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Candida species distribution and antifungal susceptibility testing according to European Committee on Antimicrobial Susceptibility Testing and new vs. old Clinical and Laboratory Standards Institute clinical breakpoints: a 6-year prospective candidaemia survey from the fungal infection network of Switzerland


Orasch, Christina; Marchetti, Oscar; Garbino, Jorge; Schrenzel, Jacques; Zimmerli, Stefan; Mühlethaler, Konrad; Rossi, Marco; Pfyffer, Gaby; Ruef, Christian; Fehr, Jan; Zbinden, Reinhard; Calandra, Thierry; Bille, Jacques (2014). Candida species distribution and antifungal susceptibility testing according to European Committee on Antimicrobial Susceptibility Testing and new vs. old Clinical and Laboratory Standards Institute clinical breakpoints: a 6-year prospective candidaemia survey from the fungal infection network of Switzerland. Clinical Microbiology and Infection, 20(7):698-705.

Abstract

We analyzed the species distribution of Candida blood isolates (CBI), prospectively collected between 2004 and 2009 within FUNGINOS, and compared their antifungal susceptibility according to clinical breakpoints defined by: EUCAST in 2013, CLSI in 2008 (old CLSI breakpoints) and 2012 (new CLSI breakpoints). CBI were tested for susceptiblity to fluconazole, voriconazole and caspofungin by microtitre broth dilution (Sensititre(®) YeastOne(TM) test panel). Of 1090 CBI, 675 (61.9%) were C. albicans, 191 (17.5%) C. glabrata, 64 (5.9%) C. tropicalis, 59 (5.4%) C. parapsilosis, 33 (3%) C. dubliniensis, 22 (2%) C. krusei and 46 (4.2%) rare Candida species. Independently of the breakpoints applied, C. albicans was almost uniformely (>98%) susceptible to all 3 antifungal agents. In contrast, the proportions of fluconazole- and voriconazole- susceptible C. tropicalis and F-susceptible C. parapsilosis were lower according to EUCAST/new CLSI breakpoints than to the old CLSI breakpoints. For caspofungin, non-susceptibility occurred mainly in C. krusei (63.3%) and C. glabrata (9.4%). Nine isolates (5 C. tropicalis, 3 C. albicans, 1 C. parapsilosis) were cross-resistant to azoles according to EUCAST breakpoints compared to 3 isolates (2 C. albicans, 1 C. tropicalis) according to new and 2 (2 C. albicans) to old CLSI breakpoints. Four species (C. albicans, C. glabrata, C. tropicalis, C. parapsilosis) represented >90% of all CBI. In vitro resistance to fluconazole, voriconazole and caspofungin was rare among C. albicans, but an increase of non-susceptibile isolates was observed among C. tropicalis/C. parapsilosis for the azoles and C. glabrata/C. krusei for caspofungin according to EUCAST and new CLSI breakpoints compared to old CLSI breakpoints. This article is protected by copyright. All rights reserved.

Abstract

We analyzed the species distribution of Candida blood isolates (CBI), prospectively collected between 2004 and 2009 within FUNGINOS, and compared their antifungal susceptibility according to clinical breakpoints defined by: EUCAST in 2013, CLSI in 2008 (old CLSI breakpoints) and 2012 (new CLSI breakpoints). CBI were tested for susceptiblity to fluconazole, voriconazole and caspofungin by microtitre broth dilution (Sensititre(®) YeastOne(TM) test panel). Of 1090 CBI, 675 (61.9%) were C. albicans, 191 (17.5%) C. glabrata, 64 (5.9%) C. tropicalis, 59 (5.4%) C. parapsilosis, 33 (3%) C. dubliniensis, 22 (2%) C. krusei and 46 (4.2%) rare Candida species. Independently of the breakpoints applied, C. albicans was almost uniformely (>98%) susceptible to all 3 antifungal agents. In contrast, the proportions of fluconazole- and voriconazole- susceptible C. tropicalis and F-susceptible C. parapsilosis were lower according to EUCAST/new CLSI breakpoints than to the old CLSI breakpoints. For caspofungin, non-susceptibility occurred mainly in C. krusei (63.3%) and C. glabrata (9.4%). Nine isolates (5 C. tropicalis, 3 C. albicans, 1 C. parapsilosis) were cross-resistant to azoles according to EUCAST breakpoints compared to 3 isolates (2 C. albicans, 1 C. tropicalis) according to new and 2 (2 C. albicans) to old CLSI breakpoints. Four species (C. albicans, C. glabrata, C. tropicalis, C. parapsilosis) represented >90% of all CBI. In vitro resistance to fluconazole, voriconazole and caspofungin was rare among C. albicans, but an increase of non-susceptibile isolates was observed among C. tropicalis/C. parapsilosis for the azoles and C. glabrata/C. krusei for caspofungin according to EUCAST and new CLSI breakpoints compared to old CLSI breakpoints. This article is protected by copyright. All rights reserved.

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18 citations in Web of Science®
15 citations in Scopus®
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Additional indexing

Contributors:Fungal Infection Network of Switzerland
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > Institute of Medical Microbiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2014
Deposited On:03 Feb 2014 15:15
Last Modified:05 Apr 2016 17:27
Publisher:Wiley-Blackwell
ISSN:1198-743X
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/1469-0691.12440
PubMed ID:24188136

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