Abstract
Amphotericin B (AmB) resistance in Candida spp. is very rare. Three cases of fungemia, due to amphotericin B-resistant Candida spp. in pediatric patients after previous neurosurgery for brain tumors, are reported. The Candida strains - one C. guillermondii, one C. lusitaniae, and one C. parapsilosis - showed minimum inhibitory concentrations (MICs) to AmB of 2-4 microg/ml. Two of the three patients had been pretreated with AmB for 5-11 days. All three patients were successfully treated with intravenous fluconazole (6-10 mg/kg per day) for 16-28 days, and all survived. Despite AmB resistance in Candida spp. being very rare, C. lusitaniae, C. guillermondii, and C. parapsilosis isolates in documented infections should be tested for AmB resistance, mainly in patients not responding to therapy with AmB.
Publication types
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Adolescent
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Amphotericin B / pharmacology*
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Amphotericin B / therapeutic use
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Antifungal Agents / pharmacology*
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Antifungal Agents / therapeutic use
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Brain Neoplasms / complications
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Brain Neoplasms / surgery*
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Candida / drug effects*
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Candida / isolation & purification
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Candidiasis / drug therapy
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Candidiasis / microbiology*
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Catheterization, Central Venous / adverse effects
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Child
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Child, Preschool
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Craniotomy*
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Cross Infection / drug therapy
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Cross Infection / microbiology*
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Drug Resistance, Microbial
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Equipment Contamination
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Fluconazole / therapeutic use
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Fungemia / drug therapy
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Fungemia / microbiology*
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Hospitals, Pediatric / statistics & numerical data
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Humans
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Microbial Sensitivity Tests
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Postoperative Complications / drug therapy
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Postoperative Complications / microbiology*
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Slovakia
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Species Specificity
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Ventriculoperitoneal Shunt / adverse effects
Substances
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Antifungal Agents
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Amphotericin B
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Fluconazole