The epidemiology of Candida albicans has changed with the rise in immunocom
promised patients and the pressures of antifungal treatment and prophylaxis
, We assessed the genotype distribution of recently obtained, globally dive
rse isolates in comparison with isolates recovered in the United States and
United Kingdom before 1985, in order to determine temporal and geographic
differences, We used EcoRI digestion of cellular DNA to generate restrictio
n fragment length polymorphisms, dividing the isolates into 4 groups. From
15 diverse geographic areas, 439 isolates obtained over 20 years were divid
ed into 121 genotypes within groups A (289 isolates), B (85), C (56), and D
(9), Differences in genotype distribution existed among the localities (P
< .0001) and between isolates obtained before 1990 versus those recovered s
ince then (P = .009). Comparison of pre-1985 United States/United Kingdom i
solates with post-1994 United States isolates revealed a trend toward a cha
nging genotype distribution (P = .057). Global post-1985 isolates were diff
erent in genotype distribution from United States/United Kingdom isolates (
P < .0001). The distribution of isolates from Israel was unique (P < .0001)
. These differences could be due in part to the increasing prevalence of gr
oup C strains worldwide.