Candida spp. with Acquired Echinocandin Resistance, France, 2004–20101
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Lortholary, and the French Mycoses Study Group 3We report 20 episodes of infection caused by acquired echinocandin-resistant Candida spp.harboring diverse and new Fksp mutations.For 12 patients, initial isolates (low MIC, wild-type Fksp sequence) and subsequent isolates (after caspofungin treatment, high MIC, mutated Fksp) were genetically related.E chinocandins are effective in patients with invasive candidiasis and recommended as fi rst-line therapy, especially for patients with severe sepsis or those previously exposed to azoles or infected with Candida glabrata (1).Fewer than 50 persons infected with echinocandin-resistant species that are usually susceptible, such as C. albicans, C. glabrata, C. tropicalis, and C. krusei, have been described in limited series or case reports (2-4).All species were found in patients preexposed to echinocandins.The major mechanism of resistance is related to mutations in FKS genes coding for β-1,3-glucan-synthase (5), with almost 20 known FKS mutations.We describe the characteristics of infections from caspofungin-resistant Candida spp.isolates belonging to usually susceptible species recorded in France (2004)(2005)(2006)(2007)(2008)(2009)(2010) and analyze their FKS mutations and effect on echinocandin susceptibility.
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Echinocandin resistance is most commonly detected after 3-4 weeks of treatment.
“It is most commonly detected after 3–4 weeks of treatment and is associated with a dismal outcome.”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [21]
Echinocandin resistance is most commonly detected after 3-4 weeks of treatment.
“It is most commonly detected after 3–4 weeks of treatment and is associated with a dismal outcome.”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [20]
Resistance is more often found in C. glabrata, although this species is less frequent than C. albicans as a cause of invasive infections.
“Resistance is more often found in C. glabrata, although this species is less frequent than C. albicans as a cause of invasive infections and has been reported on both sides of the Atlantic ocean (Fig 1) (21;22).”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [21]
Although some cases are reported after short-term use (a week), most cases are diagnosed after 3-4 weeks of therapy or even later.
“Although some cases are reported after short-term use (a week)(13;19), most cases are diagnosed after 3–4 weeks of therapy or even later (12;20;21).”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [21]
Acquired FKS alterations are most commonly substitutions, but deletions and stop codons have also been reported in C. glabrata.
“Acquired FKS alterations are most commonly substitutions, but deletions and stop codons have also been reported in C. glabrata (Table 1) (16;21).”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [21]
The MIC increase caused by a specific FKS alteration may be species specific.
“Finally, the MIC increase caused by a specific alteration may be species specific.”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [20]
Resistant isolates can be detected in the oral flora post-candidaemia treatment at a rate of approximately 10%, often in co-existence with susceptible isolates, but are detected at a lower rate and apparently typically later (3-4 weeks) among blood isolates.
“Resistant isolates can be detected in the oral flora post candidaemia treatment at a rate of approx. 10% often in co-existence with susceptible isolates but is detected at a lower rate and apparently typically later (3–4 weeks) among blood isolates (12;21;24).”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [21]
Echinocandin resistance often develops in a progressive manner.
“Echinocandin resistance often develop in a progressive manner.”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [21]
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- Authors
- Dannaoui, E., Desnos-Ollivier, M., Garcia-Hermoso, D., Grenouillet, F., Cassaing, S., Baixench, M.-T., Bretagne, S., Dromer, F., Lortholary, O., & the French Mycoses Study Group
- Affiliations
- Institut Pasteur (FR)
- Corresponding author
- Lortholary, Olivier
- Venue
- Emerging infectious diseases
- Published
- 2012-01
- Volume
- 18
- Issue
- 1
- Pages
- 86-90
- ISSN
- 1080-6040 (ISSN-L)
- 1080-6059
- PMC
- PMC3310099
- OpenAlex
- W2063071284
- Cited by
- 130
- References
- 15
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 6 · 2020: 8 · 2019: 10 · 2018: 8 · 2017: 10 · 2016: 10 · 2015: 16 · 2014: 23 · 2013: 13 · 2012: 9
- FWCI
- 12.58
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Emerging infectious diseases (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Gilead Sciences
- Astellas Pharma
- Université Paris Descartes
- Institut de Veille Sanitaire
- 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 Biology › Yeasts and Rust Fungi Studies
- Keywords
- echinocandin resistance, Candida, caspofungin, acquired resistance, invasive candidiasis, beta-1,3-glucan synthase, antifungal susceptibility, Candida albicans, Candida glabrata, Candida tropicalis, Candida krusei
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Antifungal Agents, Candida, Candidiasis, Female, France, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Drug Resistance, Fungal, Echinocandins, Young Adult
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