Abdominal candidiasis is a hidden reservoir of echinocandin resistance

FKS mutant Candida isolates were recovered from 24% (6/25) of abdominal candidiasis patients exposed to echinocandin. Candida glabrata (29%) and Candida albicans (14%) mutants were identified. Multidrug-resistant bacteria were recovered from 83% of FKS mutant infections. Mutations were associated wi...

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Veröffentlicht in:	Antimicrobial agents and chemotherapy 2014-12, Vol.58 (12), p.7601-7605
Hauptverfasser:	Shields, Ryan K, Nguyen, M Hong, Press, Ellen G, Clancy, Cornelius J
Format:	Artikel
Sprache:	eng
Schlagworte:	Abdominal Abscess Abdominal Abscess - drug therapy Abdominal Abscess - microbiology Abdominal Abscess - mortality Abdominal Abscess - pathology Adult Aged Antifungal Agents Antifungal Agents - therapeutic use Candida albicans Candida albicans - drug effects Candida albicans - genetics Candida albicans - growth & development Candida glabrata Candida glabrata - drug effects Candida glabrata - genetics Candida glabrata - growth & development Candidiasis Candidiasis - drug therapy Candidiasis - microbiology Candidiasis - mortality Candidiasis - pathology Drug Resistance, Fungal - genetics Echinocandins Echinocandins - therapeutic use Female Humans Male Mechanisms of Resistance Microbial Sensitivity Tests Middle Aged Mutation Peritonitis Peritonitis - drug therapy Peritonitis - microbiology Peritonitis - mortality Peritonitis - pathology Survival Analysis
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Zusammenfassung:	FKS mutant Candida isolates were recovered from 24% (6/25) of abdominal candidiasis patients exposed to echinocandin. Candida glabrata (29%) and Candida albicans (14%) mutants were identified. Multidrug-resistant bacteria were recovered from 83% of FKS mutant infections. Mutations were associated with prolonged echinocandin exposure (P = 0.01), breakthrough infections (P = 0.03), and therapeutic failures despite source control interventions (100%). Abdominal candidiasis is a hidden reservoir for the emergence of echinocandin-resistant Candida.
ISSN:	0066-4804 1098-6596
DOI:	10.1128/AAC.04134-14