Kofteridis DP, Lewis RE, Kontoyiannis DP. J Antimicrob Chemother 2010;65:293–5.
Despite extensive use, resistance to echinocandins is still uncommon. This is a retrospective case series of seven patients with hematological malignancies and invasive candidiasis due to caspofungin-non-susceptible isolates. The minimum inhibitory concentrations to caspofungin of these isolates ranged 8–16 mg/L. Despite two unrelated deaths in this case series, all patients responded to a modification in their antifungal therapy.
Resistance to echinocandins among Candida spp. is rare. The cut-off point for considering a Candida spp. as being non-susceptible is a minimum inhibitory concentration (MIC) of >2 mg/L. The investigators report on the clinical characteristics and outcomes of cases of caspofungin-non-susceptible invasive candidiasis (IC) identified at the MD Anderson Cancer Center (Houston, TX, USA) between 2005 and 2008. De novo candidemia was defined as an infection occurring in the absence of systemic antifungal therapy, whereas breakthrough candidemia was defined as infection occurring in the setting of ≥7 days of empirical or prophylactic antifungal therapy.