TABLE 1.
JHH Candida kefyr isolates and echinocandin susceptibilities
| Patient no. | Hematologic malignancya | Chemotherapyb | Isolate | Source | Date of culture (mo and yr) | Treatment with antifungals ≤30 days prior to positive culture (days)c |
MICd |
|||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICA | FLU | VOR | LAMB | ANID | CAS | MICA | ||||||
| 1 | AML (new) | FLAM | C113 | Blood | Jul 2009 | 8 | No | No | No | 0.25 | 0.125 | 4 |
| 2 | AML (new) | AcDVP16 | C124 | Mucosa | Jul 2009 | 20 | No | No | No | 0.5 | 0.125 | 2 |
| 3 | MM (relapse) | Othere | C125 | Mucosa | Jul 2009 | No | No | No | No | 0.06 | 0.06 | 0.03 |
| 4 | AML (new) | AcDVP16 | C126 | Mucosa | Jul 2009 | 11 | No | No | No | 0.06 | 0.06 | 0.25 |
| 5 | AML (new) | FLAM | C127 | Mucosa | Jul 2009 | 1 | No | No | 9 | 0.06 | 0.03 | 0.25 |
| 6 | Pre-B cell ALL | Otherf | C128 | Mucosa | Jul 2009 | 4 | No | No | No | 0.06 | 0.06 | 0.25 |
| 7 | AML (new) | None | C129 | Mucosa | Jul 2009 | 6 | No | No | No | 0.06 | 0.06 | 0.25 |
| 8 | AML (relapse) | Otherg | C112 | Blood | Aug 2009 | No | No | No | No | 0.03 | 0.06 | 0.25 |
| C115 | Blood | Jul 2010 | No | No | No | No | 0.25 | 0.25 | 0.5 | |||
| 9 | AML (new) | FLAM | C123 | Mucosa | Aug 2009 | 10 | No | 7 | No | 0.5 | 0.125 | 1 |
| 10 | AML (relapse) | FLAM | C117 | Blood | Oct 2009 | No | 10 | No | No | 0.06 | 0.06 | 0.25 |
| 11 | AML (new) | FLAM | C122 | Mucosa | Dec 2009 | No | No | 2 | 14 | 0.06 | 0.06 | 0.125 |
| 12 | AML (new) | AcDVP16 | C116 | Blood | Aug 2010 | 20 | 5 | 2 | No | >8.0 | 4 | >8.0 |
| 13 | AML (relapse) | FLAM | C119 | Mucosa | Sep 2010 | No | No | 8 | 21 | 0.06 | 0.06 | 0.125 |
| C120 | Mucosa | Sep 2010 | 8 | No | 3 | 30 | 0.06 | 0.06 | 0.125 | |||
| 14 | GS (relapse) | Otherg | C121 | Mucosa | Sep 2010 | 12 | No | 11 | No | 0.06 | 0.06 | 0.125 |
| 15 | AML (relapse) | AcDVP16 | C118 | Blood | May 2011 | 14 | No | No | 23 | 0.25 | 0.25 | 0.5 |
| 16 | AML (relapse) | Otherh | C114 | Blood | Feb 2010 | 18 | 7 | No | 9 | 0.5 | 0.25 | 1 |
| 17 | AML (relapse) | AcDVP16 | C130 | Stool | Oct 2012 | 1 | No | No | No | 0.03 | 0.06 | 0.25 |
| C131 | Stool | Oct 2012 | 8 | No | No | No | 1 | 0.25 | 1 | |||
| C132 | Blood | Oct 2012 | 14 | No | No | No | >8.0 | 2 | >8.0 | |||
| C133 | Blood | Oct 2012 | 14 | No | No | No | >8.0 | 2 | >8.0 | |||
| C134 | Blood | Oct 2012 | 15 | No | No | No | >8.0 | 2 | >8.0 | |||
| C135 | Blood | Oct 2012 | 16 | No | No | No | >8.0 | 2 | >8.0 | |||
| C136 | Stool | Oct 2012 | 17 | No | No | No | >8.0 | 2 | >8.0 | |||
| C. kefyri | 0.125 | 0.25 | 0.125 | |||||||||
| Wild-type MICsj | 0.06 | 0.125 | 0.25 | |||||||||
a
AML, acute myelogenous leukemia; MM, multiple myeloma; ALL, acute lymphocytic leukemia; GS, granulocytic sarcoma.
b
FLAM, flavopiridol, cytarabine, and mitoxantrone; AcDVP16, cytarabine, daunorubicin, and etoposide.
c
MICA, micafungin; FLU, fluconazole; VOR, voriconazole; LAMB, liposomal amphotericin B.
d
ANID, anidulafungin; CAS, caspofungin.
e
Other: bortezomib, cyclophosphamide, and lenolidomide.
f
Other: polyethylene glycol (PEG)-asparaginase.
g
Other: Investigational agent, topotecan, and carboplatin.
h
Other: Chk-1 inhibitor and clofarabine.
i
C. kefyr ATCC-4922.
j
Modal values were calculated using MICs observed for C. kefyr isolates ATCC-4922, C115, C117, and C130. See Materials and Methods.