ArticleAntimicrobial agents and chemotherapy2014
Antifungal resistance to fluconazole and echinocandins is not emerging in yeast isolates causing fungemia in a Spanish tertiary care center.
Article in Antimicrobial agents and chemotherapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Global prevalence and trends of fluconazole resistance in non-albicans Candida species: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- BeyondJournal of fungi (Basel, Switzerland) · 2026Article
- Candidemia in a tertiary hospital in Southern Brazil.Revista do Instituto de Medicina Tropical de Sao Paulo · 2026Article
- Heterogeneity ofMicrobiology spectrum · 2025Article
- Review
- Meyerozyma guilliermondii species complex: review of current epidemiology, antifungal resistance, and mechanisms.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2022Review
- Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?Antimicrobial agents and chemotherapy · 2021Article
- Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients.Journal of fungi (Basel, Switzerland) · 2021Article
- The Quiet and Underappreciated Rise of Drug-Resistant Invasive Fungal Pathogens.Journal of fungi (Basel, Switzerland) · 2020Review
- The efflux pump inhibitor tetrandrine exhibits synergism with fluconazole or voriconazole against Candida parapsilosis.Molecular biology reports · 2019Article
- What's new on emerging resistant Candida species.Intensive care medicine · 2019Article
- Candidemia due toCurrent medical mycology · 2019Article
- Pathogenesis of the Candida parapsilosis Complex in the Model Host Caenorhabditis elegans.Genes · 2018Article
- Resistance to Echinocandins in Candida Can Be Detected by Performing the Etest Directly on Blood Culture Samples.Antimicrobial agents and chemotherapy · 2018Article
- Mutant Prevention Concentration and Mutant Selection Window of Micafungin and Anidulafungin in Clinical Candida glabrata Isolates.Antimicrobial agents and chemotherapy · 2018Article
- Impact of inappropriate antifungal therapy according to current susceptibility breakpoints on Candida bloodstream infection mortality, a retrospective analysis.BMC infectious diseases · 2017Article
- Candida guilliermondii Complex Is Characterized by High Antifungal Resistance but Low Mortality in 22 Cases of Candidemia.Antimicrobial agents and chemotherapy · 2017Article
- The Etest Performed Directly on Blood Culture Bottles Is a Reliable Tool for Detection of Fluconazole-Resistant Candida albicans Isolates.Antimicrobial agents and chemotherapy · 2017Article
- Epidemiology and reporting of candidaemia in Belgium: a multi-centre study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Article
- Multicenter Study of Method-Dependent Epidemiological Cutoff Values for Detection of Resistance in Candida spp. and Aspergillus spp. to Amphotericin B and Echinocandins for the Etest Agar Diffusion Method.Antimicrobial agents and chemotherapy · 2017Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Accurate knowledge of fungemia epidemiology requires identification of strains to the molecular level. Various studies have shown that the rate of resistance to fluconazole ranges from 2.5% to 9% in Candida spp. isolated from blood samples. However, trends in antifungal resistance have received little attention and have been studied only using CLSI M27-A3 methodology. We assessed the fungemia epidemiology in a large tertiary care institution in Madrid, Spain, by identifying isolates to the molecular level and performing antifungal susceptibility testing according to the updated breakpoints of European Committee for Antimicrobial Susceptibility Testing (EUCAST) definitive document (EDef) 7.2. We studied 613 isolates causing 598 episodes of fungemia in 544 patients admitted to our hospital (January 2007 to December 2013). Strains were identified after amplification and sequencing of the ITS1-5.8S-ITS2 region and further tested for in vitro susceptibility to amphotericin B, fluconazole, posaconazole, voriconazole, micafungin, and anidulafungin. Resistance was defined using EUCAST species-specific breakpoints, and epidemiological cutoff values (ECOFFs) were applied as tentative breakpoints. Most episodes were caused by Candida albicans (46%), Candida parapsilosis (28.7%), Candida glabrata (9.8%), and Candida tropicalis (8%). Molecular identification enabled us to better detect cryptic species of Candida guilliermondii and C. parapsilosis complexes and episodes of polyfungal fungemia. The overall percentage of fluconazole-resistant isolates was 5%, although it was higher in C. glabrata (8.6%) and non-Candida yeast isolates (47.4%). The rate of resistance to echinocandins was 4.4% and was mainly due to the presence of intrinsically resistant non-Candida species. Resistance mainly affected non-Candida yeasts. The rate of resistance to fluconazole and echinocandins did not change considerably during the study period.
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