Species Distribution of Candidemia and Their Susceptibility in a Single Japanese University Hospital: Prior Micafungin Use Affects the Appearance of <i>Candida parapsilosis</i> and Elevation of Micafungin MICs in Non-<i>parapsilosis Candida</i> Species
Introduction: Micafungin is a recommended echinocandin antifungal agent for candidemia treatment and prophylaxis. However, overuse of echinocandin antifungals may cause resistance. There is currently no information available regarding the low susceptibility associated with using micafungin. This stu...
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| Format: | Article |
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MDPI AG
2021-07-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/7/8/596 |
| _version_ | 1797523275908120576 |
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| author | Yasutaka Sakamoto Kazuhiro Kawabe Tomoyo Suzuki Kayoko Sano Kazuo Ide Tetsuta Nishigaki Yuki Enoki Kazuaki Taguchi Hirofumi Koike Hideaki Kato Yukiko Sahashi Kazuaki Matsumoto |
| author_facet | Yasutaka Sakamoto Kazuhiro Kawabe Tomoyo Suzuki Kayoko Sano Kazuo Ide Tetsuta Nishigaki Yuki Enoki Kazuaki Taguchi Hirofumi Koike Hideaki Kato Yukiko Sahashi Kazuaki Matsumoto |
| author_sort | Yasutaka Sakamoto |
| collection | DOAJ |
| description | Introduction: Micafungin is a recommended echinocandin antifungal agent for candidemia treatment and prophylaxis. However, overuse of echinocandin antifungals may cause resistance. There is currently no information available regarding the low susceptibility associated with using micafungin. This study investigated the effect of micafungin use on changes in the detected <i>Candida</i> species and low susceptibility. Methods: We conducted a retrospective survey and included records of <i>Candida</i> spp. detected in blood cultures from January 2010 to December 2018 in our hospital. Survey items included clinical outcomes at 30 days after positive cultures, patient characteristics, and drug prescription status. Patient background information included gender, previous hospitalization, stay in the intensive care unit, comorbidities, and history of surgery (within 90 days before candidemia onset) and drug exposure. Species detected and their minimum inhibitory concentrations (MICs) and amount of antifungal prescriptions by department were investigated. Risk factors for detecting <i>C. parapsilosis</i> and for low susceptibility to micafungin were evaluated using multivariate analysis. Results: A total of 153 <i>Candida</i> clinical blood isolates were collected and <i>C. albicans</i> was the most prevalent species, followed by <i>C. parapsilosis</i> and <i>C. glabrata</i>. In the analysis by department, antifungal use and non-<i>albicans Candida</i> species were most frequently detected in the hematology department. Multivariate analysis showed that prior micafungin use increased the risk of <i>C. parapsilosis</i> (odds ratio (OR) 4.22; 95% confidence interval (CI) 1.39–12.79; <i>p</i> = 0.011). MIC<sub>90</sub> of micafungin on <i>C. glabrata</i> and <i>C. parapsilosis</i> was 1.0 μg/mL. Prior micafungin use was clarified as a risk factor resulting in MIC > 0.06 μg/mL for micafungin in non-<i>parapsilosis Candida</i> species (OR 13.2; 95% CI 3.23–54.2; <i>p</i> < 0.01). Conclusion: Prior micafungin use increased the risk of <i>C. parapsilosis</i> and the MIC > 0.06 μg/mL of micafungin in non-<i>parapsilosis Candida</i> species. Since there are only a few antifungal options, further antifungal stewardship considering azole antifungal agents use is required. |
| first_indexed | 2024-03-10T08:41:06Z |
| format | Article |
| id | doaj.art-8356a5ba01284bf694c9e26670e2aca6 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T08:41:06Z |
| publishDate | 2021-07-01 |
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| series | Journal of Fungi |
| spelling | doaj.art-8356a5ba01284bf694c9e26670e2aca62023-11-22T08:16:30ZengMDPI AGJournal of Fungi2309-608X2021-07-017859610.3390/jof7080596Species Distribution of Candidemia and Their Susceptibility in a Single Japanese University Hospital: Prior Micafungin Use Affects the Appearance of <i>Candida parapsilosis</i> and Elevation of Micafungin MICs in Non-<i>parapsilosis Candida</i> SpeciesYasutaka Sakamoto0Kazuhiro Kawabe1Tomoyo Suzuki2Kayoko Sano3Kazuo Ide4Tetsuta Nishigaki5Yuki Enoki6Kazuaki Taguchi7Hirofumi Koike8Hideaki Kato9Yukiko Sahashi10Kazuaki Matsumoto11Division of Pharmacodynamics, Keio University Faculty of Pharmacy, Tokyo 105-8512, JapanDepartment of Pharmacy, Yokohama City University Hospital, Yokohama 236-0004, JapanDepartment of Pharmacy, Yokohama City University Hospital, Yokohama 236-0004, JapanDepartment of Clinical Laboratory, Yokohama City University Hospital, Yokohama 236-0004, JapanDepartment of Pharmacy, Yokohama City University Hospital, Yokohama 236-0004, JapanDepartment of Pharmacy, Yokohama City University Hospital, Yokohama 236-0004, JapanDivision of Pharmacodynamics, Keio University Faculty of Pharmacy, Tokyo 105-8512, JapanDivision of Pharmacodynamics, Keio University Faculty of Pharmacy, Tokyo 105-8512, JapanDepartment of Pharmacy, Yokohama City University