Abdominal candidiasis is a hidden reservoir of echinocandin resistance

Antimicrob Agents Chemother. 2014 Dec;58(12):7601-5. doi: 10.1128/AAC.04134-14. Epub 2014 Oct 6.

Abstract

FKS mutant Candida isolates were recovered from 24% (6/25) of abdominal candidiasis patients exposed to echinocandin. Candida glabrata (29%) and Candida albicans (14%) mutants were identified. Multidrug-resistant bacteria were recovered from 83% of FKS mutant infections. Mutations were associated with prolonged echinocandin exposure (P = 0.01), breakthrough infections (P = 0.03), and therapeutic failures despite source control interventions (100%). Abdominal candidiasis is a hidden reservoir for the emergence of echinocandin-resistant Candida.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Abscess / drug therapy
  • Abdominal Abscess / microbiology*
  • Abdominal Abscess / mortality
  • Abdominal Abscess / pathology
  • Adult
  • Aged
  • Antifungal Agents / therapeutic use*
  • Candida albicans / drug effects*
  • Candida albicans / genetics
  • Candida albicans / growth & development
  • Candida glabrata / drug effects*
  • Candida glabrata / genetics
  • Candida glabrata / growth & development
  • Candidiasis / drug therapy
  • Candidiasis / microbiology*
  • Candidiasis / mortality
  • Candidiasis / pathology
  • Drug Resistance, Fungal / genetics
  • Echinocandins / therapeutic use*
  • Female
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mutation
  • Peritonitis / drug therapy
  • Peritonitis / microbiology*
  • Peritonitis / mortality
  • Peritonitis / pathology
  • Survival Analysis

Substances

  • Antifungal Agents
  • Echinocandins