• 作者：Javier Pemá ; n^a ; ^{peman_jav@gva.es} ; Emilia Cantó ; n^b ; Juan José ; Camarena Miñ ; ana^c ; Julia Alcoba Florez^d ; Julia Echeverria^e ; David Navarro Ortega^f ; José ; Mart&#237 ; nez Alarcó ; n^g ; Dionisia Fontanals^h ; Bá ; rbara Gomila Sardⁱ ; Buenaventura Buend&#237 ; a Moreno^j ; Luis Torroba^k ; Josefina Ayats^l ; Miguel Á ; ngel Bratos Pé ; rez^m ; Mar&#237 ; a Á ; lvarez Ferná ; ndezⁿ ; Ferrá ; n Sá ; nchez Reus^&ntilde ; ; Isabel Ferná ; ndez Natal^o ; Gloria Royo Garc&#237 ; a^p ; Guillermo Ezpeleta^q ; Estrella Mart&#237 ; n-Mazuelos^r ; Isabel Iglesias^s ; Antonio Rezusta^t ; Inmaculada Ram&#237 ; rez de Ocariz^u ; Amelia Gó ; mez Nieto^v ; el Grupo de Estudio FUNGEMYCA^&loz ;
• 关键词：Fungemia ; Espa&ntilde ; a ; Epidemiologí ; a ; Fluconazol ; Candida ; Sensibilidad ; Candidemia
• 刊名：Revista Iberoamericana de Micolog铆a
• 出版年：2011
• 期刊代码：pca320_11301406
• 类别：med
• 出版时间：April-June 2011
• 卷：28
• 期：2
• 页码：91-99
• 文件大小：150 K

Background

Recent epidemiological surveillance studies have reported an increase in fungaemia caused by non-Candida albicans species, as well as a decrease in fluconazole susceptibility.

Objectives

To evaluate changes in the epidemiology of fungaemia in Spain comparing data from a new surveillance epidemiological study conducted in 2009 with a previous study carried out from 1997 to 1999 (Pem谩n J, et al. Eur J Clin Microbiol Infect Dis. 2005).

Methods

From January 2009 to February 2010, 44 Spanish hospitals participated in a prospective multicentre fungaemia surveillance study to ascertain whether there have been changes in the epidemiology and fluconazole susceptibility. Susceptibility was determined by the colorimetric method Sensititre Yeast One. Demographic and clinical data and the first isolate of each episode were gathered.

Results

A total of 1,377 isolates from 1,357 fungaemia episodes were collected, 46.7%from patients older than 64 years and 8.6%from children less than 1 year old. C. albicans (44.7%), Candida parapsilosis (29.1%), Candida glabrata (11.5%), Candida tropicalis (8.2%), and Candida krusei (1.9%) were the most frequent species isolated. Distribution varied with the geographical area. C. albicans incidence has increased significantly in the last 10 years in Catalu帽a (39.1 vs. 54.7%, P  = 0.03) and decreased in the Valencian Community (49.1 vs. 34.6%, P  = 0.002) and Extremadura (58.3 vs. 20%, P  = 0.01). Susceptibility to fluconazole was similar for all geographical areas, although resistance in C. albicans was ten times greater for patients aged more than 64 years. The overall rate of fluconazole resistance (MIC > 32 mg/L) has decreased with respect to that obtained 10 years ago (3.7 vs. 2.5%) mainly in C. albicans (3 vs. 1.6%).

Conclusions

In the last ten years, species distribution and fluconazole susceptibility have not significantly changed, although a lower rate of fluconazole resistance has been observed. Species distribution varies with hospital, hospitalization Unit and geographical area.