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Enferm Infecc Microbiol Clin ; 22(6): 328-31, 2004.
Article in Spanish | MEDLINE | ID: mdl-15228899

ABSTRACT

INTRODUCTION: Antifungal therapy for mucosal candidiasis caused by fluconazole-resistant Candida species is problematic. The aim of this study was to investigate the in vitro activity of caspofungin against Candida strains with reduced susceptibility to fluconazole isolated from HIV-infected patients. METHODS: The in vitro activity of caspofungin was assessed in 28 fluconazole-resistant Candida isolates obtained from the oral cavity of a cohort of 174 consecutive HIV-infected patients. Minimum inhibitory concentrations (MICs) were determined by a standardized broth microdilution method, as recommended by the NCCLS. RESULTS: Overall, caspofungin MICs ranged from < or = 0.06 microg/ml to 1 microg/ml. MICs at which 50% (MIC50) and 90% (MIC90) of isolates were inhibited were 0.25 microg/ml and 0.5 microg/ml, respectively. MICs ranged from < or = 0.06 microg/ml to 0.5 microg/ml for Candida albicans (n = 11), and < 0.06 microg/ml to 1 microg/ml or Candida glabrata (n = 11). MICs for the two strains of Candida krusei were 0.125 microg/ml and 1 microg/ml. The range of MICs for Candida tropicalis and Candida inconspicua strains was 0.25 microg/ml to 0.5 microg/ml. CONCLUSION: Caspofungin was very active in vitro against a variety of fluconazole-resistant Candida strains recovered from a clinical cohort of HIV-infected patients. The MIC50 values and MIC ranges were slightly higher for Candida glabrata than for Candida albicans.


Subject(s)
Candida/drug effects , Candidiasis, Oral/microbiology , Fluconazole/pharmacology , HIV Infections/complications , Peptides, Cyclic , Peptides/pharmacology , Candida albicans/drug effects , Candida glabrata/drug effects , Candida tropicalis/drug effects , Candidiasis, Oral/complications , Caspofungin , Cohort Studies , Cross-Sectional Studies , Drug Resistance, Fungal , Echinocandins , Humans , Lipopeptides , Microbial Sensitivity Tests , Species Specificity
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