1. Are there changes in candidemia epidemiology and susceptibility profile in 7 Belgian hospitals after a 5 year period? C. Van Laer 1*,2, K. Lagrou 2, P. Vandecandelaere 3*, AM. Van den Abeele 4*, J. Frans 5*, R. Cartuyvels 6*, E. Oris 7*, H. De Beenhouwer 1*, K. Van Vaerenbergh 1*, A. Boel 1* 1 OLV Hospital, Aalst, 2 University Hospitals Leuven, Leuven, 3 Jan Yperman Hospital, Ieper, 4 Sint-Lucas Hospital, Ghent, 5 Imelda Hospital, Bonheiden, 6 Jessa Hospital, Hasselt, 7 Hospital Zuid-Oost Limburg, Genk; Belgium. *On behalf of the BILULU study group. Are there changes in candidemia epidemiology and susceptibility profile in 7 Belgian hospitals after a 5 year period? C. Van Laer 1*,2, K. Lagrou 2, P. Vandecandelaere 3*, AM. Van den Abeele 4*, J. Frans 5*, R. Cartuyvels 6*, E. Oris 7*, H. De Beenhouwer 1*, K. Van Vaerenbergh 1*, A. Boel 1* 1 OLV Hospital, Aalst, 2 University Hospitals Leuven, Leuven, 3 Jan Yperman Hospital, Ieper, 4 Sint-Lucas Hospital, Ghent, 5 Imelda Hospital, Bonheiden, 6 Jessa Hospital, Hasselt, 7 Hospital Zuid-Oost Limburg, Genk; Belgium. *On behalf of the BILULU study group. The aim of this study was to evaluate susceptibilities of all yeasts isolated from blood cultures during a 9 month period in 7 Belgian hospitals. The obtained susceptibility results were compared with those from a study 5 years ago in the same hospitals where the susceptibility of 84 yeasts, isolated from December 2004 till June 2005, was determined. From December 2010 till August 2011, all yeasts isolated from blood cultures (n=106, no duplicates) were collected in 7 Belgian hospitals: Onze Lieve Vrouw Hospital, Aalst (n=11) University Hospitals Leuven, Leuven (n=56) Jan Yperman Hospital, Ieper (n=8) Sint-Lucas Hospital, Ghent (n=5) Imelda Hospital, Bonheiden (n=6) Jessa Hospital, Hasselt (n=10) Hospital Zuid-Oost Limburg, Genk (n=10) All isolates were identified to species level by ITS2 fragment length analysis. Susceptibility testing was performed in one centre on RPMI agar (AES Chemunex Laboratoire, Bruz Cedex, France) with E-test (Etest® BioMérieux, Marcy-l’Etoile, France) for fluconazole, voriconazole, caspofungin and amphotericin B. Results were interpreted following CLSI M27-S3 guidelines and ATCC 22019 C. parapsilosis and ATCC 6258 C. krusei were used as QC (2). Species distribution for the 106 isolates was: 56 Candida albicans strains, 35 C. glabrata, 8 C. parapsilosis, 2 C. tropicalis, 1 C. krusei, 1 C. kefyr, 1 C. dubliniensis, 1 Trichosporon species and 1 Cryptococcus neoformans (fig 1). In comparison with the previous study, a shift from C. albicans (63%  53%) to C. glabrata (21%  33%) was observed. Compared with our data from 5 years ago, we observed no significant changes in resistance patterns. Although there seemed to be a shift in species distribution, confirmation with more data is needed. Fig 2: MIC distributions for fluconazole, voriconazole, caspofungin and amphotericin B of all yeasts, C. albicans and C. glabrata isolates from blood cultures (12/’04-06/’05 vs. 12/’10-08/’11) Overall MIC distribution was obtained (fig 2). All C. albicans strains remained susceptible to fluconazole, voriconazole and caspofungin, with MIC values (in µg/mL) respectively from 0,038 to 0,75 (MIC 90 : 0,38), from 0,003 to 0,064 (MIC 90 : 0,012) and from 0,008 to 0,32 (MIC 90 : 0,125). For amphotericin B MIC ranges varied from 0,002 to 1 (MIC 90 : 0,5). Of 35 C. glabrata strains, 21 strains were susceptible to fluconazole (MIC ranges 3-8, MIC 90 : 8), 12 strains SDD (MIC ranges 12-24, MIC 90 : 24) and 2 strains resistant (MIC >256). The MIC values for voriconazole were 0,032-0,75 for fluconazole susceptible strains, 0,25-0,5 for fluconazole SDD strains and 3-8 for fluconazole resistant strains. All strains were susceptible to caspofungin with MIC values of 0,008-0,25 (MIC 90 : 0,19). The MIC values for amphotericin B ranged from 0,002 to 1 (MIC 90 : 0,75). MIC distributions are shown in fig 2. All C. parapsilosis strains were susceptible to fluconazole (MIC 0,25-1, MIC 90 : 1) and voriconazole (MIC 0,008-0,064, MIC 90 : 0,032). MIC distributions for caspofungin were 0,25-1,5 (MIC 90 : 1), for amphotericin B 0,38-1 (MIC 90 : 1). Fig 1: Species distribution of all yeasts isolated from blood cultures Introduction Materials and methods References Results (1)Boel A. et al, Susceptibility of yeasts isolated from hemocultures in 7 Belgian hospitals, Poster ISHAM 2006 (2)CLSI Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; 3th Informational Supplement, M27-S3, vol 28 n°15 Acknowledgement: The authors thank Pfizer for the supply of materials for susceptibility testing: E-test and RPMI agars. contact: christine.1.vanlaer@uzleuven.be all yeasts (n=106) C. glabrata (n=35) C. albicans (n=56) Conclusions