Clinical pathogenesis of candidemia caused by non-albicans Candida species

Abstract

A proportional increase in candidemia due to non-albicans Candida species has been reported worldwide. In our hospital, 36 of 58 candidemia cases were caused by non-albicans Candida species between 1996 and 2007. Candidemia due to non-albicans Candida species is associated with fluconazole (FLCZ) exposure. In our cases, 36 of 36 non-albicans candidemia cases received FLCZ while 18 of 22 albicans candidemia cases received this drug. In general, non-albicans Candida species including C. tropicalis, C. parapsilosis, and C. guilliermondii are susceptible to FLCZ. On the other hand, C. glabrata and C. krusei exhibit decreased susceptibility to FLCZ. Our in vitro susceptibility test revealed the same results as above although C. guilliermondii showed an elevated MIC to FLCZ (4-8 μg/ml). In addition, both C. parapsilosis and C. guilliermondii showed elevated MICs to micafungin (1 μg/ml and 0.5-2 μg/ml, respectively) which is generally useful for non-albicans Candida species.