Comparison of simulated candidemia detection during prophylactic antifungal therapy

Diagn Microbiol Infect Dis. 2022 Oct;104(2):115768. doi: 10.1016/j.diagmicrobio.2022.115768. Epub 2022 Jul 16.

Abstract

Background: We investigated the neutralization performance of various automated blood culture systems for antifungal agents with regard to the most commonly isolated Candida species.

Methods: In this study, we evaluated the time to detection (TTD) of simulated candidemia for 6 Candida spp. (C. albicans, C. auris, C. glabrata, C. krusei, C. parapsilosis, and C. tropicalis) in 3 automated blood culture systems (BACTEC™ FX, BACT/ALERT® 3D, and BACT/ALERT® VIRTUO®), with or without trough and peak levels of eight antifungal agents (amphotericin B, anidulafungin, caspofungin, fluconazole, itraconazole, micafungin, posaconazole, and voriconazole).

Results: Caspofungin and micafungin significantly prolonged the TTDs for most of the tested strains in the 3 blood culture instruments, especially at peak concentrations.

Conclusion: Peak concentrations of caspofungin and micafungin influence the performance of blood culture detection systems. Therefore, one should be careful about the possibility of prolonged TTDs for candidemia when using the abovementioned antifungal agents.

Keywords: Candida; antifungal therapy; candidemia; evaluation; prophylaxis.

MeSH terms

  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Candida
  • Candida albicans
  • Candida glabrata
  • Candida parapsilosis
  • Candida tropicalis
  • Candidemia* / diagnosis
  • Candidemia* / drug therapy
  • Candidemia* / prevention & control
  • Caspofungin
  • Fluconazole
  • Humans
  • Micafungin
  • Microbial Sensitivity Tests

Substances

  • Antifungal Agents
  • Fluconazole
  • Caspofungin
  • Micafungin