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Schmalreck AF, Willinger B, Idelevich EA, et al. Parallel and cross-resistances of clinical yeast isolates determined by susceptibility pattern analysis. GMS Infect Dis. 2016;4:Doc02doi: 10.3205/id000020.
Schmalreck, A. F., Willinger, B., Idelevich, E. A., Fegeler, C., Lass-Flörl, C., Fegeler, W., & Becker, K. (2016). Parallel and cross-resistances of clinical yeast isolates determined by susceptibility pattern analysis. GMS infectious diseases, 4Doc02. https://doi.org/10.3205/id000020
Schmalreck, Arno F, et al. "Parallel and cross-resistances of clinical yeast isolates determined by susceptibility pattern analysis." GMS infectious diseases vol. 4 (2016): Doc02. doi: https://doi.org/10.3205/id000020
Schmalreck AF, Willinger B, Idelevich EA, Fegeler C, Lass-Flörl C, Fegeler W, Becker K. Parallel and cross-resistances of clinical yeast isolates determined by susceptibility pattern analysis. GMS Infect Dis. 2016 Jun 07;4:Doc02. doi: 10.3205/id000020. eCollection 2016. PMID: 30671316; PMCID: PMC6301743.
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GMS Infect Dis. 2016 Jun 07;4:Doc02. doi: 10.3205/id000020. eCollection 2016.

Parallel and cross-resistances of clinical yeast isolates determined by susceptibility pattern analysis.

GMS infectious diseases

Arno F Schmalreck, Birgit Willinger, Evgeny A Idelevich, Christian Fegeler, Cornelia Lass-Flörl, Wolfgang Fegeler, Karsten Becker

Affiliations

  1. Mikrobiologische Beratung und Service (MBS), München, Germany.
  2. Division of Clinical Microbiology, Department of Laboratory Medicine, University Vienna, Austria.
  3. Institute of Medical Microbiology, University Hospital Münster, Germany.
  4. Medical Informatics, Faculty of Informatics, University Heilbronn, Germany.
  5. Section Hygiene and Medical Microbiology, Medical University Innsbruck, Austria.

PMID: 30671316 PMCID: PMC6301743 DOI: 10.3205/id000020

Abstract

For calculated initial antifungal therapy, knowledge on parallel and cross-resistances are vitally important particularly in the case of multiresistant isolates. Based on a strain collection of 1,062 yeast isolates from a German/Austrian multicentre study, susceptibility pattern analysis (SPA) was used to determine the proportion of parallel and cross-resistances to eight antifungal agents (AFAs) encompassing flucytosine, amphotericin B, azoles (fluconazole, voriconazole and posaconazole) and echinocandins (caspofungin, micafungin and anidulafungin). A total of 414 (39.0%) isolates were resistant for one or more of the AFAs. Resistance to one AFA was shown for 18.1% of all isolates. For 222 isolates (20.9%), resistance to two to seven AFAs was noted (7.7%; 7.7%; 3.6%; 1.0%; 0.7% and 0.2% to 2, 3, 4, 5, 6 and 7 antifungal compounds, respectively). Partial parallel resistances within the azole and echinocandin classes, respectively, were found for 81 (7.6%) and 70 (6.6%) isolates. Complete parallel resistances for azoles, echinocandins and combined for both classes were exhibited by 93 (8.8%), 18 (1.7%) and 6 (0.6%) isolates, respectively. Isolates displaying cross-resistances between azoles and echinocandins were infrequently found. Highly resistant isolates (resistance to ≥6 AFAs) were almost exclusively represented by

Keywords: Candida; amphotericin B; anidulafungin; antifungals; cross-resistance; fluconazole, voriconazole; flucytosine; micafungin; parallel resistance; posaconazole, caspofungin; susceptibility pattern analysis; susceptibility testing

Conflict of interest statement

K.B. has received research support from Pfizer as well as lecture, travel and other fees from Cubist Pharmaceuticals, MSD Sharp & Dohme, Novartis Pharma and Pfizer. Ch.F. has received lecture, travel

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