Volume 18, Number 1—January 2012
Dispatch
Candida spp. with Acquired Echinocandin Resistance, France, 2004–20101
Table 2
Patient no. |
Strain |
Species |
MIC, µg/m, AM3/RPMI 1640 medium | Fksp mutation | ||||
---|---|---|---|---|---|---|---|---|
Caspofungin |
Micafungin |
Anidulafungin |
Gene |
Mutation |
||||
1* | 05BL1-38 | C. albicans | 1/2 | 0.25/1 | 0.06/0.125 | FKS1 (HS1) | F641S | |
2* | ODL13-1254 | C. albicans | 1/2 | 1/1 | 0.5/0.5 | FKS1 (HS1) | S645Y | |
3† | 06BL2-127 | C. albicans | 2/2 | 1/0.5 | 0.125/0.125 | FKS1 (HS1) | F641S‡ + S645P‡ | |
4 | ODL19-1894 | C. albicans | 4/2 | 2/2 | 0.125/0.25 | FKS1 (HS1) | S645P | |
5* | 08BL1-94 | C. albicans | 2/4 | 0.25/1 | 0.06/0.5 | FKS1 (HS2) | R1361G§ | |
6* | 08BL2-143 | C. albicans | 8/4 | 4/2 | 0.25/0.5 | FKS1 (HS1) | S645P | |
7* | 09BL1-43 | C. albicans | 1/2 | 0.25/1 | 0.06/0.25 | FKS1 (HS1) | F641S | |
8* | 09BL1-77 | C. albicans | 0.5/0.5 | 0.5/0.25 | 0.015/0.03 | FKS1 (HS1) | R647G§ | |
9 | 06BL1-34 | C. krusei | 4/8 | 2/4 | 1/2 | FKS1 (HS1) | L648W§,¶ | |
10* | 10BL1-50 | C. krusei | 2/4 | 1/2 | 0.06/1 | FKS1 (HS1) | F645L§,¶ | |
11 | ODL7-647 | C. glabrata | 8/8 | 0.5/1 | 0.25/0.125 | FKS2 | DelF658# | |
12* | 07BL2-157 | C. glabrata | 4/1 | 1/0.5 | 0.25/0.5 | FKS2 | DelF658# | |
13* | 06BL1-33 | C. glabrata | 8/8 | 4/8 | 2/2 | FKS2 | S663P | |
14* | ODL21-2028 | C. glabrata | 1/1 | 0.25/0.25 | 0.25/0.25 | FKS1 | S629P | |
15* | ODL22-2183 | C. glabrata | 8/2 | 0.25/0.25 | 0.25/1 | FKS2 | S663P | |
16 | ODL23-2221 | C. glabrata | 1/4 | 0.06/2 | 0.06/0.25 | FKS1 + FKS2 | F625I§ (FKS1) + P667T§ (FKS2) | |
17* | 08BL2-142 | C. glabrata | 1/4 | 0.25/2 | 0.25/2 | FKS2 | S663P | |
18 | 09BL1-55 | C. glabrata | 8/4 | 2/4 | 0.5/0.5 | FKS2 | S663P | |
19 | 10BL1-19 | C. glabrata | 0.5/4 | 0.06/0.5 | 0.06/1 | FKS2 | F659S + L664V§ | |
20 | 10BL1-67 | C. glabrata | 4/4 | 0.5/1 | 0.125/1 | FKS2 | DelF658# |
*Parentage of initial isolate available.
†In this patient, another isolate with reduced susceptibility to echinocandin was retrieved. This isolate harbored an S645P mutation in FKS1.
‡Heterozygous mutation.
§Mutations not already described (13).
¶Strains had also an L701M mutation.
#Deletion.
