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Journal of Clinical Microbiology, March 2001, p. 949-953, Vol. 39, No. 3
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.3.949-953.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Prevalence and Antifungal Susceptibility of 442 Candida Isolates from Blood and Other Normally Sterile Sites: Results of a 2-Year (1996 to 1998) Multicenter Surveillance Study in Quebec, Canada

G. St-Germain,1,* M. Laverdière,2 R. Pelletier,3 A.-M. Bourgault,4 M. Libman,5 C. Lemieux,4 and G. Noël4

Laboratoire de Santé Publique du Québec, Institut National de Santé Publique, Sainte-Anne-de-Bellevue,1 Hôpital Maisonneuve-Rosemont, Montréal,2 CHUQ Pavillon Hôtel-Dieu de Québec, Québec,3 Centre Hospitalier Universitaire de Montréal, Montréal,4 and Montreal General Hospital, Montréal,5 Québec, Canada

Received 6 July 2000/Returned for modification 16 October 2000/Accepted 19 December 2000

During a 2-year surveillance program (1996 to 1998) in Quebec, Canada, 442 strains of Candida species were isolated from 415 patients in 51 hospitals. The distribution of species was as follows: Candida albicans, 54%; C. glabrata, 15%; C. parapsilosis, 12%; C. tropicalis, 9%; C. lusitaniae, 3%; C. krusei, 3%; and Candida spp., 3%. These data, compared to those of a 1985 survey, indicate variations in species distribution, with the proportions of C. glabrata and C. parapsilosis increasing by 9 and 4%, respectively, and those of C. albicans and C. tropicalis decreasing by 10 and 7%, respectively. However, these differences are statistically significant for C. glabrata and C. tropicalis only. MICs of amphotericin B were >= 4 µg/ml for 3% of isolates, all of which were non-C. albicans species. Three percent of C. albicans isolates were resistant to flucytosine (>= 32 µg/ml). Resistance to itraconazole (>= 1 µg/ml) and fluconazole (>= 64 µg/ml) was observed, respectively, in 1 and 1% of C. albicans, 14 and 9% of C. glabrata, 5 and 0% of C. tropicalis, and 0% of C. parapsilosis and C. lusitaniae isolates. Clinical data were obtained for 343 patients. The overall crude mortality rate was 38%, reflecting the multiple serious underlying illnesses found in these patients. Bloodstream infections were documented for 249 patients (73%). Overall, systemic triazoles had been administered to 10% of patients before the onset of candidiasis. The frequency of isolation of non-C. albicans species was significantly higher in this group of patients. Overall, only two C. albicans isolates were found to be resistant to fluconazole. These were obtained from an AIDS patient and a leukemia patient, both of whom had a history of previous exposure to fluconazole. At present, it appears that resistance to fluconazole in Quebec is rare and is restricted to patients with prior prolonged azole treatment.

* Corresponding author. Mailing address: Laboratoire de Santé Publique du Québec, 20045 Chemin Sainte-Marie, Sainte-Anne-de-Bellevue, Québec H9X 3R5, Canada. Phone: (514) 457-2070. Fax: (514) 457-6346. E-mail: ggermain{at}lspq.org.

Journal of Clinical Microbiology, March 2001, p. 949-953, Vol. 39, No. 3
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.3.949-953.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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