Posttreatment Antifungal Resistance among Colonizing Candida Isolates in Candidemia Patients: Results from a Systematic Multicenter Study
| Autor: | Esad Dzajic, Helle Krogh Johansen, Rasmus Hare Jensen, K. M. T. Astvad, Lise Kristensen, Maiken Cavling Arendrup, Lars Lemming, Bente Olesen, Lillian Marie Søes, Lars Peter Nielsen, Flemming S Rosenvinge |
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| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Antifungal Male Antifungal Agents medicine.drug_class Denmark 030106 microbiology Candida/classification Microbial Sensitivity Tests Drug Resistance Fungal/drug effects Microbiology Epidemiology and Surveillance 03 medical and health sciences Acquired resistance Drug Resistance Fungal medicine Humans Pharmacology (medical) Candida albicans Candidemia/drug therapy Fluconazole Aged Candida Pharmacology Candida glabrata biology Candidemia minimum inhibitory concentrations eucast technical note intensive-care-unit echinocandin resistance blood-stream changing epidemiology cystic-fibrosis invasive candidiasis healthy controls risk-factor Microbiology Pharmacology & Pharmacy biology.organism_classification Fluconazole/therapeutic use bacterial infections and mycoses Infectious Diseases Multicenter study Antifungal Agents/pharmacology Multilocus sequence typing Female Genetic relatedness After treatment Multilocus Sequence Typing |
| Zdroj: | Jensen, R H, Johansen, H K, Søes, L M, Lemming, L E, Rosenvinge, F S, Nielsen, L, Olesen, B, Kristensen, L, Dzajic, E, Astvad, K M T & Arendrup, M C 2016, ' Posttreatment Antifungal Resistance among Colonizing Candida Isolates in Candidemia Patients : Results from a Systematic Multicenter Study ', Antimicrobial Agents and Chemotherapy, vol. 60, no. 3, pp. 1500-1508 . https://doi.org/10.1128/aac.01763-15 Jensen, R H, Johansen, H K, Søes, L M, Lemming, L E, Rosenvinge, F S, Nielsen, L, Olesen, B, Kristensen, L, Dzajic, E, Astvad, K M T & Arendrup, M C 2015, ' Posttreatment Antifungal Resistance among Colonizing Candida Isolates in Candidemia Patients : Results from a Systematic Multicenter Study ', Antimicrobial Agents and Chemotherapy, vol. 60, no. 3, pp. 1500-8 . https://doi.org/10.1128/AAC.01763-15 |
| ISSN: | 1098-6596 |
| DOI: | 10.1128/aac.01763-15 |
| Popis: | The prevalence of intrinsic and acquired resistance among colonizing Candida isolates from patients after candidemia was investigated systematically in a 1-year nationwide study. Patients were treated at the discretion of the treating physician. Oral swabs were obtained after treatment. Species distributions and MIC data were investigated for blood and posttreatment oral isolates from patients exposed to either azoles or echinocandins for = 7 days. Species identification was confirmed using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and internal transcribed spacer (ITS) sequencing, susceptibility was examined by EUCAST EDef 7.2 methodology, echinocandin resistance was examined by FKS sequencing, and genetic relatedness was examined by multilocus sequence typing (MLST). One hundred ninety-three episodes provided 205 blood and 220 oral isolates. MLST analysis demonstrated a genetic relationship for 90% of all paired blood and oral isolates. Patients exposed to azoles for >= 7 days (n = 93) had a significantly larger proportion of species intrinsically less susceptible to azoles (particularly Candida glabrata) among oral isolates than among initial blood isolates (36.6% versus 12.9%; P < 0.001). A similar shift toward species less susceptible to echinocandins among 85 patients exposed to echinocandins for >= 7 days was not observed (4.8% of oral isolates versus 3.2% of blood isolates; P > 0.5). Acquired resistance in Candida albicans was rare (= 7 days. Species identification was confirmed using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and internal transcribed spacer (ITS) sequencing, susceptibility was examined by EUCAST EDef 7.2 methodology, echinocandin resistance was examined by FKS sequencing, and genetic relatedness was examined by multilocus sequence typing (MLST). One hundred ninety-three episodes provided 205 blood and 220 oral isolates. MLST analysis demonstrated a genetic relationship for 90% of all paired blood and oral isolates. Patients exposed to azoles for >= 7 days (n = 93) had a significantly larger proportion of species intrinsically less susceptible to azoles (particularly Candida glabrata) among oral isolates than among initial blood isolates (36.6% versus 12.9%; P < 0.001). A similar shift toward species less susceptible to echinocandins among 85 patients exposed to echinocandins for >= 7 days was not observed (4.8% of oral isolates versus 3.2% of blood isolates; P > 0.5). Acquired resistance in Candida albicans was rare ( |
| Databáze: | OpenAIRE |
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