Abstract
PurposeTo determine the burden of antifungal resistance in fungi over the last 10 years.MethodsPerformance of a semi-nationwide surveillance on antifungal resistance.ResultsWe observed a low frequency of azole resistance in Aspergillus fumigatus, a moderate increase of echinocandin resistance in yeasts, and a stable amphotericin B activity in yeasts and molds. Posaconazole resistance in Aspergillus terreus occurred in a few isolates.ConclusionThe burden of resistance in fungi seems to be low in Tyrol, Austria.
Highlights
MethodsInvasive fungal infections (IFI) are associated with a high rate of morbidity and mortality in at-risk patients [1]
In Austria, a continuous monitoring of antimicrobial resistance is required by law; the idea is to increase the awareness of health-care associated infections, to provide data which support national and international comparison, and at least to provide reference data
The absence of ECVs and clinical breakpoints (CBPs) for rare species such as Candida lusitaniae and C. guilliermondii does not support a categorization in wild types and non-wild types; an increase of isolates with high Minimal inhibitory concentration (MIC) over time was not recorded
Summary
Invasive fungal infections (IFI) are associated with a high rate of morbidity and mortality in at-risk patients [1]. In Austria, a continuous monitoring of antimicrobial resistance is required by law; the idea is to increase the awareness of health-care associated infections, to provide data which support national and international comparison, and at least to provide reference data. 2670 yeasts and 1565 molds were detected from routine sampling and were evaluated for their antifungal susceptibility. The Etest® (bioMérieux, Vienna, Austria) and the reference methods released by the European Committee of Antimicrobial Susceptibility Testing for yeasts and molds (EUCAST-AFST) [5, 6] were applied to evaluate the in vitro susceptibility against amphotericin B, anidulafungin, voriconazole, posaconazole, and isavuconazole; MIC results were read following 24 h of incubation, if not, otherwise, indicated. EUCAST antifungal clinical breakpoints (CBPs) and epidemiological cutoffs (ECVs) have been used to monitor the emergence of resistance; these values segregate wild-type. Resistance trends were calculated for species for which in vitro resistance increased > 0.5% within the last 10 years
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