Table 2.
Susceptibility of Candida Bloodstream Isolates to Antifungal Drugs According to CLSI Document M60-Ed2
| Species | S or WT* | I | SDD | R or Non-WT** | No. of Isolates Tested | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2004–2008 | 2009–2013 | 2014–2018 | 2004–2008 | 2009–2013 | 2014–2018 | 2004–2008 | 2009–2013 | 2014–2018 | 2004–2008 | 2009–2013 | 2014–2018 | 2004–2008 | 2009–2013 | 2014–2018 | |
| Candida albicans | |||||||||||||||
| Fluconazole | 99% | 99% | 99% | - | - | - | 0% | 0% | 1% | 1% | 1% | 0% | 411 | 426 | 330 |
| Voriconazole | 99% | 99% | 99% | 0% | 0% | 0% | - | - | - | 0% | 1% | 0% | 411 | 428 | 277 |
| Posaconazole | 99%* | 98%* | 96%* | - | - | - | - | - | - | 1%** | 2%** | 4%** | 227 | 426 | 214 |
| Caspofungin | 100% | 99% | 98% | 0% | 0% | 1% | - | - | - | 0% | 0% | 1% | 409 | 426 | 150 |
| Amphotericin B | 100%* | 100%* | 100%* | - | - | - | - | - | - | 0%** | 0%** | 0%** | 399 | 425 | 214 |
| Anidulafungin | -a | 99% | 99% | -a | 0% | 0% | - | - | - | -a | 1% | 1% | 0 | 141 | 212 |
| Micafungin | -a | 100% | 98% | -a | 0% | 0% | - | - | - | -a | 0% | 2% | 0 | 218 | 176 |
| Candida glabrata | |||||||||||||||
| Fluconazole | - | - | - | - | - | - | 90% | 92% | 91% | 10% | 8% | 9% | 117 | 124 | 176 |
| Voriconazole | 79% | 61% | 70.5%* | - | - | - | - | - | - | 21%** | 39%** | 29.5%** | 117 | 124 | 44 |
| Posaconazole | 92.5%* | 70%* | 86%* | - | - | - | - | - | - | 7.5%** | 30%** | 14%** | 67 | 124 | 43 |
| Caspofungin | 91% | 94% | 95% | 8% | 6% | 2% | - | - | - | 1% | 0% | 3% | 117 | 124 | 104 |
| Amphotericin B | 100%* | 100%* | 100%* | - | - | - | - | - | - | 0%** | 0%** | 0%** | 117 | 124 | 147 |
| Anidulafungin | -a | 100% | 98% | -a | 0% | 1% | - | - | - | -a | 0% | 1% | 0 | 40 | 124 |
| Micafungin | -a | 100% | 98% | -a | 0% | 2% | - | - | - | -a | 0% | 0% | 0 | 75 | 107 |
| Candida krusei | |||||||||||||||
| Fluconazole | - | - | - | - | - | - | - | - | - | - | - | - | |||
| Voriconazole | 81% | 100% | 91% | 14% | 0% | 9% | - | - | - | 5% | 0% | 0% | 21 | 20 | 11 |
| Posaconazole | 100%* | 100%* | 100%* | - | - | - | - | - | - | 0%** | 0%** | 0%** | 13 | 20 | 3 |
| Caspofungin | 38% | 85% | 78% | 43% | 15% | 22% | - | - | - | 19% | 0% | 0% | 21 | 20 | 9 |
| Amphotericin B | 100%* | 100%* | 100%* | - | - | - | - | - | - | 0%** | 0%** | 0%** | 21 | 20 | 16 |
| Anidulafungin | -a | 100% | 100% | -a | 0% | 0% | - | - | - | -a | 0% | 0% | 0 | 6 | 15 |
| Micafungin | -a | 100% | 100% | -a | 0% | 0% | - | - | - | -a | 0% | 0% | 0 | 12 | 4 |
| Candida parapsilosis | |||||||||||||||
| Fluconazole | 94% | 93% | 96% | - | - | - | 6% | 0% | 0% | 0% | 7% | 4% | 35 | 30 | 50 |
| Voriconazole | 100% | 100% | 95% | 0% | 0% | 2% | - | - | - | 0% | 0% | 2% | 35 | 30 | 44 |
| Posaconazole | 100%* | 97%* | 97.5%* | - | - | - | - | - | - | 0%** | 3%** | 2.5%** | 24 | 30 | 40 |
| Caspofungin | 100% | 100% | 100% | 0% | 0% | 0% | - | - | - | 0% | 0% | 0% | 35 | 30 | 19 |
| Amphotericin B | 100%* | 100%* | 97.5%* | - | - | - | - | - | - | 0%** | 0%** | 2.5%** | 35 | 30 | 40 |
| Anidulafungin | -a | 100% | 97% | -a | 0% | 3% | - | - | - | -a | 0% | 0% | 0 | 11 | 39 |
| Micafungin | -a | 100% | 97% | -a | 0% | 3% | - | - | - | -a | 0% | 0% | 0 | 14 | 34 |
| Candida tropicalis | |||||||||||||||
| Fluconazole | 90% | 82% | 80% | - | - | - | 5% | 6% | 9% | 5% | 12% | 11% | 42 | 33 | 45 |
| Voriconazole | 83% | 82% | 75% | 14% | 6% | 16% | - | - | - | 2% | 12% | 9% | 42 | 33 | 44 |
| Posaconazole | 75%* | 70%* | 74%* | - | - | - | - | - | - | 25%** | 30%** | 26%** | 20 | 33 | 35 |
| Caspofungin | 100% | 91% | 96% | 0% | 6% | 4% | - | - | - | 0% | 3% | 0% | 42 | 33 | 25 |
| Amphotericin B | 100%* | 100%* | 100%* | - | - | - | - | - | - | 0%** | 0%** | 0%** | 41 | 33 | 35 |
| Anidulafungin | -a | 100% | 97% | -a | 0% | 3% | - | - | - | -a | 0% | 0% | 0 | 6 | 32 |
| Micafungin | -a | 100% | 100% | -a | 0% | 0% | - | - | - | -a | 0% | 0% | 0 | 12 | 10 |
Abbreviations: CLSI, Clinical and Laboratory Standards Institute; I, intermediate; R, resistant; S, susceptible; SDD, susceptible, dose-dependent; WT, wild type.
Classification according to CLSI clinical breakpoints (CBP). In the absence of established CBP, CLSI epidemiological cutoff values (ECV) were used for discrimination between WT* and non-WT** isolates (CLSI document M59-Ed3).
aIsolates were not tested for the specific drug.