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Journal of Clinical Microbiology, October 2006, p. 3578-3582, Vol. 44, No. 10
0095-1137/06/$08.00+0     doi:10.1128/JCM.00863-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Candida rugosa, an Emerging Fungal Pathogen with Resistance to Azoles: Geographic and Temporal Trends from the ARTEMIS DISK Antifungal Surveillance Program

M. A. Pfaller,1* D. J. Diekema,1 A. L. Colombo,2 C. Kibbler,3 K. P. Ng,4 D. L. Gibbs,5 V. A. Newell,5 and the Global Antifungal Surveillance Group

University of Iowa College of Medicine, Iowa City, Iowa,1 Escola Paulista de Medicina, Sao Paulo, Brazil,2 Royal Free Hospital, London, United Kingdom,3 University Malaya, Kuala Lumpur, Malaysia,4 Giles Scientific, Inc., Santa Barbara, California5

Received 24 April 2006/ Returned for modification 5 June 2006/ Accepted 31 July 2006

Candida rugosa is a fungus that appears to be emerging as a cause of infection in some geographic regions. We utilized the extensive database of the ARTEMIS DISK Antifungal Surveillance Program to describe the geographic and temporal trends in the isolation of C. rugosa from clinical specimens and the in vitro susceptibilities of 452 isolates to fluconazole and voriconazole. C. rugosa accounted for 0.4% of 134,715 isolates of Candida, and the frequency of isolation increased from 0.03% to 0.4% over the 6.5-year study period (1997 to 2003). C. rugosa was most common in the Latin American region (2.7% versus 0.1 to 0.4%). Decreased susceptibility to fluconazole (40.5% susceptible) was observed in all geographic regions; however, isolates from Europe and North America were much more susceptible (97 to 100%) to voriconazole than those from other geographic regions (55.8 to 58.8%). C. rugosa was most often isolated from blood and urine in patients hospitalized at the Medical and Surgical inpatient services. Notably, bloodstream isolates were the least susceptible to both fluconazole and voriconazole. C. rugosa should be considered, along with the established pathogens Candida krusei and Candida glabrata, as a species of Candida with reduced susceptibility to the azole antifungal agents.

* Corresponding author. Mailing address: Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242. Phone: (319) 384-9566. Fax: (319) 356-4916. E-mail: michael-pfaller{at}uiowa.edu.

Journal of Clinical Microbiology, October 2006, p. 3578-3582, Vol. 44, No. 10
0095-1137/06/$08.00+0     doi:10.1128/JCM.00863-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

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