Caspofungin resistance in Candida albicans: correlating clinical outcome with laboratory susceptibility testing of three isogenic isolates serially obtained from a patient with progressive Candida esophagitis

Antimicrob Agents Chemother. 2004 Apr;48(4):1382-3. doi: 10.1128/AAC.48.4.1382-1383.2004.

Abstract

A patient with azole-refractory thrush-esophagitis responded initially to caspofungin, but the treatment eventually failed. In a murine model, caspofungin was effective against two early isolates for which the MICs of caspofungin were low, but it was less effective against a late isolate for which the MIC of caspofungin was greater. We concluded that there is a correlation between in vivo failure and rising in vitro caspofungin MICs.

Publication types

  • Case Reports

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications
  • Adult
  • Animals
  • Antifungal Agents / pharmacology*
  • Antifungal Agents / therapeutic use*
  • Candida albicans / drug effects*
  • Candidiasis / drug therapy*
  • Candidiasis / microbiology
  • Caspofungin
  • Drug Resistance, Fungal
  • Echinocandins
  • Esophagitis / drug therapy*
  • Esophagitis / microbiology
  • Humans
  • Lipopeptides
  • Male
  • Mice
  • Mice, Inbred ICR
  • Microbial Sensitivity Tests
  • Peptides / pharmacology*
  • Peptides / therapeutic use*
  • Peptides, Cyclic*
  • Treatment Failure

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Peptides
  • Peptides, Cyclic
  • Caspofungin