Tags

Type your tag names separated by a space and hit enter

Impact of antifungal prophylaxis on colonization and azole susceptibility of Candida species.
Antimicrob Agents Chemother. 2009 Dec; 53(12):5026-34.AA

Abstract

Two large studies compared posaconazole and fluconazole or itraconazole for prophylaxis in subjects undergoing allogeneic hematopoietic stem cell transplantation or subjects with acute myelogenous leukemia. To assess the impact of prophylaxis on colonization and the development of resistance in Saccharomyces yeasts, identification and susceptibility testing were performed with yeasts cultured at regular intervals from mouth, throat, and stool samples. Prior to therapy, 34 to 50% of the subjects were colonized with yeasts. For all three drugs, the number of positive Candida albicans cultures decreased during drug therapy. In contrast, the proportion of subjects with positive C. glabrata cultures increased by two- and fourfold in the posaconazole and itraconazole arms, respectively. Likewise, in the fluconazole arm the proportion of subjects with positive C. krusei cultures increased twofold. C. glabrata was the species that most frequently exhibited decreases in susceptibility, and this trend did not differ significantly between the prophylactic regimens. For the subset of subjects from whom colonizing C. glabrata isolates were recovered at the baseline and the end of treatment, approximately 40% of the isolates exhibited more than fourfold increases in MICs during therapy. Molecular typing of the C. albicans and C. glabrata isolates confirmed that the majority of the baseline and end-of-treatment isolates were closely related, suggesting that they were persistent colonizers and not newly acquired. Overall breakthrough infections by Candida species were very rare (approximately 1%), and C. glabrata was the colonizing species that was the most frequently associated with breakthrough infections.

Authors+Show Affiliations

Schering-Plough Research Institute, Kenilworth, NJ 07033, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19786600

Citation

Mann, Paul A., et al. "Impact of Antifungal Prophylaxis On Colonization and Azole Susceptibility of Candida Species." Antimicrobial Agents and Chemotherapy, vol. 53, no. 12, 2009, pp. 5026-34.
Mann PA, McNicholas PM, Chau AS, et al. Impact of antifungal prophylaxis on colonization and azole susceptibility of Candida species. Antimicrob Agents Chemother. 2009;53(12):5026-34.
Mann, P. A., McNicholas, P. M., Chau, A. S., Patel, R., Mendrick, C., Ullmann, A. J., Cornely, O. A., Patino, H., & Black, T. A. (2009). Impact of antifungal prophylaxis on colonization and azole susceptibility of Candida species. Antimicrobial Agents and Chemotherapy, 53(12), 5026-34. https://doi.org/10.1128/AAC.01031-09
Mann PA, et al. Impact of Antifungal Prophylaxis On Colonization and Azole Susceptibility of Candida Species. Antimicrob Agents Chemother. 2009;53(12):5026-34. PubMed PMID: 19786600.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of antifungal prophylaxis on colonization and azole susceptibility of Candida species. AU - Mann,Paul A, AU - McNicholas,Paul M, AU - Chau,Andrew S, AU - Patel,Reena, AU - Mendrick,Cara, AU - Ullmann,Andrew J, AU - Cornely,Oliver A, AU - Patino,Hernando, AU - Black,Todd A, Y1 - 2009/09/28/ PY - 2009/9/30/entrez PY - 2009/9/30/pubmed PY - 2010/2/2/medline SP - 5026 EP - 34 JF - Antimicrobial agents and chemotherapy JO - Antimicrob Agents Chemother VL - 53 IS - 12 N2 - Two large studies compared posaconazole and fluconazole or itraconazole for prophylaxis in subjects undergoing allogeneic hematopoietic stem cell transplantation or subjects with acute myelogenous leukemia. To assess the impact of prophylaxis on colonization and the development of resistance in Saccharomyces yeasts, identification and susceptibility testing were performed with yeasts cultured at regular intervals from mouth, throat, and stool samples. Prior to therapy, 34 to 50% of the subjects were colonized with yeasts. For all three drugs, the number of positive Candida albicans cultures decreased during drug therapy. In contrast, the proportion of subjects with positive C. glabrata cultures increased by two- and fourfold in the posaconazole and itraconazole arms, respectively. Likewise, in the fluconazole arm the proportion of subjects with positive C. krusei cultures increased twofold. C. glabrata was the species that most frequently exhibited decreases in susceptibility, and this trend did not differ significantly between the prophylactic regimens. For the subset of subjects from whom colonizing C. glabrata isolates were recovered at the baseline and the end of treatment, approximately 40% of the isolates exhibited more than fourfold increases in MICs during therapy. Molecular typing of the C. albicans and C. glabrata isolates confirmed that the majority of the baseline and end-of-treatment isolates were closely related, suggesting that they were persistent colonizers and not newly acquired. Overall breakthrough infections by Candida species were very rare (approximately 1%), and C. glabrata was the colonizing species that was the most frequently associated with breakthrough infections. SN - 1098-6596 UR - https://www.unboundmedicine.com/medline/citation/19786600/Impact_of_antifungal_prophylaxis_on_colonization_and_azole_susceptibility_of_Candida_species_ L2 - http://aac.asm.org/cgi/pmidlookup?view=long&pmid=19786600 DB - PRIME DP - Unbound Medicine ER -