TABLE 5.
Rates of resistance to caspofungin, micafungin, and anidulafungin of isolates of species with available breakpoints proposed by the CLSI M27-S3 document and the EUCAST procedurea
| Species (nb) | Category | % of isolates in category for antifungal agent |
|||
|---|---|---|---|---|---|
| Caspofungin, CLSIf | Micafungin, CLSI | Anidulafungin |
|||
| CLSI | EUCAST | ||||
| C. albicans (348) | I | 0.3 | 0.3 | 0 | NA |
| R | 0 | 0 | 0 | 0.29 | |
| C. parapsilosis complex (200)c | I | 0 | 0 | 0 | 100 |
| R | 0 | 0 | 0 | 0 | |
| C. glabrata complex (103)d | I | 34.6 | 0 | 0 | NA |
| R | 1.0 | 1.0 | 1.0 | 0.97 | |
| C. tropicalis (59) | I | 1.7 | 0 | 0 | NA |
| R | 0 | 3.3 | 3.3 | 3.39 | |
| C. krusei (15) | I | 6.7 | 0 | 0 | NA |
| R | 0 | 0 | 0 | 0 | |
| C. guilliermondii (13) | I | 0 | 0 | 0 | NA |
| R | 0 | 0 | 0 | ||
| Globale | I | 5.1 | 0 | 0 | 27.1 |
| R | 2.2 | 1.9 | 1.8 | 3.1e | |
The overall resistance rate also included the non-wild-type isolates. I, intermediate category according to the CLSI and EUCAST procedures. NA, not applicable.
n, no. of isolates.
Isolates of C. metapsilosis (n = 7) and C. orthopsilosis (n = 2) were considered to be C. parapsilosis for analysis of the rate of resistance.
The C. nivariensis isolate was considered to be C. glabrata for analysis of the rate of resistance.
For CLSI, tentative rates of resistance to echinocandins (non-wild-type isolates) were calculated by using the ECVs for C. lusitaniae, C. guilliermondii, C. dubliniensis, and C. kefyr; In order to make comparable the rate of resistance obtained both by CLSI and EUCAST, we tentatively used the C. albicans breakpoints (R > 4 mg/liter) for classifying the remaining Candida and non-Candida isolates (n = 19) as susceptible or resistant to fluconazole and voriconazole; Rhodotorula species, C. neoformans, and Trichosporon species isolates were considered intrinsically resistant to echinocandins. For EUCAST, the isolates were considered resistant if showing an MIC > 0.06 mg/liter, except for C. albicans (R > 0.03 mg/liter) and species from the C. parapsilosis complex (R > 4).