Anidulafungin and micafungin MIC breakpoints are superior to that of caspofungin for identifying FKS mutant Candida glabrata strains and Echinocandin resistance.
By CLSI interpretive criteria, anidulafungin and micafungin MICs determined by various methods were sensitive (60 to 70%) and highly specific (94 to 100%) for identifying FKS mutations among 120 Candida glabrata isolates. Anidulafungin and micafungin breakpoints were more specific than CLSI's caspofungin breakpoint in identifying FKS mutant strains and patients with invasive candidiasis who were likely to fail echinocandin treatment (P ≤ 0.0001 for both). Echinocandin MICs were most useful clinically when interpreted in the context of prior echinocandin exposure.
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Ryan K
RK
Shields
M Hong
MH
Nguyen
Ellen G
EG
Press
Cassaundra L
CL
Updike
Cornelius J
CJ
Clancy
D000077612:Anidulafungin; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D041221:Candida glabrata / Q000187:drug effects; D002177:Candidiasis / Q000188:drug therapy*; D000077336:Caspofungin; D054714:Echinocandins / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D055666:Lipopeptides / Q000494:pharmacology* / Q000627:therapeutic use*; D000077551:Micafungin; D008826:Microbial Sensitivity Tests
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077612:Anidulafungin; D000077336:Caspofungin; D000077551:Micafungin