The epidemiology of non-Candida yeast isolated from blood: The Asia Surveillance Study.
candidemia
echinocandin
fungemia
presumptive therapy
yeast
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
07
05
2018
revised:
10
09
2018
accepted:
12
09
2018
pubmed:
20
9
2018
medline:
5
3
2019
entrez:
20
9
2018
Statut:
ppublish
Résumé
Current guidelines recommend echinocandins as first-line therapy for candidemia. However, several non-Candida yeast are non-susceptible to echinocandins (echinocandin non-susceptible yeast, ENSY), including Cryptococcus, Geotrichum, Malassezia, Pseudozyma, Rhodotorula, Saprochaete, Sporobolomyces and Trichosporon. In laboratories that are not equipped with rapid diagnostic tools, it often takes several days to identify yeast, and this may lead to inappropriate presumptive use of echinocandins in patients with ENSY fungemia. The aim of this study was to determine the distribution of ENSY species during a 1-year, laboratory surveillance programme in Asia. Non-duplicate yeast isolated from blood or bone marrow cultures at 25 hospitals in China, Hong Kong, India, Singapore, Taiwan and Thailand were analysed. Isolates were considered to be duplicative if they were obtained within 7 days from the same patient. Of 2155 yeast isolates evaluated, 175 (8.1%) were non-Candida yeast. The majority of non-Candida yeast were ENSY (146/175, 83.4%). These included Cryptococcus (109 isolates), Trichosporon (23), Rhodotorula (10) and Malassezia (4). The proportion of ENSY isolates (146/2155, 6.7%) differed between tropical (India, Thailand and Singapore; 51/593, 8.6%) and non-tropical countries/regions (China, Hong Kong and Taiwan; 95/1562, 6.1%, P = 0.038). ENSY was common in outpatient clinics (25.0%) and emergency departments (17.8%) but rare in intensive care units (4.7%) and in haematology-oncology units (2.9%). Cryptococcus accounted for the majority of the non-Candida species in emergency departments (21/24, 87.5%) and outpatient clinics (4/5, 80.0%). Isolation of non-Candida yeast from blood cultures was not rare, and the frequency varied among medical units and countries.
Sections du résumé
BACKGROUND
BACKGROUND
Current guidelines recommend echinocandins as first-line therapy for candidemia. However, several non-Candida yeast are non-susceptible to echinocandins (echinocandin non-susceptible yeast, ENSY), including Cryptococcus, Geotrichum, Malassezia, Pseudozyma, Rhodotorula, Saprochaete, Sporobolomyces and Trichosporon. In laboratories that are not equipped with rapid diagnostic tools, it often takes several days to identify yeast, and this may lead to inappropriate presumptive use of echinocandins in patients with ENSY fungemia. The aim of this study was to determine the distribution of ENSY species during a 1-year, laboratory surveillance programme in Asia.
METHODS
METHODS
Non-duplicate yeast isolated from blood or bone marrow cultures at 25 hospitals in China, Hong Kong, India, Singapore, Taiwan and Thailand were analysed. Isolates were considered to be duplicative if they were obtained within 7 days from the same patient.
RESULTS
RESULTS
Of 2155 yeast isolates evaluated, 175 (8.1%) were non-Candida yeast. The majority of non-Candida yeast were ENSY (146/175, 83.4%). These included Cryptococcus (109 isolates), Trichosporon (23), Rhodotorula (10) and Malassezia (4). The proportion of ENSY isolates (146/2155, 6.7%) differed between tropical (India, Thailand and Singapore; 51/593, 8.6%) and non-tropical countries/regions (China, Hong Kong and Taiwan; 95/1562, 6.1%, P = 0.038). ENSY was common in outpatient clinics (25.0%) and emergency departments (17.8%) but rare in intensive care units (4.7%) and in haematology-oncology units (2.9%). Cryptococcus accounted for the majority of the non-Candida species in emergency departments (21/24, 87.5%) and outpatient clinics (4/5, 80.0%).
CONCLUSIONS
CONCLUSIONS
Isolation of non-Candida yeast from blood cultures was not rare, and the frequency varied among medical units and countries.
Identifiants
pubmed: 30230062
doi: 10.1111/myc.12852
pmc: PMC7379604
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
112-120Subventions
Organisme : Pfizer
ID : 201108019RC
Organisme : Ministry of Science and Technology, Taiwan
ID : NSC 102-2314-B-002 -158 -MY3
Investigateurs
Ying-Chun Xu
(YC)
Hui Wang
(H)
Zi-Yong Sun
(ZY)
Lan-Lan Wang
(LL)
Juan Lu
(J)
Qing Yang
(Q)
Qiang-Qiang Zhang
(QQ)
Hai-Feng Shao
(HF)
Kang Liao
(K)
Patrick Cy Woo
(PC)
Rungmei Sk Marak
(RS)
Anupma Jyoti Kindo
(AJ)
Chieh-Liang Wu
(CL)
Mao-Wang Ho
(MW)
Lih-Shinn Wang
(LS)
Pattaya Riengchan
(P)
Informations de copyright
© 2018 The Authors. Mycoses Published by Blackwell Verlag GmbH.
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