Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 1;73(6):1677-1680.
doi: 10.1093/jac/dky059.

Echinocandin resistance among Candida isolates at an academic medical centre 2005-15: analysis of trends and outcomes

Todd P McCarty  1   2 , Shawn R Lockhart  3 , Stephen A Moser  1 , Jennifer Whiddon  1 , Joanna Zurko  4 , Cau D Pham  3 , Peter G Pappas  1
Affiliations

Echinocandin resistance among Candida isolates at an academic medical centre 2005-15: analysis of trends and outcomes

Todd P McCarty et al. J Antimicrob Chemother. .

Abstract

Objectives: To identify the frequency of micafungin resistance among clinically significant isolates of Candida stored at our institution from 2005 to 2015. Chart review of patients with resistant isolates then informed the clinical setting and outcomes associated with these infections.

Methods: Clinical Candida isolates had been stored at -80°C in Brucella broth with 20% glycerol from 2005. Isolates were tested using broth microdilution to determine micafungin MICs. All Candida glabrata isolates and all isolates demonstrating decreased susceptibility to micafungin were screened for FKS mutations using a Luminex assay.

Results: In total, 3876 Candida isolates were tested for micafungin resistance, including 832 C. glabrata isolates. Of those, 33 isolates from 31 patients were found to have either decreased susceptibility to micafungin and/or an FKS mutation. C. glabrata accounted for the majority of these isolates. While bloodstream infections were found to have a very high mortality rate, isolates from other sites were uncommonly associated with 30-day mortality. Overall resistance rates were very low.

Conclusions: Echinocandin resistance in C. glabrata has been increasingly reported but rates at our institution remain very low. We hypothesize that a focus on antifungal stewardship may have led to these observations. Knowledge of local resistance patterns is key to appropriate empirical treatment strategies.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Candida bloodstream infections over time. BSI, bloodstream infection.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Magill SS, Edwards JR, Bamberg W et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014; 370: 1198–208. - PMC - PubMed
    1. Alexander BD, Johnson MD, Pfeiffer CD et al. Increasing echinocandin resistance in Candida glabrata: clinical failure correlates with presence of FKS mutations and elevated minimum inhibitory concentrations. Clin Infect Dis 2013; 56: 1724–32. - PMC - PubMed
    1. Beyda ND, John J, Kilic A et al. FKS mutant Candida glabrata: risk factors and outcomes in patients with candidemia. Clin Infect Dis 2014; 59: 819–25. - PubMed
    1. Pfaller MA, Castanheira M, Lockhart SR et al. Frequency of decreased susceptibility and resistance to echinocandins among fluconazole-resistant bloodstream isolates of Candida glabrata. J Clin Microbiol 2012; 50: 1199–203. - PMC - PubMed
    1. Vallabhaneni S, Cleveland AA, Farley MM et al. Epidemiology and risk factors for echinocandin nonsusceptible Candida glabrata bloodstream infections: data from a large multisite population-based candidemia surveillance program, 2008-2014. Open Forum Infect Dis 2015; 2: ofv163. - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources