TY - JOUR
T1 - European candidaemia is characterised by notable differential epidemiology and susceptibility pattern
T2 - Results from the ECMM Candida III study
AU - Arendrup, Maiken Cavling
AU - Arikan-Akdagli, Sevtap
AU - Jørgensen, Karin Meinike
AU - Barac, Aleksandra
AU - Steinmann, J. rg
AU - Toscano, Cristina
AU - Arsenijevic, Valentina Arsic
AU - Sartor, Assunta
AU - Lass-Flörl, Cornelia
AU - Hamprecht, Axel
AU - Matos, Tadeja
AU - Rogers, Benedict R. S.
AU - Quiles, Inmaculada
AU - Buil, Jochem
AU - Özenci, Volkan
AU - Krause, Robert
AU - Bassetti, Matteo
AU - Loughlin, Laura
AU - Denis, Blandine
AU - Grancini, Anna
AU - White, P. Lewis
AU - Lagrou, Katrien
AU - Willinger, Birgit
AU - Rautemaa-Richardson, Riina
AU - Hamal, Petr
AU - Ener, Beyza
AU - Unalan-Altintop, Tugce
AU - Evren, Ebru
AU - Hilmioglu-Polat, Suleyha
AU - Oz, Yasemin
AU - Ozyurt, Ozlem Koyuncu
AU - Aydin, Faruk
AU - Růžička, Filip
AU - Meijer, Eelco F. J.
AU - Gangneux, Jean Pierre
AU - Lockhart, Deborah E. A.
AU - Khanna, Nina
AU - Logan, Clare
AU - Scharmann, Ulrike
AU - Desoubeaux, Guillaume
AU - Roilides, Emmanuel
AU - Talento, Alida Fe
AU - van Dijk, Karin
AU - Koehler, Philipp
AU - Salmanton-García, Jon
AU - Cornely, Oliver A.
AU - Hoenigl, Martin
N1 - Funding Information: The confirmatory species identification, susceptibility testing and target gene sequencing conducted at the Statens Serum Institut and at Hacettepe University did not receive any external funding. Otherwise, the study, including case-based reimbursements for participating centres for study participation and reimbursements for shipment of isolates from each centre to the SSI, Copenhagen, Denmark, was partly funded by an Investigator Initiated Research Grant from Scynexis . The funder had no influence on the study design or on the analysis of the results. Funding Information: The confirmatory species identification, susceptibility testing and target gene sequencing conducted at the Statens Serum Institut and at Hacettepe University did not receive any external funding. Otherwise, the study, including case-based reimbursements for participating centres for study participation and reimbursements for shipment of isolates from each centre to the SSI, Copenhagen, Denmark, was partly funded by an Investigator Initiated Research Grant from Scynexis. The funder had no influence on the study design or on the analysis of the results. Publisher Copyright: © 2023 The Authors
PY - 2023/11
Y1 - 2023/11
N2 - The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25–33%) while Italy and Turkey had the highest C. parapsilosis proportions (24–26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence.
AB - The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25–33%) while Italy and Turkey had the highest C. parapsilosis proportions (24–26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence.
KW - C. parapsilosis
KW - Candida
KW - EUCAST
KW - Echinocandin resistance
KW - Fks1
KW - Fluconazole resistance
UR - http://www.scopus.com/inward/record.url?scp=85170210574&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jinf.2023.08.001
DO - https://doi.org/10.1016/j.jinf.2023.08.001
M3 - Article
C2 - 37549695
SN - 0163-4453
VL - 87
SP - 428
EP - 437
JO - Journal of Infection
JF - Journal of Infection
IS - 5
ER -