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Transpl Infect Dis. 2014 Jun;16(3):469-72. doi: 10.1111/tid.12230. Epub 2014 May 9.

Development of echinocandin-resistant Candida albicans candidemia following brief prophylactic exposure to micafungin therapy.

Author information

1
Department of Pharmacy Services, Yale-New Haven Hospital, New Haven, Connecticut, USA.

Abstract

Empiric antifungal coverage is indicated in patients with graft-versus-host disease (GVHD) following a stem cell transplant (SCT) who are febrile and neutropenic for extended periods of time. Empiric antifungal coverage is indicated for patients with hematologic malignancies who have persistent fever and neutropenia as well as patients who have GVHD following SCT. Although the prophylactic use of antifungals is a cornerstone of the care for such patients, the selection of the particular antifungal is at the discretion of the clinician. We report a patient case whose surveillance blood cultures obtained 14 days after the switch from voriconazole to micafungin were positive for the growth of Candida albicans. Clinicians prescribing echinocandin therapy for antifungal prophylaxis must be aware of the risks of echinocandin resistance and possible breakthrough candidemia with C. albicans.

KEYWORDS:

C. albicans; Fks1; breakthrough; echinocandin; resistance; stem cell transplant

PMID:
24810789
DOI:
10.1111/tid.12230
[Indexed for MEDLINE]
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