Epidemiology of Candidemia and Antifungal Susceptibility in Invasive Candida Species in the Asia-Pacific Region

• Published in: Future microbiology Vol. 11; no. 11; pp. 1461 - 1477
• Main Authors: Wang, He, Xu, Ying-Chun, Hsueh, Po-Ren
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.10.2016
• Subjects: Antifungal agents; Antifungal Agents - therapeutic use; Asia - epidemiology; Azoles - therapeutic use; Candida; Candida - drug effects; Candida - isolation & purification; Candida - pathogenicity; Candida albicans; Candida albicans - drug effects; Candida albicans - pathogenicity; Candida glabrata - drug effects; Candida glabrata - isolation & purification; Candida glabrata - pathogenicity; Candida tropicalis - drug effects; Candida tropicalis - isolation & purification; Candida tropicalis - pathogenicity; Candidemia; Candidemia - drug therapy; Candidemia - epidemiology; Candidemia - microbiology; Candidiasis; Candidiasis, Invasive - drug therapy; Candidiasis, Invasive - epidemiology; Candidiasis, Invasive - microbiology; Drug Resistance, Fungal - drug effects; Echinocandins; Echinocandins - therapeutic use; Epidemiology; Etiology; Fluconazole; Fluconazole - therapeutic use; Hematology; Hospitals; Humans; Incidence; Infections; Intensive care; Itraconazole; Itraconazole - therapeutic use; Lipopeptides - therapeutic use; Micafungin; Microbial Sensitivity Tests; Mortality; Patients; Phenotype; Phenotypes; Prevalence; Species; Trends; Voriconazole; Voriconazole - therapeutic use; Singapore; Asia; Asia-Pacific region; China; Taiwan; Thailand; India; invasive candidiasis; Asia-Pacific region; candidemia; antifungal susceptibility
• ISSN: 1746-0913; 1746-0921
• DOI: 10.2217/fmb-2016-0099

In the Asia-Pacific region, Candida albicans is the predominant Candida species causing invasive candidiasis/candidemia in Australia, Japan, Korea, Hong Kong, Malaysia, Singapore and Thailand whereas C. tropicalis is the most frequently encountered Candida species in Pakistan and India. Invasive isolates of C. albicans, C. parapsilosis complex and C. tropicalis remain highly susceptible to fluconazole (>90% susceptible). Fluconazole resistance (6.8-15%), isolates with the non-wild-type phenotype for itraconazole susceptibility (3.9-10%) and voriconazole (5-17.8%), and echinocandin resistance (2.1-2.2% in anidulafungin and 2.2% in micafungin) among invasive C. glabrata complex isolates are increasing in prevalence. Moreover, not all isolates of C. tropicalis have been shown to be susceptible to fluconazole (nonsusceptible rate, 5.7-11.6% in China) or voriconazole (nonsusceptible rate, 5.7-9.6% in China).