薬理と治療

Abstract

Background　Candida species are major pathogens responsible for sepsis, and have been linked to high mortality rates. Here, we conducted an investigation of Candida bloodstream isolates obtained at Fukuoka University Hospital to examine the changes in their characteristics over time. In addition, we investigated the correlation between initial antifungal therapy and its clinical efficacy. Methods　We studied the species distribution, antifungal susceptibility, initial drug, Candida albicans genotypes, and treatment success rates in 133 cases of candidemia at Fukuoka University Hospital over the period from 2011 to 2021. Results　Candida albicans was the most common species（49％）followed by Candida parapsilosis（ 20％）, Candida glabrata（14％）, and Candida tropicalis（7％）. C. albicans was the most frequently detected species in all years except 2018. There was little change in antifungal susceptibility over the study period. However, the minimum inhibitory concentrations（MICs） of azole antifungal drugs were higher for non–albicans Candida（NAC）than C. albicans isolates. Micafungin was the most frequently used first–line drug, and there were no strains with low susceptibility to the first–line drug. There was no significant difference in treatment success rate between C. albicans and NAC（P＝0.64）. Conclusions　There were no significant changes in the distribution of Candida species over the study period at Fukuoka University Hospital（P＝0.24）. However, the MICs of azole antifungal drugs were higher for NAC than C. albicans isolates, indicating a decline in susceptibility over time. Therefore, continuous monitoring and investigation are necessary for future assessments.（Jpn Pharmacol Ther 2023；51：1677‒84）