Timing of susceptibility-based antifungal drug administration in patients with Candida bloodstream infection: correlation with outcomes

Grim, Shellee A.; Berger, Karen; Teng, Christine B; Gupta, Sandeep; Layden, Jennifer E.; Janda, William M.; Clark, Nina M.

doi:10.1093/jac/dkr511

Cited by 101 publications

(74 citation statements)

References 25 publications

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“…The introduction of these newer agents (triazoles and echinocandins) and the development of standardized testing methods by the Clinical and Laboratory Standards Institute (CLSI) Subcommittee on Antifungal Susceptibility Testing (17)(18)(19) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) (20) have proven to be invaluable to the clinician (21)(22)(23)(24)(25)(26)(27)(28), particularly with the introduction of clinical breakpoints (CBPs) (11,(29)(30)(31). The advent of global surveillance programs, backed by molecular ID and resistance detection, has resulted in a vast accumulation of data that has presented a clearer view of changing patterns in fungal species distributions and the emergence of less-susceptible and less-common species (2, 6-8, 12, 14, 32, 33).…”

mentioning

confidence: 99%

Echinocandin and Triazole Antifungal Susceptibility Profiles for Clinical Opportunistic Yeast and Mold Isolates Collected from 2010 to 2011: Application of New CLSI Clinical Breakpoints and Epidemiological Cutoff Values for Characterization of Geographic and Temporal Trends of Antifungal Resistance

et al. 2013

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The SENTRY Antimicrobial Surveillance Program monitors global susceptibility and resistance rates of newer and established antifungal agents. We report the echinocandin and triazole antifungal susceptibility patterns for 3,418 contemporary clinical isolates of yeasts and molds. The isolates were obtained from 98 laboratories in 34 countries during 2010 and 2011. Yeasts not presumptively identified by CHROMagar, the trehalose test, or growth at 42°C and all molds were sequence identified using internal transcribed spacer (ITS) and 28S (yeasts) or ITS, translation elongation factor (TEF), and 28S (molds) genes. Susceptibility testing was performed against 7 antifungals (anidulafungin, caspofungin, micafungin, fluconazole, itraconazole, posaconazole, and voriconazole) using CLSI methods. Rates of resistance to all agents were determined using the new CLSI clinical breakpoints and epidemiological cutoff value criteria, as appropriate. Sequencing of fks hot spots was performed for echinocandin non-wildtype (WT) strains. Isolates included 3,107 from 21 Candida spp., 146 from 9 Aspergillus spp., 84 from Cryptococcus neoformans, 40 from 23 other mold species, and 41 from 9 other yeast species. Among Candida spp., resistance to the echinocandins was low (0.0 to 1.7%). Candida albicans and Candida glabrata that were resistant to anidulafungin, caspofungin, or micafungin were shown to have fks mutations. Resistance to fluconazole was low among the isolates of C. albicans (0.4%), Candida tropicalis (1.3%), and Candida parapsilosis (2.1%); however, 8.8% of C. glabrata isolates were resistant to fluconazole. Among echinocandin-resistant C. glabrata isolates from 2011, 38% were fluconazole resistant. Voriconazole was active against all Candida spp. except C. glabrata (10.5% non-WT), whereas posaconazole showed decreased activity against C. albicans (4.4%) and Candida krusei (15.2% non-WT). All agents except for the echinocandins were active against C. neoformans, and the triazoles were active against other yeasts (MIC 90 , 2 g/ml). The echinocandins and triazoles were active against Aspergillus spp. (MIC 90 /minimum effective concentration [MEC 90 ] range, 0.015 to 2 g/ml), but the echinocandins were not active against other molds (MEC 90 range, 4 to >16 g/ml). Overall, echinocandin and triazole resistance rates were low; however, the fluconazole and echinocandin coresistance among C. glabrata strains warrants continued close surveillance.

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confidence: 99%

Echinocandin and Triazole Antifungal Susceptibility Profiles for Clinical Opportunistic Yeast and Mold Isolates Collected from 2010 to 2011: Application of New CLSI Clinical Breakpoints and Epidemiological Cutoff Values for Characterization of Geographic and Temporal Trends of Antifungal Resistance

et al. 2013

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“…Özellikle triazol grubu antifungal ajanların sık kullanılmasıyla hem C. albicans dışındaki türlerde artış hem de antifungal ajanlara dirençte artış saptanmış ve bütün bunların sonucunda antifungal ajanların in vitro duyarlılıklarını ölçen testler daha da önem kazanmış ve buna yönelik çalışmalar yoğunlaşmıştır [9,10] .…”

Section: Discussionunclassified

Fungal Infections; Species Distribution and Treatment Response

Kostakoğlu¹,

Yılmaz²,

Köksal³

2018

FLORA

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“…Candidemia and disseminated candidiasis mortality rates have not improved markedly over the past few years and remain in the 30-40 % range, resulting in a serious economic impact [10,11]. Candidemia is associated with considerable prolongation of the length of hospital stay (70 days vs. 40 days in matched patients) [10][11][12].…”

Section: Epidemiologymentioning

confidence: 99%

Candidiasis

Sobel¹

2015

Diagnosis and Treatment of Fungal Infections

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Timing of susceptibility-based antifungal drug administration in patients with Candida bloodstream infection: correlation with outcomes

Abstract: Candida bloodstream infection is associated with high mortality, despite timely receipt of appropriate antifungal therapy.

Cited by 101 publications

References 25 publications

Echinocandin and Triazole Antifungal Susceptibility Profiles for Clinical Opportunistic Yeast and Mold Isolates Collected from 2010 to 2011: Application of New CLSI Clinical Breakpoints and Epidemiological Cutoff Values for Characterization of Geographic and Temporal Trends of Antifungal Resistance

Echinocandin and Triazole Antifungal Susceptibility Profiles for Clinical Opportunistic Yeast and Mold Isolates Collected from 2010 to 2011: Application of New CLSI Clinical Breakpoints and Epidemiological Cutoff Values for Characterization of Geographic and Temporal Trends of Antifungal Resistance

Fungal Infections; Species Distribution and Treatment Response

Candidiasis

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