JAC Advance Access published online on December 19, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh053
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Departments of Clinical
Laboratory Medicine, Graduate School of Medicine, Kyoto University,
54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 6068507;
* Corresponding author. E-mail: stakakr{at}kuhp.kyoto-u.ac.jp.
Received 7 August 2003
; revised 21 October 2003
; accepted 5 November 2003
Objectives: The aim of this study
was to evaluate species distribution and antifungal susceptibility
of Candida blood isolates in Japan. Methods: In a 1 year surveillance programme,
535 Candida blood isolates were collected. Identification
of species was followed by examination with the broth microdilution
method, as described in NCCLS M27-A2, of antifungal susceptibility
to six agents, including voriconazole and micafungin, with readings
after 24 and 48 h of incubation. Results: The overall species distribution was:
41% Candida albicans, 23% Candida
parapsilosis, 18% Candida glabrata,
12% Candida tropicalis and 2% Candida krusei. The concentrations of fluconazole
necessary to inhibit 90% of the isolates (MIC90)
at 24/48 h were 0.25/1 mg/L for C. albicans, 0.5/2
mg/L for C. parapsilosis, 4/32 mg/L for C.
glabrata and 4/>128 mg/L for C. tropicalis.
Percentages of fluconazole resistance were 1.8% for C.
albicans, 0.8% for C. parapsilosis,
5.2% for C. glabrata and 3.2% for C. tropicalis, taking the tendency of trailing
growth of C. tropicalis into account. MIC90 of
voriconazole was 0.5 mg/L, although 35% of isolates less
susceptible ( Conclusions: These data suggest that, in Japan,
the species distribution of Candida bloodstream
infections and the fluconazole resistance rate are similar to those
reported previously in North America and Europe. Voriconazole and
micafungin appear to have strong in vitro activity
against Candida blood isolates, although continuing
surveillance and further clinical research are needed.
Keywords: candidaemia, triazoles, echinocandins
National surveillance of species distribution in
blood isolates of Candida species in Japan and
their susceptibility to six antifungal agents including voriconazole
and micafungin
2 KKR Takamatsu Hospital, Takamatsu,
Kagawa 7600018, Japan
16 mg/L) to fluconazole
showed resistance (2 mg/L). Micafungin
was very active against all species (MIC90, 0.03 mg/L)
except for C. parapsilosis (MIC90, 2
mg/L).
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