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Mycology

In Vitro Susceptibility of Invasive Isolates of Candida spp. to Anidulafungin, Caspofungin, and Micafungin: Six Years of Global Surveillance

M. A. Pfaller, L. Boyken, R. J. Hollis, J. Kroeger, S. A. Messer, S. Tendolkar, D. J. Diekema
M. A. Pfaller
1Departments of Pathology
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  • For correspondence: michael-pfaller@uiowa.edu
L. Boyken
1Departments of Pathology
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R. J. Hollis
1Departments of Pathology
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J. Kroeger
1Departments of Pathology
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S. A. Messer
1Departments of Pathology
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S. Tendolkar
1Departments of Pathology
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D. J. Diekema
1Departments of Pathology
2Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
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DOI: 10.1128/JCM.01901-07
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This article has a correction. Please see:

  • In Vitro Susceptibility of Invasive Isolates of Candida spp. to Anidulafungin, Caspofungin, and Micafungin: Six Years of Global Surveillance
    - September 03, 2008

ABSTRACT

The echinocandins are being used increasingly as therapy for invasive candidiasis. Prospective sentinel surveillance for the emergence of in vitro resistance to the echinocandins among invasive Candida sp. isolates is indicated. We determined the in vitro activities of anidulafungin, caspofungin, and micafungin against 5,346 invasive (bloodstream or sterile-site) isolates of Candida spp. collected from over 90 medical centers worldwide from 1 January 2001 to 31 December 2006. We performed susceptibility testing according to the CLSI M27-A2 method and used RPMI 1640 broth, 24-h incubation, and a prominent inhibition endpoint for determination of the MICs. Of 5,346 invasive Candida sp. isolates, species distribution was 54% C. albicans, 14% C. parapsilosis, 14% C. glabrata, 12% C. tropicalis, 3% C. krusei, 1% C. guilliermondii, and 2% other Candida spp. Overall, all three echinocandins were very active against Candida: anidulafungin (MIC50, 0.06 μg/ml; MIC90, 2 μg/ml), caspofungin (MIC50, 0.03 μg/ml; MIC90, 0.25 μg/ml), micafungin (MIC50, 0.015 μg/ml; MIC90, 1 μg/ml). More than 99% of isolates were inhibited by ≤2 μg/ml of all three agents. Results by species (expressed as the percentages of isolates inhibited by ≤2 μg/ml of anidulafungin, caspofungin, and micafungin, respectively) were as follows: for C. albicans, 99.6%, 100%, and 100%; for C. parapsilosis, 92.5%, 99.9%, and 100%; for C. glabrata, 99.9%, 99.9%, and 100%; for C. tropicalis, 100%, 99.8%, and 100%; for C. krusei, 100%, 100%, and 100%; and for C. guilliermondii, 90.2%, 95.1%, and 100%. There was no significant change in the activities of the three echinocandins over the 6-year study period and no difference in activity by geographic region. All three echinocandins have excellent in vitro activities against invasive strains of Candida isolated from centers worldwide. Our prospective sentinel surveillance reveals no evidence of emerging echinocandin resistance among invasive clinical isolates of Candida spp.

  • Copyright © 2008 American Society for Microbiology
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In Vitro Susceptibility of Invasive Isolates of Candida spp. to Anidulafungin, Caspofungin, and Micafungin: Six Years of Global Surveillance
M. A. Pfaller, L. Boyken, R. J. Hollis, J. Kroeger, S. A. Messer, S. Tendolkar, D. J. Diekema
Journal of Clinical Microbiology Jan 2008, 46 (1) 150-156; DOI: 10.1128/JCM.01901-07

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In Vitro Susceptibility of Invasive Isolates of Candida spp. to Anidulafungin, Caspofungin, and Micafungin: Six Years of Global Surveillance
M. A. Pfaller, L. Boyken, R. J. Hollis, J. Kroeger, S. A. Messer, S. Tendolkar, D. J. Diekema
Journal of Clinical Microbiology Jan 2008, 46 (1) 150-156; DOI: 10.1128/JCM.01901-07
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KEYWORDS

antifungal agents
Candida
candidiasis
echinocandins
Lipoproteins

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