Head-to-Head Comparison of the Activities of Currently Available Antifungal Agents against 3,378 Spanish Clinical Isolates of Yeasts and Filamentous Fungi
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We have compared the activities of posaconazole and other currently available antifungal agents against a collection of 3,378 clinical isolates of yeasts and filamentous fungi. A total of 1,997 clinical isolates of Candida spp., 359 of other yeast species, 697 strains of Aspergillus spp., and 325 nondermatophyte non- Aspergillus spp. were included. The average geometric means of the MICs of agents that were tested against Candida spp. were 0.23 μg/ml for amphotericin B, 0.29 μg/ml for flucytosine, 0.97 μg/ml for fluconazole, 0.07 μg/ml for itraconazole, 0.04 μg/ml for voriconazole, 0.15 μg/ml for caspofungin, and 0.03 μg/ml for posaconazole. Voriconazole and posaconazole were active in vitro against the majority of isolates, with resistance to fluconazole and itraconazole, and against Cryptococcus neoformans and other Basidiomycota yeasts. Posaconazole was the most active of antifungal agents tested against Aspergillus spp., with an average geometric mean of 0.10 μg/ml. It was active against Paecilomyces spp., Penicillium spp., Scedosporium apiospermum , and some black fungi, such as Alternaria spp. Multiresistant filamentous fungi, such as Scedosporium prolificans , Scopulariopsis brevicaulis , and Fusarium solani , were also resistant to voriconazole, caspofungin, and posaconazole. Amphotericin B and posaconazole were found to be active against most of the Mucorales strains tested. Posaconazole and currently available antifungal agents exhibit a potent activity in vitro against the majority of pathogenic fungal species.
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Variations in the structure of azoles are responsible for the cross-resistance patterns among Candida species.
“It appears that variations in the structure of azoles are responsible for the cross-resistance patterns among Candida species [92–94].”
From <i>Candida</i>Infections, Causes, Targets, and Resistance Mechanisms: Traditional and Alternative Antifungal Agents (2013) · cites this paper as [92]
The rate of invasive candidiasis is far higher than that of any other invasive mycosis and is comparable to those of many invasive bacterial diseases.
“Despite the variation in incidence found among the different population-based studies, the rate of IC is far higher than that of any other invasive mycosis (Tables 2 and 4) and is comparable to those of many invasive bacterial diseases (52, 74, 125, 193).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [52]
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- Authors
- Cuenca-Estrella, M., Gomez-Lopez, A., Mellado, E., Buitrago, M. J., Monzon, A., & Rodriguez-Tudela, J. L.
- Affiliations
- Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Salud Carlos III (ES)
- ORCID
- Mellado, Emilia
- Venue
- Antimicrobial Agents and Chemotherapy
- Publisher
- American Society for Microbiology
- Published
- 2006-03
- Volume
- 50
- Issue
- 3
- Pages
- 917-921
- ISSN
- 0066-4804 (ISSN-L)
- 1098-6596
- PMC
- PMC1426453
- OpenAlex
- W2160917189
- Cited by
- 298
- References
- 32
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 6 · 2023: 6 · 2022: 5 · 2021: 9 · 2020: 11 · 2019: 3 · 2018: 8 · 2017: 10 · 2016: 12 · 2015: 10 · 2014: 20 · 2013: 14 · 2012: 9
- FWCI
- 23.42
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Antimicrobial Agents and Chemotherapy (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- 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
- Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
- Keywords
- posaconazole, antifungal agents, clinical fungal isolates, Candida, Aspergillus, filamentous fungi, antifungal susceptibility, minimum inhibitory concentration, voriconazole resistance, caspofungin, amphotericin B, fluconazole resistance, itraconazole, Cryptococcus neoformans, Scedosporium prolificans, Scedosporium apiospermum, Paecilomyces, Penicillium, Mucorales, black fungus, Spanish isolates
- MeSH terms
- Caspofungin, Amphotericin B, Antifungal Agents, Flucytosine, Fungi, Humans, Microbial Sensitivity Tests, Mycoses, Peptides, Cyclic, Pyrimidines, Spain, Triazoles, Yeasts, Fluconazole, Itraconazole, Echinocandins, Lipopeptides, Voriconazole
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