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Michael A. Pfaller - One of the best experts on this subject based on the ideXlab platform.
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A global evaluation of voriconazole activity tested against recent clinical isolates of Candida Spp.
Diagnostic Microbiology and Infectious Disease, 2008Co-Authors: Daniel J. Diekema, Shawn A. Messer, Richard J. Hollis, Linda Boyken, S. Tendolkar, J. Kroeger, Ronald N. Jones, Michael A. PfallerAbstract:Abstract Voriconazole susceptibility testing was performed on 7191 Candida Spp. from 78 centers worldwide between 2004 and 2007. Voriconazole was very active in vitro (MIC 50 /MIC 90 , 0.008/0.25 μg/mL; 98% susceptible). In comparison to 5866 Candida Spp. isolates collected during global surveillance from 1997 to 2001, there were no changes in voriconazole mean MIC or MIC distribution.
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activities of micafungin against 315 invasive clinical isolates of fluconazole resistant Candida Spp
Journal of Clinical Microbiology, 2006Co-Authors: S A Messer, Daniel J. Diekema, S. Tendolkar, L Boyken, R J Hollis, Michael A. PfallerAbstract:Micafungin is a new echinocandin exhibiting broad-spectrum activity against Candida Spp. The activity of the echinocandins against Candida species known to express intrinsic or acquired resistance to fluconazole is of interest. We determined the MICs of micafungin and caspofungin against 315 invasive clinical (bloodstream and other sterile-site) isolates of fluconazole-resistant Candida species obtained from geographically diverse medical centers between 2001 and 2004. MICs were determined using broth microdilution according to the CLSI reference method M27-A2. RPMI 1640 was used as the test medium, and we used the MIC endpoint of prominent growth reduction at 24 h. Among the 315 fluconazole-resistant Candida isolates, 146 (46%) were C. krusei, 110 (35%) were C. glabrata, 41 (13%) were C. albicans, and 18 (6%) were less frequently isolated species. Micafungin had good in vitro activity against all fluconazole-resistant Candida Spp. tested; the MICs at which 50% (MIC50) and 90% (MIC90) of isolates were inhibited were 0.03 μg/ml and 0.06 μg/ml, respectively. All the fluconazole-resistant Candida Spp. were inhibited at a micafungin MIC that was ≤1 μg/ml. Among the most common fluconazole-resistant Candida Spp. tested in the collection, C. glabrata exhibited the lowest micafungin MICs (MIC90, ≤0.015 μg/ml), followed by C. albicans (MIC90, 0.03 μg/ml) and C. krusei (MIC90, 0.06 μg/ml). The new echinocandin micafungin has excellent in vitro activity against 315 invasive clinical isolates of fluconazole-resistant Candida, which represents the largest collection to date of fluconazole-resistant Candida isolates tested against micafungin. Micafungin may prove useful in the treatment of infections due to azole-resistant Candida.
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in vitro activities of anidulafungin against more than 2 500 clinical isolates of Candida Spp including 315 isolates resistant to fluconazole
Journal of Clinical Microbiology, 2005Co-Authors: Michael A. Pfaller, S. Tendolkar, S A Messer, L Boyken, R J Hollis, Daniel J. DiekemaAbstract:Anidulafungin is an echinocandin antifungal agent with potent activity against Candida Spp. We assessed the in vitro activity of anidulafungin against 2,235 clinical isolates of Candida Spp. using the CLSI broth microdilution method. Anidulafungin was very active against Candida Spp. (the MIC at which 90% of strains are inhibited [MIC90] was 2 μg/ml when MIC endpoint criteria of partial inhibition [MIC-2] were used). Candida albicans, C. glabrata, C. tropicalis, C. krusei, and C. kefyr were the most susceptible species of Candida (MIC90, 0.06 to 0.12 μg/ml), and C. parapsilosis, C. lusitaniae, and C. guilliermondii were the least susceptible (MIC90, 0.5 to 2 μg/ml). In addition, 315 fluconazole-resistant isolates were tested, and 99% were inhibited by ≤1 μg/ml of anidulafungin. These results provide further evidence for the spectrum and potency of anidulafungin activity against a large and geographically diverse collection of clinically important isolates of Candida Spp.
Daniel J. Diekema - One of the best experts on this subject based on the ideXlab platform.
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A global evaluation of voriconazole activity tested against recent clinical isolates of Candida Spp.
Diagnostic Microbiology and Infectious Disease, 2008Co-Authors: Daniel J. Diekema, Shawn A. Messer, Richard J. Hollis, Linda Boyken, S. Tendolkar, J. Kroeger, Ronald N. Jones, Michael A. PfallerAbstract:Abstract Voriconazole susceptibility testing was performed on 7191 Candida Spp. from 78 centers worldwide between 2004 and 2007. Voriconazole was very active in vitro (MIC 50 /MIC 90 , 0.008/0.25 μg/mL; 98% susceptible). In comparison to 5866 Candida Spp. isolates collected during global surveillance from 1997 to 2001, there were no changes in voriconazole mean MIC or MIC distribution.
