TABLE 4.
Published cases of Candida sp. infections associated with increased MICs of echinocandins as determined by the CLSI reference methoda
| Reference | Organism | Infection (comment) | Antifungal treatment | Isolate (source) | MIC (μg/ml)
|
FKS mutation | Comment(s) | ||
|---|---|---|---|---|---|---|---|---|---|
| CAS | MFG | AFG | |||||||
| Hernandez et al. (26) | C. albicans | Esophagitis (HIV) | FLC, AMB, CAS | A | 0.25 | ND | ND | ND | Resistance confirmed in an animal model |
| B | 0.25 | ND | ND | ND | |||||
| C | >64 | ND | ND | ND | |||||
| Laverdiere et al. (31) | C. albicans | Esophagitis (HIV) | FLC, VRC, AMB, CAS, ITZ, MFG | A | 0.06 | 0.03 | 0.03 | None | S645F and R1361H mutations |
| B | 2 | 2 | 1 | Yes | |||||
| C1 | 2 | 2 | 1 | Yes | |||||
| C2 | 1 | 2 | 0.5 | Yes | |||||
| Miller et al. (34) | C. albicans | Esophagitis (HIV) | FLC, VRC, AMB, CAS | A | 8 | ND | ND | Yes | S645P mutation; susceptible parent not available |
| Park et al. (46) | C. albicans | Disseminated (patient A) | CAS | A (oral) | 0.5 | ND | ND | None | S645F and S645P mutations; resistance confirmed in animals |
| B (blood) | >8 | ND | ND | Yes | |||||
| C (lung) | >8 | ND | ND | Yes | |||||
| D (liver) | 0.25 | ND | ND | None | |||||
| Park et al. (46) | C. albicans | Disseminated (patient B) | CAS | A (urine) | 0.5 | ND | ND | None | S645F mutation; resistance confirmed in animals |
| B (urine) | 0.5 | ND | ND | None | |||||
| C (oral) | 4 | ND | ND | Yes | |||||
| D (oral) | 4 | ND | ND | Yes | |||||
| Daneman et al. (13) | C. glabrata | Fungemia (3 episodes) | CAS (3 courses) | A (blood) | 0.5 | ND | ND | ND | |
| B (blood) | 8 | ND | ND | ND | |||||
| C (blood) | 8 | ND | ND | ND | |||||
| D (blood) | >16 | ND | ND | ND | |||||
| Dodgson et al. (17) | C. glabrata | Fungemia | AMB, VRC, CAS | A (blood) | 0.12 | ND | ND | ND | S663P mutation |
| B (blood) | >8 | >8 | >8 | Yes | |||||
| C (bone marrow) | >8 | ND | ND | ND | |||||
| Krogh-Madsen et al. (29) | C. glabrata | Fungemia | CAS, VRC | A (gall bladder) | 0.5 | ND | ND | ND | Resistance confirmed in animal model |
| B (urine) | >8 | ND | ND | ND | |||||
| C (gall bladder) | 8 | ND | ND | ND | |||||
| D (gall bladder) | 1 | ND | ND | ND | |||||
| Villareal et al. (62) | C. glabrata | Fungemia | CAS | A (blood) | 0.125 | ND | 0.03 | ND | |
| B (peritoneal fluid) | 8 | ND | 0.125 | ND | |||||
| Hakki et al. (25) | C. krusei | Fungemia | CAS, AMB, VRC | A (blood) | 2 | 0.5 | 0.25 | None | F655C mutation in one allele (27) |
| B (throat) | 8 | 4 | 4 | Yes | |||||
| Park et al. (46) | C. krusei | Fungemia | CAS | A (stool) | 32 | ND | ND | Yes | R1361G mutation; susceptible parent not available |
| Moudgal et al. (36) | C. parapsilosis | Prosthetic valve endocarditis | AMB, 5FC, FLC, CAS | A (blood) | 2 | 8 | 1 | ND | |
| B (blood) | >16 | >16 | 2 | ND | |||||
| Cleary et al. (10) | C. glabrata | Fungemia | CAS | A (blood) | 0.06 | 0.06 | 0.03 | None | D632E mutation |
| B (blood) | >4 | >4 | >4 | Yes | |||||
| C (blood) | >4 | >4 | >4 | Yes | |||||
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.