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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.

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
Scopus Subject Areas:Health Sciences > Microbiology (medical)
Health Sciences > Infectious Diseases
Language:English
Date:2014
Deposited On:03 Feb 2014 15:15
Last Modified:10 Jul 2025 01:39
Publisher:Wiley-Blackwell
ISSN:1198-743X
OA Status:Closed
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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