1887

Abstract

The antifungal susceptibility pattern of 302 isolates collected during an Italian survey on invasive fungal infections in an intensive care setting was investigated. The results were correlated with some epidemiological data and compared with the antifungal profiles obtained in a previous survey. No resistance to echinocandins was detected. The overall resistance levels to fluconazole, posaconazole and voriconazole were 12.6, 6.0 and 7.1 %, respectively. and accounted for more than half of all the fluconazole resistant isolates. Reduced susceptibility to fluconazole is not uncommon among isolates (12.3 %) and appears to be increasing, particularly among isolates, which showed an increase in resistant isolates from 2 % in the 1990s to 25.8 % in the present study. Routine antifungal susceptibility testing of this species is therefore recommended.

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2012-03-01
2024-03-28
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References

  1. Arendrup M. C., Bruun B., Christensen J. J., Fuursted K., Johansen H. K., Kjaeldgaard P., Knudsen J. D., Kristensen L., Møller J. other authors 2011a; National surveillance of fungemia in Denmark (2004 to 2009). J Clin Microbiol 49:325–334 [View Article][PubMed]
    [Google Scholar]
  2. Arendrup M. C., Rodriguez-Tudela J. L., Park S., Garcia-Effron G., Delmas G., Cuenca-Estrella M., Gomez-Lopez A., Perlin D. S. 2011b; Echinocandin susceptibility testing of Candida spp. using EUCAST EDef 7.1 and CLSI M27-A3 standard procedures: analysis of the influence of bovine serum albumin supplementation, storage time, and drug lots. Antimicrob Agents Chemother 55:1580–1587 [View Article][PubMed]
    [Google Scholar]
  3. CLSI 2008; Reference method for broth dilution antifungal susceptibility testing of yeasts, 3rd edn. Document M27–A3. Wayne, PA: Clinical and Laboratory Standards Institute;
  4. Kett D. H., Azoulay E., Echeverria P. M., Vincent J. L. for the Extended Prevalence of Infection in ICU Study (EPIC II) Group of Investigators 2011; Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study. Crit Care Med 39:665–670 [View Article][PubMed]
    [Google Scholar]
  5. Lockhart S. R., Wagner D., Iqbal N., Pappas P. G., Andes D. R., Kauffman C. A., Brumble L. M., Hadley S., Walker R. other authors 2011; Comparison of in vitro susceptibility characteristics of Candida species from cases of invasive candidiasis in solid organ and stem cell transplant recipients: Transplant-Associated Infections Surveillance Network (TRANSNET), 2001 to 2006. J Clin Microbiol 49:2404–2410 [View Article][PubMed]
    [Google Scholar]
  6. Pappas P. G. Mycoses Study Group 2011; Candidemia in the intensive care unit: miles to go before we sleep. Crit Care Med 39:884–885 [View Article][PubMed]
    [Google Scholar]
  7. Pfaller M. A., Diekema D. J., Ostrosky-Zeichner L., Rex J. H., Alexander B. D., Andes D., Brown S. D., Chaturvedi V., Ghannoum M. A. other authors 2008; Correlation of MIC with outcome for Candida species tested against caspofungin, anidulafungin, and micafungin: analysis and proposal for interpretive MIC breakpoints. J Clin Microbiol 46:2620–2629 [View Article][PubMed]
    [Google Scholar]
  8. Pfaller M. A., Andes D., Diekema D. J., Espinel-Ingroff A., Sheehan D. CLSI Subcommittee for Antifungal Susceptibility Testing 2010; Wild-type MIC distributions, epidemiological cutoff values and species-specific clinical breakpoints for fluconazole and Candida: time for harmonization of CLSI and EUCAST broth microdilution methods. Drug Resist Updat 13:180–195 [View Article][PubMed]
    [Google Scholar]
  9. Pfaller M. A., Andes D., Arendrup M. C., Diekema D. J., Espinel-Ingroff A., Alexander B. D., Brown S. D., Chaturvedi V., Fowler C. L. other authors 2011a; Clinical breakpoints for voriconazole and Candida spp. revisited: review of microbiologic, molecular, pharmacodynamic, and clinical data as they pertain to the development of species-specific interpretative criteria. Diagn Microbiol Infect Dis 70:330–343 [View Article]
    [Google Scholar]
  10. Pfaller M. A., Diekema D. J., Andes D., Arendrup M. C., Brown S. D., Lockhart S. R., Motyl M., Perlin D. S. CLSI Subcommittee for Antifungal Testing 2011b; Clinical breakpoints for the echinocandins and Candida revisited: integration of molecular, clinical, and microbiological data to arrive at species-specific interpretive criteria. Drug Resist Updat 14:164–176 [View Article][PubMed]
    [Google Scholar]
  11. Pfaller M. A., Moet G. J., Messer S. A., Jones R. N., Castanheira M. 2011c; Candida bloodstream infections: comparison of species distributions and antifungal resistance patterns in community-onset and nosocomial isolates in the SENTRY Antimicrobial Surveillance Program, 2008–2009. Antimicrob Agents Chemother 55:561–566 [View Article][PubMed]
    [Google Scholar]
  12. Tortorano A. M., Rigoni A. L., Biraghi E., Prigitano A., Viviani M. A. FIMUA-ECMM Candidaemia Study Group 2003; The European Confederation of Medical Mycology (ECMM) survey of candidaemia in Italy: antifungal susceptibility patterns of 261 non-albicans Candida isolates from blood. J Antimicrob Chemother 52:679–682 [View Article][PubMed]
    [Google Scholar]
  13. Tortorano A. M., Prigitano A., Biraghi E., Viviani M. A. on behalf of the FIMUA-ECMM Candidaemia Study Group 2005; The European Confederation of Medical Mycology (ECMM) survey of candidaemia in Italy: in vitro susceptibility of 375 Candida albicans isolates and biofilm production. J Antimicrob Chemother 56:777–779 [View Article][PubMed]
    [Google Scholar]
  14. Tortorano A. M., Dho G., Prigitano A., Breda G., Grancini A., Emmi V., Cavanna C., Marino G., Morero S. other authors 2012; Invasive fungal infections in the intensive care unit: a multicentre, prospective, observational study in Italy (2006–2008). Mycoses 55:73–79[PubMed] [CrossRef]
    [Google Scholar]
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