The prevalence of invasive candidiasis caused by non- has rapidly increased. () is an important pathogen associated with substantial mortality. Our study examined the antifungal temporal susceptibility of and cross-resistance/non-wild-type patterns with other azoles and echinocandins. Laboratory data of all adult patients with isolated from clinical specimens at the Mayo Clinic, Rochester, from 2012 to 2022 were collected. Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints were used. We obtained 1046 isolates from 877 patients. Using CLSI and EUCAST breakpoints, 187 (17.9%) isolates and 256 (24.5%) isolates were fluconazole-resistant, respectively. Focusing on bloodstream infections, fluconazole-resistance ranged from 16 to 22%. Among those 187 fluconazole-resistant isolates, 187 (100%) and 184 (98.4%) isolates were also voriconazole and posaconazole non-wild-type, respectively, with 97 (51.9%) isolates deemed non-wild type for itraconazole. The fluconazole susceptibility pattern has not changed over the past decade. The proportion of fluconazole-resistant is relatively high, which could be due to the complexity of patients and fluconazole exposure. Itraconazole appears to be a compelling step-down therapy for fluconazole-resistant , given the high proportion of wild-type isolates. Further research to examine clinical outcomes is warranted.
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| http://dx.doi.org/10.3390/jof9080821 | DOI Listing |
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