In vitro susceptibilities of bloodstream isolates of Candida species to six antifungal agents: results from a population-based active surveillance programme, Barcelona, Spain, 2002–2003

Cuenca‐Estrella, Manuel; Rodriguez, Dolores; Almirante, Benito; Morgan, Juliette; Planes, Ana María; Almela, Manel; Mensa, José; Sánchez, Fernández; Ayats, Josefina; Gimenez, Montserrat; Salvadó, Margarita; Warnock, David W.; Pahissa, Albert; Rodríguez-Tudela, Juan Luis

doi:10.1093/jac/dkh548

Cited by 124 publications

(89 citation statements)

References 33 publications

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“…Longitudinal surveillance studies from individual institutions, cities, countries, and broad geographic regions document the sustained activities of these agents versus C. albicans, C. tropicalis, and C. parapsilosis and the ongoing potential for C. glabrata to develop resistance to both triazoles (2,10,12,17,27,46,55,63). Using the ARTEMIS database, we have confirmed and extended these observations globally over a 10.5-year period of study.…”

Section: Discussionmentioning

confidence: 55%

Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-Year Analysis of Susceptibilities of Candida Species to Fluconazole and Voriconazole as Determined by CLSI Standardized Disk Diffusion

Pfaller¹,

Diekema

Gibbs³

et al. 2010

J Clin Microbiol

601

507

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.2% of Candida isolates tested were susceptible (S) to fluconazole; however, 13 of 31 species identified exhibited decreased susceptibility (<75% S), similar to that seen with the resistant (R) species C. glabrata and C. krusei. Among 197,619 isolates of Candida spp. tested against voriconazole, 95.0% were S and 3% were R. About 30% of fluconazole-R isolates of C. albicans, C. glabrata, C. tropicalis, C. rugosa, C. lipolytica, C. pelliculosa, C. apicola, C. haemulonii, C. humicola, C. lambica, and C. ciferrii remained S to voriconazole. An increase in fluconazole resistance over time was seen with C. parapsilosis, C. guilliermondii, C. lusitaniae, C. sake, and C. pelliculosa. Among the emerging fluconazole-R species were C. guilliermondii (11.4% R), C. inconspicua (53.2% R), C. rugosa (41.8% R), and C. norvegensis (40.7% R). The rates of isolation of C. rugosa, C. inconspicua, and C. norvegensis increased by 5-to 10-fold over the 10.5-year study period. C. guilliermondii and C. rugosa were most prominent in Latin America, whereas C. inconspicua and C. norvegensis were most common in Eastern European countries. This survey identifies several less-common species of Candida with decreased susceptibility to azoles. These organisms may pose a future threat to optimal antifungal therapy and underscore the importance of prompt and accurate species identification and antifungal susceptibility testing.Antifungal susceptibility testing is playing an increasing role as a means to track the development of antifungal resistance in epidemiological studies (2, 10, 12, 17, 27, 45-47, 55, 63). One of the important by-products of the standardization of antifungal susceptibility testing has been the ability to conduct surveillance for antifungal resistance using uniform methods (44). Meaningful large-scale surveys of antifungal susceptibility and resistance conducted over time would not be possible without a standardized broth microdilution (BMD) or disk diffusion (DD) method for performing the in vitro studies (12,38,60). Global surveillance programs such as the ARTEMIS antifungal surveillance program for DD testing (49,57,60) and MIC testing (12, 13), the European Confederation of Medical Mycology (ECMM) survey of candidemia (68), and the SENTRY Antifungal Surveillance Program (36-38) promote the use of standardized DD and BMD methods and provide useful and consistent antifungal susceptibility data from a broad international network of hospitals and laboratories.The ARTEMIS global antifungal surveillance program is among the most comprehensive and long-running fungal surveillance programs (12,45,57,58,60). The ARTEMIS program was designed to address many of the potential limitations of resistance surveillance studies (26): (i) it is both longitudinal (1997 to present) and global (142 participating sites in 41 countries) in scope, (ii) it employs standardized DD (7) and BMD (9) antifungal susceptibility test methods, (iii) both internal quality control (QC) performed in each participating laboratory and external quality assurance...

