Candida species distribution and antifungal susceptibility testing according to European Committee on Antimicrobial Susceptibility Testing and new vs. old Clinical and Laboratory Standards Institute clinical breakpoints: a 6-year prospective candidaemia s

Journal Article

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Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

Clin.Microbiol.Infect.

Jul

698

705

CI: (c) 2013 The Authors Clinical Microbiology and Infection (c) 2013; JID: 9516420; 0 (Antifungal Agents); 0 (Echinocandins); 8VZV102JFY (Fluconazole); F0XDI6ZL63 (caspofungin); JFU09I87TR (Voriconazole); OTO: NOTNLM; 2013/07/18 [received]; 2013/10/28 [r

France

1469-0691; 1198-743X

PMID: 24188136

eng

Journal Article; Research Support, Non-U.S. Gov't; IM

10.1111/1469-0691.12440 [doi]

Unknown(0)

24188136

We analyzed the species distribution of Candida blood isolates (CBIs), prospectively collected between 2004 and 2009 within FUNGINOS, and compared their antifungal susceptibility according to clinical breakpoints defined by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) in 2013, and the Clinical and Laboratory Standards Institute (CLSI) in 2008 (old CLSI breakpoints) and 2012 (new CLSI breakpoints). CBIs were tested for susceptiblity to fluconazole, voriconazole and caspofungin by microtitre broth dilution (Sensititre(R) YeastOne test panel). Of 1090 CBIs, 675 (61.9%) were C. albicans, 191 (17.5%) C. glabrata, 64 (5.9%) C. tropicalis, 59 (5.4%) C. parapsilosis, 33 (3%) C. dubliniensis, 22 (2%) C. krusei and 46 (4.2%) rare Candida species. Independently of the breakpoints applied, C. albicans was almost uniformly (>98%) susceptible to all three antifungal agents. In contrast, the proportions of fluconazole- and voriconazole-susceptible C. tropicalis and F-susceptible C. parapsilosis were lower according to EUCAST/new CLSI breakpoints than to the old CLSI breakpoints. For caspofungin, non-susceptibility occurred mainly in C. krusei (63.3%) and C. glabrata (9.4%). Nine isolates (five C. tropicalis, three C. albicans and one C. parapsilosis) were cross-resistant to azoles according to EUCAST breakpoints, compared with three isolates (two C. albicans and one C. tropicalis) according to new and two (2 C. albicans) according to old CLSI breakpoints. Four species (C. albicans, C. glabrata, C. tropicalis and C. parapsilosis) represented >90% of all CBIs. In vitro resistance to fluconazole, voriconazole and caspofungin was rare among C. albicans, but an increase of non-susceptibile isolates was observed among C. tropicalis/C. parapsilosis for the azoles and C. glabrata/C. krusei for caspofungin according to EUCAST and new CLSI breakpoints compared with old CLSI breakpoints.

European Society of Clinical Microbiology and Infectious Diseases

Orasch,C., Marchetti,O., Garbino,J., Schrenzel,J., Zimmerli,S., Muhlethaler,K., Pfyffer,G., Ruef,C., Fehr,J., Zbinden,R., Calandra,T., Bille,J.

Infectious Diseases Service, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.

20131212

http://vp9py7xf3h.search.serialssolutions.com/?charset=utf-8&pmid=24188136

2014