophia M. Rozanova, Irina G. Multykh, Nikolay N. Klimko, Elena D. Agapova, Natalya V. Dmitrieva, Abdul Mohsen Al-Rasheed, Jan Trupl, Leon Langsadl, Alena Vaculikova, Hupkova Helena, Denise Roditi, Anwar Hoosen, H. H. Crewe-Brown, M. N. Janse van Rensburg, Adriano Duse, Kyungwon Lee, Mi Na Kim, A. del Palacio, Aurora Sanchez-Sousa, Jacques Bille, K. Muhlethaler, Jen Hsien Wang, Malai Vorachit, Deniz Gur, Volkan Korten, John Paul, Brian Jones, F. Kate Gould, Chris Kibbler, Nigel Weightman, Ian M. Gould, Ruth Ashbee, Rosemarie Barnes, Jose Antonio Vazquez, Ed Chan, Davise Larone, Ellen Jo Baron, Mahmoud A. Ghannoum, Mike Rinaldi, Kevin Hazen, Elyse Foraker, Heidi Reyes, Axel Santiago

Research output: Contribution to journalArticlepeer-review

148 Scopus citations

Abstract

Although a rare cause of invasive candidiasis, Candida guilliermondii has been reported to exhibit decreased susceptibility to antifungal agents. Aside from case reports and small surveys, there is little information regarding the epidemiology and antifungal susceptibility profile of C. guilliermondii. We report geographic and temporal trends in the isolation and antifungal susceptibilities of 1,029 C. guilliermondii clinical isolates collected from 127 medical centers as part of the ARTEMIS DISK Antifungal Surveillance Program. In addition, we report the in vitro susceptibility of 132 bloodstream isolates of C. guilliermondii to caspofungin. C. guilliermondii represented 1.4% of the 75,761 isolates collected from 2001 to 2003 and was most common among isolates from Latin America (3.7% versus 0.6 to 1.1%). Decreased susceptibility to fluconazole was noted (75% susceptible; range, 68 to 77% across regions), and voriconazole was more active in vitro against C. guilliermondii than fluconazole (91% susceptible; range, 88 to 93% across regions). Fluconazole was least active against isolates from dermatology (58%) and surgical (69%) services and against isolates associated with skin and soft tissue infection (68%, compared to 85% susceptible for bloodstream isolates). There was no evidence of increasing azole resistance over time among C. guilliermondii isolates tested from 2001 to 2003. Of 132 bloodstream isolates of C. guilliermondii tested against caspofungin, most were inhibited by ≤2 μg/ml (96%; MIC 50/MIC90, 0.5/1.0 μg/ml). C. guilliermondii, a species that exhibits reduced susceptibility to fluconazole, is the sixth most frequently isolated Candida species from this large survey and may be an emerging pathogen in Latin America.

Original languageEnglish (US)
Pages (from-to)3551-3556
Number of pages6
JournalJournal of clinical microbiology
Volume44
Issue number10
DOIs
StatePublished - Oct 1 2006

ASJC Scopus subject areas

  • Microbiology (medical)

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