TABLE 2.
MIC distributions of studied antifungals versus isolates and rates of resistant/non-wild-type isolatesa
| Organism(s) and drug | No. of isolates at each MIC, in mg/liter |
No. of isolates (%) |
|||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ≤0.001 | 0.002 | 0.004 | 0.008 | 0.016 | 0.03 | 0.06 | 0.125 | 0.25 | 0.5 | 1 | 2 | 4 | 8 | 16 | 32 | ≥64 | Resistant | Non-wild type | |
| C. albicans (n = 410) | |||||||||||||||||||
| Amphotericin B | — | — | 0 | 0 | 0 | 0 | 12 | 98 | 217 | 78 | 5 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Fluconazole | — | — | — | — | — | — | 28 | 239 | 125 | 12 | 2 | 0 | 0 | 1 | 0 | 0 | 3 | 4 (1.0) | 6 (1.5) |
| Voriconazole | 4 | 46 | 280 | 61 | 11 | 2 | 2 | 0 | 0 | 1 | 0 | 0 | 0 | 3b | — | — | — | 4 (1.0) | 6 (1.5) |
| Posaconazole | 1 | 4 | 83 | 205 | 81 | 27 | 5 | 1 | 0 | 0 | 0 | 0 | 0 | 3b | — | — | — | 4 (1.0) | 4 (1.0) |
| Isavuconazole | 25 | 239 | 120 | 16 | 6 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 3b | — | — | — | ND | 4 (1.0) |
| Micafungin | 10 | 104 | 244 | 42 | 10 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Anidulafungin | 13 | 178 | 190 | 19 | 9 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| C. parapsilosis complex (n = 237) | |||||||||||||||||||
| Amphotericin B | — | — | 0 | 0 | 0 | 0 | 4 | 20 | 105 | 101 | 7 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Fluconazole | — | — | — | — | — | — | 0 | 3 | 116 | 93 | 22 | 3 | 0 | 0 | 0 | 0 | 0 | 0 (0) | 0 (0) |
| Voriconazole | 0 | 0 | 16 | 125 | 78 | 15 | 3 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Posaconazole | 0 | 0 | 0 | 10 | 76 | 106 | 45 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Isavuconazole | 0 | 33 | 104 | 83 | 16 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | ND | 0 (0) |
| Micafungin | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 10 | 36 | 140 | 50 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Anidulafungin | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 3 | 14 | 53 | 153 | 13 | 0 | — | — | — | 0 (0) | 0 (0) |
| C. glabrata (n = 110) | |||||||||||||||||||
| Amphotericin B | — | — | 0 | 0 | 0 | 0 | 3 | 14 | 65 | 27 | 1 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Fluconazole | — | — | — | — | — | — | 0 | 0 | 0 | 0 | 0 | 5 | 37 | 49 | 9 | 2 | 8 | 10 (9.1) | 10 (9.1) |
| Voriconazole | 0 | 0 | 0 | 0 | 0 | 2 | 15 | 35 | 47 | 4 | 2 | 4 | 1 | 0 | — | — | — | ND | 5 (4.5) |
| Posaconazole | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 8 | 32 | 53 | 9 | 4 | 2 | 0 | — | — | — | ND | 6 (5.5) |
| Isavuconazole | 0 | 1 | 0 | 1 | 1 | 14 | 35 | 32 | 16 | 1 | 5 | 3 | 1 | 0 | — | — | — | ND | 10 (9.1) |
| Micafungin | 0 | 0 | 0 | 93 | 15 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Anidulafungin | 0 | 0 | 0 | 0 | 41 | 64 | 4 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | 1 (0.9) | 1 (0.9) |
| C. tropicalis (n = 65) | |||||||||||||||||||
| Amphotericin B | — | — | 0 | 0 | 0 | 0 | 1 | 4 | 36 | 22 | 2 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Fluconazole | — | — | — | — | — | — | 0 | 10 | 37 | 14 | 4 | 0 | 0 | 0 | 0 | 0 | 0 | 0 (0) | 0 (0) |
