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

Antimicrob Agents Chemother. 2011 Nov;55(11):5358-61. doi: 10.1128/AAC.00690-11. Epub 2011 Aug 22.

Abstract

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).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use*
  • Candida / drug effects*
  • Candida / pathogenicity*
  • Case-Control Studies
  • Caspofungin
  • Drug Resistance, Fungal
  • Echinocandins / therapeutic use*
  • Female
  • France
  • Fungemia / drug therapy*
  • Hematologic Neoplasms / drug therapy*
  • Hematologic Neoplasms / microbiology
  • Humans
  • Lipopeptides
  • Male
  • Middle Aged
  • Risk Factors

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Caspofungin