Volume 25, Number 9—September 2019
Research
Clonality of Fluconazole-Nonsusceptible Candida tropicalis in Bloodstream Infections, Taiwan, 2011–2017
Pao-Yu Chen, Yu-Chung Chuang, Un-In Wu, Hsin-Yun Sun, Jann-Tay Wang, Wang-Huei Sheng, Hsiu-Jung Lo, Hurng-Yi Wang, Yee-Chun Chen
, and Shan-Chwen Chang
, and Shan-Chwen Chang
Table 1
Comparison of antifungal susceptibility distribution of 344 Candida troplicalis blood isolates, Taiwan, 2011–2017*
| Antifungal agents | Total, n = 344 | Fluconazole-susceptible isolates, n = 286 | Fluconazole-nonsusceptible isolates |
||
|---|---|---|---|---|---|
| Total,† n = 58 | Clonal complex 3,‡ n = 36 | Other clonal complexes,‡ n = 19 | |||
| Fluconazole | |||||
| MIC50 | 1 | 1 | 216 | 256 | 8 |
| MIC90 | 32 | 2 | 512 | 512 | 128 |
| Range | 0.06–512 | 0.06–2 | 4–512 | 32–512 | 4–512 |
| NS rates, no. (%) |
58 (16.9) |
0 |
58 (100)§ |
36 (100) |
19 (100) |
| Itraconazole | |||||
| MIC50 | 0.25 | 0.25 | 0.5 | 0.5 | 0.06 |
| MIC90 | 0.5 | 0.25 | 1 | 1 | 1 |
| Range | 0.06–32 | 0.03–0.5 | 0.06–32 | 0.25–1 | 0.06–32 |
| NWT rates, no. (%) |
20 (5.8) |
0 |
20 (34.5)§ |
18 (50) |
2 (10.5) |
| Posaconazole | |||||
| MIC50 | 0.25 | 0.25 | 0.5 | 0.5 | 0.5 |
| MIC90 | 0.5 | 0.5 | 1 | 1 | 1 |
| Range | 0.06–16 | 0.004–0.5 | 0.06–16 | 0.25–2 | 0.06–16 |
| NS rates, no. (%) |
285 (82.9) |
228 (79.7) |
57 (98.3)§ |
36 (100) |
18 (94.7) |
| Voriconazole | |||||
| MIC50 | 0.12 | 0.12 | 4 | 8 | 0.5 |
| MIC90 | 2 | 0.12 | 16 | 16 | 4 |
| Range | 0.004–16 | 0.004–0.25 | 0.25–16 | 1–16 | 0.25–16 |
| NS rates, no. (%) |
75 (21.8) |
17 (5.9) |
58 (100)§ |
36 (100) |
19 (100) |
| Anidulafungin | |||||
| MIC50 | 0.06 | 0.06 | 0.12 | 0.12 | 0.06 |
| MIC90 | 0.12 | 0.12 | 0.12 | 0.12 | 0.12 |
| Range | 0.008–1 | 0.008–0.5 | 0.008–1 | 0.008–1 | 0.008–0.25 |
| NS rates¶, no. (%) |
2 (0.6) |
1 (0.4) |
1 (1.7) |
1 (2.8) |
0 |
| Caspofungin | |||||
| MIC50 | 0.06 | 0.06 | 0.06 | 0.06 | 0.06 |
| MIC90 | 0.12 | 0.12 | 0.25 | 0.25 | 0.25 |
| Range | 0.015–8 | 0.015–2 | 0.015–8 | 0.015–8 | 0.015–0.25 |
| NS rates¶, no. (%) |
3 (0.9) |
2 (0.7) |
1 (1.7) |
1 (2.8) |
0 |
| Micafungin | |||||
| MIC50 | 0.03 | 0.03 | 0.03 | 0.03 | 0.03 |
| MIC90 | 0.03 | 0.03 | 0.03 | 0.03 | 0.03 |
| Range | 0.015–2 | 0.004–1 | 0.015–2 | 0.015–2 | 0.015–0.03 |
| NS rates¶, no. (%) |
2 (0.6) |
1 (0.4) |
1 (1.7) |
1 (2.8) |
0 |
| Amphotericin | |||||
| MIC50 | 1 | 1 | 1 | 1 | 1 |
| MIC90 | 1 | 1 | 1 | 1 | 1 |
| Range | 0.25–1 | 0.25–1 | 0.25–1 | 0.50–1 | 0.25–1 |
| NWT rates, no. (%) |
0 |
0 |
0 |
0 |
0 |
| Flucytosine | |||||
| MIC50 | 0.03 | 0.03 | 0.03 | 0.03 | 0.03 |
| MIC90 | 0.06 | 0.06 | 0.12 | 0.03 | 0.50 |
| Range | 0.03–64 | 0.03–64 | 0.03–32 | 0.03–0.03 | 0.03–32 |
| NWT rates, no. (%) | 4 (1.2) | 3 (1.0) | 1 (1.7) | 0 | 1 (5.3) |
*MICs and ranges are reported in μg/mL. NS, nonsusceptible; NWT, non–wild-type.
†Of 58 fluconazole-nonsusceptible isolates, only 55 isolates were typable with subsequent assignment of clonal complex.
‡Details of CCs and corresponding MIC data are available in Appendix Table 1 (https://wwwnc.cdc.gov/EID/article/25/9/19-0520-App1.pdf).
§Comparison of antifungal NS rates between FS isolates (n = 256) and FNS isolates (n = 58) by χ2 tests, p<0.001.
¶The susceptibility discrepancy among 3 echinocandins may be attributed to significant variability in caspofungin susceptibility testing, which resulted in false resistance reporting.
Page created: August 21, 2019
Page updated: August 21, 2019
Page reviewed: August 21, 2019
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