National surveillance of antifungal susceptibility of Candida species in South Korean hospitals

Abstract

We investigated the species distribution and antifungal susceptibility of Candida isolates from tertiary and non-tertiary hospitals in South Korea from 20022004. Of the 612 Candida isolates that were collected, Candida albicans, C. parapsilosis, C. tropicalis, and C. glabrata occurred most frequently, accounting for 97.3% and 96.8% of the isolates in tertiary and non-tertiary hospitals, respectively. C. albicans was the most common isolate, but the incidence of non-C. albicansCandida species was higher than that of C. albicans in tertiary hospitals. The Candida species had much lower MIC90 to voriconazole (tertiary hospitals: 0.5 g/ml, non-tertiary hospitals: 0.25 g/ml) than to fluconazole (tertiary hospitals: 8 g/ml, non-tertiary hospitals: 4 g/ml). The MIC90 of Candida isolates to 5-flucytosine in non-tertiary hospitals was two times higher than that observed in tertiary facilities. The C. glabrata isolates showed a tendency toward strong resistance to fluconazole, but C. parapsilosis isolates were susceptible to all of the evaluated antifungal agents. Voriconazole showed strong in vitro activity against Candida species, especially C. krusei, which is resistant to fluconazole and 5-flucytosine. To our knowledge, this is the first report of Candida antifungal susceptibility that includes non-tertiary hospitals in South Korea. © 2009 ISHAM.