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

doi:10.1128/JCM.01901-07

DOI: 10.1128/JCM.01901-07

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Tables

TABLE 1.

Species distribution of Candida isolates by geographic region

Candida species	% of isolates^a
Candida species	APAC (n = 958)	LAM (n = 1,112)	EU (n = 1,787)	NAM (n = 1,489)	Total (n = 5,346)
C. albicans	57.10	47.93	58.42	50.03	53.67
C. parapsilosis	15.97	18.62	10.63	14.04	14.20
C. glabrata	8.46	5.67	13.93	23.77	13.97
C. tropicalis	14.20	19.96	8.56	7.66	11.69
C. krusei	0.94	1.62	4.87	1.48	2.54
C. guilliermondii	0.73	3.60	0.50	0.34	1.14
C. lusitaniae	0.63	0.63	1.29	1.48	1.08
C. kefyr	0.10	0.63	1.23	0.47	0.69
C. famata	0.84	0.72	0.22	0.27	0.45
Candida spp.^b	1.04	0.63	0.34	0.47	0.56

↵ a Regions: APAC, Asia-Pacific (16 study sites); LAM, Latin America (15 study sites); EU, Europe (32 study sites); NAM, North America (28 study sites). For each region, the number of isolates (n) is given in parentheses.
↵ b Includes C. pelliculosa (11 isolates), C. lipolytica (8 isolates), C. dubliniensis (6 isolates), C. rugosa (2 isolates), C. zeylanoides (2 isolates), and C. intermedia (1 isolate).

TABLE 2.

In vitro susceptibilities of 5,346 clinical isolates of Candida spp. to anidulafungin, caspofungin, and micafungin

Organism	No. of isolates tested	Antifungal agent	Cumulative % of isolates susceptible at a MIC (μg/ml) of^a:
Organism	No. of isolates tested	Antifungal agent	0.007	0.015	0.03	0.06	0.12	0.25	0.5	1	2	4	≥8
C. albicans	2,869	Anidulafungin	6.2	33.5	69.5	92.4	99.1	99.5	99.5	99.6	100.0
		Caspofungin	1.7	26.7	74.2	97.1	99.3	99.9	100.0
		Micafungin	11.9	80.6	96.4	99.3	99.4	99.5	99.6	100.0
C. parapsilosis	759	Anidulafungin			0.3	0.3	0.3	1.4	4.7	27.9	92.5	100.0
		Caspofungin		0.1	0.5	3.3	10.7	52.2	89.5	98.6	99.9	100.0
		Micafungin		0.1	0.3	0.3	0.5	6.1	24.4	79.3	100.0
C. glabrata	747	Anidulafungin		0.4	7.8	62.4	93.6	99.4	99.7	99.9	99.9	100.0
		Caspofungin		7.0	65.2	95.3	98.4	99.2	99.7	99.9	99.9	99.9	100.0
		Micafungin	13.7	91.4	97.9	98.9	99.5	99.9	99.9	100.0
C. tropicalis	625	Anidulafungin	3.2	24.2	75.7	95.0	98.4	99.4	99.5	99.5	100.0
		Caspofungin	1.3	31.0	79.7	97.3	99.0	99.7	99.7	99.8	99.8	99.8	100.0
		Micafungin	4.0	39.5	77.6	96.3	98.6	99.5	99.7	100.0
C. krusei	136	Anidulafungin		2.9	47.1	90.4	99.3	99.3	100.0
		Caspofungin		0.7	0.7	41.9	75.7	94.9	99.3	100.0
		Micafungin		2.2	13.2	85.3	96.3	100.0
C. guilliermondii	61	Anidulafungin					3.3	6.6	13.1	57.4	90.2	100.0
		Caspofungin			1.6	4.9	11.5	39.3	80.3	95.1	95.1	95.1	100.0
		Micafungin		3.3	3.3	6.6	11.5	21.3	65.6	98.4	100.0
C. lusitaniae	58	Anidulafungin				1.7	13.8	43.1	96.6	100.0
		Caspofungin			3.4	6.9	44.8	89.7	96.6	100.0
		Micafungin			1.7	8.6	63.8	96.6	98.3	100.0
C. kefyr	37	Anidulafungin		2.7	10.8	56.8	100.0
		Caspofungin	13.5	97.3	100.0
		Micafungin		5.4	40.5	100.0
C. famata	24	Anidulafungin		4.2	16.7	20.8	20.8	20.8	25.0	50.0	100.0
		Caspofungin		4.2	12.5	20.8	37.5	70.8	70.8	95.8	100.0
		Micafungin		4.2	16.7	16.7	20.8	33.3	75.0	91.7	100.0
Candida spp.	30	Anidulafungin	3.3	30.0	50.0	63.3	63.3	73.3	86.7	93.3	96.7	96.7	100.0
		Caspofungin		16.7	43.3	63.3	73.3	96.7	100.0
		Micafungin		20.0	53.3	66.7	66.7	86.7	100.0
Total	5,346	Anidulafungin	3.7	21.1	48.9	72.6	82.0	83.4	84.7	88.7	98.8	99.9	100.0
		Caspofungin	1.2	19.7	59.4	79.6	84.0	91.9	98.1	99.7	99.9	99.9	100.0
		Micafungin	8.8	60.9	75.6	81.9	83.3	85.0	88.5	97.0	100.0

↵ a Values corresponding to MICs at which at least 90% of isolates are inhibited are listed in bold type.

TABLE 3.

