ArticleAntimicrobial agents and chemotherapy2015
Posttreatment Antifungal Resistance among Colonizing Candida Isolates in Candidemia Patients: Results from a Systematic Multicenter Study.
Article in Antimicrobial agents and chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers.
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Who cites it
47 citing papers in PubMed.
- Phenotypic and genotypic differences between bloodstream and non-bloodMicrobiology spectrum · 2026Article
- Interconnected worlds: a comprehensive review of fungal defenses, antimicrobial resistance, and their evolutionary dynamics.IMA fungus · 2026Review
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- Role of liposomal amphotericin B in intensive care unit: an expert opinion paper.Journal of anesthesia, analgesia and critical care · 2025Review
- Mechanisms of multidrug resistance caused by an Ipi1 mutation in the fungal pathogen Candida glabrata.Nature communications · 2025Article
- Tracking Candidemia Trends and Antifungal Resistance Patterns across Europe: An In-Depth Analysis of Surveillance Systems and Surveillance Studies.Journal of fungi (Basel, Switzerland) · 2024Article
- Evolutionary dynamics in gut-colonizing Candida glabrata during caspofungin therapy: Emergence of clinically important mutations in sphingolipid biosynthesis.PLoS pathogens · 2024Article
- Article
- Novel antifungals and treatment approaches to tackle resistance and improve outcomes of invasive fungal disease.Clinical microbiology reviews · 2024Review
- Optimizing the Treatment of Invasive Candidiasis-A Case for Combination Therapy.Open forum infectious diseases · 2024Article
- Genomic description of acquired fluconazole- and echinocandin-resistance in patients with serialJournal of clinical microbiology · 2024Article
- Antifungal susceptibility, molecular epidemiology, and clinical risk factors ofFrontiers in cellular and infection microbiology · 2024Article
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- Fungemia in Hospitalized Adult Patients with Hematological Malignancies: Epidemiology and Risk Factors.Journal of fungi (Basel, Switzerland) · 2023Article
- Management of Bacterial and Fungal Infections in the ICU: Diagnosis, Treatment, and Prevention Recommendations.Infection and drug resistance · 2023Review
- Liposomal amphotericin B-the future.The Journal of antimicrobial chemotherapy · 2022Article
- Pan-Echinocandin ResistantJournal of fungi (Basel, Switzerland) · 2022Article
- PRO: Biomarker surveillance for invasive fungal infections without antifungal prophylaxis could safely reduce antifungal use in acute leukaemia.JAC-antimicrobial resistance · 2022Article
- Diagnosis and Treatment of Invasive Candidiasis.Antibiotics (Basel, Switzerland) · 2022Review
- Antifungal drug resistance: an update.European journal of hospital pharmacy : science and practice · 2022Article
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11 authors.
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Abstract
The prevalence of intrinsic and acquired resistance among colonizing Candida isolates from patients after candidemia was investigated systematically in a 1-year nationwide study. Patients were treated at the discretion of the treating physician. Oral swabs were obtained after treatment. Species distributions and MIC data were investigated for blood and posttreatment oral isolates from patients exposed to either azoles or echinocandins for <7 or ≥ 7 days. Species identification was confirmed using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and internal transcribed spacer (ITS) sequencing, susceptibility was examined by EUCAST EDef 7.2 methodology, echinocandin resistance was examined by FKS sequencing, and genetic relatedness was examined by multilocus sequence typing (MLST). One hundred ninety-three episodes provided 205 blood and 220 oral isolates. MLST analysis demonstrated a genetic relationship for 90% of all paired blood and oral isolates. Patients exposed to azoles for ≥ 7 days (n = 93) had a significantly larger proportion of species intrinsically less susceptible to azoles (particularly Candida glabrata) among oral isolates than among initial blood isolates (36.6% versus 12.9%; P < 0.001). A similar shift toward species less susceptible to echinocandins among 85 patients exposed to echinocandins for ≥ 7 days was not observed (4.8% of oral isolates versus 3.2% of blood isolates; P > 0.5). Acquired resistance in Candida albicans was rare (<5%). However, acquired resistance to fluconazole (29.4%; P < 0.05) and anidulafungin (21.6%; P < 0.05) was common in C. glabrata isolates from patients exposed to either azoles or echinocandins. Our findings suggest that the colonizing mucosal microbiota may be an unrecognized reservoir of resistant Candida species, especially C. glabrata, following treatment for candidemia. The resistance rates were high, raising concern in general for patients exposed to antifungal drugs.
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