Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: 10.5-year analysis of susceptibilities of noncandidal yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing

M A Pfaller; D J Diekema; D L Gibbs; V A Newell; H Bijie; D Dzierzanowska; N N Klimko; V Letscher-Bru; M Lisalova; K Muehlethaler; C Rennison; M Zaidi

doi:10.1128/JCM.01747-08

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Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: 10.5-year analysis of susceptibilities of noncandidal yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing

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Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: 10.5-year analysis of susceptibilities of noncandidal yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing

M A Pfaller, D J Diekema, D L Gibbs, V A Newell, H Bijie, D Dzierzanowska, N N Klimko, V Letscher-Bru, M Lisalova, K Muehlethaler, …

Journal of clinical microbiology, Vol.47(1), pp.117-123

01/2009

DOI: 10.1128/JCM.01747-08

PMCID: PMC2620874

PMID: 19005141

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Abstract

Fluconazole in vitro susceptibility test results determined by the CLSI M44-A disk diffusion method for 11,240 isolates of noncandidal yeasts were collected from 134 study sites in 40 countries from June 1997 through December 2007. Data were collected for 8,717 yeast isolates tested with voriconazole from 2001 through 2007. A total of 22 different species/organism groups were isolated, of which Cryptococcus neoformans was the most common (31.2% of all isolates). Overall, Cryptococcus (32.9%), Saccharomyces (11.7%), Trichosporon (10.6%), and Rhodotorula (4.1%) were the most commonly identified genera. The overall percentages of isolates in each category (susceptible, susceptible dose dependent, and resistant) were 78.0%, 9.5%, and 12.5% and 92.7%, 2.3%, and 5.0% for fluconazole and voriconazole, respectively. Less than 30% of fluconazole-resistant isolates of Cryptococcus spp., Cryptococcus albidus, Cryptococcus laurentii, Trichosporon beigelii/Trichosporon cutaneum, Rhodotorula spp., Rhodotorula rubra/Rhodotorula mucilaginosa, and Rhodotorula glutinis remained susceptible to voriconazole. Emerging resistance to fluconazole was documented among isolates of C. neoformans from the Asia-Pacific, Africa/Middle East, and Latin American regions but not among isolates from Europe or North America. This survey documents the continuing broad spectrum of activity of voriconazole against opportunistic yeast pathogens but identifies several of the less common species with decreased azole susceptibility. These organisms may pose a future threat to optimal antifungal therapy and emphasize the importance of prompt and accurate species identification.

Africa

Europe

Latin America

Middle East

North America

Antifungal Agents - pharmacology

Fluconazole - pharmacology

Humans

Mycoses - microbiology

Pyrimidines - pharmacology

Yeasts - drug effects

Asia, Southeastern

Triazoles - pharmacology

Microbial Sensitivity Tests - standards

Voriconazole

Drug Resistance, Fungal

Details

Title: Subtitle: Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: 10.5-year analysis of susceptibilities of noncandidal yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing
Creators: M A Pfaller - Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242, USA. michael-pfaller@uiowa.edu
D J Diekema
D L Gibbs
V A Newell
H Bijie
D Dzierzanowska
N N Klimko
V Letscher-Bru
M Lisalova
K Muehlethaler
C Rennison
M Zaidi
Contributors: Global Antifungal Surveillance Group (Author)
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.47(1), pp.117-123
DOI: 10.1128/JCM.01747-08
PMID: 19005141
PMCID: PMC2620874
NLM abbreviation: J Clin Microbiol
ISSN: 0095-1137
eISSN: 1098-660X
Publisher: United States
Language: English
Date published: 01/2009
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986264102771

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