title: Breakthrough fungal infections in stem cell transplant recipients receiving voriconazole.
abstract: Infection with voriconazole-resistant fungi may become problematic, because organisms with decreased susceptibility have been noted. Breakthrough fungal infections occurred in 13 of 139 patients who received voriconazole at our center during the period of September 1998 through September 2003. Zygomycetes were found in 6 patients, and Candida glabrata bloodstream infection occurred in 4 patients. Minimal inhibitory concentrations were > or =1 microg/mL for all available isolates. Yeasts and molds with decreased susceptibility to voriconazole may cause invasive infection in patients treated successfully for aspergillosis.
authors.affiliation: Program in Infectious Diseases, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Imhof
authors.forename: S Arunmozhi
authors.initials: SA
authors.lastname: Balajee
authors.forename: David N
authors.initials: DN
authors.lastname: Fredricks
authors.forename: Janet A
authors.initials: JA
authors.lastname: Englund
authors.forename: Kieren A
authors.initials: KA
authors.lastname: Marr
mesh_terms: D000328:Adult; D001228:Aspergillosis / Q000188:drug therapy; D001230:Aspergillus / Q000187:drug effects / Q000302:isolation & purification; D041221:Candida glabrata / Q000187:drug effects / Q000378:metabolism / Q000502:physiology; D002177:Candidiasis / Q000188:drug therapy / Q000378:metabolism; D002648:Child; D025141:Drug Resistance, Fungal / Q000187:drug effects* / Q000502:physiology; D005260:Female; D016469:Fungemia / Q000188:drug therapy / Q000378:metabolism; D005658:Fungi / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D016867:Immunocompromised Host / Q000502:physiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole; D020096:Zygomycosis / Q000188:drug therapy / Q000378:metabolism
chemical_list: D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole