Publication details

European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM<i> Candida</i> III study

Authors	ARENDRUP Maiken Cavling ARIKAN-AKDAGLI Sevtap JORGENSEN Karin Meinike BARAC Aleksandra STEINMANN Jorg TOSCANO Cristina ARSENIJEVIC Valentina Arsic SARTOR Assunta LASS-FLOERL Cornelia HAMPRECHT Axel MATOS Tadeja ROGERS Benedict R S QUILES Inmaculada BUIL Jochem OZENCI Volkan KRAUSE Robert BASSETTI Matteo LOUGHLIN Laura DENIS Blandine GRANCINI Anna WHITE P Lewis LAGROU Katrien WILLINGER Birgit RAUTEMAA-RICHARDSON Riina HAMAL Petr ENER Beyza UNALAN-ALTINTOP Tugce EVREN Ebru HILMIOGLU-POLAT Suleyha OZ Yasemin OZYURT Ozlem Koyuncu AYDIN Faruk RŮŽIČKA Filip MEIJER Eelco F J GANGNEUX Jean Pierre LOCKHART Deborah E A KHANNA Nina LOGAN Clare SCHARMANN Ulrike DESOUBEAUX Guillaume ROILIDES Emmanuel TALENTO Alida Fe KARIN van Dijk KOEHLER Philipp SALMANTON-GARCIA Jon CORNELY Oliver A HOENIGL Martin
Year of publication	2023
Type	Article in Periodical
Magazine / Source	JOURNAL OF INFECTION
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.sciencedirect.com/science/article/pii/S0163445323004516?via%3Dihub
Doi	http://dx.doi.org/10.1016/j.jinf.2023.08.001
Keywords	Candida; C. parapsilosis; Fluconazole resistance; Echinocandin resistance; Fks1; EUCAST
Description	The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candi-daemia 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 re-sistant 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.(c) 2023 The Author(s). Published by Elsevier Ltd on behalf of The British Infection Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).