Fluconazole exposure rather than clonal spreading is correlated with the emergence of Candida glabrata with cross-resistance to triazole antifungal agents

摘要: The emergence of antifungal resistance in Candida species has raised concern recent years, especially toward triazole. Several newer triazole agents have been introduced which a broader spectrum for fungal infections, such as voriconazole. However, cross-resistance among triazoles is major with regard to their clinical application. Antifungal susceptibility was performed using E-test 166 isolates (29 blood and 137 nonblood isolates) 2003 2004. We applied pulsed-field gel electrophoresis genotyping. Ninety C. albicans, 47 tropicalis, 27 glabrata, two krusei were included. All susceptible amphotericin B. Eleven (40.7%) the glabrata had intermediate caspofungin. Forty-seven (28.3%) not fluconazole, including 16 isolates. except seven C. glabrata drugs positive correlation minimum inhibitory concentrations (MICs). Fluconazole MIC good predictor voriconazole, determined receiver operating characteristic curve. Furthermore, high diversity pulsotypes observed. Previous fluconazole exposure within 3 months associated reduced glabrata. demonstrated significant values four tested drugs. No B caspofungin resistant found this study. previous opposed clonal spreading. Selection pressure due use may play role cross-resistance.