Nationwide Surveillance of Antifungal Resistance of Bloodstream Isolates in South Korean Hospitals: Two Year Report from Kor-GLASS

Overview

Journal J Fungi (Basel)

Date 2022 Oct 27

PMID 36294562

Authors

Eun Jeong Won

Min Ji Choi

Seok Hoon Jeong

Dokyun Kim

Kyeong Seob Shin

Jeong Hwan Shin

Young Ree Kim

Hyun Soo Kim

Young Ah Kim

Young Uh

Namhee Ryoo

Jeong Su Park

Kyoung Un Park

Seung A Byun

Ga Yeong Lee

Soo Hyun Kim

Jong Hee Shin

Affiliations

Soon will be listed here.

Abstract

We incorporated nationwide Candida antifungal surveillance into the Korea Global Antimicrobial Resistance Surveillance System (Kor-GLASS) for bacterial pathogens. We prospectively collected and analyzed complete non-duplicate blood isolates and information from nine sentinel hospitals during 2020−2021, based on GLASS early implementation protocol for the inclusion of Candida species. Candida species ranked fourth among 10,758 target blood pathogens and second among 4050 hospital-origin blood pathogens. Among 766 Candida blood isolates, 87.6% were of hospital origin, and 41.3% occurred in intensive care unit patients. Adults > 60 years of age accounted for 75.7% of cases. Based on species-specific clinical breakpoints, non-susceptibility to fluconazole, voriconazole, caspofungin, micafungin, and anidulafungin was found in 21.1% (154/729), 4.0% (24/596), 0.1% (1/741), 0.0% (0/741), and 0.1% (1/741) of the isolates, respectively. Fluconazole resistance was determined in 0% (0/348), 2.2% (3/135, 1 Erg11 mutant), 5.3% (7/133, 6 Pdr1 mutants), and 5.6% (6/108, 4 Erg11 and 1 Cdr1 mutants) of C. albicans, C. tropicalis, C. glabrata, and C. parapsilosis isolates, respectively. An echinocandin-resistant C. glabrata isolate harbored an F659Y mutation in Fks2p. The inclusion of Candida species in the Kor-GLASS system generated well-curated surveillance data and may encourage global Candida surveillance efforts using a harmonized GLASS system.

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