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Antimicrobial Agents and Chemotherapy, April 2004, p. 1382-1383, Vol. 48, No. 4
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.4.1382-1383.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Caspofungin Resistance in Candida albicans: Correlating Clinical Outcome with Laboratory Susceptibility Testing of Three Isogenic Isolates Serially Obtained from a Patient with Progressive Candida Esophagitis

Department of Medicine, Division Infectious Diseases (7881),¹ Department of Microbiology,² Department of Pathology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900³

Received 13 May 2003/ Returned for modification 4 October 2003/ Accepted 9 December 2003

A patient with azole-refractory thrush-esophagitis responded initially to caspofungin, but the treatment eventually failed. In a murine model, caspofungin was effective against two early isolates for which the MICs of caspofungin were low, but it was less effective against a late isolate for which the MIC of caspofungin was greater. We concluded that there is a correlation between in vivo failure and rising in vitro caspofungin MICs.

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