References
- Pappas PG, Kauffman CA, Andes D, Benjamin DK Jr, Calandra TF, Edwards JE Jr, Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;48:503–35. DOIPubMedGoogle Scholar
- Baixench MT, Aoun N, Desnos-Ollivier M, Garcia-Hermoso D, Bretagne S, Ramires S, Acquired resistance to echinocandins in Candida albicans: case report and review. J Antimicrob Chemother. 2007;59:1076–83. DOIPubMedGoogle Scholar
- Pfeiffer CD, Garcia-Effron G, Zaas AK, Perfect JR, Perlin DS, Alexander BD. Breakthrough invasive candidiasis in patients on micafungin. J Clin Microbiol. 2010;48:2373–80. DOIPubMedGoogle Scholar
- Sun HY, Singh N. Characterisation of breakthrough invasive mycoses in echinocandin recipients: an evidence-based review. Int J Antimicrob Agents. 2010;35:211–8. DOIPubMedGoogle Scholar
- Perlin DS. Resistance to echinocandin-class antifungal drugs. Drug Resist Updat. 2007;10:121–30. DOIPubMedGoogle Scholar
- Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing. (EUCAST). EUCAST definitive document EDef 7.1: method for the determination of broth microdilution MICs of antifungal agents for fermentative yeasts. Clin Microbiol Infect. 2008;14:398–405. DOIPubMedGoogle Scholar
- Desnos-Ollivier M, Bretagne S, Raoux D, Hoinard D, Dromer F, Dannaoui E. Mutations in the fks1 gene in Candida albicans, C. tropicalis, and C. krusei correlate with elevated caspofungin MICs uncovered in AM3 medium using the method of the European Committee on Antibiotic Susceptibility Testing. Antimicrob Agents Chemother. 2008;52:3092–8. DOIPubMedGoogle Scholar
- Katiyar S, Pfaller M, Edlind T. Candida albicans and Candida glabrata clinical isolates exhibiting reduced echinocandin susceptibility. Antimicrob Agents Chemother. 2006;50:2892–4. DOIPubMedGoogle Scholar
- Foulet F, Nicolas N, Eloy O, Botterel F, Gantier JC, Costa JM, Microsatellite marker analysis as a typing system for Candida glabrata. J Clin Microbiol. 2005;43:4574–9. DOIPubMedGoogle Scholar
- Garcia-Hermoso D, Cabaret O, Lecellier G, Desnos-Ollivier M, Hoinard D, Raoux D, Comparison of microsatellite length polymorphism and multilocus sequence typing for DNA-based typing of Candida albicans. J Clin Microbiol. 2007;45:3958–63. DOIPubMedGoogle Scholar
- Garcia-Hermoso D, MacCallum DM, Lott TJ, Sampaio P, Serna MJ, Grenouillet F, Multicenter collaborative study for standardization of Candida albicans genotyping using a polymorphic microsatellite marker. J Clin Microbiol. 2010;48:2578–81. DOIPubMedGoogle Scholar
- Arendrup MC, Park S, Rodriguez-Tudela JL, Hope W, Lass-Flörl C, Donnelly PJ, EUCAST susceptibility testing of Candida species to echinocandins: improved separation between wild type isolates and fks mutants by supplementation of BSA to the test medium. 21st European Congress of Clinical Microbiology and Infectious Diseases 27th International Congress of Chemotherapy; 2011; Milan, Italy.
- Pfaller MA, Diekema DJ, Andes D, Arendrup MC, Brown SD, Lockhart SR, Clinical breakpoints for the echinocandins and Candida revisited: integration of molecular, clinical, and microbiological data to arrive at species-specific interpretive criteria. Drug Resist Updat. 2011;14:164–76. DOIPubMedGoogle Scholar
- Lortholary O, Desnos-Ollivier M, Sitbon K, Fontanet A, Bretagne S, Dromer F. Recent exposure to caspofungin or fluconazole influences the epidemiology of candidemia: a prospective multicenter study involving 2,441 patients. Antimicrob Agents Chemother. 2011;55:532–8. DOIPubMedGoogle Scholar
- Blanchard E, Lortholary O, Boukris-Sitbon K, Desnos-Ollivier M, Dromer F, Guillemot D, Prior caspofungin exposure in patients with haematological malignancies is a risk factor for subsequent fungemia due to decreased susceptible Candidda spp.: a case-control study in Paris, France. Antimicrob Agents Chemother. 2011;55:5358–61. DOIPubMedGoogle Scholar
1This work was presented in part at the 20th European Congress of Clinical Microbiology and Infectious Diseases, Vienna, Austria, April 10–13, 2010 (abstract no. O346).
2These authors contributed equally to this article.
3Additional members of the French Mycoses Study Group who contributed data are listed at the end of this article.
Page created: December 19, 2011
Page updated: December 19, 2011
Page reviewed: December 19, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.