In Vitro Susceptibilities of Candida spp. to Caspofungin: Four Years of Global Surveillance

Caspofungin is being used increasingly as therapy for invasive candidiasis. Prospective sentinel surveillance for emergence of in vitro resistance to caspofungin among invasive Candida spp. isolates is indicated. We determined the in vitro activity of caspofungin against 8,197 invasive (bloodstream...

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Published in:Journal of Clinical Microbiology 2006-03, Vol.44 (3), p.760-763
Main Authors: Pfaller, M. A, Boyken, L, Hollis, R. J, Messer, S. A, Tendolkar, S, Diekema, D. J
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Language:English
Subjects:
Antifungal Agents - pharmacology
Biological and medical sciences
Candida - classification
Candida - drug effects
Candida - isolation & purification
Candida albicans
Candida rugosa
Candidiasis - drug therapy
Candidiasis - microbiology
Drug Resistance, Fungal
Echinocandins
Fundamental and applied biological sciences. Psychology
Humans
In Vitro Techniques
Infectious diseases
Lipopeptides
Medical sciences
Microbial Sensitivity Tests
Microbiology
Miscellaneous
Mycology
Peptides, Cyclic - pharmacology
Species Specificity
Time Factors
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Boyken, L
Hollis, R. J
Messer, S. A
Tendolkar, S
Diekema, D. J
description Caspofungin is being used increasingly as therapy for invasive candidiasis. Prospective sentinel surveillance for emergence of in vitro resistance to caspofungin among invasive Candida spp. isolates is indicated. We determined the in vitro activity of caspofungin against 8,197 invasive (bloodstream or sterile-site) unique patient isolates of Candida collected from 91 medical centers worldwide from 1 January 2001 to 31 December 2004. We performed antifungal susceptibility testing according to the Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS) M27-A2 method and used a 24-h prominent inhibition endpoint for determination of the MIC. Of 8,197 invasive Candida spp. isolates, species distribution was as follows: 54% Candida albicans, 14% C. glabrata, 14% C. parapsilosis, 11% C. tropicalis, 3% C. krusei, and 4% other Candida spp. Overall, caspofungin was very active against Candida (MIC₅₀/MIC₉₀, 0.03/0.25 [micro]g/ml; 98.2% were inhibited at a MIC of
doi_str_mv 10.1128/JCM.44.3.760-763.2006
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A ; Boyken, L ; Hollis, R. J ; Messer, S. A ; Tendolkar, S ; Diekema, D. J</creator><creatorcontrib>Pfaller, M. A ; Boyken, L ; Hollis, R. J ; Messer, S. A ; Tendolkar, S ; Diekema, D. J</creatorcontrib><description>Caspofungin is being used increasingly as therapy for invasive candidiasis. Prospective sentinel surveillance for emergence of in vitro resistance to caspofungin among invasive Candida spp. isolates is indicated. We determined the in vitro activity of caspofungin against 8,197 invasive (bloodstream or sterile-site) unique patient isolates of Candida collected from 91 medical centers worldwide from 1 January 2001 to 31 December 2004. We performed antifungal susceptibility testing according to the Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS) M27-A2 method and used a 24-h prominent inhibition endpoint for determination of the MIC. Of 8,197 invasive Candida spp. isolates, species distribution was as follows: 54% Candida albicans, 14% C. glabrata, 14% C. parapsilosis, 11% C. tropicalis, 3% C. krusei, and 4% other Candida spp. Overall, caspofungin was very active against Candida (MIC₅₀/MIC₉₀, 0.03/0.25 [micro]g/ml; 98.2% were inhibited at a MIC of &lt;/=0.5 [micro]g/ml and 99.7% were inhibited at a MIC of &lt;/=1 [micro]g/ml). Results by species (expressed as MIC₅₀/MIC₉₀ and the percentage inhibited at &lt;/=1 [micro]g/ml) were as follows: C. albicans, 0.03/0.06, 99.9; C. glabrata, 0.03/0.06, 99.9; C. parapsilosis, 0.5/0.5, 99.0; C. tropicalis, 0.03/0.06, 99.7; C. krusei, 0.12/0.5, 99.0; and C. guilliermondii, 0.5/1, 94.4. Of the 25 isolates with caspofungin MICs of &gt;1 [micro]g/ml, 12 isolates were C. parapsilosis, 6 isolates were C. guilliermondii, 2 isolates were C. rugosa, and 1 isolate each was C. albicans, C. glabrata, C. krusei, C. lusitaniae, and C. tropicalis. There was no significant change in caspofungin activity over the 4-year study period. Likewise, there was no difference in activity by geographic region. Caspofungin has excellent in vitro activity against invasive clinical isolates of Candida from centers worldwide. 