Trends in frequency and in vitro susceptibilities to antifungal agents, including voriconazole and anidulafungin, of Candida bloodstream isolates. Results from a six-year study (1996-2001).
The frequency of isolation and antifungal susceptibility patterns to established and two new antifungal agents were determined for 218 Candida spp isolates causing bloodstream infection from 1996 to 2001. Overall, 41.7% of the candidemias were due to C. albicans, followed by C. parapsilosis (22%), C. tropicalis (16.1%), C. glabrata (11.9%), C. krusei (6%) and miscellaneous Candida spp (2.3%). Isolates of C. albicans C. parapsilosis and C. tropicalis (80% of isolates) were highly susceptible to fluconazole (94 to 100% at </= 8 microg/ml) and voriconazole (97 to 100% at </= 1 microg/ml). By comparison with the newer agents itraconazole was less active (77 to 97% at </=0.12 microg/ml). Only 77% and 15% of C. glabrata isolates were inhibited by fluconazole at </= 8 microg/ml and itraconazole at </=0.12 microg/ml, respectively. Voriconazole showed a remarkable in vitro potency against C. glabrata as well as C. krusei isolates (100% at </= 1 microg/ml). Anidulafungin was very active against Candida spp isolates (MIC90: </= 0.5 microg/ml), except C. parapsilosis (MIC90: 4 microg/ml) and two C. guilliermondii isolates (MIC: >/= 32 microg/ml).
Marco
F
F
Serveis de Microbiologia i Infeccions, Hospital Clínic, IDIBAPS, Facultat de Medicina, Universitat de Barcelona, Spain. fmarco@clinic.ub.es
Danés
C
C
Almela
M
M
Jurado
A
A
Mensa
J
J
de la Bellacasa
J Puig
JP
Espasa
M
M
Martínez
J A
JA
Jiménez de Anta
M T
MT
D000077612:Anidulafungin; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000145:classification / Q000187:drug effects*; D002177:Candidiasis / Q000097:blood*; D025141:Drug Resistance, Fungal; D054714:Echinocandins; D005260:Female; D016469:Fungemia / Q000097:blood*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests / Q000706:statistics & numerical data / Q000639:trends; D010456:Peptides, Cyclic / Q000494:pharmacology*; D011743:Pyrimidines / Q000494:pharmacology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013030:Spain; D014230:Triazoles / Q000494:pharmacology*; D065819:Voriconazole
D000935:Antifungal Agents; D054714:Echinocandins; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; D000077612:Anidulafungin; D065819:Voriconazole