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Section: Discussionmentioning

confidence: 55%

Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-Year Analysis of Susceptibilities of Candida Species to Fluconazole and Voriconazole as Determined by CLSI Standardized Disk Diffusion

Pfaller¹,

Diekema

Gibbs³

et al. 2010

J Clin Microbiol

601

507

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“…This level of activity was unchanged over time and when stratified by geographic regions of the world (data not shown). Itraconazole had little meaningful activity against flu- a Includes C. dubliniensis (7), C. lipolytica (7), C. famata (6), and C. zeylanoides (6). conazole-resistant isolates of C. glabrata (Table 2); however, 86% of the fluconazole-resistant isolates of C. albicans, C. parapsilosis, C. tropicalis, and C. krusei were inhibited by Յ1 g of itraconazole per ml.…”

Section: Methodsmentioning

confidence: 99%

“…Among the myriad of opportunistic fungal pathogens, the three most important groups include Candida spp., Cryptococcus neoformans, and Aspergillus spp. (6,9,13,15,22,24,25,28,29). In recent years, several new developments in the area of antifungal therapy have improved the ability of physicians to prevent and treat these important mycoses (14, 23, 29, 31-33, 35, 37).…”

mentioning

confidence: 99%

“…Certainly a great deal of attention has been paid to the new triazoles (e.g., voriconazole, posaconazole, and ravuconazole), with their potency and improved spectrum of activity, including activity against fluconazole-resistant Candida spp., C. neoformans, and Aspergillus spp. (6,7,12,13,22,24,32,33,37,38). Despite the wellfounded enthusiasm for the new antifungal agents, it is important to continue to assess the activity of the older, more established agents, especially those, such as itraconazole, for which the development of new formulations has overcome some of the major deficiencies (i.e., bioavailability) of the drug when it was first introduced (2-5, 10, 16, 18, 19, 29, 36, 39, 40).…”

mentioning

confidence: 99%

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In Vitro Susceptibilities of Clinical Isolates of Candida Species, Cryptococcus neoformans , and Aspergillus Species to Itraconazole: Global Survey of 9,359 Isolates Tested by Clinical and Laboratory Standards Institute Broth Microdilution Methods

Pfaller¹,

Boyken²,

Hollis³

et al. 2005

J Clin Microbiol

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The in vitro activity of itraconazole was determined against 7,299 isolates of Candida spp., 1,615 isolates of Cryptococcus neoformans, and 445 isolates of Aspergillus spp. obtained from over 200 medical centers worldwide. Itraconazole was active against all Candida spp. (96% of MICs were <1 g/ml) with the exception of C. glabrata (77% of MICs were <1 g/ml). Itraconazole inhibited 94% of C. krusei and 84% of other fluconazole-resistant Candida species, exclusive of C. glabrata, at a MIC of <1 g/ml. Itraconazole was not active against fluconazoleresistant isolates of C. glabrata. Only modest activity was seen against C. neoformans (80% of MICs were <1 g/ml); however, itraconazole showed excellent activity against Aspergillus spp. (94% of MICs were <1 g/ml). These results provide an update on the antifungal activity of itraconazole against major opportunistic fungal pathogens. In light of the new intravenous formulation of itraconazole these data suggest that this agent remains a viable systemically active antifungal agent.

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“… Echinocandins possess very low MIC resulting high safety margin [244,245].  Well tolerable with only mild side effects  Possible associations with hyperbilirubinaemia, acute renal failure, and haemolytic anaemia [246].…”

Section: Echinocandins Eg Caspofungin Micafungin and Anidulafunginmentioning

confidence: 99%

Future therapies targeted towards eliminatingCandidabiofilms and associated infections

Bandara

Matsubara

Samaranayake

2016

Expert Review of Anti-infective Therapy

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In vitro susceptibilities of bloodstream isolates of Candida species to six antifungal agents: results from a population-based active surveillance programme, Barcelona, Spain, 2002–2003

Cited by 124 publications

References 33 publications

Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-Year Analysis of Susceptibilities of Candida Species to Fluconazole and Voriconazole as Determined by CLSI Standardized Disk Diffusion

Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-Year Analysis of Susceptibilities of Candida Species to Fluconazole and Voriconazole as Determined by CLSI Standardized Disk Diffusion

In Vitro Susceptibilities of Clinical Isolates of Candida Species, Cryptococcus neoformans , and Aspergillus Species to Itraconazole: Global Survey of 9,359 Isolates Tested by Clinical and Laboratory Standards Institute Broth Microdilution Methods

Future therapies targeted towards eliminatingCandidabiofilms and associated infections

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