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A</creatorcontrib><creatorcontrib>Boyken, L</creatorcontrib><creatorcontrib>Hollis, R. J</creatorcontrib><creatorcontrib>Messer, S. A</creatorcontrib><creatorcontrib>Tendolkar, S</creatorcontrib><creatorcontrib>Diekema, D. J</creatorcontrib><title>In Vitro Susceptibilities of Candida spp. to Caspofungin: Four Years of Global Surveillance</title><title>Journal of Clinical Microbiology</title><addtitle>J Clin Microbiol</addtitle><description>Caspofungin is being used increasingly as therapy for invasive candidiasis. Prospective sentinel surveillance for emergence of in vitro resistance to caspofungin among invasive Candida spp. isolates is indicated. We determined the in vitro activity of caspofungin against 8,197 invasive (bloodstream or sterile-site) unique patient isolates of Candida collected from 91 medical centers worldwide from 1 January 2001 to 31 December 2004. We performed antifungal susceptibility testing according to the Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS) M27-A2 method and used a 24-h prominent inhibition endpoint for determination of the MIC. Of 8,197 invasive Candida spp. isolates, species distribution was as follows: 54% Candida albicans, 14% C. glabrata, 14% C. parapsilosis, 11% C. tropicalis, 3% C. krusei, and 4% other Candida spp. Overall, caspofungin was very active against Candida (MIC₅₀/MIC₉₀, 0.03/0.25 [micro]g/ml; 98.2% were inhibited at a MIC of &lt;/=0.5 [micro]g/ml and 99.7% were inhibited at a MIC of &lt;/=1 [micro]g/ml). Results by species (expressed as MIC₅₀/MIC₉₀ and the percentage inhibited at &lt;/=1 [micro]g/ml) were as follows: C. albicans, 0.03/0.06, 99.9; C. glabrata, 0.03/0.06, 99.9; C. parapsilosis, 0.5/0.5, 99.0; C. tropicalis, 0.03/0.06, 99.7; C. krusei, 0.12/0.5, 99.0; and C. guilliermondii, 0.5/1, 94.4. Of the 25 isolates with caspofungin MICs of &gt;1 [micro]g/ml, 12 isolates were C. parapsilosis, 6 isolates were C. guilliermondii, 2 isolates were C. rugosa, and 1 isolate each was C. albicans, C. glabrata, C. krusei, C. lusitaniae, and C. tropicalis. There was no significant change in caspofungin activity over the 4-year study period. Likewise, there was no difference in activity by geographic region. Caspofungin has excellent in vitro activity against invasive clinical isolates of Candida from centers worldwide. Our prospective sentinel surveillance reveals no evidence of emerging caspofungin resistance among invasive clinical isolates of CANDIDA:</description><subject>Antifungal Agents - pharmacology</subject><subject>Biological and medical sciences</subject><subject>Candida - classification</subject><subject>Candida - drug effects</subject><subject>Candida - isolation &amp; purification</subject><subject>Candida albicans</subject><subject>Candida rugosa</subject><subject>Candidiasis - drug therapy</subject><subject>Candidiasis - microbiology</subject><subject>Drug Resistance, Fungal</subject><subject>Echinocandins</subject><subject>Fundamental and applied biological sciences. 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subjects Antifungal Agents - pharmacology
Biological and medical sciences
Candida - classification
Candida - drug effects
Candida - isolation & purification
Candida albicans
Candida rugosa
Candidiasis - drug therapy
Candidiasis - microbiology
Drug Resistance, Fungal
Echinocandins
Fundamental and applied biological sciences. Psychology
Humans
In Vitro Techniques
Infectious diseases
Lipopeptides
Medical sciences
Microbial Sensitivity Tests
Microbiology
Miscellaneous
Mycology
Peptides, Cyclic - pharmacology
Species Specificity
Time Factors
title In Vitro Susceptibilities of Candida spp. to Caspofungin: Four Years of Global Surveillance
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