Journal
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
Volume 40, Issue 7, Pages 1539-1545Publisher
SPRINGER
DOI: 10.1007/s10096-020-04147-5
Keywords
Uncommon Candida species; Fungemia; Antifungal treatment; Antifungal susceptibility; Breakthrough fungemia; Epidemiological cut-off value
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Fungemia caused by uncommon Candida species is a rare but emerging threat with potential resistance to antifungal agents. The study found echinocandins and voriconazole to be effective against all tested isolates, but some species showed reduced susceptibility to fluconazole.
Fungemia caused by uncommon Candida species (UCS) (other than C.albicans, C.glabrata, C.parapsilosis, C.tropicalis, C.krusei) is a rare but emerging threat with their potential to exhibit reduced susceptibility or resistance to antifungal agents. We identified 25 patients with UCS fungemia (9 C.kefyr, 8 C.lusitaniae, 4 C.dubliniensis, 2 C.guilliermondii, 1 C.pelliculosa, 1 C.rugosa) through January 2011 and August 2018. Echinocandins were the most common administered agents, followed by fluconazole. Overall mortality was 44%. Echinocandins and voriconazole showed sufficient activity against all tested isolates. High fluconazole MICs among C.guilliermondii, C.pelliculosa, and C.rugosa were determined. MIC value of C.pelliculosa was above the epidemiological cut-off proposed for fluconazole.
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