Variation in echinocandin MIC profiles by geographic region

Region(s) and species	No. of isolates tested	Antifungal agent	No. of isolates for which the MIC (μg/ml) was:
Region(s) and species	No. of isolates tested	Antifungal agent	0.007	0.015	0.03	0.06	0.12	0.25	0.5	1	2	4	≥8
Asia-Pacific
C. albicans	547	Anidulafungin	32	136	195	128	49	4		1	2
		Caspofungin	12	139	228	148	16	3	1
		Micafungin	63	351	108	21			2	2
C. parapsilosis	153	Anidulafungin			1			1	5	44	96	6
		Caspofungin		1		6	9	65	55	9	8
		Micafungin		1				5	34	91	22
C. glabrata	81	Anidulafungin			6	55	18	2
		Caspofungin		8	56	16	1
		Micafungin	16	55	8		2
C. tropicalis	136	Anidulafungin	5	26	67	34	4
		Caspofungin	2	48	58	24	3	1
		Micafungin	7	38	60	23	5	3
C. krusei	9	Anidulafungin			4	5
		Caspofungin				7	2
		Micafungin			1	6	2
C. guilliermondii	7	Anidulafungin					1			1	4	1
		Caspofungin			1			2	3	1
		Micafungin				1		1	3	2
C. lusitaniae	6	Anidulafungin					2	3	1
		Caspofungin					3	3
		Micafungin				1	4	1
C. kefyr	1	Anidulafungin					1
		Caspofungin		1
		Micafungin				1
C. famata	8	Anidulafungin		1	1					2	4
		Caspofungin		1		1	1	4	1
		Micafungin			2				3	1	2
Latin America
C. albicans	533	Anidulafungin	34	134	185	134	42	2			2
		Caspofungin	7	119	249	134	19	5
		Micafungin	57	363	88	23				2
C. parapsilosis	207	Anidulafungin			1			2	10	61	123	10
		Caspofungin			2	5	24	81	77	16	1	1
		Micafungin			1		1	19	50	109	27
C. glabrata	63	Anidulafungin			8	42	12	1
		Caspofungin		4	37	18	4
		Micafungin	8	53	2
C. tropicalis	222	Anidulafungin	5	39	119	47	6	5			1
		Caspofungin	2	61	110	42	5	2
		Micafungin	6	79	91	39	4	2		1
C. krusei	18	Anidulafungin			9	8	1
		Caspofungin				6	7	5
		Micafungin			1	15	2
C. guilliermondii	40	Anidulafungin						2	3	20	10	5
		Caspofungin				1	4	10	17	5			3
		Micafungin					4	2	18	15	1
C. lusitaniae	7	Anidulafungin						3	4
		Caspofungin					2	3	2
		Micafungin					5	2
C. kefyr	7	Anidulafungin			2	3	2
		Caspofungin		7
		Micafungin			4	3
C. famata	8	Anidulafungin				1				2	5
		Caspofungin				1	1	1	4	1
		Micafungin						2	4	2
Europe
C. albicans	1,044	Anidulafungin	47	268	399	268	56	1	1		4
		Caspofungin	12	238	534	230	25	4	1
		Micafungin	108	748	155	25	3	1		4
C. parapsilosis	190	Anidulafungin						4	3	40	124	19
		Caspofungin			1	5	11	71	79	22	1
		Micafungin					1	7	26	111	45
C. glabrata	249	Anidulafungin		1	14	135	91	7		1
		Caspofungin		17	146	69	14	3
		Micafungin	28	199	18	3	1
C. tropicalis	153	Anidulafungin	7	33	87	19	5	1	1
		Caspofungin	3	48	74	24	3	1
		Micafungin	8	60	53	28	3	1
C. krusei	87	Anidulafungin		3	38	36	9		1
		Caspofungin		1		32	31	18	4	1
		Micafungin		2	12	60	9	4
C. guilliermondii	9	Anidulafungin					1		1	3	4
		Caspofungin				1		3	3		2
		Micafungin		1		1		1	4	2
C. lusitaniae	23	Anidulafungin				1	2	6	13	1
		Caspofungin				2	7	11	1	2
		Micafungin			1	1	10	10		1
C. kefyr	22	Anidulafungin			1	10	11
		Caspofungin	2	19	1
		Micafungin			6	16
C. famata	4	Anidulafungin			2					1	1
		Caspofungin			2		1	1
		Micafungin		1	1				2
North America
C. albicans	745	Anidulafungin	64	246	254	128	43	5		1	4
		Caspofungin	18	220	354	145	4	3	1
		Micafungin	114	508	102	14	2		2	3
C. parapsilosis	209	Anidulafungin						2	7	31	147	22
		Caspofungin				5	12	98	72	22
		Micafungin						11	29	106	63
C. glabrata	354	Anidulafungin		2	27	176	132	14	2			1
		Caspofungin		23	196	122	4	3	4	1			1
		Micafungin	50	274	20	6	1	2		1
C. tropicalis	114	Anidulafungin	3	33	49	21	6				2
		Caspofungin	1	29	62	20				1			1
		Micafungin	4	45	34	27	2		1	1
C. krusei	22	Anidulafungin		1	9	10	2
		Caspofungin				11	6	3	2
		Micafungin		1	1	17	2	1
C. guilliermondii	5	Anidulafungin								3	2
		Caspofungin						2	2	1
		Micafungin						2	2	1
C. lusitaniae	22	Anidulafungin					3	5	13	1
		Caspofungin			2		10	9	1
		Micafungin				2	13	6	1
C. kefyr	7	Anidulafungin		1		4	2
		Caspofungin	3	4
		Micafungin		2	3	2
C. famata	4	Anidulafungin							1	1	2
		Caspofungin					1	2	1
		Micafungin					1	1	1	1