In the period 1992-95 there was a significant shift in the spectrum of
Candida species in the University Hospital in Greifswald. During this
time, the annual number of specimens taken for mycological investigat
ions of adults increased threefold (total n=11 568). The isolation rat
e of Candida species was 50.5%. The percentage of C. albicans isolates
decreased from 76% to 54.4% with the lowest level in 1994. The opposi
te trend in the occurrence of non-C. albicans species was seen, for ex
ample the occurrence of C. glabrata, from 11.7% to 28.4%. We found onl
y 98 strains of C. parapsilosis (1.4%) during-the 4 years. The occurre
nce of Candida species in a variety of habitats was different. During
the 4 years, the same annual percentages of C. albicans (mean 87.9%) w
ere isolated from endoscopic oesophageal smears, whereas the distribut
ion of Candida yeasts from the oral cavity, the respiratory tract, fae
ces and urine had changed. Over the years, at these locations, C. albi
cans was less frequently isolated and non-C. albicans species clearly
increased. The highest occurrence of C. glabrata was found in urine, i
n which the isolation percentage almost doubled from 23.1% to 40.9% in
1994. In contrast to adults, in all specimens originating from a paed
iatric clinic that included neonatology the occurrence of C. albicans
was high (83.5% in 1995), but the isolation rate of Candida species wa
s low (12.3%). These results are important because of the differences
in yeast susceptibility, of non-C. albicans species in particular, aga
inst antifungal drugs.