| Voriconazole | 0 | 0 | 0 | 6 | 34 | 17 | 7 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Posaconazole | 0 | 0 | 1 | 16 | 21 | 25 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Isavuconazole | 0 | 3 | 28 | 31 | 2 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | ND | 0 (0) |
| Micafungin | 0 | 0 | 0 | 3 | 44 | 15 | 1 | 1 | 0 | 0 | 0 | 1 | 0 | 0 | — | — | — | ND | 2 (3.1) |
| Anidulafungin | 0 | 0 | 0 | 15 | 38 | 8 | 3 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | — | — | — | 1 (1.5) | 1 (1.5) |
| C. krusei (n = 21) | |||||||||||||||||||
| Amphotericin B | — | — | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 17 | 3 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Fluconazole | — | — | — | — | — | — | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 6 | 8 | 7 | 21 (100) | 0 (0) |
| Voriconazole | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4 | 9 | 8 | 0 | 0 | 0 | 0 | — | — | — | ND | 0 (0) |
| Posaconazole | 0 | 0 | 0 | 0 | 1 | 2 | 4 | 8 | 6 | 0 | 0 | 0 | 0 | 0 | — | — | — | ND | 0 (0) |
| Isavuconazole | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 12 | 6 | 1 | 0 | 0 | 0 | 0 | — | — | — | ND | 0 (0) |
| Micafungin | 0 | 0 | 0 | 0 | 0 | 0 | 15 | 6 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | ND | 0 (0) |
| Anidulafungin | 0 | 0 | 0 | 0 | 0 | 14 | 7 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | — | — | — | 0 (0) | 0 (0) |
| Other Candida spp. (n = 28) | |||||||||||||||||||
| Amphotericin B | — | — | 0 | 0 | 0 | 2 | 6 | 10 | 6 | 4 | 0 | 0 | 0 | 0 | — | — | — | ND | ND |
| Fluconazole | — | — | — | — | — | — | 2 | 5 | 5 | 0 | 0 | 5 | 5 | 1 | 2 | 2 | 1 | 6 (21.4) | ND |
| Voriconazole | 0 | 0 | 3 | 8 | 2 | 0 | 6 | 4 | 3 | 1 | 0 | 0 | 1 | 0 | — | — | — | ND | ND |
| Posaconazole | 0 | 0 | 2 | 2 | 8 | 2 | 5 | 3 | 6 | 0 | 0 | 0 | 0 | 0 | — | — | — | ND | ND |
| Isavuconazole | 0 | 5 | 5 | 3 | 0 | 2 | 3 | 5 | 1 | 3 | 0 | 1 | 0 | 0 | — | — | — | ND | ND |
| Micafungin | 0 | 1 | 0 | 1 | 6 | 4 | 4 | 5 | 2 | 3 | 0 | 1 | 1 | 0 | — | — | — | ND | ND |
| Anidulafungin | 0 | 0 | 1 | 7 | 2 | 3 | 3 | 0 | 2 | 2 | 6 | 2 | 0 | 0 | — | — | — | ND | ND |
| Non-Candida yeasts (n = 25) | |||||||||||||||||||
| Amphotericin B | — | — | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 5 | 9 | 5 | 0 | 4b | — | — | — | ND | ND |
| Fluconazole | — | — | — | — | — | — | 0 | 0 | 0 | 2 | 5 | 1 | 5 | 1 | 1 | 2 | 8 | ND | ND |
| Voriconazole | 0 | 1 | 1 | 1 | 3 | 2 | 4 | 1 | 2 | 4 | 3 | 2 | 0 | 1b | — | — | — | ND | ND |
| Posaconazole | 0 | 0 | 0 | 2 | 3 | 5 | 5 | 3 | 4 | 3 | 0 | 0 | 0 | 0 | — | — | — | ND | ND |
| Isavuconazole | 0 | 1 | 1 | 1 | 5 | 2 | 6 | 1 | 2 | 3 | 1 | 2 | 0 | 0 | — | — | — | ND | ND |
| Micafungin | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 0 | 1 | 1 | 21b | — | — | — | ND | ND |
| Anidulafungin | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 0 | 1 | 2 | 20b | — | — | — | ND | ND |
a
Underlined values indicate non-wild-type isolates according to ECOFFs, and values in bold indicate resistant isolates (EUCAST breakpoint table v 10.0), with the exception of C. krusei, which was considered intrinsically resistant to fluconazole (30, 31). —, nontested antifungal concentration. ND, not done, as either breakpoints or ECOFFs were not available.
b
Isolates with MICs of ≥8 mg/liter.