Micafungin pharmacodynamics predict clinical outcomes in hospitalized patients with candidemia caused by certain Candida species.

Study Objective: Echinocandins are guideline-preferred therapies for invasive candidiasis (IC). Fixed dosing of echinocandins is commonly used despite variations in body mass index and echinocandin susceptibility. The purpose of this study was to evaluate clinical outcomes of micafungin based on population-predicted pharmacokinetic/pharmacodynamic (PK/PD) factors and susceptibility.

Development of the invasive candidiasis discharge [I Can discharge] model: a mixed methods analysis.

Patients with invasive candidiasis (IC) have complex medical and infectious disease problems that often require continued care after discharge. This study aimed to assess echinocandin use at hospital discharge and develop a transition of care (TOC) model to facilitate discharge for patients with IC. This was a mixed method study design that used epidemiologic assessment to better understand echinocandin use at hospital discharge TOC.

A Vancomycin HPLC Assay for Use in Gut Microbiome Research.

The human microbiome project has revolutionized our understanding of the interaction between commensal microbes and human health. By far, the biggest perturbation of the microbiome involves use of broad-spectrum antibiotics excreted in the gut. Thus, pharmacodynamics of microbiome changes in relation to drug exposure pharmacokinetics is an emerging field.

Clumping Morphology Influences Virulence Uncoupled from Echinocandin Resistance in Candida glabrata.

Here, we report two paired sets of an index wild-type Candida glabrata bloodstream isolate and subsequent echinocandin-resistant FKS mutant. One paired set exhibited a higher proportion of clumping cells and was more virulent in the invertebrate host Galleria mellonella than the other paired set. No virulence difference between the paired index and FKS strains was observed.

Antifungal Resistance: a Concerning Trend for the Present and Future.

Purpose Of Review: The global emergence of antifungal resistance among Candida spp. and Aspergillus spp. is a growing threat to public health, driven largely by the expanding use of antifungals in both the clinical and agricultural settings.

Comparative in vitro pharmacodynamic analysis of isavuconazole, voriconazole, and posaconazole against clinical isolates of aspergillosis, mucormycosis, fusariosis, and phaeohyphomycosis.

We compared the in vitro pharmacodynamics of isavuconazole, voriconazole, and posaconazole against 92 clinical isolates from documented cases of invasive aspergillosis, mucormycosis, fusariosis, and phaeohyphomycosis. Whereas inhibitory and fungicidal concentrations of these triazoles were predictably similar with the exception of Mucorales, isavuconazole appeared to have improved pharmacodynamics against Fusarium solani.

Drosophila melanogaster as a model to study virulence and azole treatment of the emerging pathogen Candida auris.

Objectives: Candida auris is an emerging, often MDR, yeast pathogen. Efficient animal models are needed to study its pathogenicity and treatment. Therefore, we developed a C.

Adjuvant β-Lactam Therapy Combined with Vancomycin for Methicillin-Resistant Bacteremia: Does β-Lactam Class Matter?

We analyzed the impact of vancomycin (VAN) combined with adjuvant β-lactam therapy (Combo) on persistent (≥5 days) methicillin-resistant bacteremia versus VAN alone by using pooled data from two previously published observational studies ( = 156). Combo was inversely associated with persistent bacteremia (adjusted odds ratio, 0.460; 95% confidence interval, 0.

Evaluation of BacT/Alert FA Blood Culture Bottles and T2Candida Assay for Detection of Candida in the Presence of Antifungals.

The T2Candida assay is a novel, non-culture-based assay for the diagnosis of candidemia directly from whole blood. The impact of antifungals on the performance of the T2Candida assay and blood culture bottles has not been well described. In this study, the performance of the T2Candida assay was compared to that of blood culture in detecting spp.

Prevalence and predictors of spontaneous bacterial peritonitis due to ceftriaxone-resistant organisms at a large tertiary centre in the USA.

Objectives: The epidemiology of spontaneous bacterial peritonitis (SBP) due to ceftriaxone-resistant organisms has not been well studied in the USA. The primary objective of this study was to assess the prevalence and predictors of ceftriaxone-resistant SBP at a large US tertiary-care centre.

Methods: This 1:1:4 case-case-control study included 141 adults with liver cirrhosis admitted from November 2011 to March 2016.

Rezafungin (CD101), a next-generation echinocandin: A systematic literature review and assessment of possible place in therapy.

Objectives: Rezafungin (CD101) is a novel echinocandin currently under development. The purpose of this study was to perform a systematic literature review of published evidence on rezafungin and an antimicrobial stewardship audit of real-world use of echinocandins to determine areas of unmet medical needs and potential places in therapy for rezafungin.

Methods: The systematic literature review identified 8 peer-reviewed manuscripts and 19 separate abstracts.

