Emerging echinocandin-resistant Candida albicans and glabrata in Switzerland

Coste, Alix T.; Kritikos, Antonios; Li, J; Khanna, Nina; Goldenberger, Daniel; Garzoni, Christian; Zehnder, C; Boggian, Katia; Neofytos, Dionysios; Riat, Arnaud; Bachmann, Daniel; Sanglard, Dominique; Lamoth, Frédéric

doi:10.1007/s15010-020-01475-8

Cited by 42 publications

(40 citation statements)

References 13 publications

(32 reference statements)

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“…Our findings may alter the awareness of non- albicans Candida species and their spectrum of therapeutic resistance in the general care of elderly people. Due to C. glabrata increasingly gaining importance in several patient groups, such as abdominal surgery patients, or due to the occurrence of echinocandin resistance in this species [ 36 , 37 , 38 ], our findings should be taken into account when treating elderly patients. Screening for oral [ 39 ] or gastrointestinal fungal colonization prior to surgical intervention or when employing indwelling devices might be a tool to facilitate adequate subsequent calculated antifungal therapy [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly

et al. 2021

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In elderly patients, several morbidities or medical treatments predisposing for fungal infections occur at a higher frequency, leading to high mortality and morbidity in this vulnerable patient group. Often, this is linked to an innately azole-resistant yeast species such as Candida glabrata or C. krusei. Additionally, host age per se and the wearing of dentures have been determined to influence the mix of colonizing species and, consequently, the species distribution of invasive fungal infections. Since both old age and the wearing of dentures are two tightly connected parameters, it is still unclear which of them is the main contributor. Here, we performed a cross-sectional study on a cohort (N = 274) derived from three groups of healthy elderly, diseased elderly, and healthy young controls. With increasing host age, the frequency of oral colonization by a non-albicans Candida species, mainly by C. glabrata, also increased, and the wearing of dentures predisposed for colonization by C. glabrata irrespectively of host age. Physically diseased hosts, on the other hand, were more frequently orally colonized by C. albicans than by other yeasts. For both C. albicans and C. glabrata, isolates from the oral cavity did not generally display an elevated biofilm formation capacity. In conclusion, intrinsically azole-drug-resistant, non-albicans Candida yeasts are more frequent in the oral cavities of the elderly, and fungal cells not contained in biofilms may predispose for subsequent systemic infection with these organisms. This warrants further exploration of diagnostic procedures, e.g., before undergoing elective abdominal surgery or when using indwelling devices on this patient group.

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Section: Discussionmentioning

confidence: 99%

Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly

et al. 2021

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“…Overall, the rates of echinocandin treatment failure for candidemia due to FKS -mutant Candida spp. ranges from 60 to 90% [ 51 , 52 , 54 , 55 ], while the usual failure rate of echinocandins in the big trials of candidemia is around 10 to 30% [ 56 , 57 , 58 , 59 ].…”

Section: Correlation Between Mics and Outcome: Current Evidencementioning

confidence: 99%

Role and Interpretation of Antifungal Susceptibility Testing for the Management of Invasive Fungal Infections

Lamoth

Lewis

Kontoyiannis

2020

JoF

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Invasive fungal infections (IFIs) are associated with high mortality rates and timely appropriate antifungal therapy is essential for good outcomes. Emerging antifungal resistance among Candida and Aspergillus spp., the major causes of IFI, is concerning and has led to the increasing incorporation of in vitro antifungal susceptibility testing (AST) to guide clinical decisions. However, the interpretation of AST results and their contribution to management of IFIs remains a matter of debate. Specifically, the utility of AST is limited by the delay in obtaining results and the lack of pharmacodynamic correlation between minimal inhibitory concentration (MIC) values and clinical outcome, particularly for molds. Clinical breakpoints for Candida spp. have been substantially revised over time and appear to be reliable for the detection of azole and echinocandin resistance and for outcome prediction, especially for non-neutropenic patients with candidemia. However, data are lacking for neutropenic patients with invasive candidiasis and some non-albicans Candida spp. (notably emerging Candida auris). For Aspergillus spp., AST is not routinely performed, but may be indicated according to the epidemiological context in the setting of emerging azole resistance among A. fumigatus. For non-Aspergillus molds (e.g., Mucorales, Fusarium or Scedosporium spp.), AST is not routinely recommended as interpretive criteria are lacking and many confounders, mainly host factors, seem to play a predominant role in responses to antifungal therapy. This review provides an overview of the pre-clinical and clinical pharmacodynamic data, which constitute the rationale for the use and interpretation of AST testing of yeasts and molds in clinical practice.

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“…было показано увеличение количества таких штаммов с 4,9% до 12,3% в период с 2001 по 2010 г. [25], и по добные данные продолжают появляться в разных стра нах [26]. Тем не менее в России, по данным исследова ния, проведенного в НИИ антимикробной химиотерапии (Смоленск), ЭК показали высокую активность в отноше нии клинических штаммов C. glabrata, чувствительность которых определялась с помощью методики Sensititre TM YeastOne TM (панель YO10) в соответствии с рекоменда циями производителя, а интерпретация результатов про водилась на основании критериев Института клиниче ских и лабораторных стандартов (CLSI) (M27 A3).…”

Section: резистентность к эхинокандинамunclassified

The current place of echinocandins in the treatment and prophylaxis of invasive fungal infections

Веселов

2020

CMAC

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Invasive fungal infections continue to show steady growth among various patient populations, accompanied by high rates of both morbidity and attributive mortality. For the treatment of invasive mycoses, a few number of drugs are currently available, which include polyenes, azoles, echinocandins, allylamines and flucytosine. Among these groups, echinocandins – anidulafungin, caspofungin and mycafungin – represent a key class of antifungal drugs, primarily for the treatment of the most common form of systemic fungal infections – Invasive candidiasis. Possessing a unique mechanism of action that determines fungicidal activity against yeast pathogens, a predictable pharmacokinetics profile, and good safety profile, echinocandins have firmly taken the lead in the treatment of infections caused by Candida species. In addition, they are used in the treatment of refractory cases of invasive aspergillosis and for the prevention of invasive mycoses in selected patient populations. In this brief review, the main clinical and pharmacological characteristics of echinocandins and their positioning within the current versions of practical recommendations will be presented.

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Emerging echinocandin-resistant Candida albicans and glabrata in Switzerland

Cited by 42 publications

References 13 publications

Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly

Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly

Role and Interpretation of Antifungal Susceptibility Testing for the Management of Invasive Fungal Infections

The current place of echinocandins in the treatment and prophylaxis of invasive fungal infections

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