A multicentre study to evaluate the impact of timing of caspofungin administration on outcomes of invasive candidiasis in non-immunocompromised adult patients

Hsu, Donald I.; Nguyen, Megan; Nguyen, Lee; Law, Anandi V.; Wong-Beringer, Annie

doi:10.1093/jac/dkq216

Cited by 52 publications

(37 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Whereas a shift to non-albicans species of Candida, particularly C. glabrata, has been a cause for alarm among clinicians caring for profoundly ill patients in the hospital (23,26,61), others have suggested that this is not a concern in the current "echinocandin era" (16,56,57). Prior to the availability of the echinocandins, concern over the reduced azole susceptibility of C. glabrata was a major issue for clinicians (10,22,29,32,54).…”

Section: Resultsmentioning

confidence: 99%

Frequency of Decreased Susceptibility and Resistance to Echinocandins among Fluconazole-Resistant Bloodstream Isolates of Candida glabrata

et al. 2012

View full text Add to dashboard Cite

The echinocandin class of antifungal agents is considered to be the first-line treatment of bloodstream infections (BSI) due to Candida glabrata. Recent reports of BSI due to strains of C. glabrata resistant to both fluconazole and the echinocandins are of concern and prompted us to review the experience of two large surveillance programs, the SENTRY Antimicrobial Surveillance Program for the years 2006 through 2010 and the Centers for Disease Control and Prevention population-based surveillance conducted in 2008 to 2010. The in vitro susceptibilities of 1,669 BSI isolates of C. glabrata to fluconazole, voriconazole, anidulafungin, caspofungin, and micafungin were determined by CLSI broth microdilution methods. Fluconazole MICs of >64 g/ml were considered resistant. Strains for which anidulafungin and caspofungin MICs were >0.5 g/ml and for which micafungin MICs were >0.25 g/ml were considered resistant. A total of 162 isolates (9.7%) were resistant to fluconazole, of which 98.8% were nonsusceptible to voriconazole (MIC > 0.5 g/ml) and 9.3%, 9.3%, and 8.0% were resistant to anidulafungin, caspofungin, and micafungin, respectively. There were 18 fluconazole-resistant isolates that were resistant to one or more of the echinocandins (11.1% of all fluconazole-resistant isolates), all of which contained an acquired mutation in fks1 or fks2. By comparison, there were no echinocandin-resistant strains detected among 110 fluconazole-resistant isolates of C. glabrata tested in 2001 to 2004. These data document the broad emergence of coresistance over time to both azoles and echinocandins in clinical isolates of C. glabrata.

show abstract

Section: Resultsmentioning

confidence: 99%

Frequency of Decreased Susceptibility and Resistance to Echinocandins among Fluconazole-Resistant Bloodstream Isolates of Candida glabrata

et al. 2012

View full text Add to dashboard Cite

show abstract

“…achieve suitable growth for MIC testing by 24 h of incubation (14)(15)(16)36). Given the facts that a shorter incubation period is more efficient and practical for use in the clinical laboratory (16,36) and that research has shown that early/ correct antifungal treatment has a positive effect on outcomes for patients with candidemia (5,6,12,19,20,23,27,29,33,53), the CLSI has determined that fluconazole MICs may be used after a 24-h incubation, providing earlier clinically useful information to clinicians caring for patients with invasive candidiasis (IC) (31,36). Currently, the CLSI recommends that MICs for the newer triazoles, posaconazole and voriconazole, be read after 48 h of incubation for testing of Candida spp.…”

mentioning

confidence: 99%

Wild-Type MIC Distributions and Epidemiological Cutoff Values for Posaconazole and Voriconazole and Candida spp. as Determined by 24-Hour CLSI Broth Microdilution

et al. 2011

View full text Add to dashboard Cite

In the absence of clinical breakpoints (CBPs) for posaconazole, these WT distributions and ECVs will be useful in surveillance for emergence of reduced susceptibility to posaconazole among Candida spp. Whereas a CBP for susceptibility of <1 g/ml has been established for voriconazole and all species of Candida, it is notable that ECVs for this agent range from 10-to >100-fold lower than the CBP, depending on the species of Candida. The CBP is inadequate in detecting the emergence of voriconazole resistance among most Candida species encountered clinically. The CBPs for voriconazole should be reassessed, with consideration for development of species-specific CBPs.

show abstract

“…There now are several lines of evidence that indicate that early and appropriate (correct dose and susceptible organism) antifungal therapy has a positive effect on outcomes and resource utilization for patients with candidemia (2,14,15,19,22,24,28,39). The choice of antifungal therapy may be optimized by the use of routine onsite antifungal susceptibility testing (4,5,8,13,16,18,23,27,37).…”

mentioning

confidence: 99%

Validation of 24-Hour Posaconazole and Voriconazole MIC Readings versus the CLSI 48-Hour Broth Microdilution Reference Method: Application of Epidemiological Cutoff Values to Results from a Global Candida Antifungal Surveillance Program

et al. 2011

View full text Add to dashboard Cite

We performed 24-and 48-h MIC determinations of posaconazole and voriconazole against more than 16,000 clinical isolates of Candida species. By using the 24-and 48-h epidemiological cutoff values (ECVs), the categorical agreement between the 24-h and reference 48-h broth microdilution results ranged from 97.1% (C. parapsilosis and voriconazole) to 99.8% (C. krusei and voriconazole), with 0.0 to 2.9% very major discrepancies (VMD). The essential agreement (within 2 log 2 dilutions) between the 24-and 48-h results was 99.6% for both posaconazole and voriconazole. The MIC results obtained for both posaconazole and voriconazole after only 24 h of incubation may be used to determine the susceptibilities of Candida spp. to these important antifungal agents. The applications of ECVs to this large collection of Candida isolates suggests the potential to develop 24-h species-specific clinical breakpoints for both posaconazole and voriconazole.

show abstract

A multicentre study to evaluate the impact of timing of caspofungin administration on outcomes of invasive candidiasis in non-immunocompromised adult patients

Abstract: Non-albicans Candida species accounted for the majority of IC in caspofungin-treated patients. Improved outcomes were observed for patients initiated with caspofungin within 72 h of positive culture compared with those who received delayed therapy.

Cited by 52 publications

References 20 publications

Frequency of Decreased Susceptibility and Resistance to Echinocandins among Fluconazole-Resistant Bloodstream Isolates of Candida glabrata

Frequency of Decreased Susceptibility and Resistance to Echinocandins among Fluconazole-Resistant Bloodstream Isolates of Candida glabrata

Wild-Type MIC Distributions and Epidemiological Cutoff Values for Posaconazole and Voriconazole and Candida spp. as Determined by 24-Hour CLSI Broth Microdilution

Validation of 24-Hour Posaconazole and Voriconazole MIC Readings versus the CLSI 48-Hour Broth Microdilution Reference Method: Application of Epidemiological Cutoff Values to Results from a Global Candida Antifungal Surveillance Program

Contact Info

Product

Resources

About