Azoles and Echinocandins for Intra-Abdominal Candidiasis: More Resistance Than at First Glance?

Abdominal candidiasis is difficult to treat, and the abdominal cavity may serve as an occult reservoir for resistant yeasts. To determine the accuracy of antifungal resistance testing, researchers in Spain assessed the susceptibilities of 125 initial isolates (the first samples of each species obtained per patient) compared with 183 sequential isolates (obtained in subsequent samples) from 112 patients with abdominal candidiasis.

All 308 isolates included C. albicans (58.1%), C. glabrata (32.8%), C. tropicalis (5.5%), and C. parapsilosis (3.6%). Comparing all isolates with initial isolates only, resistance rates per patient were 13.4% vs. 8.0% (P=0.09) for fluconazole and 8.9% vs. 1.8% (P=0.01) for echinocandins. Antifungal resistance was pr…