Antifungal susceptibility of invasive Candida bloodstream isolates from the Asia-Pacific region

Tan, Thean Yen; Hsu, Li Yang; Alejandria, Marissa M.; Chaiwarith, Romanee; Chinniah, Terrence; Chayakulkeeree, Methee; Choudhury, Saugata; Chen, Yen Hsu; Shin, Jong Hee; Kiratisin, Pattarachai; Mendoza, Myrna; Prabhu, Kavitha; Supparatpinyo, Khuanchai; Tan, Ai Ling; Phan, Xuan Thi; Tran, Thi Thanh Nga; Nguyen, Gia Binh; Doan, Mai Phuong; Huynh, Van An; Nguyen, Su Minh Tuyet; Tran, Thanh Binh; Van Pham, Hung

doi:10.1093/mmy/myv114

Cited by 139Antifungal resistance and susceptibilityYeasts and Rust Fungi StudiesFungal Infections and Studies

Antifungal susceptibility of invasive Candida bloodstream isolates from the Asia-Pacific region

Tan, Thean Yen, Hsu, Li Yang, Alejandria, Marissa M., Chaiwarith, Romanee, Chinniah, Terrence, Chayakulkeeree, Methee, Choudhury, Saugata, Chen, Yen Hsu +14 more·2016·Medical Mycology

DOI 10.1093/mmy/myv114

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Abstract

Bloodstream infections caused by Candida species are of increasing importance and associated with significant mortality. We performed a multi-centre prospective observational study to identify the species and antifungal susceptibilities of invasive bloodstream isolates of Candida species in the Asia-Pacific region. The study was carried out over a two year period, involving 13 centers from Brunei, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Identification of Candida species was performed at each study center, and reconfirmed at a central laboratory. Susceptibility testing was performed using a commercial broth dilution panel (Sensititre YeastOne YST-010, Thermofisher, United Kingdom) with susceptibility categorisation (S = susceptible, S-DD = susceptible dose-dependent) applied using breakpoints from the Clinical Laboratory Standards Institute. Eight hundred and sixty-one Candida isolates were included in the study. The most common species were C. albicans (35.9%), C. tropicalis (30.7%), C. parapsilosis (15.7%), and C. glabrata (13.6%). Non-albicans species exceeded C. albicans species in centers from all countries except Taiwan. Fluconazole susceptibility was almost universal for C. albicans (S = 99.7%) but lower for C. tropicalis (S = 75.8%, S-DD = 6.1%), C. glabrata (S-DD = 94.9%), and C. parapsilosis (S = 94.8%). Echinocandins demonstrated high rates of in vitro susceptibility (S>99%) against C. albicans, C. tropicalis, and C. parapsilosis This study demonstrates that non-albicans species are the most common isolates from bloodstream infections in most countries in the Asia-Pacific region, with C. tropicalis as the predominant species. Because of the prevalence of reduced susceptibility to fluconazole in non-albicans species, the study indicates that echinocandins should be the antifungal of choice in clinically unstable or high-risk patients with documented candidemia.

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The resistant strain of Candida tropicalis might have spread in the Asia-Pacific region.
“These results suggest that this resistant strain might have spread in the Asia-Pacific region.”
From Distribution, trends, and antifungal susceptibility ofCandidaspecies causing candidemia in Japan, 2010–2019: A retrospective observational study based on national surveillance data (2022) · cites this paper as [22]
The proportion of each Candida species isolated from candidemia cases in Japan is more similar to that in the US and Europe than to the proportion in the Asia-Pacific region.
“Overall, our study shows that the proportion of each Candida species isolated from candidemia cases in Japan is more similar to that in the US and Europe, than to the proportion in the Asia-Pacific region, which may be due to the differences in the climate.”
From Distribution, trends, and antifungal susceptibility ofCandidaspecies causing candidemia in Japan, 2010–2019: A retrospective observational study based on national surveillance data (2022) · cites this paper as [22]
Tan et al. reported Candida tropicalis to be the second most abundant isolate (30.7%) in the Asia-Pacific region.
“Tan, et al. obtained Candida spp. From seven countries in the Asia-Pacific region and reported C. tropicalis to be the second most abundant isolate (30.7%).22”
From Distribution, trends, and antifungal susceptibility ofCandidaspecies causing candidemia in Japan, 2010–2019: A retrospective observational study based on national surveillance data (2022) · cites this paper as [22]
The resistance rate of Candida tropicalis for voriconazole was reported to be 14%, 25.6%, and 16.7% in the Asia-Pacific region, China, and Australia, respectively.
“The resistance rate of C. tropicalis for VRCZ was reported to be 14%, 25.6%, and 16.7% in the Asia-Pacific region,22 China26 and Australia,21 respectively.”
From Distribution, trends, and antifungal susceptibility ofCandidaspecies causing candidemia in Japan, 2010–2019: A retrospective observational study based on national surveillance data (2022) · cites this paper as [22]

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Authors: Tan, T. Y., Hsu, L. Y., Alejandria, M. M., Chaiwarith, R., Chinniah, T., Chayakulkeeree, M., Choudhury, S., Chen, Y. H., Shin, J. H., Kiratisin, P., Mendoza, M., Prabhu, K., Supparatpinyo, K., Tan, A. L., Phan, X. T., Tran, T. T. N., Nguyen, G. B., Doan, M. P., Huynh, V. A., Nguyen, S. M. T., Tran, T. B., & Van Pham, H.
Affiliations: Changi General Hospital (SG)
National University Health System (SG)
Philippine General Hospital (PH)
Maharaj Nakorn Chiang Mai Hospital (TH)
Raja Isteri Pengiran Anak Saleha Hospital (BN)
Siriraj Hospital (TH)
Tan Tock Seng Hospital (SG)
National Yang Ming Chiao Tung University (TW)
Chonnam National University Hospital (KR)
National Kidney and Transplant Institute (PH)
Singapore General Hospital (SG)
Cho Ray Hospital (VN)
Bạch Mai Hospital (VN)
Bệnh viện Nhân dân Gia Định (VN)
Corresponding author: Tan, Thean Yen
ORCID: Tan, Thean Yen
Hsu, Li Yang
Alejandria, Marissa M.
Chaiwarith, Romanee
Chinniah, Terrence
Chayakulkeeree, Methee
Choudhury, Saugata
Chen, Yen Hsu
Shin, Jong Hee
Kiratisin, Pattarachai
Supparatpinyo, Khuanchai
Phan, Xuan Thi
Venue: Medical Mycology
Publisher: Oxford University Press (OUP)
Published: 2016-02-11
Volume: 54
Issue: 5
Pages: 471-477
ISSN: 0268-1218 (ISSN-L)
1369-3786
1460-2709
DOI: 10.1093/mmy/myv114
OpenAlex: W2338633945
Cited by: 139
References: 28
Citations by year: 2026: 6 · 2025: 14 · 2024: 10 · 2023: 11 · 2022: 12 · 2021: 16 · 2020: 18 · 2019: 18 · 2018: 15 · 2017: 16 · 2016: 3
FWCI: 16.01
Type: journal article
Language: en
Open access: closed
Locations: Medical Mycology (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords: candidemia, antifungal susceptibility, fluconazole resistance, echinocandins, Candida albicans, Candida tropicalis, Candida parapsilosis, Candida glabrata, non-albicans Candida, Asia-Pacific region, species distribution
MeSH terms: Antifungal Agents, Asia, Southeastern, Candida, Humans, Microbial Sensitivity Tests, Prospective Studies, Prevalence, Candidemia

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Antifungal susceptibility of invasive Candida bloodstream isolates from the Asia-Pacific region

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