Hospital, Yokohama 236-0004, JapanInfection Prevention and Control Department, Yokohama City University Hospital, Yokohama 236-0004, JapanDepartment of Pharmacy, Yokohama City University Hospital, Yokohama 236-0004, JapanDivision of Pharmacodynamics, Keio University Faculty of Pharmacy, Tokyo 105-8512, JapanIntroduction: Micafungin is a recommended echinocandin antifungal agent for candidemia treatment and prophylaxis. However, overuse of echinocandin antifungals may cause resistance. There is currently no information available regarding the low susceptibility associated with using micafungin. This study investigated the effect of micafungin use on changes in the detected <i>Candida</i> species and low susceptibility. Methods: We conducted a retrospective survey and included records of <i>Candida</i> spp. detected in blood cultures from January 2010 to December 2018 in our hospital. Survey items included clinical outcomes at 30 days after positive cultures, patient characteristics, and drug prescription status. Patient background information included gender, previous hospitalization, stay in the intensive care unit, comorbidities, and history of surgery (within 90 days before candidemia onset) and drug exposure. Species detected and their minimum inhibitory concentrations (MICs) and amount of antifungal prescriptions by department were investigated. Risk factors for detecting <i>C. parapsilosis</i> and for low susceptibility to micafungin were evaluated using multivariate analysis. Results: A total of 153 <i>Candida</i> clinical blood isolates were collected and <i>C. albicans</i> was the most prevalent species, followed by <i>C. parapsilosis</i> and <i>C. glabrata</i>. In the analysis by department, antifungal use and non-<i>albicans Candida</i> species were most frequently detected in the hematology department. Multivariate analysis showed that prior micafungin use increased the risk of <i>C. parapsilosis</i> (odds ratio (OR) 4.22; 95% confidence interval (CI) 1.39–12.79; <i>p</i> = 0.011). MIC<sub>90</sub> of micafungin on <i>C. glabrata</i> and <i>C. parapsilosis</i> was 1.0 μg/mL. Prior micafungin use was clarified as a risk factor resulting in MIC > 0.06 μg/mL for micafungin in non-<i>parapsilosis Candida</i> species (OR 13.2; 95% CI 3.23–54.2; <i>p</i> < 0.01). Conclusion: Prior micafungin use increased the risk of <i>C. parapsilosis</i> and the MIC > 0.06 μg/mL of micafungin in non-<i>parapsilosis Candida</i> species. Since there are only a few antifungal options, further antifungal stewardship considering azole antifungal agents use is required.https://www.mdpi.com/2309-608X/7/8/596candidemiarisk factormicafungin<i>C. parapsilosis</i>non-<i>albicans Candida</i> speciesminimum inhibitory concentrations |
| spellingShingle | Yasutaka Sakamoto Kazuhiro Kawabe Tomoyo Suzuki Kayoko Sano Kazuo Ide Tetsuta Nishigaki Yuki Enoki Kazuaki Taguchi Hirofumi Koike Hideaki Kato Yukiko Sahashi Kazuaki Matsumoto Species Distribution of Candidemia and Their Susceptibility in a Single Japanese University Hospital: Prior Micafungin Use Affects the Appearance of <i>Candida parapsilosis</i> and Elevation of Micafungin MICs in Non-<i>parapsilosis Candida</i> Species Journal of Fungi candidemia risk factor micafungin <i>C. parapsilosis</i> non-<i>albicans Candida</i> species minimum inhibitory concentrations |
| title | Species Distribution of Candidemia and Their Susceptibility in a Single Japanese University Hospital: Prior Micafungin Use Affects the Appearance of <i>Candida parapsilosis</i> and Elevation of Micafungin MICs in Non-<i>parapsilosis Candida</i> Species |
| title_full | Species Distribution of Candidemia and Their Susceptibility in a Single Japanese University Hospital: Prior Micafungin Use Affects the Appearance of <i>Candida parapsilosis</i> and Elevation of Micafungin MICs in Non-<i>parapsilosis Candida</i> Species |
| title_fullStr | Species Distribution of Candidemia and Their Susceptibility in a Single Japanese University Hospital: Prior Micafungin Use Affects the Appearance of <i>Candida parapsilosis</i> and Elevation of Micafungin MICs in Non-<i>parapsilosis Candida</i> Species |
| title_full_unstemmed | Species Distribution of Candidemia and Their Susceptibility in a Single Japanese University Hospital: Prior Micafungin Use Affects the Appearance of <i>Candida parapsilosis</i> and Elevation of Micafungin MICs in Non-<i>parapsilosis Candida</i> Species |
| title_short | Species Distribution of Candidemia and Their Susceptibility in a Single Japanese University Hospital: Prior Micafungin Use Affects the Appearance of <i>Candida parapsilosis</i> and Elevation of Micafungin MICs in Non-<i>parapsilosis Candida</i> Species |
| title_sort | species distribution of candidemia and their susceptibility in a single japanese university hospital prior micafungin use affects the appearance of i candida parapsilosis i and elevation of micafungin mics in non i parapsilosis candida i species |
| topic | candidemia risk factor micafungin <i>C. parapsilosis</i> non-<i>albicans Candida</i> species minimum inhibitory concentrations |
| url | https://www.mdpi.com/2309-608X/7/8/596 |
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