title: Geographic variation in the susceptibilities of invasive isolates of Candida glabrata to seven systemically active antifungal agents: a global assessment from the ARTEMIS Antifungal Surveillance Program conducted in 2001 and 2002.
abstract: We examined the susceptibilities to amphotericin B, flucytosine, fluconazole, posaconazole, ravuconazole, voriconazole, and caspofungin of 601 invasive isolates of Candida glabrata and grouped the isolates by geographic location: North America (331 isolates), Latin America (58 isolates), Europe (135 isolates), and Asia-Pacific (77 isolates). Caspofungin (MIC at which 90% of isolates tested are susceptible [MIC(90)], 0.12 microg/ml; 100% of strains are susceptible [S] at a MIC of </=1 microg/ml) and flucytosine (MIC(90), 0.12 microg/ml; 99.2% S) were the most active agents in all geographic regions. Fluconazole susceptibility was highest in the Asia-Pacific region (80.5% S, 3.9% resistant [R]) and lowest in North America (64% S, 10.3% R) and Latin America (62.1% S, 3.4% R). The extended-spectrum triazoles were most active in the Asia-Pacific region (90 to 96.1% S) and least active in North America (82.5 to 90.3% S). All 46 isolates that were resistant to fluconazole were susceptible to caspofungin (MIC(90), 0.06 microg/ml) and flucytosine (MIC(90), 0.12 microg/ml) and exhibited variable cross-resistance to posaconazole, ravuconazole, and voriconazole.
authors.affiliation: Department of Pathology, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA. michael-pfaller@uiowa.edu
authors.forename: M A
authors.initials: MA
authors.lastname: Pfaller
authors.forename: S A
authors.initials: SA
authors.lastname: Messer
authors.forename: L
authors.initials: L
authors.lastname: Boyken
authors.forename: S
authors.initials: S
authors.lastname: Tendolkar
authors.forename: R J
authors.initials: RJ
authors.lastname: Hollis
authors.forename: D J
authors.initials: DJ
authors.lastname: Diekema
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D041221:Candida glabrata / Q000187:drug effects*; D025141:Drug Resistance, Fungal; D008826:Microbial Sensitivity Tests; D013997:Time Factors
chemical_list: D000935:Antifungal Agents