Geographic and Temporal Trends in Isolation and Antifungal Susceptibility of Candida parapsilosis : a Global Assessment from the ARTEMIS DISK Antifungal Surveillance Program, 2001 to 2005

Abstract

We examined data from the ARTEMIS DISK Antifungal Surveillance Program to describe geographic and temporal trends in the isolation of Candida parapsilosis from clinical specimens and the in vitro susceptibilities of 9,371 isolates to fluconazole and voriconazole. We also report the in vitro susceptibility of bloodstream infection (BSI) isolates of C. parapsilosis to the echinocandins, anidulafungin, caspofungin, and micafungin. C. parapsilosis represented 6.6% of the 141,383 isolates of Candida collected from 2001 to 2005 and was most common among isolates from North America (14.3%) and Latin America (9.9%). High levels of susceptibility to both fluconazole (90.8 to 95.8%) and voriconazole (95.3 to 98.1%) were observed in all geographic regions with the exception of the Africa and Middle East region (79.3 and 85.8% susceptible to fluconazole and voriconazole, respectively). C. parapsilosis was most often isolated from blood and skin and/or soft tissue specimens and from patients hospitalized in the medical, surgical, intensive care unit (ICU) and dermatology services. Notably, isolates from the surgical ICU were the least susceptible to fluconazole (86.3%). There was no evidence of increasing azole resistance over time among C. parapsilosis isolates tested from 2001 to 2005. Of BSI isolates tested against the three echinocandins, 92, 99, and 100% were inhibited by concentrations of <2 g/ml of anidulafungin (621 isolates tested), caspofungin (1,447 isolates tested), and micafungin (539 isolates tested), respectively. C. parapsilosis is a ubiquitous pathogen that remains susceptible to the azoles and echinocandins; however, both the frequency of isolation and the resistance of C. parapsilosis to fluconazole and voriconazole may vary by geographic region and clinical service.

Prevalence and antifungal susceptibility of Candida parapsilosis complex isolates collected from oral cavities of HIV-infected individuals

“…C. parapsilosis groups I, II and III were recently established as distinct species, which were classified by genotyping and designated C. parapsilosis sensu stricto, C. orthopsilosis and C. metapsilosis, respectively (Tavanti et al, 2005). Although the C. parapsilosis complex has been recognized as comprising distinct species, little is known about the transmission and infectivity of the two more rare species present within the complex, C. orthopsilosis and C. metapsilosis, while C. parapsilosis has now been recognized as a major human fungal pathogen, ranking as the second or third most frequently occurring cause of bloodstream infection in Europe, Canada and Latin America (Almirante et al, 2006;Pemán et al, 2005;Pfaller et al, 2008). Data on the frequency of isolation of C. orthopsilosis and C. metapsilosis have just started to be released (Odds et al, 2007;Tavanti et al, 2007;Kocsubé et al, 2007;Gomez-Lopez et al, 2008;Lockhart et al, 2008;Hensgens et al, 2009;Silva et al, 2009;Gonçalves et al, 2010;Ghannoum et al, 2010;Bonfietti et al, 2012).…”

Comparação entre microdiluição e disco difusão para o teste de susceptibilidade aos antifúngicos contra Candida spp.

“…Candida spp. resistentes ao fluconazol têm sido detectadas em diversas partes do mundo (PFALLER, 2008(PFALLER, , 2010b. No entanto, a resistência à anfotericina B não é comumente detectada, apesar dessa droga está em uso a mais de 50 anos (DIEKEMA et al, 2009;LANIADO-LABORÍN;CABRALES-VARGAS, 2009).…”

“…No entanto, a resistência à anfotericina B não é comumente detectada, apesar dessa droga está em uso a mais de 50 anos (DIEKEMA et al, 2009;LANIADO-LABORÍN;CABRALES-VARGAS, 2009). Na última década foram implantados programas de vigilância da resistência fúngica, o mais importante deles é o ARTEMIS DISK, que monitora a resistência ao fluconazol e ao voriconazol em 134 instituições de 40 países, incluindo o Brasil, utilizando a metodologia de disco difusão (PFALLER et al, 2008(PFALLER et al, , 2009a(PFALLER et al, , 2009b(PFALLER et al, , 2010b.…”

Evidence for the presence of proteolytically active secreted aspartic proteinase 1 of Candida parapsilosis in the cell wall

“…In epidemiological surveys it ranks as the second or third most common Candida species, depending on the medical setting and geographical area. 1,2 It is a major cause of nosocomial infections by yeasts, and high incidence of C. parapsilosis has been reported in neonatal intensive care units. 3,4 C. parapsilosis infections are often exogenous.…”