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activities of micafungin against 315 invasive clinical isolates of fluconazole resistant Candida Spp
Journal of Clinical Microbiology, 2006Co-Authors: S A Messer, Daniel J. Diekema, S. Tendolkar, L Boyken, R J Hollis, Michael A. PfallerAbstract:Micafungin is a new echinocandin exhibiting broad-spectrum activity against Candida Spp. The activity of the echinocandins against Candida species known to express intrinsic or acquired resistance to fluconazole is of interest. We determined the MICs of micafungin and caspofungin against 315 invasive clinical (bloodstream and other sterile-site) isolates of fluconazole-resistant Candida species obtained from geographically diverse medical centers between 2001 and 2004. MICs were determined using broth microdilution according to the CLSI reference method M27-A2. RPMI 1640 was used as the test medium, and we used the MIC endpoint of prominent growth reduction at 24 h. Among the 315 fluconazole-resistant Candida isolates, 146 (46%) were C. krusei, 110 (35%) were C. glabrata, 41 (13%) were C. albicans, and 18 (6%) were less frequently isolated species. Micafungin had good in vitro activity against all fluconazole-resistant Candida Spp. tested; the MICs at which 50% (MIC50) and 90% (MIC90) of isolates were inhibited were 0.03 μg/ml and 0.06 μg/ml, respectively. All the fluconazole-resistant Candida Spp. were inhibited at a micafungin MIC that was ≤1 μg/ml. Among the most common fluconazole-resistant Candida Spp. tested in the collection, C. glabrata exhibited the lowest micafungin MICs (MIC90, ≤0.015 μg/ml), followed by C. albicans (MIC90, 0.03 μg/ml) and C. krusei (MIC90, 0.06 μg/ml). The new echinocandin micafungin has excellent in vitro activity against 315 invasive clinical isolates of fluconazole-resistant Candida, which represents the largest collection to date of fluconazole-resistant Candida isolates tested against micafungin. Micafungin may prove useful in the treatment of infections due to azole-resistant Candida.
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in vitro activities of anidulafungin against more than 2 500 clinical isolates of Candida Spp including 315 isolates resistant to fluconazole
Journal of Clinical Microbiology, 2005Co-Authors: Michael A. Pfaller, S. Tendolkar, S A Messer, L Boyken, R J Hollis, Daniel J. DiekemaAbstract:Anidulafungin is an echinocandin antifungal agent with potent activity against Candida Spp. We assessed the in vitro activity of anidulafungin against 2,235 clinical isolates of Candida Spp. using the CLSI broth microdilution method. Anidulafungin was very active against Candida Spp. (the MIC at which 90% of strains are inhibited [MIC90] was 2 μg/ml when MIC endpoint criteria of partial inhibition [MIC-2] were used). Candida albicans, C. glabrata, C. tropicalis, C. krusei, and C. kefyr were the most susceptible species of Candida (MIC90, 0.06 to 0.12 μg/ml), and C. parapsilosis, C. lusitaniae, and C. guilliermondii were the least susceptible (MIC90, 0.5 to 2 μg/ml). In addition, 315 fluconazole-resistant isolates were tested, and 99% were inhibited by ≤1 μg/ml of anidulafungin. These results provide further evidence for the spectrum and potency of anidulafungin activity against a large and geographically diverse collection of clinically important isolates of Candida Spp.
Amanda Latercia Tranches Dias - One of the best experts on this subject based on the ideXlab platform.
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aspartic proteinases of Candida Spp role in pathogenicity and antifungal resistance
Mycoses, 2014Co-Authors: Naiara Chaves Silva, Jessica Maria Nery, Amanda Latercia Tranches DiasAbstract:Summary Fungal infections represent a serious health risk as they are particularly prevalent in immunocompromised individuals. Candida Spp. pathogenicity depends on several factors and secreted aspartic proteinases (Sap) are considered one of the most critical factors as they are associated with adhesion, invasion and tissue damage. The production of proteinases is encoded by a family of 10 genes known as SAP, which are distributed differently among the species. The expression of these genes may be influenced by environmental conditions, which generally result in a higher fungal invasive potential. Non-pathogenic Candida Spp. usually have fewer SAP genes, which are not necessarily expressed in the genome. Exposure to subinhibitory concentrations of antifungal agents promotes the development of resistant strains with an increased expression of SAP genes. In general, Candida Spp. isolates that are resistant to antifungals show a higher secretion of Sap than the susceptible isolates. The relationship between Sap secretion and the susceptibility profile of the isolates is of great interest, although the role of SAPs in the development of resistance to antifungal agents remains still unclear. This review is the first one to address these issues.
Silvia Terraneo - One of the best experts on this subject based on the ideXlab platform.
