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Development of echinocandin‐resistant C andida albicans candidemia following brief prophylactic exposure to micafungin therapy
Author(s) -
Ruggero M.A.,
Topal J.E.
Publication year - 2014
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12230
Subject(s) - micafungin , echinocandin , medicine , voriconazole , neutropenia , candida albicans , intensive care medicine , antifungal , empiric therapy , febrile neutropenia , echinocandins , fluconazole , caspofungin , microbiology and biotechnology , chemotherapy , dermatology , alternative medicine , pathology , biology
Empiric antifungal coverage is indicated in patients with graft‐versus‐host disease ( GVHD ) following a stem cell transplant ( SCT ) who are febrile and neutropenic for extended periods of time. Empiric antifungal coverage is indicated for patients with hematologic malignancies who have persistent fever and neutropenia as well as patients who have GVHD following SCT . Although the prophylactic use of antifungals is a cornerstone of the care for such patients, the selection of the particular antifungal is at the discretion of the clinician. We report a patient case whose surveillance blood cultures obtained 14 days after the switch from voriconazole to micafungin were positive for the growth of C andida albicans . Clinicians prescribing echinocandin therapy for antifungal prophylaxis must be aware of the risks of echinocandin resistance and possible breakthrough candidemia with C . albicans .