Candida Bloodstream Infections in Italy: Changing Epidemiology during 16 Years of Surveillance
Table 1
Species-specific breakpoints for antifungal agents for the most common species of Candida isolates.
Species
Antifungal agent
MIC (µg/mL)
S
SDD
I
R
C. albicans
Amphotericin B
<1
≥1
Fluconazole
≤2
4
≥8
Voriconazole
≤0.12
0.25–0.5
≥1
Posaconazole
≤0.12
0.25–0.5
≥1
Anidulafungin
≤0.25
0.5
≥1
Caspofungin
≤0.25
0.5
≥1
Micafungin
≤0.25
0.5
≥1
C. parapsilosis
Amphotericin B
<1
≥1
Fluconazole
≤2
4
≥8
Voriconazole
≤0.12
0.25–0.5
≥1
Posaconazole
≤0.12
0.25–0.5
≥1
Anidulafungin
≤2
4
≥8
Caspofungin
≤2
4
≥8
Micafungin
≤2
4
≥8
C. glabrata
Amphotericin B
<1
≥1
Fluconazole
≤32
≥64
Voriconazole
≥1
Posaconazole
≥1
Anidulafungin
≤0.12
0.25
≥0.5
Caspofungin
≤0.12
0.25
≥0.5
Micafungin
≤0.06
0.12
≥0.25
C. guilliermondii
Amphotericin B
<1
≥1
Fluconazole
Voriconazole
Posaconazole
Anidulafungin
≤2
4
≥8
Caspofungin
≤2
4
≥8
Micafungin
≤2
4
≥8
C. tropicalis
Amphotericin B
<1
≥1
Fluconazole
≤2
4
≥8
Voriconazole
≤0.12
0.25–0.5
≥1
Posaconazole
≤0.12
0.25–0.5
≥1
Anidulafungin
≤0.25
0.5
≥1
Caspofungin
≤0.25
0.5
≥1
Micafungin
≤0.25
0.5
≥1
C. krusei
Amphotericin B
<1
≥1
Fluconazole
—
—
—
Voriconazole
≤0.5
1
≥2
Posaconazole
≤0.5
1
≥2
Anidulafungin
≤0.25
0.5
≥1
Caspofungin
≤0.25
0.5
≥1
Micafungin
≤0.25
0.5
≥1
Data compiled from [9–12]. S, susceptible; SDD, susceptible-dose-dependent; I, intermediate; R, resistant. All C. krusei isolates were considered intrinsically resistant to fluconazole [9].
