Caspofungin-non-susceptible Candida isolates in cancer patients.

OBJECTIVES To identify the frequency of caspofungin-non-susceptible Candida isolates in cancer patients with candidiasis. METHODS We reviewed the in vitro susceptibilities (M27-A3 CLSI method) of 650 Candida spp. associated with invasive candidiasis episodes in 582 hospitalized cancer patients (2005-08). RESULTS AND CONCLUSIONS We identified seven caspofungin-non-susceptible Candida strains (three Candida tropicalis, two Candida glabrata and two Candida albicans) from 650 Candida isolates (1%). C. tropicalis (three out of seven) was the most common non-susceptible species isolated. All patients responded to a change of antifungal therapy. Further surveillance should focus on the potential broader emergence of echinocandin resistance, as the clinical use of this antifungal class continues to expand in cancer patients.