Table 3.
In vitro susceptibility of 203 fungemia isolates to nine antifungal agentsa
| Species (no. of isolates tested) | Drug | MIC (mg/liter) |
No. (%) of resistant isolates |
|||
|---|---|---|---|---|---|---|
| Range | 50% | 90% | CLSI | Species-specific clinical breakpointc | ||
| C. parapsilosis (95) | AND | 0.016–4 | 1 | 2 | 2 | 0 |
| CAS | 0.008–2 | 0.5 | 0.5 | 0 | 0 | |
| MCF | 0.016–8 | 1 | 2 | 1 (1.1) | 1 (1.1) | |
| FZ | 0.12–8 | 1 | 2 | 0 | 0 | |
| ITZ | 0.016–0.25 | 0.06 | 0.12 | 0 | ND | |
| VOR | 0.008–0.12 | 0.008 | 0.03 | 0 | 0 | |
| POS | 0.008–1 | 0.03 | 0.12 | 0 | ND | |
| AMB | 0.12–1 | 0.25 | 0.5 | 0 | ND | |
| FLC | 0.06–1 | 0.06 | 0.25 | 0 | ND | |
| C. albicans (74) | AND | 0.016–0.5 | 0.016 | 0.12 | 0 | 0 |
| CAS | 0.008–0.5 | 0.03 | 0.12 | 0 | 0 | |
| MCF | 0.008–1 | 0.016 | 0.03 | 0 | 1 (1.4) | |
| FZ | 0.06–256 | 0.5 | 0.5 | 1 (1.4) | 2 (2.7) | |
| ITZ | 0.016–8 | 0.06 | 0.12 | 1 (1.4) | ND | |
| VOR | 0.008–8 | 0.008 | 0.016 | 1 (1.4) | 1 (1.4) | |
| POS | 0.008–8 | 0.03 | 0.12 | 1 (1.4) | ND | |
| AMB | 0.12–0.5 | 0.25 | 0.5 | 0 | ND | |
| FLC | 0.06–32 | 0.06 | 0.5 | 1 (1.4) | ND | |
| C. tropicalis (12) | AND | 0.016–8 | 0.12 | 0.25 | 1 (8.3) | 1 (8.3) |
| CAS | 0.03–0.25 | 0.06 | 0.25 | 0 | 0 | |
| MCF | 0.016–8 | 0.03 | 0.06 | 1 (8.3) | 1 (8.3) | |
| FZ | 0.5–256 | 1 | 256 | 2 (16.6) | 2 (16.6) | |
| ITZ | 0.03–16 | 0.25 | 8 | 2 (16.6) | ND | |
| VOR | 0.03–8 | 0.06 | 2 | 1 (8.3) | 2 (16.6) | |
| POS | 0.03–4 | 0.25 | 4 | 1 (8.3) | ND | |
| AMB | 0.25–2 | 0.5 | 0.5 | 1 (8.3) | ND | |
| FLC | 0.06–2 | 0.06 | 2 | 0 | ND | |
| C. glabrata (8) | AND | 0.016–0.03 | 0.03 | 0 | 0 | |
| CAS | 0.008–0.12 | 0.03 | 0 | 0 | ||
| MCF | 0.008–0.016 | 0.016 | 0 | 0 | ||
| FZ | 1–16 | 4 | 0 | 0 | ||
| ITZ | 0.12–1 | 0.25 | 1 | ND | ||
| VOR | 0.03–0.25 | 0.06 | 0 | ND | ||
| POS | 0.06–1 | 0.25 | 0 | ND | ||
| AMB | 0.12–1 | 0.25 | 0 | ND | ||
| FLC | 0.06 | 0.06 | 0 | ND | ||
| C. guilliermondii (5) | AND | 0.5–2 | 1 | 0 | 0 | |
| CAS | 0.12–0.5 | 0.25 | 0 | 0 | ||
| MCF | 0.25–1 | 0.5 | 0 | 0 | ||
| FZ | 0.5–8 | 4 | 0 | ND | ||
| ITZ | 0.03–0.5 | 0.25 | 0 | ND | ||
| VOR | 0.008–0.12 | 0.06 | 0 | ND | ||
| POS | 0.016–0.5 | 0.12 | 0 | ND | ||
| AMB | 0.25–0.5 | 0.25 | 0 | ND | ||
| FLC | 0.06 | 0.06 | 0 | ND | ||
| C. lusitaniae (4) | AND | 0.12–0.5 | 0.25 | 0 | ND | |
| CAS | 0.06–0.25 | 0.12 | 0 | ND | ||
| MCF | 0.008–0.5 | 0.06 | 0 | ND | ||
| FZ | 0.25–1 | 0.25 | 0 | ND | ||
| ITZ | 0.03–0.12 | 0.12 | 0 | ND | ||
| VOR | 0.008–0.016 | 0.008 | 0 | ND | ||
| POS | 0.03–0.06 | 0.03 | 0 | ND | ||
| AMB | 0.12–0.5 | 0.25 | 0 | ND | ||
| FLC | 0.06 | 0.06 | 0 | ND | ||
| C. krusei (2) | AND | 0.016–0.06 | 0.016 | 0 | 0 | |
| CAS | 0.25 | 0.25 | 0 | 0 | ||
| MCF | 0.12 | 0.12 | 0 | 0 | ||
| FZ | 64 | 64 | 2 (100) | 2 (100) | ||
| ITZ | 0.25 | 0.25 | 0 | ND | ||
| VOR | 0.25 | 0 | ND | |||
| POS | 0.25–0.5 | 0.25 | 0 | ND | ||
| AMB | 0.5 | 0.5 | 0 | ND | ||
| FLC | 02–8 | 2 | 0 | ND | ||
| Other yeastsb (3) | AND | 8 | 8 | 2 (66.6) | ND | |
| CAS | 8 | 2 (66.6) | ND | |||
| MCF | 8 | 8 | 2 (66.6) | ND | ||
| FZ | 4–256 | 4 | 1 (33.3) | ND | ||
| ITZ | 0.03–2 | 0.03 | 1 (33.3) | ND | ||
| VOR | 0.06–4 | 0.06 | 1 (33.3) | ND | ||
| POS | 0.25–8 | 0.25 | 1 (33.3) | ND | ||
| AMB | 0.5 | 0.5 | 0 | ND | ||
| FLC | 0.06–2 | 0.06 | 0 | ND | ||
| Overall (203) | AND | 0.015–8 | 0.12 | 5 (2.48) | ||
| CAS | 0.008–8 | 0.12 | 2 (1) | |||
| MCF | 0.008–8 | 0.25 | 4 (2) | |||
| FZ | 0.06–256 | 0.5 | 6 (3) | |||
| ITZ | 0.016–16 | 0.06 | 4 (2) | |||
| VOR | 0.008–8 | 0.008 | 3 (1.5) | |||
| POS | 0.008–8 | 0.03 | 3 (1.5) | |||
| AMB | 0.12–2 | 0.25 | 1 (0.5) | |||
| FLC | 0.06–32 | 0.06 | 1 (0.5) | |||
a
AND, anidulafungin; CAS, caspofungin; MCF, micafungin; FZ, fluconazole; ITZ, itraconazole; VOR, voriconazole; POS, posaconazole; AMB, amphotericin B; FLC, flucytosine; ND, not defined.
b
One isolate each of C. famata, T. asahii, and R. glutinis.
c
Defined in Materials and Methods.