Original Article

Korean J Lab Med 2010; 30(4): 364-372

Published online August 1, 2010

Copyright © Korean Society for Laboratory Medicine.

Species Distribution and Antifungal Susceptibilities of Yeast Clinical Isolates from Three Hospitals in Korea, 2001 to 2007

Mi-Kyung Lee, M.D.1, Dongeun Yong, M.D.2, Myungsook Kim, M.T.2, Mi-Na Kim, M.D.3, and Kyungwon Lee, M.D.2

Department of Laboratory Medicine1, Chung-Ang University College of Medicine, Seoul; Department of Laboratory Medicine2 and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul; Department of Laboratory Medicine3, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea

Correspondence to: Mi-Kyung Lee, M.D.
Department of Laboratory Medicine, Chung-Ang University College of Medicine, 65-207 Hangang-ro 3-ga, Yongsan-gu, Seoul 140-757, Korea
Tel : +82-2-748-9837, Fax : +82-2-748-9929
E-mail :

Received: January 15, 2010; Revised: May 31, 2010; Accepted: July 12, 2010


Background: We utilized results from the ARTEMIS DISK Global Antifungal Surveillance Program to evaluate the species distribution and fluconazole and voriconazole susceptibilities of yeast isolates from clinical specimens in South Korea from 2001 to 2007.
Methods: Data were collected on 5,665 yeast isolates from all body sites at three locations. All investigators tested clinical yeast isolates using the CLSI M44-A disk diffusion method. Test plates were automatically read and results were recorded using the BIOMIC image analysis plate reader system (Giles Scientific, USA). Species, drug, zone diameter, susceptibility category, and quality control results were collected quarterly via e-mail for analysis.
Results: Candida albicans was the most common isolate, but a progressive increase in non-C. albicans Candida and noncandidal yeast species has been observed in recent years. The overall percentages of isolates in each category (susceptible, susceptible dose dependent, and resistant) were 98.8%, 0.5%, and 0.7% and 99.2%, 0.2%, and 0.6% for fluconazole and voriconazole, respectively. Candida of 3 species exhibited decreased susceptibility to fluconazole (<90% S) in the order of that seen with the resistant (R) species: C. krusei, C. guilliermondii, and C. glabrata. Emerging resistance to fluconazole or voriconazole was documented among isolates of Cryptococcus neoformans, Trichosporon spp., and Rhodotorula spp.
Conclusions: The species distribution and antifungal susceptibilities of yeasts may differ according to specimen type, testing method, hospital, and geographic region. Therefore, further largescaled, long-term surveillance studies are needed to isolate yeasts and to confirm the species distribution and antifungal susceptibilities of yeast isolates from clinical specimens in Korea.

Keywords: Yeast, Fluconazole, Voriconazole, Surveillance