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A Multicenter Study of Antifungal Use and Species Distribution and Antifungal Susceptibilities of Candida Isolates in South Korea

 Ju Hyeon Shin  ;  Eun Jeong Won  ;  Soo Hyun Kim  ;  Jong Hee Shin  ;  Dain Lee  ;  Dong Hyun Lee  ;  Young Ah Kim  ;  Jongyoun Yi  ;  Jeong Hwan Shin  ;  Kyeong Seob Shin  ;  Seok Hoon Jeong 
 Korean Journal of Medical Mycology (대한의진균학회지), Vol.25(1) : 10-16, 2020-03 
Journal Title
Korean Journal of Medical Mycology(대한의진균학회지)
Issue Date
Antifungal susceptibility ; Antifungal usage ; Candida ; Multicenter surveillance
Background: Candidiasis control should include monitoring the epidemiology and resistance to various antifungal agents. In this study, the researchers investigated the Candida species recovered from clinical specimens at particular geographic areas or hospitals.

Objective: The present study is geared toward the evaluation of antifungal drug usage at Korean hospitals in 2016. It is also essential that species distribution and antifungal susceptibilities of Candida isolates should be looked into to provide important data that can help devise therapeutic strategies to control the disease.

Methods: Systemic antifungal agent usage over a one-year period was investigated at 10 Korean hospitals. Identification and antifungal susceptibility tests were performed on clinical isolates of the Candida species, which were collected over a three-month period.

Results: The total antifungal usage in each hospital ranged from 7.7 to 158.9 defined daily doses (DDDs) per 1,000 patient days. Fluconazole was most commonly used (37.1%), followed by amphotericin B (30.6%), itraconazole (9.7%), echinocandins (8.8%), voriconazole (7.5%), and posaconazole (6.3%), respectively. Among 274 Candida isolates, C. albicans was the most frequently recovered (51.1%), followed by C. glabrata (15.7%), C. tropicalis (15.0%), and C. parapsilosis (13.5%), respectively. Through the application of either species-specific clinical breakpoints or epidemiological cutoff values to Candida isolates, the non-susceptibility rates to fluconazole, voriconazole, amphotericin B, and micafungin were found in 20.7%, 5.6%, 0%, and 0% of isolates, respectively.

Conclusion: This nationwide multicenter study showed that total antifungal use varied considerably according to each hospital. Non-susceptibility to fluconazole should be further monitored, considering the drug's frequent use in Korea.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Jeong, Seok Hoon(정석훈) ORCID logo https://orcid.org/0000-0001-9290-897X
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