Parallel and cross-resistances of clinical yeast isolates determined by susceptibility pattern analysis

GMS Infectious Diseases

Willinger, Birgit¹  Becker, Karsten²  Idelevich, Evgeny A.²  Fegeler, Wolfgang²  Fegeler, Christian³  Schmalreck, Arno F.⁴  Lass-Flörl, Cornelia⁵ 

[1] Division of Clinical Microbiology, Department of Laboratory Medicine, University Vienna, Austria;Institute of Medical Microbiology, University Hospital Münster, Germany;Medical Informatics, Faculty of Informatics, University Heilbronn, Germany;Mikrobiologische Beratung und Service (MBS), München, Germany;Section Hygiene and Medical Microbiology, Medical University Innsbruck, Austria;

关键词: Candida;    antifungals;    flucytosine;    amphotericin B;    fluconazole, voriconazole;    posaconazole, caspofungin;    micafungin;    anidulafungin;    susceptibility testing;    susceptibility pattern analysis;    parallel resistance;    cross-resistance;   

DOI  :  10.3205/id000020

来源: DOAJ

【 摘 要 】

For calculated initial antifungal therapy, knowledge on parallel and cross-resistances are vitally important particularly in the case of multiresistant isolates. Based on a strain collection of 1,062 yeast isolates from a German/Austrian multicentre study, susceptibility pattern analysis (SPA) was used to determine the proportion of parallel and cross-resistances to eight antifungal agents (AFAs) encompassing flucytosine, amphotericin B, azoles (fluconazole, voriconazole and posaconazole) and echinocandins (caspofungin, micafungin and anidulafungin). A total of 414 (39.0%) isolates were resistant for one or more of the AFAs. Resistance to one AFA was shown for 18.1% of all isolates. For 222 isolates (20.9%), resistance to two to seven AFAs was noted (7.7%; 7.7%; 3.6%; 1.0%; 0.7% and 0.2% to 2, 3, 4, 5, 6 and 7 antifungal compounds, respectively). Partial parallel resistances within the azole and echinocandin classes, respectively, were found for 81 (7.6%) and 70 (6.6%) isolates. Complete parallel resistances for azoles, echinocandins and combined for both classes were exhibited by 93 (8.8%), 18 (1.7%) and 6 (0.6%) isolates, respectively. Isolates displaying cross-resistances between azoles and echinocandins were infrequently found. Highly resistant isolates (resistance to ≥6 AFAs) were almost exclusively represented by . Highly standardized testing of AFAs in parallel and from the same inocula followed by SPA allows detailed insights in the prevalence and distribution of susceptibility patterns of microbial isolates.

【 授权许可】

Unknown