Candida rugosa, an emerging fungal pathogen with resistance to azoles: Geographic and temporal trends from the ARTEMIS DISK Antifungal Surveillance Program

M. A. Pfaller, D. J. Diekema, A. L. Colombo, C. Kibbler, K. P. Ng, 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 Zhang, Nan Shan ZhongPilar 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, Shan Chwen Chang, 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

73 Scopus citations


Candida rugosa is a fungus that appears to be emerging as a cause of infection in some geographic regions. We utilized the extensive database of the ARTEMIS DISK Antifungal Surveillance Program to describe the geographic and temporal trends in the isolation of C. rugosa from clinical specimens and the in vitro susceptibilities of 452 isolates to fluconazole and voriconazole. C. rugosa accounted for 0.4% of 134,715 isolates of Candida, and the frequency of isolation increased from 0.03% to 0.4% over the 6.5-year study period (1997 to 2003). C. rugosa was most common in the Latin American region (2.7% versus 0.1 to 0.4%). Decreased susceptibility to fluconazole (40.5% susceptible) was observed in all geographic regions; however, isolates from Europe and North America were much more susceptible (97 to 100%) to voriconazole than those from other geographic regions (55.8 to 58.8%). C. rugosa was most often isolated from blood and urine in patients hospitalized at the Medical and Surgical inpatient services. Notably, bloodstream isolates were the least susceptible to both fluconazole and voriconazole. C. rugosa should be considered, along with the established pathogens Candida krusei and Candida glabrata, as a species of Candida with reduced susceptibility to the azole antifungal agents.

Original languageEnglish (US)
Pages (from-to)3578-3582
Number of pages5
JournalJournal of clinical microbiology
Issue number10
StatePublished - Oct 1 2006

ASJC Scopus subject areas

  • Microbiology (medical)


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