[In vitro activity of caspofungin against fluconazole-resistant Candida isolates from patients with HIV infection].
BACKGROUND
Antifungal therapy for mucosal candidiasis caused by fluconazole-resistant Candida species is problematic. The aim of this study was to investigate the in vitro activity of caspofungin against Candida strains with reduced susceptibility to fluconazole isolated from HIV-infected patients.


METHODS
The in vitro activity of caspofungin was assessed in 28 fluconazole-resistant Candida isolates obtained from the oral cavity of a cohort of 174 consecutive HIV-infected patients. Minimum inhibitory concentrations (MICs) were determined by a standardized broth microdilution method, as recommended by the NCCLS.


RESULTS
Overall, caspofungin MICs ranged from < or = 0.06 microg/ml to 1 microg/ml. MICs at which 50% (MIC50) and 90% (MIC90) of isolates were inhibited were 0.25 microg/ml and 0.5 microg/ml, respectively. MICs ranged from < or = 0.06 microg/ml to 0.5 microg/ml for Candida albicans (n = 11), and < 0.06 microg/ml to 1 microg/ml or Candida glabrata (n = 11). MICs for the two strains of Candida krusei were 0.125 microg/ml and 1 microg/ml. The range of MICs for Candida tropicalis and Candida inconspicua strains was 0.25 microg/ml to 0.5 microg/ml.


CONCLUSIONS
Caspofungin was very active in vitro against a variety of fluconazole-resistant Candida strains recovered from a clinical cohort of HIV-infected patients. The MIC50 values and MIC ranges were slightly higher for Candida glabrata than for Candida albicans.
Ortiz de la Tabla-Ducasse
Victoria
V
Sección de Microbiología, Hospital Universitario de San Juan, San Juan, Alicante, Spain. ortiz_vic@gva.es
Masiá-Canuto
Mar
M
Martín-González
Coral
C
Gutiérrez-Rodero
Félix
F
D002175:Candida / Q000187:drug effects*; D002176:Candida albicans / Q000187:drug effects; D041221:Candida glabrata / Q000187:drug effects; D041022:Candida tropicalis / Q000187:drug effects; D002180:Candidiasis, Oral / Q000150:complications / Q000382:microbiology*; D000077336:Caspofungin; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D025141:Drug Resistance, Fungal; D054714:Echinocandins; D015725:Fluconazole / Q000494:pharmacology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D055666:Lipopeptides; D008826:Microbial Sensitivity Tests; D010455:Peptides / Q000494:pharmacology*; D010456:Peptides, Cyclic; D013045:Species Specificity
D054714:Echinocandins; D055666:Lipopeptides; D010455:Peptides; D010456:Peptides, Cyclic; D015725:Fluconazole; D000077336:Caspofungin