TABLE 4.

Published cases of Candida sp. infections associated with increased MICs of echinocandins as determined by the CLSI reference methoda

ReferenceOrganismInfection (comment)Antifungal treatmentIsolate (source)MIC (μg/ml)FKS mutationComment(s)
CASMFGAFG
Hernandez et al. (26) C. albicans Esophagitis (HIV)FLC, AMB, CASA0.25NDNDNDResistance confirmed in an animal model
B0.25NDNDND
C>64NDNDND
Laverdiere et al. (31) C. albicans Esophagitis (HIV)FLC, VRC, AMB, CAS, ITZ, MFGA0.060.030.03NoneS645F and R1361H mutations
B221Yes
C1221Yes
C2120.5Yes
Miller et al. (34) C. albicans Esophagitis (HIV)FLC, VRC, AMB, CASA8NDNDYesS645P mutation; susceptible parent not available
Park et al. (46) C. albicans Disseminated (patient A)CASA (oral)0.5NDNDNoneS645F and S645P mutations; resistance confirmed in animals
B (blood)>8NDNDYes
C (lung)>8NDNDYes
D (liver)0.25NDNDNone
Park et al. (46) C. albicans Disseminated (patient B)CASA (urine)0.5NDNDNoneS645F mutation; resistance confirmed in animals
B (urine)0.5NDNDNone
C (oral)4NDNDYes
D (oral)4NDNDYes
Daneman et al. (13) C. glabrata Fungemia (3 episodes)CAS (3 courses)A (blood)0.5NDNDND
B (blood)8NDNDND
C (blood)8NDNDND
D (blood)>16NDNDND
Dodgson et al. (17) C. glabrata FungemiaAMB, VRC, CASA (blood)0.12NDNDNDS663P mutation
B (blood)>8>8>8Yes
C (bone marrow)>8NDNDND
Krogh-Madsen et al. (29) C. glabrata FungemiaCAS, VRCA (gall bladder)0.5NDNDNDResistance confirmed in animal model
B (urine)>8NDNDND
C (gall bladder)8NDNDND
D (gall bladder)1NDNDND
Villareal et al. (62) C. glabrata FungemiaCASA (blood)0.125ND0.03ND
B (peritoneal fluid)8ND0.125ND
Hakki et al. (25) C. krusei FungemiaCAS, AMB, VRCA (blood)20.50.25NoneF655C mutation in one allele (27)
B (throat)844Yes
Park et al. (46) C. krusei FungemiaCASA (stool)32NDNDYesR1361G mutation; susceptible parent not available
Moudgal et al. (36) C. parapsilosis Prosthetic valve endocarditisAMB, 5FC, FLC, CASA (blood)281ND
B (blood)>16>162ND
Cleary et al. (10) C. glabrata FungemiaCASA (blood)0.060.060.03NoneD632E mutation
B (blood)>4>4>4Yes
C (blood)>4>4>4Yes
  • a Data were compiled from references 6, 10, 13, 17, 25, 26, 29, 31, 34, 36, 46, and 62. Abbreviations: CLSI, Clinical and Laboratory Standards Institute; AMB, amphotericin B; FLC, fluconazole; VRC, voriconazole; 5FC, flucytosine; ITZ, itraconazole; CAS, caspofungin; MFG, micafungin; AFG, anidulafungin; ND, not done.