Isavuconazole, micafungin, and 8 comparator antifungal agents' susceptibility profiles for common and uncommon opportunistic fungi collected in 2013: temporal analysis of antifungal drug resistance using CLSI species-specific clinical breakpoints and proposed epidemiological cutoff values

Pfaller, M.A.; Rhomberg, P.R.; Messer, S.A.; Jones, R.N.; Castanheira, M.

doi:10.1016/j.diagmicrobio.2015.04.008

Cited by 127Antifungal resistance and susceptibilityFungal Plant Pathogen ControlAntibiotic Resistance in Bacteria

Isavuconazole, micafungin, and 8 comparator antifungal agents' susceptibility profiles for common and uncommon opportunistic fungi collected in 2013: temporal analysis of antifungal drug resistance using CLSI species-specific clinical breakpoints and proposed epidemiological cutoff values

Pfaller, M.A., Rhomberg, P.R., Messer, S.A., Jones, R.N., Castanheira, M.·2015·Diagnostic Microbiology and Infectious Disease

DOI 10.1016/j.diagmicrobio.2015.04.008

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Abstract

The in vitro activities of isavuconazole, micafungin, and 8 comparator antifungal agents were determined for 1613 clinical isolates of fungi (1320 isolates of Candida spp., 155 of Aspergillus spp., 103 of non-Candida yeasts, and 35 non-Aspergillus molds) collected during a global survey conducted in 2013. The vast majority of the isolates of the 21 different species of Candida, with the exception of Candida glabrata (MIC90, 2 μg/mL), Candida krusei (MIC90, 1 μg/mL), and Candida guilliermondii (MIC90, 8 μg/mL), were inhibited by ≤0.25 μg/mL of isavuconazole. C. glabrata and C. krusei were largely inhibited by ≤1 μg/mL of isavuconazole. Resistance to fluconazole was seen in 0.5% of Candida albicans isolates, 11.1% of C. glabrata isolates, 2.5% of Candida parapsilosis isolates, 4.5% of Candida tropicalis isolates, and 20.0% of C. guilliermondii isolates. Resistance to the echinocandins was restricted to C. glabrata (1.3-2.1%) and C. tropicalis (0.9-1.8%). All agents except for the echinocandins were active against 69 Cryptococcus neoformans isolates, and the triazoles, including isavuconazole, were active against the other yeasts. Both the mold active triazoles as well as the echinocandins were active against 155 Aspergillus spp. isolates belonging to 10 species/species complex. In general, there was low resistance levels to the available systemically active antifungal agents in a large, contemporary (2013), global collection of molecularly characterized yeasts and molds. Resistance to azoles and echinocandins was most prominent among isolates of C. glabrata, C. tropicalis, and C. guilliermondii.

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Up to 96% of C. auris may exhibit resistance to fluconazole, compared with 0.5-2% for C. albicans, 4-9% for C. tropicalis, 2-6% for C. parapsilosis, and 11-13% for C. glabrata.
“Indeed, up to 96% of C. auris may exhibit resistance to fluconazole, an exceptionally high value compared to 0.5–2% for C. albicans, 4–9% for C. tropicalis, 2–6% for C. parapsilosis, and 11–13% for C. glabrata [16,40,41].”
From Evolutionary Emergence of Drug Resistance in Candida Opportunistic Pathogens (2018) · cites this paper as [41]
Although varying rates of fluconazole resistance have been observed for C. albicans in particular types of infection, resistance rates remain low in general.
“Although varying rates of fluconazole resistance have been observed for C. albicans in particular types of infection, resistance rates remain low in general.9 , 31 , 32”
From Molecular and genetic basis of azole antifungal resistance in the opportunistic pathogenic fungusCandida albicans (2020) · cites this paper as [31]
Estimates of non-susceptible or resistant C. glabrata clinical isolates across several geographic regions are: fluconazole 3.4%-70%, amphotericin B 2.5%-60%, caspofungin 1.3%-16.2%, and 5-flucytosine 0.8%-35%.
“Estimates regarding the percentage of non-susceptible or resistant C. glabrata clinical isolates against four antifungal drugs used in clinical practice, across several geographic regions are: fluconazole, 3.4%–70%; amphotericin B, 2.5%–60%; caspofungin, 1.3%–16.2%, and 5-flucytosine, 0.8%–35%, which are clearly concerning numbers [171,173,174,175,176,177,178,179,180,181,182,183,184,185,186,187,”
From Candida glabrata Biofilms: How Far Have We Come? (2017) · cites this paper as [176]

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Authors: Pfaller, M. A., Rhomberg, P. R., Messer, S. A., Jones, R. N., & Castanheira, M.
Affiliations: University of Iowa (US)
JMI Laboratories (US)
Corresponding author: Pfaller, M.A.
ORCID: Pfaller, M.A.
Rhomberg, P.R.
Messer, S.A.
Jones, R.N.
Castanheira, M.
Venue: Diagnostic Microbiology and Infectious Disease
Publisher: Elsevier BV
Published: 2015-08
Volume: 82
Issue: 4
Pages: 303-313
ISSN: 0732-8893 (ISSN-L)
DOI: 10.1016/j.diagmicrobio.2015.04.008
OpenAlex: W2108677302
Cited by: 127
References: 73
Citations by year: 2026: 7 · 2025: 6 · 2024: 7 · 2023: 12 · 2022: 4 · 2021: 11 · 2020: 9 · 2019: 12 · 2018: 17 · 2017: 17 · 2016: 21 · 2015: 4
FWCI: 15.28
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Diagnostic Microbiology and Infectious Disease (publishedVersion)
PubMed (publishedVersion)
Funders: Pfizer
Astellas Pharma Global Development
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
Keywords: isavuconazole, micafungin, antifungal resistance, Candida glabrata, Candida tropicalis, Candida guilliermondii, Candida albicans, Candida parapsilosis, Candida krusei, Cryptococcus neoformans, Aspergillus, echinocandins, triazoles, fluconazole resistance, azole resistance, epidemiological cut-off values, clinical breakpoints, opportunistic fungal pathogens, antifungal susceptibility, temporal trends
MeSH terms: Micafungin, Antifungal Agents, Fungi, Humans, Microbial Sensitivity Tests, Mycoses, Nitriles, Opportunistic Infections, Pyridines, Triazoles, Global Health, Drug Resistance, Fungal, Echinocandins, Lipopeptides

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Isavuconazole, micafungin, and 8 comparator antifungal agents' susceptibility profiles for common and uncommon opportunistic fungi collected in 2013: temporal analysis of antifungal drug resistance using CLSI species-specific clinical breakpoints and proposed epidemiological cutoff values

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