cancidas and Fungemia

We describe the acquisition of flucytosine, azole, and caspofungin resistance in sequential Candida glabrata bloodstream isolates collected from a bone marrow transplant patient with clinical failure. Point mutations in C. glabrata FUR1 (CgFUR1) and CgFKS2 and overexpression of CgCDR1 and CgCDR2 were observed in resistant isolates.

Topics: Antifungal Agents; Azoles; Candida glabrata; Candidiasis; Caspofungin; Child; Drug Resistance, Fungal; Echinocandins; Female; Flucytosine; Fungal Proteins; Fungemia; Hematopoietic Stem Cell Transplantation; Humans; Lipopeptides; Microbial Sensitivity Tests; Point Mutation

We describe the prevalences and susceptibility profiles of two recently described species, Candida metapsilosis and Candida orthopsilosis, related to Candida parapsilosis in candidemia. The prevalences of these species (1.7% for C. metapsilosis and 1.4% for C. orthopsilosis) are significant. Differences observed in their susceptibility profiles could have therapeutic importance.

Topics: Antifungal Agents; Candida; Candidiasis; Fungemia; Humans; Microbial Sensitivity Tests; Population Surveillance; Prevalence; Spain; Species Specificity

We describe a case of recurring Candida glabrata infection in a 68-year-old African-American female on caspofungin therapy. The initial isolate was susceptible, but isolates recovered during following relapses were not. All isolates were clonal, and high-MIC strains contained a mutation in the highly conserved hot spot 1 region of Fks1p.

Topics: Aged; Antifungal Agents; Candida glabrata; Candidiasis; Caspofungin; Drug Resistance, Fungal; Echinocandins; Fatal Outcome; Female; Fungal Proteins; Fungemia; Glucosyltransferases; Humans; Lipopeptides; Membrane Proteins; Microbial Sensitivity Tests; Mutation

We identified three cases of C. tropicalis strains causing breakthrough fungemia in allogeneic stem cell recipients receiving caspofungin prophylaxis and treatment. Three genetically unrelated isolates with high echinocandin MICs were identified. Each strain carried a characteristic mutation conferring an amino acid substitution within Fks1p hot spot 1.

Topics: Aged; Aged, 80 and over; Antifungal Agents; Candida tropicalis; Candidiasis; Caspofungin; Drug Resistance, Fungal; Echinocandins; Fungemia; Hematologic Neoplasms; Humans; Lipopeptides; Male; Middle Aged

In vitro susceptibility of 58 isolates of Pichia anomala to five antifungal drugs using two broth microdilution methods (CLSI and EUCAST) was analyzed. Low susceptibility to itraconazole was observed. Fluconazole, voriconazole, amphotericin B, and caspofungin showed good antifungal activity, although relatively high drug concentrations were necessary to inhibit the isolates.

Topics: Amphotericin B; Antifungal Agents; Cross Infection; Fluconazole; Fungemia; Humans; Itraconazole; Microbial Sensitivity Tests; Pichia

Paradoxical growth of some Candida isolates occurs at concentrations above the MIC for echinocandins. In 60 Candida bloodstream isolates from cancer patients (20 C. albicans isolates and 10 isolates each of C. parapsilosis, C. tropicalis, C. krusei, and C. glabrata), paradoxical growth was more frequent with caspofungin than micafungin or anidulafungin, was unrelated to MIC, and was strikingly absent in C. glabrata isolates.

Topics: Antifungal Agents; Candida; Candidiasis; Culture Media; Fungemia; Humans; Microbial Sensitivity Tests; Neoplasms; Peptides, Cyclic; Species Specificity