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Susceptibility

Antifungal Susceptibility Survey of 2,000 Bloodstream Candida Isolates in the United States

Luis Ostrosky-Zeichner, John H. Rex, Peter G. Pappas, Richard J. Hamill, Robert A. Larsen, Harold W. Horowitz, William G. Powderly, Newton Hyslop, Carol A. Kauffman, John Cleary, Julie E. Mangino, Jeannette Lee
Luis Ostrosky-Zeichner
1University of Texas—Houston Medical School, Houston, Texas
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  • For correspondence: luis.ostrosky-zeichner@uth.tmc.edu
John H. Rex
1University of Texas—Houston Medical School, Houston, Texas
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Peter G. Pappas
2University of Alabama at Birmingham, Birmingham, Alabama
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Richard J. Hamill
3Baylor University, Houston, Texas
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Robert A. Larsen
4University of Southern California, Los Angeles, California
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Harold W. Horowitz
5New York Medical College, Valhalla, New York
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William G. Powderly
6Washington University, St. Louis, Missouri
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Newton Hyslop
7Tulane Medical Center, New Orleans, Louisiana
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Carol A. Kauffman
8University of Michigan and VA Medical Center, Ann Arbor, Michigan
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John Cleary
9University of Mississippi, Jackson, Mississippi
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Julie E. Mangino
10Ohio State University, Columbus, Ohio
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Jeannette Lee
2University of Alabama at Birmingham, Birmingham, Alabama
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DOI: 10.1128/AAC.47.10.3149-3154.2003
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ABSTRACT

Candida bloodstream isolates (n = 2,000) from two multicenter clinical trials carried out by the National Institute of Allergy and Infectious Diseases Mycoses Study Group between 1995 and 1999 were tested against amphotericin B (AMB), flucytosine (5FC), fluconazole (FLU), itraconazole (ITR), voriconazole (VOR), posaconazole (POS), caspofungin (CFG), micafungin (MFG), and anidulafungin (AFG) using the NCCLS M27-A2 microdilution method. All drugs were tested in the NCCLS-specified RPMI 1640 medium except for AMB, which was tested in antibiotic medium 3. A sample of isolates was also tested in RPMI 1640 supplemented to 2% glucose and by using the diluent polyethylene glycol (PEG) in lieu of dimethyl sulfoxide for those drugs insoluble in water. Glucose supplementation tended to elevate the MIC, whereas using PEG tended to decrease the MIC. Trailing growth occurred frequently with azoles. Isolates were generally susceptible to AMB, 5FC, and FLU. Rates of resistance to ITR approached 20%. Although no established interpretative breakpoints are available for the candins (CFG, MFG, and AFG) and the new azoles (VOR and POS), they all exhibited excellent antifungal activity, even for those strains resistant to the other aforementioned agents.

  • Copyright © 2003 American Society for Microbiology
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Antifungal Susceptibility Survey of 2,000 Bloodstream Candida Isolates in the United States
Luis Ostrosky-Zeichner, John H. Rex, Peter G. Pappas, Richard J. Hamill, Robert A. Larsen, Harold W. Horowitz, William G. Powderly, Newton Hyslop, Carol A. Kauffman, John Cleary, Julie E. Mangino, Jeannette Lee
Antimicrobial Agents and Chemotherapy Sep 2003, 47 (10) 3149-3154; DOI: 10.1128/AAC.47.10.3149-3154.2003

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Antifungal Susceptibility Survey of 2,000 Bloodstream Candida Isolates in the United States
Luis Ostrosky-Zeichner, John H. Rex, Peter G. Pappas, Richard J. Hamill, Robert A. Larsen, Harold W. Horowitz, William G. Powderly, Newton Hyslop, Carol A. Kauffman, John Cleary, Julie E. Mangino, Jeannette Lee
Antimicrobial Agents and Chemotherapy Sep 2003, 47 (10) 3149-3154; DOI: 10.1128/AAC.47.10.3149-3154.2003
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KEYWORDS

antifungal agents
Candida
candidiasis

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