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impact of Candida Spp isolation in the respiratory tract in patients with intensive care unit acquired pneumonia
Clinical Microbiology and Infection, 2016Co-Authors: Silvia Terraneo, Miquel Ferrer, Mariano Esperatti, Marta Di Pasquale, Valeria Giunta, Mariano Rinaudo, Ignacio Martinloeches, Francesca De RosaAbstract:Abstract In immunocompetent patients with nosocomial pneumonia, the relationship between Candida Spp. isolation in respiratory samples and outcomes or association with other pathogens is controversial. We therefore compared the characteristics and outcomes of patients with intensive care unit-acquired pneumonia (ICUAP), with or without Candida Spp. isolation in the respiratory tract. In this prospective non-interventional study, we assessed 385 consecutive immunocompetent patients with ICUAP, according to the presence or absence of Candida Spp. in lower respiratory tract samples. Candida Spp. was isolated in at least one sample in 82 (21%) patients. Patients with Candida Spp. had higher severity scores and organ dysfunction at admission and at onset of pneumonia. In multivariate analysis, previous surgery, diabetes mellitus and higher Simplified Acute Physiology Score II at ICU admission independently predicted isolation of Candida Spp. There were no significant differences in the rate of specific aetiological pathogens, the systemic inflammatory response, and length of stay between patients with and without Candida Spp. Mortality was also similar, even adjusted for potential confounders in propensity-adjusted multivariate analyses (adjusted hazard ratio 1.08, 95% CI 0.57–2.05, p 0.80 for 28-day mortality and adjusted hazard ratio 1.38, 95% CI 0.81–2.35, p 0.24 for 90-day mortality). Antifungal therapy was more frequently prescribed in patients with Candida Spp. in respiratory samples but did not influence outcomes. Candida Spp. airway isolation in patients with ICUAP is associated with more initial disease severity but does not influence outcomes in these patients, regardless of the use or not of antifungal therapy.
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Impact of Candida Spp. colonization of respiratory tract in patients with intensive care unit-acquired pneumonia
European Respiratory Journal, 2013Co-Authors: Silvia Terraneo, Miquel Ferrer, Mariano Esperatti, Marta Di Pasquale, Valeria Giunta, Mariano Rinaudo, Hugo Loureiro, Rogelio Peralta, Francesca De Rosa, Gianluigi Li BassiAbstract:Introduction : In immunocompetent patients with respiratory infections, concomitant colonization by Candida Spp. seems not clinically relevant. However, Candida Spp. airway colonization could promote development of ICU-acquired pneumonia (ICUAP) due to Pseudomonas aeruginosa and multi-drug resistant bacteria, prolonged stay and worse outcomes. We compared characteristic and outcomes of patients with ICUAP, with or without airway colonization by Candida Spp. Methods : We prospectively collected 385 consecutive immunocompetent patients with ICUAP, clustered according to the presence or absence in sputum, tracheal aspirate or bronchoalveolar lavage of Candida Spp. Results : Candida Spp. was found in 82 (21%) patients. Colonized patients had a higher APACHE-II, SAPS-II and SOFA scores at baseline and higher rate of diabetes and chronic renal failure. Conversely, previous use of antibiotics and steroid therapy was less frequent. The rate of etiologic diagnosis was lower, as well as the isolation of Enterobacteriaceae and Pseudomonas aeruginosa . The length of stay and mortality were similar in both groups. Following adjustment for potential confounders, patients with Candida Spp. remained with similar ICU (adjusted odds-ratio (OR) 1.70, 96, 95% confidence interval (CI) 0.81-3.59, p=0.16) and hospital mortality (adj. OR 1.23, 95% CI 0.63-2.42, p=0.54). Conclusion : Patients with ICUAP and Candida Spp. colonization had lower rates of Enterobacteriaceae and P. aeruginosa aetiology. Despite worse initial clinical presentation, they had similar outcomes to patients not colonized by Candida Spp. Supported: IDIBAPS, CibeRes(CB06/06/0028)-ISCiii, 2009 SGR 911.
Pierreemmanuel Charles - One of the best experts on this subject based on the ideXlab platform.
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Candida Spp airway colonization could promote antibiotic resistant bacteria selection in patients with suspected ventilator associated pneumonia
Intensive Care Medicine, 2012Co-Authors: Mael Hamet, Arnaud Pavon, Frederic Dalle, A Pechinot, Sebastien Prin, Jeanpierre Quenot, Pierreemmanuel CharlesAbstract:Objective Candida Spp. airway colonization could promote development of ventilator-associated pneumonia (VAP) caused by Pseudomonas aeruginosa, a potentially multidrug-resistant (MDR) bacteria, and worsen the outcome of VAP regardless of pathogen. We therefore address the question of the risk of MDR bacteria isolation within the airway of patients with suspected VAP, whether Candida Spp. is present or not.
