• Wei Liu, Jingwen Tan, Jimei Sun, Zhijiang Xu, Min Li, Qing Yang, Haifeng Shao, Liyan Zhang, Weixia Liu, Zhe Wan, Wei Cui, Bin Zang, Dongpo Jiang, Qiang Fang, Bingyu Qin, Tiehe Qin, Weiqin Li, Fengmei Guo, Dawei Liu, Xiandong Guan, Kaijiang Yu, Haibo Qiu, Ruoyu Li, and China-SCAN team.
• Peking University First Hospital, Research Center for Medical Mycology, Peking University, Beijing, China.
• J. Antimicrob. Chemother. 2014 Jan 1; 69 (1): 162-7.

ObjectivesThe objectives of this study were to determine species distribution and in vitro antifungal susceptibility of Candida isolates identified in the multicentre China-SCAN study of invasive Candida infection (ICI) in intensive care units (ICUs) across China.MethodsCandida isolates from patients in the China-SCAN study with documented ICI were evaluated by a central laboratory. Species were identified using chromogenic culture media or the API 20C AUX kit. Susceptibility to fluconazole, voriconazole, itraconazole, caspofungin and amphotericin B was determined using the CLSI broth microdilution method (M27-A3) and updated clinical breakpoints or epidemiological cut-off values.ResultsA total of 389 isolates from 244 patients were analysed. Species identified most frequently were Candida albicans (40.1%), Candida parapsilosis (21.3%), Candida tropicalis (17.2%) and Candida glabrata (12.9%). Rarer species such as Lodderomyces elongisporus and Candida ernobii were also identified. Fluconazole susceptibility was evident in 85.9% (134/156) of C. albicans, 62.7% (42/67) of C. tropicalis and 48.2% (40/83) of C. parapsilosis isolates. Susceptibility to voriconazole was ≥ 90% among all species. All isolates were susceptible to amphotericin B and caspofungin except C. glabrata [86.0% (43/50) susceptible to caspofungin]. Cross-resistance between fluconazole and voriconazole was observed for C. parapsilosis and C. glabrata.ConclusionsAlthough C. albicans was the predominant single species, non-albicans species constituted >50% of isolates. Fluconazole susceptibility was lower in most non-albicans species, indicating that fluconazole resistance should be closely monitored. Susceptibility to voriconazole, amphotericin B and caspofungin is encouraging. Differences between these data and those from other regions emphasize the importance of assessing regional variations.

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