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Trends in antifungal resistance in Candida from a multicenter study conducted in Madrid (CANDIMAD study): fluconazole-resistant C. parapsilosis spreading has gained traction in 2022.
Díaz-García, Judith; Machado, Marina; Alcalá, Luis; Reigadas, Elena; Pérez-Ayala, Ana; Gómez-García de la Pedrosa, Elia; Gónzalez-Romo, Fernando; Cuétara, María Soledad; García-Esteban, Coral; Quiles-Melero, Inmaculada; Zurita, Nelly Daniela; Muñoz-Algarra, María; Durán-Valle, María Teresa; Sánchez-García, Aida; Muñoz, Patricia; Escribano, Pilar; Guinea, Jesus.
Afiliación
  • Díaz-García J; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.
  • Machado M; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain.
  • Alcalá L; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.
  • Reigadas E; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain.
  • Pérez-Ayala A; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.
  • Gómez-García de la Pedrosa E; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain.
  • Gónzalez-Romo F; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058) , Madrid, Spain.
  • Cuétara MS; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.
  • García-Esteban C; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain.
  • Quiles-Melero I; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058) , Madrid, Spain.
  • Zurita ND; Hospital Universitario 12 de Octubre , Madrid, Spain.
  • Muñoz-Algarra M; Instituto de Investigación Sanitaria del Hospital 12 de Octubre , Madrid, Spain.
  • Durán-Valle MT; Hospital Universitario Ramón y Cajal , Madrid, Spain.
  • Sánchez-García A; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) , Madrid, Spain.
  • Muñoz P; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III , Madrid, Spain.
  • Escribano P; Hospital Universitario Clínico San Carlos , Madrid, Spain.
  • Guinea J; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos IdISSC , Madrid, Spain.
Antimicrob Agents Chemother ; 67(11): e0098623, 2023 11 15.
Article en En | MEDLINE | ID: mdl-38092562
We previously conducted a multicenter surveillance study on Candida epidemiology and antifungal resistance in Madrid (CANDIMAD study; 2019-2021), detecting an increase in fluconazole-resistant Candida parapsilosis. We here present data on isolates collected in 2022. Furthermore, we report the epidemiology and antifungal resistance trends during the entire period, including an analysis per ward of admission. Candida spp. incident isolates from blood cultures and intra-abdominal samples from patients cared for at 16 hospitals in Madrid, Spain, were tested with the EUCAST E.Def 7.3.2 method against amphotericin B, azoles, micafungin, anidulafungin, and ibrexafungerp and were molecularly characterized. In 2022, we collected 766 Candida sp. isolates (686 patients; blood cultures, 48.8%). Candida albicans was the most common species found, and Candida auris was undetected. No resistance to amphotericin B was found. Overall, resistance to echinocandins was low (0.7%), whereas fluconazole resistance was 12.0%, being higher in blood cultures (16.0%) mainly due to fluconazole-resistant C. parapsilosis clones harboring the Y132F-R398I ERG11p substitutions. Ibrexafungerp showed in vitro activity against the isolates tested. Whereas C. albicans was the dominant species in most hospital wards, we observed increasing C. parapsilosis proportions in blood. During the entire period, echinocandin resistance rates remained steadily low, while fluconazole resistance increased in blood from 6.8% (2019) to 16% (2022), mainly due to fluconazole-resistant C. parapsilosis (2.6% in 2019 to 36.6% in 2022). Up to 7 out of 16 hospitals were affected by fluconazole-resistant C. parapsilosis. In conclusion, rampant clonal spreading of C. parapsilosis fluconazole-resistant genotypes is taking place in Madrid.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Candida / Fluconazol Límite: Humans Idioma: En Revista: Antimicrob Agents Chemother Año: 2023 Tipo del documento: Article País de afiliación: España

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Candida / Fluconazol Límite: Humans Idioma: En Revista: Antimicrob Agents Chemother Año: 2023 Tipo del documento: Article País de afiliación: España