European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study.

Autor: Arendrup, Maiken Cavling, Arikan-Akdagli, Sevtap, Jørgensen, Karin Meinike, Barac, Aleksandra, Steinmann, Jörg, Toscano, Cristina, Arsenijevic, Valentina Arsic, Sartor, Assunta, Lass-Flörl, Cornelia, Hamprecht, Axel, Matos, Tadeja, Rogers, Benedict R.S., Quiles, Inmaculada, Buil, Jochem, Özenci, Volkan, Krause, Robert, Bassetti, Matteo, Loughlin, Laura, Denis, Blandine, Grancini, Anna
Zdroj: Journal of Infection; Nov2023, Vol. 87 Issue 5, p428-437, 10p
Abstrakt: The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25–33%) while Italy and Turkey had the highest C. parapsilosis proportions (24–26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis , 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks -alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence. • Candidaemia epidemiology differs notably across 41 centres in 17 countries. • C. albicans proportions varied from 77% in Austria to 36% in Turkey. • Acquired fluconazole resistance emerges in C. parapsilosis in southern Europe. • A novel echinocandin resistance mutation and MDR was demonstrated in C. parapsilosis. • Antifungal stewardship and infection control is of utmost importance. [ABSTRACT FROM AUTHOR]
Databáze: Supplemental Index
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