Global trends in the distribution of Candida species causing candidemia

Guinea, Jesús

doi:10.1111/1469-0691.12539

Cited by 569 publications

(520 citation statements)

References 56 publications

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“…En una revisión reciente de Guinea sobre la tendencia global de especies causantes de candidemia, se evidencia que, en la mayoría de los países, C. albicans es la especie más frecuentemente identificada, pero con variaciones en la frecuencia de las especies no-albicans más relevantes; así, en E.U.A. y países del norte de Europa predomina C. glabrata mientras que en España y Brasil lo es C. parapsilosis, con baja frecuencia de C. glabrata, planteándose la hipótesis que esto fuera consecuencia de clima, uso de antifúngicos o procedimientos de manejo de CVC 12 .…”

Section: Discussionunclassified

Cambios clínicos y epidemiológicos de candidemias en pacientes adultos desde 2000 a 2013

Siri

Legarraga

García

et al. 2017

Rev. chil. infectol.

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60 years, 77,5% had at least one co-morbidity. Candida albicans was the species most frequently identified 55%, followed by C. glabrata 18.3%, C. tropicalis 11.7% and C. parapsilosis 9.2%. Comparing 2000-2006 vs 2007-2013, increased the frequency of C. parapsilosis among non-albicans and echinocandins prescription. Patients with C. albicans showed higher APACHE-II, more requirement for invasive mechanical ventilation, greater association with CVC, and shorter incubation time compared with non-albicans species. The 30-day mortality was 31.7%. Conclusions: During this 14-years period we observed that C. albicans was the predominant specie and more recently a change among C. non-albicans increasing C. parapsilosis and decreasing C. glabrata 30-days and attributable mortality decreased together with more echinocandins prescription.]]>

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Section: Discussionunclassified

Cambios clínicos y epidemiológicos de candidemias en pacientes adultos desde 2000 a 2013

Siri

Legarraga

García

et al. 2017

Rev. chil. infectol.

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“…C andida glabrata is the second leading cause of candidemia in the United States, as well as in northern and eastern areas of Europe (1)(2)(3). With rapidly expanded usage of echinocandins, the first-line therapy for invasive candidiasis, an alarming trend of rising echinocandin resistance in C. glabrata has posed a serious clinical challenge (4)(5)(6).…”

mentioning

confidence: 99%

Rapid Detection of FKS -Associated Echinocandin Resistance in Candida glabrata

Zhao

Nagasaki

Kordalewska

et al. 2016

Antimicrob Agents Chemother

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A novel and highly accurate diagnostic assay platform was established for rapid identification of FKS mutations associated with echinocandin resistance in Candida glabrata. The assay platform uses allele-specific molecular beacon and DNA melt analysis following asymmetric PCR. A dual assay for FKS1 and FKS2 was developed to identify within 3 h the most common and clinically relevant resistance-associated mutations, including 8 FKS1 HS1 (wild type [WT], S629P, F625S, D632Y, D632E [T1896G], D632E [T1896A], I634V, and F625F) and 7 FKS2 HS1 (WT, F659del, F659S, F659V, F659L, S663P, and S663F) genotypes. A blinded panel of 188 C. glabrata clinical isolates was tested by both assays. The molecular diagnostic results from the dual assay were 100% concordant with data obtained from DNA sequencing. This platform has the potential to overcome the deficiencies of existing in vitro susceptibility-based assays to identify echinocandin-resistant C. glabrata and holds promise as a surrogate diagnostic method to better direct echinocandin therapy.C andida glabrata is the second leading cause of candidemia in the United States, as well as in northern and eastern areas of Europe (1-3). With rapidly expanded usage of echinocandins, the first-line therapy for invasive candidiasis, an alarming trend of rising echinocandin resistance in C. glabrata has posed a serious clinical challenge (4-6). Detection of echinocandin resistance can be assessed phenotypically, using either microdilution or disc diffusion MIC assays performed in accordance with guidance of the Clinical and Laboratory Standards Institute (CLSI) M27-A3 standard (7) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) Definitive Document Edef 7.2 (8). Current echinocandin clinical breakpoints for C. glabrata were established by the CLSI for all echinocandins and by EUCAST for micafungin and anidulafungin. Breakpoints were specifically developed to identify C. glabrata harboring FKS mutations by considering multiple factors, such as ␤-1,3-D-glucan synthase enzyme kinetics and echinocandin pharmacokinetic and pharmacodynamic data (6, 9). However, despite standardized methodologies, important limitations with the in vitro susceptibility testing cannot be ignored: first, the assay has a time-consuming setup and intrinsically slow turnaround time, requiring 24 to 48 h after isolate recovery; second, interlaboratory variability of caspofungin MICs has limited direct testing of this drug (10); and third, susceptible and resistant populations overlap (11).Clinical echinocandin resistance in C. glabrata is associated with amino acid substitutions caused by mutations in specific hotspot (HS) regions of FKS1 and FKS2, which encode the drug target ␤-1,3-D-glucan synthase. A recent study performed among patients with invasive candidiasis due to C. glabrata has shown that the FKS genotype is a better indicator of echinocandin therapeutic failure than MIC (12).To date, DNA sequencing is the only means to identify mutations within FKS1 and FKS2 genes. Sequence data a...

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“…Variation in the epidemiology of candidaemia in Germany, Europe as a whole, Canada, USA, and Brazil does not appear to influence the recommendations: greater proportion of C. parapsilosis in Brazil cannot explain the preferential echinocandin use as this species is considered less susceptible to echinocandins. [12] Thus, the extent to which regional epidemiology influences the recommendations of the individual guidelines is unclear. Moreover, guidelines from groups with global acclaim (e.g., ESCMID, IDSA) still significantly vary in their recommendations.…”

Section: Editorialmentioning

confidence: 99%