Antifungal resistance in patients with Candidaemia: a retrospective cohort study

Aldardeer, Namareq; Albar, Hadiel; Alattas, Majda; Eldali, Abdelmoneim; Qutub, Mohammed; Hassanien, Ashraf; Alraddadi, Basem

doi:10.1186/s12879-019-4710-z

Cited by 41 publications

(44 citation statements)

References 24 publications

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“…The rate of fluconazole resistance against C. parapsilosis candidemia in our study was higher (59.1%) than those of previously reported studies (2–6%) [ 28 – 30 ]. Recently, the emergence of fluconazole resistance of C. parapsilosis from intensive care units (30–75%) has been reported [ 31 – 33 ]. The possible mechanism of fluconazole resistance may include genetic mutation (e.g., mutation of the ERG11 gene) [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…The possible mechanism of fluconazole resistance may include genetic mutation (e.g., mutation of the ERG11 gene) [ 34 , 35 ]. Also, certain clinical factors such as previous exposure of antifungal agents, ventilation, and transfusion have been associated with fluconazole resistance of C. parapsilosis candidemia [ 31 ]. Moreover, a widespread mutation of the ERG11 gene was reported in fluconazole-resistant C. parapsilosis bloodstream isolates from a multicenter study in the Republic of Korea [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Anidulafungin Versus Micafungin in the Treatment of Candidemia in Adult Patients

2020

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anidulafungin Versus Micafungin in the Treatment of Candidemia in Adult Patients

2020

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“…Candida glabrata is the second leading cause of candidaemia in USA, 1 Canada, 2 Australia 3 and some Scandinavian countries 4‐9 and the first cause of candidaemia in intensive care units and patients with haematological malignancies and solid tumours 10,11 . Compared to the other Candida species, C glabrata is much more tolerant to antifungals, 12 which allows it to rapidly develop antifungal resistance during the course of antifungal therapy 13‐22 .…”

Section: Introductionmentioning

confidence: 99%

Low level of antifungal resistance of Candida glabrata blood isolates in Turkey: Fluconazole minimum inhibitory concentration and FKS mutations can predict therapeutic failure

Arastehfar

Daneshnia²,

Salehi

et al. 2020

Mycoses

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Background Candida glabrata is the third leading cause of candidaemia in Turkey; however, the data regarding antifungal resistance mechanisms and genotypic diversity in association with their clinical implication are limited. Objectives To assess genotypic diversity, antifungal susceptibility and mechanisms of drug resistance of C glabrata blood isolates and their association with patients' outcome in a retrospective multicentre study. Patients/Methods Isolates from 107 patients were identified by ITS sequencing and analysed by multilocus microsatellite typing, antifungal susceptibility testing, and sequencing of PDR1 and FKS1/2 hotspots (HSs). Results Candida glabrata prevalence in Ege University Hospital was twofold higher in 2014‐2019 than in 2005‐2014. Six of the analysed isolates had fluconazole MICs ≥ 32 µg/mL; of them, five harboured unique PDR1 mutations. Although echinocandin resistance was not detected, three isolates had mutations in HS1‐Fks1 (S629T, n = 1) and HS1‐Fks2 (S663P, n = 2); one of the latter was also fluconazole‐resistant. All patients infected with isolates carrying HS‐FKS mutations and/or demonstrating fluconazole MIC ≥ 32 µg/mL (except one without clinical data) showed therapeutic failure (TF) with echinocandin and fluconazole; seven such isolates were collected in Ege (n = 4) and Gulhane (n = 3) hospitals and six detected recently. Among 34 identified genotypes, none were associated with mortality or enriched for fluconazole‐resistant isolates. Conclusion Antifungal susceptibility testing should be supplemented with HS‐FKS sequencing to predict TF for echinocandins, whereas fluconazole MIC ≥ 32 µg/mL may predict TF. Recent emergence of C glabrata isolates associated with antifungal TF warrants future comprehensive prospective studies in Turkey.

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“…The studies reported results mainly for the following species: C. krusei , C. parapsilosis , C. glabrata , C. tropicalis , and C. utilis. These species are often selected because they are associated with infectious processes in humans and have virulence factors associated with greater disease severity [ 35 – 37 ]. Stratification of the results by the type of strain contributes to a better understanding of such results and to the establishment of breakpoints considering the diversity of findings for different situations.…”

Section: Discussionmentioning

confidence: 99%

Breakpoints for the Classification of Anti‐Candida Compounds in Antifungal Screening

Alves

Ferreira

Duarte

et al. 2021

BioMed Research International

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Introduction. The absence of a standardized classification scheme for the antifungal potency of compounds screened against Candida species may hinder the study of new drugs. This systematic review proposes a scheme of interpretative breakpoints for the minimum inhibitory concentration (MIC) of bioactive compounds against Candida species in in vitro tests. Materials and Methods. A literature search was conducted in the PubMed, Scopus, Web of Science, Lilacs, and SciFinder databases for the period from January 2015 to April 2020. The following inclusion criterion was used: organic compounds tested by the microdilution technique according to the Clinical and Laboratory Standards Institute protocol against reference strains of the genus Candida. A total of 545 articles were retrieved after removing duplicates. Of these, 106 articles were selected after applying the exclusion criteria and were evaluated according to the number of synthesized molecules and their chemical classes, the type of strain (reference or clinical) used in the antifungal test, the Candida species, and the MIC (in μg/mL) used. Results. The analysis was performed based on the median, quartiles (25% and 75%), maximum, and minimum values of four groups: all strains, ATCC strains, C. albicans strains, and C. albicans ATCC strains. The following breakpoints were proposed to define the categories: MIC < 3.515 μ g / mL (very strong bioactivity); 3.516-25 μg/mL (strong bioactivity); 26-100 μg/mL (moderate bioactivity); 101-500 μg/mL (weak bioactivity); 500-2000 μg/mL (very weak bioactivity); and >2000 μg/mL (no bioactivity). Conclusions. A classification scheme of the antifungal potency of compounds against Candida species is proposed that can be used to identify the antifungal potential of new drug candidates.

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Antifungal resistance in patients with Candidaemia: a retrospective cohort study

Cited by 41 publications

References 24 publications

Anidulafungin Versus Micafungin in the Treatment of Candidemia in Adult Patients

Anidulafungin Versus Micafungin in the Treatment of Candidemia in Adult Patients

Low level of antifungal resistance of Candida glabrata blood isolates in Turkey: Fluconazole minimum inhibitory concentration and FKS mutations can predict therapeutic failure

Breakpoints for the Classification of Anti‐Candida Compounds in Antifungal Screening

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