Candida krusei, a multidrug-resistant opportunistic fungal pathogen: Geographic and temporal trends from the ARTEMIS DISK Antifungal Surveillance Program, 2001 to 2005

M. A. Pfaller, D. J. Diekema, D. L. Gibbs, V. A. Newell, E. Nagy, S. Dobiasova, M. Rinaldi, R. Barton, A. Veselov, Jorge Finquelievich, Nora Tiraboschi, David Ellis, Dominique Fameree, Anne Marie van den Abeele, Jean Marc Senterre, Arnaldo Lopez Colombo, Robert Rennie, Stephen Sanche, Hu Bijie, Yingchun XuWang Fu, Nan Shan Zhong, Pilar Rivas, Catalina de Bedout, Matilde Mendez, Ricardo Vega, Nada Mallatova, Stanislava Dobiasova, Julio Ayabaca, Jeannete Zurita, M. Mallie, E. Candolfi, W. Fegeler, P. D.G. Haase, A. Rodloff, W. Bar, V. Czaika, George Petrikos, Erzsébet Puskás, Ilona Dóczi, Gyula Mestyan, Radka Nikolova, Uma Banerjee, Nathan Keller, Vivian Tullio, Gian Carlo Schito, Domenico D'Antonio, Pietro Martino, Ng Kee Peng, Celia Alpuche, Jose Santos, Rayo Morfin Ortero, Mussaret Zaidi, Jacques F. 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, Atef Shibl, Jan Trupl, Hupkova Helena, Anwar Hoosen, Jeannette Wadula, M. N. Janse van Rensburg, Adriano Duse, Kyungwon Lee, Mi Na Kim, A. del Palacio, Aurora Sanchez-Sousa, Jacques Bille, K. Muhlethaler, Shan Chwen Chang, Jen Hsien Wang, Deniz Gur, Volkan Korten, John Paul, Derek Brown, Chris Kibbler, Nigel Weightman, Ian M. Gould, Claire Rennison, Richard Barton, Rosemary Barnes, Jose Antonio Vazquez, Davise Larone, Mike Rinaldi, Heidi Reyes, Axel Santiago

Research output: Contribution to journalArticlepeer-review

172 Scopus citations


Candida krusei is well known as a fungal pathogen for patients with hematologic malignancies and for transplant recipients. Using the ARTEMIS Antifungal Surveillance Program database, we describe geographic and temporal trends in the isolation of C. krusei from clinical specimens and the in vitro susceptibilities of 3,448 isolates to voriconazole as determined by CLSI (formerly NCCLS) disk diffusion testing. In addition, we report the in vitro susceptibilities of bloodstream infection isolates of C. krusei to amphotericin B (304 isolates), flucytosine (254 isolates), anidulafungin (121 isolates), caspofungin (300 isolates), and micafungin (102 isolates) as determined by CLSI broth microdilution methods. Geographic differences in isolation were apparent; the highest frequency of isolation was seen for the Czech Republic (7.6%) and the lowest for Indonesia, South Korea, and Thailand (0 to 0.3%). Overall, 83% of isolates were susceptible to voriconazole, ranging from 74.8% in Latin America to 92.3% in North America. C. krusei was most commonly isolated from hematology-oncology services, where only 76.7% of isolates were susceptible to voriconazole. There was no evidence of increasing resistance of C. krusei to voriconazole from 2001 to 2005. Decreased susceptibilities to amphotericin B (MIC at which 90% of isolates were inhibited [MIC90], 4 μg/ml) and flucytosine (MIC90, 16 μg/ml) were noted, whereas 100% of isolates were inhibited by ≤2 μg/ml of anidulafungin (MIC 90,0.06 μg/ml), micafungin (MIC90, 0.12 μg/ml) or caspofungin (MIC90, 0.25 μg/ml). C. krusei is an uncommon but multidrug-resistant fungal pathogen. Among the systemically active antifungal agents, the echinocandins appear to be the most active against this important pathogen.

Original languageEnglish (US)
Pages (from-to)515-521
Number of pages7
JournalJournal of clinical microbiology
Issue number2
StatePublished - Feb 2008

ASJC Scopus subject areas

  • Microbiology (medical)


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