1431. Activity of echinocandins and triazoles against a contemporary (2012) worldwide collection of yeast and moulds collected from invasive infections
Session: Poster Abstract Session: Fungal Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDWEEK 2013 Fungal 1431.pdf (83.1 kB)
  • Background: Invasive fungal infections (IFIs) have emerged as major causes of morbidity and mortality, in particular among patients who are immunocompromised or hospitalized with serious underlying diseases. We evaluated 1,714 fungal clinical isolates causing IFIs against nine antifungal agents tested using CLSI reference broth microdilution methods (BMD).

    Methods: 1,486 Candida spp., 107 Aspergillus spp., 34 non-Candida yeasts, 52 Cryptococcus neoformans (CN), and 35 rare moulds (rMO) isolates causing IFI were consecutively collected and susceptibility (S) tested by CLSI BMD in a central laboratory. Yeasts were identified (ID) using CHROMagar, biochemical methods and sequencing of ITS and/or 28S regions (IGS was used for a small subset). Moulds were ID by sequencing of 1 or 2 of the following genes: ITS, 28S, beta-tubulin, TEF.

    Results: Echinocandin (EC) resistance (R) among Candida was low and R rates to anidulafungin, caspofungin, and micafungin varied from 0.0 to 2.6% among different species (Table). EC-R C. glabrata (CG) strains were shown to have fks mutations (fks1 HS1 S663F or fks2 HS1 F659 deletion) and fluconazole (FLC)-R was also observed in those strains. One C. krusei and one C. dubliniensis had L701M or S645P fks1 HS1 mutations, respectively. R to FLC among isolates of CA (0.4%) was low and stable compared to previous years. C. tropicalis (CT) and CG had higher FLC-R rates, 8.4 and 6.9%, respectively. FLC-R CT were collected in five countries (USA, China, Germany, Belgium and Thailand). Voriconazole was active against all Candida spp. inhibiting 93.1 to 99.7% of isolates using species-specific breakpoints. All agents except for the ECs and posaconazole were active vs. CN and triazoles were active vs. other yeasts (MIC90, 2 g/ml). The ECs and TZs were active vs. Aspergillus (MIC/MEC90 range, 0.015-2 g/ml), but were not active vs. rMO (MIC/MEC90 range, 4->16 g/ml).

    Conclusion: IFIs are increasing worldwide due to the augment in populations at risk. Appropriate antifungal prophylaxis and therapeutic treatment play an important role in decreasing morbidity and mortality; and although the prevalence of R is low among fungal isolates, extended monitoring of R seems prudent.

    Mariana Castanheira1, Shawn Messer2, Paul Rhomberg2, Rachel Dietrich2, Ronald Jones, MD3 and Michael Pfaller, MD2, (1)Jmi Laboratories Inc, North Liberty, IA, (2)Jmi Laboratories, Inc., North Liberty, IA, (3)JMI Laboratories Inc, North Liberty, IA

    Disclosures:

    M. Castanheira, Pfizer Inc: Grant Investigator, Grant recipient
    Astellas: Grant Investigator, Grant recipient

    S. Messer, Pfizer Inc: Grant Investigator, Grant recipient
    Astellas: Grant Investigator, Grant recipient

    P. Rhomberg, Pfizer Inc: Grant Investigator, Grant recipient
    Astellas: Grant Investigator, Grant recipient

    R. Dietrich, Pfizer Inc: Grant Investigator, Grant recipient
    Astellas: Grant Investigator, Grant recipient

    R. Jones, Pfizer Inc: Grant Investigator, Grant recipient
    Astellas: Grant Investigator, Grant recipient

    M. Pfaller, Pfizer Inc: Grant Investigator, Grant recipient
    Astellas: Grant Investigator, Grant recipient

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