Temporal trends in antifungal susceptibility of Cryptococcus neoformans isolates from a reference laboratory in the United States, 2011–2021

Background There are no established clinical breakpoints for antifungal agents against Cryptococcus species; however, epidemiological cut‐off values can help distinguish wild‐type (WT) isolates without any acquired resistance from non‐WT strains, which may harbour resistance mechanisms. Patients/Met...

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Bibliographic Details
Published in:Mycoses 2024-01, Vol.67 (1), p.e13691-n/a
Main Authors: Ordaya, Eloy E., Abu Saleh, Omar M., Vergidis, Paschalis, Deml, Sharon M., Wengenack, Nancy L., Fida, Madiha
Format: Article
Language:English
Subjects:
Amphotericin B
Amphotericin B - pharmacology
Antifungal agents
Antifungal Agents - pharmacology
antifungal resistance
antifungal susceptibility testing
Breakpoints
C. neoformans
Cerebrospinal fluid
Cryptococcosis
Cryptococcosis - drug therapy
Cryptococcosis - epidemiology
Cryptococcosis - microbiology
Cryptococcus neoformans
Epidemiology
Fluconazole
Flucytosine
Flucytosine - pharmacology
HIV
Human immunodeficiency virus
Humans
Immunocompromised hosts
Microbial Sensitivity Tests
Statistical analysis
Trends
United States - epidemiology
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Summary:Background There are no established clinical breakpoints for antifungal agents against Cryptococcus species; however, epidemiological cut‐off values can help distinguish wild‐type (WT) isolates without any acquired resistance from non‐WT strains, which may harbour resistance mechanisms. Patients/Methods We describe the trends of antifungal MICs and percentages of WT C. neoformans species complex (CNSC) isolates processed in our reference laboratory from November 2011 to June 2021. There were only nine isolates in 2011, thus, we included them in the year 2012 for data analysis. Clinical data is also described when available. Results We identified 632 CNSC, the majority collected from blood (n = 301), cerebrospinal fluid (n = 230), and respiratory (n = 71) sources. The overall percentage of WT isolates for amphotericin B (AMB), 5‐flucytosine, and fluconazole was 77%, 98%, and 91%, respectively. We noticed a statistically significant change in the percentage of AMB WT isolates over the years, with 98% of isolates being WT in 2012 compared to 79% in 2021 (p 
ISSN:0933-7407
1439-0507
DOI:10.1111/myc.13691