Prior Caspofungin Exposure in Patients with Hematological Malignancies Is a Risk Factor for Subsequent Fungemia Due to Decreased Susceptibility in Candida spp.: a Case-Control Study in Paris, France

• Published in: Antimicrobial Agents and Chemotherapy Vol. 55; no. 11; pp. 5358 - 5361
• Main Authors: Blanchard, Elodie, Lortholary, Olivier, Boukris-Sitbon, Karine, Desnos-Ollivier, Marie, Dromer, Françoise, Guillemot, Didier
• Format: Journal Article
• Language: English
• Published: Washington, DC American Society for Microbiology 01.11.2011
• Subjects: adults; Aged; antibiotic resistance; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal Agents; Antifungal Agents - therapeutic use; Biological and medical sciences; blood flow; Candida; Candida - drug effects; Candida - pathogenicity; Case-Control Studies; Clinical Therapeutics; confidence interval; Drug Resistance, Fungal; Echinocandins; Echinocandins - therapeutic use; Female; France; Fungemia; Fungemia - drug therapy; Hematologic Neoplasms; Hematologic Neoplasms - drug therapy; Hematologic Neoplasms - microbiology; Human mycoses; Humans; Infectious diseases; Life Sciences; Lipopeptides; Male; Medical sciences; Microbiology and Parasitology; Middle Aged; multivariate analysis; Mycology; Mycoses; Mycotic sepsis; odds ratio; patients; Pharmacology. Drug treatments; Risk Factors; therapeutics; France; Europe; Paris; Ile-de-France; Human; Candidiasis; Yeast; Mycosis; Drug susceptibility test; Patient; Exposure; Malignant hemopathy; Case control study; Epidemiology; Echinocandine derivatives; Fungi; Infection; Antifungal agent; Fungemia; Candida; Caspofungin; Risk factor; Fungi Imperfecti; Cancer
• ISSN: 0066-4804; 1098-6596
• DOI: 10.1128/AAC.00690-11

Infections due to caspofungin-resistant Candida isolates in patients exposed to caspofungin therapy are increasing. We report here a nested case-control study which aimed at identifying factors associated with bloodstream infections caused by Candida spp. having reduced susceptibility to caspofungin (CRSC) in adults suffering from hematological malignancies. In univariate and multivariate analyses, infections with CRSC were associated with caspofungin exposure in the previous 30 days (odds ratio [OR] = 5.25; 95% confidence interval [95% CI], 1.68–16.35) and with an age of ≤65 years (OR = 3.27; 95% CI, 1.26–8.50).