Overtreatment of Asymptomatic Candiduria among Hospitalized Patients: a Multi-institutional Study.

Candiduria is common in hospitalized patients, and asymptomatic candiduria contributes to antifungal overuse. The guidelines for management of asymptomatic candiduria do not recommend antifungal use, but rather the elimination of predisposing factors. It is unknown whether these recommendations are being followed.

Early Administration of Adjuvant β-Lactam Therapy in Combination with Vancomycin among Patients with Methicillin-Resistant Staphylococcus aureus Bloodstream Infection: A Retrospective, Multicenter Analysis.

Study Objective: To determine whether early administration of adjuvant β-lactam in combination with vancomycin (COMBO) affects clinical outcomes compared to standard vancomycin therapy alone (STAN) among patients with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection.

Design: Retrospective, multicenter cohort study.

Setting: Five academic or community hospitals throughout the United States.

Innate inflammatory response and immunopharmacologic activity of micafungin, caspofungin, and voriconazole against wild-type and FKS mutant Candida glabrata isolates.

The direct or indirect interactions that antifungals have with the host immune response may play a significant role in defining their activity in vivo. However, the impact that acquired antifungal resistance has on the immunopharmacologic activity of antifungals is not well described. We assessed the immunopharmacologic activity of caspofungin, micafungin, and voriconazole among isolates of Candida glabrata with or without FKS-mediated echinocandin resistance.

Echinocandin use in hospitalized patients: a multi-institutional study.

Background: The echinocandin antifungals are recommended as initial therapy in hospitalized patients with candidemia. Contemporary usage rates and indication for use of echinocandins have not been studied in the United States. The purpose of this study was to evaluate echinocandin usage patterns in community and academic teaching hospitals over time and to evaluate dose, duration of therapy and indications for use.

Host factors and clinical outcomes of Candida colonization in critically ill patients.

This study aimed to describe factors and outcomes associated with Candida colonization of critically ill patients. This was a cross-sectional study conducted over 2 weeks in the intensive care unit (ICU) of a tertiary care hospital at the Texas Medical Center, Houston, TX. All Candida samples were prospectively collected with demographic and clinical data collected retrospectively.

FKS mutant Candida glabrata: risk factors and outcomes in patients with candidemia.

Background: Echinocandins are recommended for Candia glabrata candidemia. Mutations in the FKS1 and FKS2 genes are associated with echinocandin resistance. Few studies have assessed risk factors for FKS mutant isolates and outcomes in patients receiving micafungin treatment.

Clinical practice patterns in hospitalized patients at risk for invasive candidiasis: role of antifungal stewardship programs in an era of rapid diagnostics.

Background: Rapid diagnostic tests for Candida are becoming available that may supplement traditional microbiological identification.

Objective: Assess clinical practice patterns in patients with or at risk of candidiasis who may benefit from the use of rapid diagnostic tests.

Methods: This was a prospective cohort study of patients with candidemia or receiving systemic antifungals conducted at a university-affiliated tertiary care hospital.

Comparison of the T2Dx instrument with T2Candida assay and automated blood culture in the detection of Candida species using seeded blood samples.

As a delay in the diagnosis and treatment of candidemia is associated with increased mortality and healthcare costs, a more rapid method of detection is urgently needed. The T2Candida assay is a new rapid diagnostic test, which uses T2 magnetic resonance technology to identify Candida spp. directly from whole blood in approximately 3 hours.

Treatment of Candida famata bloodstream infections: case series and review of the literature.

Objectives: Candida famata (also known as Debaryomyces hansenii and Torulopsis candida) is a commensal yeast found in cheese, dairy products and the environment. C. famata accounts for 0.

Significant publications on infectious diseases pharmacotherapy in 2011.

Purpose: Important articles on topics pertinent to infectious diseases (ID) pharmacotherapy published in prominent peer-reviewed journals in 2011 are summarized.

Summary: Pharmacists, physicians, and researchers from the Houston Infectious Diseases Network were asked to nominate articles published in 2011 that they perceived as having a significant impact on the field of ID pharmacotherapy. The resulting list, comprising 10 articles related to human immunodeficiency virus (HIV) disease or acquired immune deficiency syndrome (AIDS) and 38 articles on a broad range of other ID-related topics, was sent to members of the Society of Infectious Diseases Pharmacists (SIDP) for evaluation via an Internet survey.

Echinocandin resistance in Candida species: mechanisms of reduced susceptibility and therapeutic approaches.

Objective: To summarize published data regarding mechanisms of reduced echinocandin susceptibility in Candida spp., the impact of echinocandin resistance on the fitness and virulence of Candida isolates, and current and future treatment approaches.

Data Sources: A search of MEDLINE databases (1966-September 2011) was conducted.