Outbreak of Candida auris in Spain: A comparison of antifungal activity by three methods with published data

Fecha de publicación: 01/05/2019

Autores de IIS La Fe

Alba Cecilia Ruiz Gaitán

Autor
Emilia Canton Lacasa

Autor
Marcelo Ernesto Fernandez Rivero

Autor
Paula Ramírez Galleymore

Autor
Javier Pemán García

Autor

Grupos

Infección Grave

Investigador Principal

María Ángeles Tormo Mas
Infecciones Respiratorias

Investigador Principal

Raúl Méndez Ocaña
Medicina Intensiva

Leader

Álvaro Castellanos Ortega

Abstract

Candida auris is an emerging pathogen causing candidaemia outbreaks in several countries for which azole, amphotericin B (AmB) and echinocandin resistance has been reported. In this study, the antifungal susceptibilities of 73 Spanish C. auris isolates (56 bloodstream and 17 urine) to eight antifungal agents were determined using three methods. Isolates were identified by internal transcribed spacer (ITS) sequencing, and minimum inhibitory concentrations (MICs) of fluconazole, isavuconazole, itraconazole, posaconazole, voriconazole, anidulafungin, micafungin and AmB were determined by EUCAST methodology and Sensititre (R) YeastOne (R) (SYO) (bloodstream isolates) and Liofilchem (R) MIC Test Strip (all isolates). Agreement between the methods was analysed and the MICs (ours and published data) were categorised using recently proposed epidemiological cut-offvalues (ECVs). Fluconazole MICs were >64 mg/L, whilst >60% of voriconazole MICs were >1 mg/L by the three methods. Posaconazole was the most active azole (EUCAST geometric mean MIC, 0.053 mg/L), followed by isavuconazole (0.066 mg/L) and itraconazole (0.157 mg/L). Echinocandins MICs were <= 0.5 mg/L by SYO and EUCAST. The overall lowest AmB MICs (<= 0.25 mg/L) were obtained by EUCAST. Essential agreement (+/- 2 dilutions) between EUCAST and SYO was >93% for the eight antifungals. For this new C. auris clade, all isolates were resistant to fluconazole, and MICs for anidulafungin, micafungin and AmB were <= 1 mg/L using dilution methods. Voriconazole MICs were method-dependent. The number of non-wild-type (non-WT) isolates depended on the ECV applied; by the 97.5% ECV all isolates were WT except for isavuconazole (1.8% non-WT). Good essential agreement (>93%) was observed between EUCAST and SYO. (C) 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Datos de la publicación

ISSN/ISSNe:: 0924-8579, 1872-7913
Tipo:: Article
Páginas:: 541-546
DOI:: 10.1016/j.ijantimicag.2019.02.005
Factor de Impacto:: 1,509 SCImago ℠
Cuartil:: Q1 SCImago ℠

Documentos

No hay documentos

Métricas

Filiaciones

Ruiz-Gaitan, AC:: Instituto de Investigación. Med Res Inst La Fe, Severe Infect Res Grp, Ave Fernando Abril Martorell 106, Valencia 46026, Spain

Hosp Univ & Politecn La Fe, Dept Clin Microbiol, Valencia, Spain
Canton, Emilia:: Instituto de Investigación. Med Res Inst La Fe, Severe Infect Res Grp, Ave Fernando Abril Martorell 106, Valencia 46026, Spain
Fernandez-Rivero, ME:: Instituto de Investigación. Med Res Inst La Fe, Severe Infect Res Grp, Ave Fernando Abril Martorell 106, Valencia 46026, Spain
Ramirez, Paula:: Hosp Univ & Politecn La Fe, Dept Crit Care, Valencia, Spain
Peman, Javier:: Instituto de Investigación. Med Res Inst La Fe, Severe Infect Res Grp, Ave Fernando Abril Martorell 106, Valencia 46026, Spain

Hosp Univ & Politecn La Fe, Dept Clin Microbiol, Valencia, Spain