Survey of fungemia cases during the past seventeen years at Teikyo University Hospital

Abstract

Fungi were isolated from 642 cases (3.5%) of 18,403 blood samples at Teikyo University Hospital during the 17-years period between 1979 and 1995. The number of fungemia cases began to increase around 1985, reached a peak in 1988, and since then, it has been gradually decreasing. The fungal species of isolates were: (1) Candida albicans in 224 cases (34.9%), (2) C. parapsilosis in 149 cases (23.2%), (3) C. tropicalis in 87 cases (13.6%), (4) C. glabrata in 65 cases (10.1%), (5) Hansenula anomala in 58 cases (9.0%), (6) C. guilliermondii in 24 cases (3.7%), (7) C. famata in 14 cases (2.1%), (8) Trichosporon beigelii in 11 cases (1.7%), (9) C. inconspicua in 5 cases (0.8%) and C. lusitaniae in 5 cases (0.8%), and other yeasts in 33 causes (5.1%). The number of isolates of C. albicans has been decreasing since 1989, concomitant with the clinical introduction of fluconazole in this hospital. However, the number of fluconazole-insusceptible fungi such as non-albicans Candida and Trichosporon spp. has increased. Fungemia cases infected concomitantly or sequentially with two or more different fungal species have been found occasionally since 1983 and have shown a high mortality rate. The spectrum of the causative organisms of fungemia appears to be, at least, partly influenced, by the usage of antifungal agents, particularly fluconazole.