title: Comparison of in vitro susceptibility characteristics of Candida species from cases of invasive candidiasis in solid organ and stem cell transplant recipients: Transplant-Associated Infections Surveillance Network (TRANSNET), 2001 to 2006.
abstract: Invasive fungal infections (IFI) are a major cause of morbidity and mortality among both solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. Candida is the most common cause of IFI in SOT recipients and the second most common cause of IFI in HSCT recipients. We determined susceptibilities to fluconazole, voriconazole, itraconazole, posaconazole, amphotericin B, and caspofungin for 383 invasive Candida sp. isolates from SOT and HSCT recipients enrolled in the Transplant-Associated Infection Surveillance Network and correlated these results to clinical data. Fluconazole resistance in C. albicans, C. tropicalis, and C. parapsilosis isolates was low (1%), but the high percentage of C. glabrata and C. krusei isolates within this group of patients increased the overall percentage of fluconazole resistance to 16%. Voriconazole resistance was 3% overall but was 8% among C. glabrata isolates. On multivariable analysis, among HSCT recipients fluconazole nonsusceptibility was independently associated with C. glabrata, non-Hodgkin's lymphoma, cytomegalovirus (CMV) antigenemia, diabetes active at the time of the IFI, and any prior amphotericin B use; among SOT recipients, fluconazole nonsusceptibility was independently associated with any fluconazole use in the 3 months prior to the IFI, C. glabrata, ganciclovir use in the 3 months prior to the IFI, diabetes acquired since the transplant, and gender.
authors.affiliation: Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Shawn R
authors.initials: SR
authors.lastname: Lockhart
authors.forename: Debra
authors.initials: D
authors.lastname: Wagner
authors.forename: Naureen
authors.initials: N
authors.lastname: Iqbal
authors.forename: Peter G
authors.initials: PG
authors.lastname: Pappas
authors.forename: David R
authors.initials: DR
authors.lastname: Andes
authors.forename: Carol A
authors.initials: CA
authors.lastname: Kauffman
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Brumble
authors.forename: Susan
authors.initials: S
authors.lastname: Hadley
authors.forename: Randall
authors.initials: R
authors.lastname: Walker
authors.forename: James I
authors.initials: JI
authors.lastname: Ito
authors.forename: John W
authors.initials: JW
authors.lastname: Baddley
authors.forename: Tom
authors.initials: T
authors.lastname: Chiller
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Park
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D058365:Candidiasis, Invasive / Q000382:microbiology*; D025141:Drug Resistance, Fungal; D006801:Humans; D008826:Microbial Sensitivity Tests; D016377:Organ Transplantation / Q000009:adverse effects*; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014180:Transplantation
chemical_list: D000935:Antifungal Agents