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Caspofungin activity against clinical isolates of azole cross-resistant Candida glabrata overexpressing efflux pump genes

Posteraro, Brunella ; Sanguinetti, Maurizio ; Fiori, Barbara ; La Sorda, Marilena ; Spanu, Teresa ; Sanglard, Dominique ; Fadda, Giovanni

In: Journal of Antimicrobial Chemotherapy, 2006, vol. 58, no. 2, p. 458-461

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    Titre
    • Caspofungin activity against clinical isolates of azole cross-resistant Candida glabrata overexpressing efflux pump genes
    Auteur
    • Posteraro, Brunella. Istituto di Microbiologia, Università Cattolica del Sacro CuoreRome, Italy
    • Sanguinetti, Maurizio. Istituto di Microbiologia, Università Cattolica del Sacro CuoreRome, Italy
    • Fiori, Barbara. Istituto di Microbiologia, Università Cattolica del Sacro CuoreRome, Italy
    • La Sorda, Marilena. Istituto di Microbiologia, Università Cattolica del Sacro CuoreRome, Italy
    • Spanu, Teresa. Istituto di Microbiologia, Università Cattolica del Sacro CuoreRome, Italy
    • Sanglard, Dominique. Institut de Microbiologie, Centre Hospitalier Universitaire Vaudois (CHUV)Lausanne, Switzerland
    • Fadda, Giovanni. Istituto di Microbiologia, Università Cattolica del Sacro CuoreRome, Italy
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Journal of Antimicrobial Chemotherapy, 2006, vol. 58, no. 2, p. 458-461. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:304767
    Summary
    Objectives: Several studies have documented the potent in vitro activity of caspofungin against Candida spp. This is of special concern for Candida glabrata infections that are often resistant to many azole antifungal agents and, consequently, difficult to treat. The aim of the present study was to expand the data on the in vitro activity of caspofungin against azole-resistant isolates of C. glabrata. Methods: A total of 50 clinical isolates of C. glabrata were tested for susceptibility to caspofungin. The isolates were cross-resistant to multiple azoles, including fluconazole, itraconazole, ketoconazole and voriconazole. Expression of the resistance-related CgCDR1 and CgCDR2 genes was evaluated by quantitative RT-PCR analysis. The MICs of caspofungin were determined by using the National Committee for Clinical Laboratory Standards M27-A2 reference method. Results: C. glabrata isolates exhibited increased expression of the CDR efflux pump(s), and this was in accordance with their high-level azole resistance. In contrast, all the isolates were highly susceptible to caspofungin (100% of isolates were inhibited at ≤1 mg/L). Conclusions: Our results represent further evidence for the excellent antifungal potency of caspofungin, particularly against C. glabrata isolates expressing cross-resistance to azoles