NATIONAL SURVEILLANCE OF NOSOCOMIAL BLOOD-STREAM INFECTION DUE TO SPECIES OF CANDIDA OTHER THAN CANDIDA-ALBICANS - FREQUENCY OF OCCURRENCE AND ANTIFUNGAL SUSCEPTIBILITY IN THE SCOPE PROGRAM

A national surveillance program of nosocomial blood stream infections (BSI) in the USA between April 1995 and June 1996 revealed that Candid a was the fourth lending cause of nosocomial BSI, accounting for 8% of all infections. Forty-eight percent of 379 episodes of candidemia wer e due to species other than Candida albicans. The rank order of non-C. albicans species was C. glabrata (20%) > C. tropicalis (11%) > C. par apsilosis (8%) > C. krusei (5%) > other Candida spp. (4%). The species distribution varied according to geographic region, with non-C. albic ans species predominating in the Northeast (54%) and Southeast (53%) r egions, and C. albicans predominating in the Northwest (60%) and South west (70%) regions. In vitro susceptibility studies demonstrated that 95% of Man-C. albicans isolates were susceptible to 5-fluorocytosine, and 84% and 75% were susceptible to fluconazole and itraconazole, resp ectively. Geographic variation in susceptibility to itraconazole, but not other agents, was observed. Isolates from the Northwest and Southe ast regions were more frequently resistant to itraconazole (29-30%) th an those from the Northeast and Southwest regions (17-18%). Molecular epidemiologic studies revealed possible nosocomial transmission (Foe m edical centers). Continued surveillance for the presence of non-C. alb icans species among hospitalized patients is recommended. (C) 1998 Els evier Science Inc.