title: Caspofungin resistance in Candida albicans: correlating clinical outcome with laboratory susceptibility testing of three isogenic isolates serially obtained from a patient with progressive Candida esophagitis.
abstract: A patient with azole-refractory thrush-esophagitis responded initially to caspofungin, but the treatment eventually failed. In a murine model, caspofungin was effective against two early isolates for which the MICs of caspofungin were low, but it was less effective against a late isolate for which the MIC of caspofungin was greater. We concluded that there is a correlation between in vivo failure and rising in vitro caspofungin MICs.
authors.affiliation: Department of Medicine, Division Infectious Diseases (7881), The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900, USA. Hernandezs@uthscsa.edu
authors.forename: Steve
authors.initials: S
authors.lastname: Hernandez
authors.forename: José L
authors.initials: JL
authors.lastname: López-Ribot
authors.forename: Laura K
authors.initials: LK
authors.lastname: Najvar
authors.forename: Dora I
authors.initials: DI
authors.lastname: McCarthy
authors.forename: Rosie
authors.initials: R
authors.lastname: Bocanegra
authors.forename: John R
authors.initials: JR
authors.lastname: Graybill
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000818:Animals; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D002176:Candida albicans / Q000187:drug effects*; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology; D000077336:Caspofungin; D025141:Drug Resistance, Fungal; D054714:Echinocandins; D004941:Esophagitis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D055666:Lipopeptides; D008297:Male; D051379:Mice; D008813:Mice, Inbred ICR; D008826:Microbial Sensitivity Tests; D010455:Peptides / Q000494:pharmacology* / Q000627:therapeutic use*; D010456:Peptides, Cyclic; D017211:Treatment Failure
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010455:Peptides; D010456:Peptides, Cyclic; D000077336:Caspofungin