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. (12th December 2013)

• Record Type: Journal Article
• Authors: Orasch, C.; Marchetti, O.; Garbino, J.; Schrenzel, J.; Zimmerli, S.; Mühlethaler, K.; Pfyffer, G.; Ruef, C.; Fehr, J.; Zbinden, R.; Calandra, T.; Bille, J.; the Fungal Infection Network of Switzerland (FUNGINOS); Roilides, E.; Bregenzer, Thomas; Conen, Anna; Fankhauser, Hans; Flückiger, Ursula; Khanna, Nina; Frei, Reno; Heininger, Ulrich; Hertel, Roland; Franciolli, Mario; Dolina, Marisa; Rothen, Madeleine; Dubuis, Olivier; Tarr, Philipp; Graf, Suzanne; Fleisch, Felix; Risch, Martin; Ritzler, Eva; Chuard, Christian; Erard, Véronique; Fracheboud, Dominique; Emonet, Stéphane; Genne, Daniel; Lienhardt, Reto; Chave, Jean‐Philippe; Andreutti‐Zaugg, Corinne; Gallusser, Alberto; Graber, Peter; Graf, Suzanne; Monotti, Rita; Bernasconi, Enos; Krause, Martin; Herzog, Karin; Piso, Rein‐Jan; Schibli, Urs; Bally, Frank; Troillet, Nicolas; Tissière, Lysiane; Boggian, Katja; Bruderer, Thomas; Gubler, Jacques; Eich, Gerhard; Berger, Christoph;
• Is Part Of: Clinical microbiology and infection. Volume 20:Number 7(2014:Jul.)
• Page Start: 698
• Page End: 705
• Publication Date: 2013-12-12
• Subjects: Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1111/1469-0691.12440
• Languages: English
• ISSNs: 1198-743X

Abstract

<abstract abstract-type="main" id="clm12440-abs-0001"> <title>Abstract</title> <p>We analyzed the species distribution of <italic>Candida</italic> blood isolates (CBIs), prospectively collected between 2004 and 2009 within FUNGINOS, and compared their antifungal susceptibility according to clinical breakpoints defined by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) in 2013, and the Clinical and Laboratory Standards Institute (CLSI) in 2008 (old CLSI breakpoints) and 2012 (new CLSI breakpoints). CBIs were tested for susceptiblity to fluconazole, voriconazole and caspofungin by microtitre broth dilution (Sensititre<sup>®</sup> YeastOne™ test panel). Of 1090 CBIs, 675 (61.9%) were <italic>C. albicans, </italic> 191 (17.5%) <italic>C. glabrata</italic>, 64 (5.9%) <italic>C. tropicalis</italic>, 59 (5.4%) <italic>C. parapsilosis</italic>, 33 (3%) <italic>C. dubliniensis</italic>, 22 (2%) <italic>C. krusei</italic> and 46 (4.2%) rare <italic>Candida</italic> species. Independently of the breakpoints applied, <italic>C. albicans</italic> was almost uniformly (>98%) susceptible to all three antifungal agents. In contrast, the proportions of fluconazole‐ and voriconazole‐susceptible <italic>C. tropicalis</italic> and F‐susceptible <italic>C. parapsilosis</italic> were lower according to EUCAST/new CLSI breakpoints than to the old CLSI breakpoints. For caspofungin, non‐susceptibility occurred mainly in <italic>C. krusei</italic> (63.3%) and <italic>C. glabrata</italic> (9.4%). Nine isolates (five <italic>C. tropicalis</italic>, three <italic>C. albicans</italic> and one <italic>C. parapsilosis</italic>) were cross‐resistant to azoles according to EUCAST breakpoints, compared with three isolates (two <italic>C. albicans</italic> and one <italic>C. tropicalis</italic>) according to new and two (2 <italic>C. albicans</italic>) according to old CLSI breakpoints. Four species (<italic>C. albicans, C. glabrata, C. tropicalis</italic> and <italic>C. parapsilosis</italic>) represented >90% of all CBIs. <italic>In vitro</italic> resistance to fluconazole, voriconazole and caspofungin was rare among <italic>C. albicans</italic>, but an increase of non‐susceptibile isolates was observed among <italic>C. tropicalis</italic>/<italic>C. parapsilosis</italic> for the azoles and <italic>C. glabrata</italic>/<italic>C. krusei</italic> for caspofungin according to EUCAST and new CLSI breakpoints compared with old CLSI breakpoints.</p> </abstract>