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Drug-Resistant Candida glabrata Infection in Cancer Patients
Cancer patients are at risk for candidemia, and increasing Candida spp. resistance poses an emerging threat. We determined rates of antifungal drug resistance, identified factors associated with resistance, and investigated the correlation between resistance and all-cause mortality rates among cance...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Centers for Disease Control and Prevention
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214312/ https://www.ncbi.nlm.nih.gov/pubmed/25340258 http://dx.doi.org/10.3201/eid2011.140685 |
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author | Farmakiotis, Dimitrios Tarrand, Jeffrey J. Kontoyiannis, Dimitrios P. |
author_facet | Farmakiotis, Dimitrios Tarrand, Jeffrey J. Kontoyiannis, Dimitrios P. |
author_sort | Farmakiotis, Dimitrios |
collection | PubMed |
description | Cancer patients are at risk for candidemia, and increasing Candida spp. resistance poses an emerging threat. We determined rates of antifungal drug resistance, identified factors associated with resistance, and investigated the correlation between resistance and all-cause mortality rates among cancer patients with ≥1 C. glabrata–positive blood culture at MD Anderson Cancer Center, Houston, Texas, USA, during March 2005–September 2013. Of 146 isolates, 30 (20.5%) were resistant to fluconazole, 15 (10.3%) to caspofungin, and 10 (6.8%) to multiple drugs (9 caspofungin-resistant isolates were also resistant to fluconazole, 1 to amphotericin B). Independently associated with fluconazole resistance were azole preexposure, hematologic malignancy, and mechanical ventilation. Independently associated with caspofungin resistance were echinocandin preexposure, monocytopenia, and total parenteral nutrition. Fluconazole resistance was highly associated with caspofungin resistance, independent of prior azole or echinocandin use. Caspofungin resistance was associated with increased 28-day all-cause mortality rates. These findings highlight the need for good stewardship of antifungal drugs. |
format | Online Article Text |
id | pubmed-4214312 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Centers for Disease Control and Prevention |
record_format | MEDLINE/PubMed |
spelling | pubmed-42143122014-11-06 Drug-Resistant Candida glabrata Infection in Cancer Patients Farmakiotis, Dimitrios Tarrand, Jeffrey J. Kontoyiannis, Dimitrios P. Emerg Infect Dis Research Cancer patients are at risk for candidemia, and increasing Candida spp. resistance poses an emerging threat. We determined rates of antifungal drug resistance, identified factors associated with resistance, and investigated the correlation between resistance and all-cause mortality rates among cancer patients with ≥1 C. glabrata–positive blood culture at MD Anderson Cancer Center, Houston, Texas, USA, during March 2005–September 2013. Of 146 isolates, 30 (20.5%) were resistant to fluconazole, 15 (10.3%) to caspofungin, and 10 (6.8%) to multiple drugs (9 caspofungin-resistant isolates were also resistant to fluconazole, 1 to amphotericin B). Independently associated with fluconazole resistance were azole preexposure, hematologic malignancy, and mechanical ventilation. Independently associated with caspofungin resistance were echinocandin preexposure, monocytopenia, and total parenteral nutrition. Fluconazole resistance was highly associated with caspofungin resistance, independent of prior azole or echinocandin use. Caspofungin resistance was associated with increased 28-day all-cause mortality rates. These findings highlight the need for good stewardship of antifungal drugs. Centers for Disease Control and Prevention 2014-11 /pmc/articles/PMC4214312/ /pubmed/25340258 http://dx.doi.org/10.3201/eid2011.140685 Text en https://creativecommons.org/licenses/by/4.0/This is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited. |
spellingShingle | Research Farmakiotis, Dimitrios Tarrand, Jeffrey J. Kontoyiannis, Dimitrios P. Drug-Resistant Candida glabrata Infection in Cancer Patients |
title | Drug-Resistant Candida glabrata Infection in Cancer Patients |
title_full | Drug-Resistant Candida glabrata Infection in Cancer Patients |
title_fullStr | Drug-Resistant Candida glabrata Infection in Cancer Patients |
title_full_unstemmed | Drug-Resistant Candida glabrata Infection in Cancer Patients |
title_short | Drug-Resistant Candida glabrata Infection in Cancer Patients |
title_sort | drug-resistant candida glabrata infection in cancer patients |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214312/ https://www.ncbi.nlm.nih.gov/pubmed/25340258 http://dx.doi.org/10.3201/eid2011.140685 |
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