Abstract 4753
Background
Invasive candidiasis is a serious nosocomial infection developing generally in patients at risk; it is characterized by a severe clinical course and high (10-49%) additive mortality. It develops predominantly in immunocompromised, especially cancer, patients and patients in intensive care units. The purpose of the study was to analyze the etiology of invasive candidiasis and in vitro activity of caspofungin and azoles for isolates of Candida fungi.
Methods
Isolates were obtained in hospital departments in Rostov-on-Don and Rostov region in 2013-2016. Candida fungi were identified using MALDI-TOF MS; interpretation was performed according to CLSI 2012, M27-S4 criteria. Sensitivity testing was performed using the Sensititre system (Trek Diagnostic Systems, England).
Results
92 Candida isolates were obtained from blood culture: C. albicans - 31.5% (29) and non-albicans - 68.5% (63), including C. tropicalis 30.2% (19), C. parapsilosis 28.6% (18), C. glabrata 19.0% (12), C. krusei 15.9% (10) and C. guilliermondii 6.3% (4). Fungal-bacterial associations were found in 5 cases; such combinations worsened the patient’s condition and complicated the treatment. The table demonstrates comparative activities of caspofungin, fluconasole and voriconasole (susceptible – S, intermediate – I, resistant – R) in % to Candida spp.Table: 1785P
Species | n | Caspofungin S/ I/ R (%) | Fluconazole S/ I/ R (%) | Voriconazole S/ I/ R (%) |
---|---|---|---|---|
C. albicans | 29 | 100/ 0/ 0 | 82/ 3/ 15 | 90/ 6/ 4 |
C. parapsilosis | 18 | 98/ 0/ 2 | 82/ 4/ 14 | 88/ 11/ 1 |
C. tropicalis | 19 | 100/ 0/ 0 | 90/ 5/ 5 | 100/ 0/ 0 |
C. glabrata | 12 | 95/ 5/ 0 | 86/ 9/ 5 | N/A |
C. krusei | 10 | 83/ 4/ 13 | N/A | 100/ 0/ 0 |
Conclusions
Candida non albicans prevailed among invasive candidiasis pathogens (68.5%), which could be associated with the use of azole antifungal agents for the prophylaxis and empirical therapy. Dominating isolates showed decreased activity to caspofungin and azoles. Acquired resistance to azoles was noted for C. parapsilosis and C. albicans. Special attention should be paid to C. glabrata characterized by high lethality and high resistance rates. The results demonstrate the advisability of microbiological monitoring of invasive candidiasis pathogens.
Clinical trial identification
Legal entity responsible for the study
Ministry of Health of the Russian Federation.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4742 - Ki67 as an important predictor for Oncotype Dx Recurrence score risk groups in Early Breast cancer
Presenter: Fernando Namuche
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
4697 - Genetic signatures always suggest undertreatment? Experience with PAM51
Presenter: Carolina Sales
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3158 - Significance of receptors expression, mitotic index and Ki67 in breast cancer patients with Nottingham Prognostic Index (NPI) poor prognosis score
Presenter: Mejri Nesrine
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3838 - Subgroup analyses of efficacy from a phase III study comparing SB3 (trastuzumab biosimilar) with reference trastuzumab in early breast cancer patients
Presenter: Javier Cortes Castan
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
715 - Autoimmunity and benefit from trastuzumab treatment in breast cancer: results from the HERA phase 3 trial
Presenter: Amir Sonnenblick
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
2388 - Impact of hormone receptor status in HER2+ early breast cancer: a paradigm shift in the trastuzumab era
Presenter: Alexandre De Nonneville
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3742 - Sefety profile of subcutaneous trastuzumab in patients with HER2-positive early breast cancer: The french HERMIONE non-interventional prospective study
Presenter: jean-philippe Jacquin
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3647 - Real-life data on the cardiac toxicity of adjuvant fixed-dose subcutaneous trastuzumab in HER2-positive breast cancer.
Presenter: Rita De Sanctis
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3837 - Comprehensive evaluation of the pharmacokinetic profiles of SB3 and reference trastuzumab
Presenter: Xavier Pivot
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
1692 - The impact of neoadjuvant dual HER2 targeting with Pertuzumab and Trastuzumab on pathological complete response (pCR) rates: Kent Oncology Centre (KOC) experience
Presenter: Samantha Forner
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract