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Volume 14, Number 4—April 2008

Clonal Population of Flucytosine-Resistant Candida tropicalis from Blood Cultures, Paris, France

Marie Desnos-Ollivier*, Stéphane Bretagne*†, Claire Bernède*‡, Vincent Robert§, Dorothée Raoux*, Elisabeth Chachaty¶, Elisabeth Forget#, Claire Lacroix**, Françoise Dromer*Comments to Author , and the YEASTS group
Author affiliations: *Institut Pasteur, Paris, France; †Hôpital Henri Mondor–Assistance Publique Hôpitaux de Paris, Créteil, France; ‡Institut Pasteur Institut National de la Santé et de la Recherche Médicale Unité 657, Paris, France; §Centraal Bureau voor Schimmelcultures, Utrecht, the Netherlands; ¶Institut Gustave-Roussy, Villejuif, France; #Hôpital Beaujon, Clichy, France; **Hôpital Saint Louis, Paris, France;

Main Article


Distribution of 130 Candida tropicalis isolates recovered from blood cultures during the first 4 years of an active surveillance program (YEASTS study) on yeasts fungemia in the Paris area, France (October 2002 through September 2006), according to the MICs of flucytosine determined with the EUCAST microdilution method (4).

Figure. Distribution of 130 Candida tropicalis isolates recovered from blood cultures during the first 4 years of an active surveillance program (YEASTS study) on yeasts fungemia in the Paris area, France (October 2002 through September 2006), according to the MICs of flucytosine determined with the EUCAST microdilution method (4).

Main Article

  1. Odds  FC. Ecology of Candida and epidemiology of candidosis. Candida and candidosis: a review and bibliography. 2nd ed. London: Bailliere Tindall; 1988. pp. 68–82.
  2. Pfaller  MA, Diekema  DJ. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev. 2007;20:13363. DOIPubMedGoogle Scholar
  3. Pfaller  MA, Messer  SA, Boyken  L, Huynh  H, Hollis  RJ, Diekema  DJ. In vitro activities of 5-fluorocytosine against 8,803 clinical isolates of Candida spp.: global assessment of primary resistance using National Committee for Clinical Laboratory Standards susceptibility testing methods. Antimicrob Agents Chemother. 2002;46:351821. DOIPubMedGoogle Scholar
  4. Cuenca-Estrella  M, Moore  CB, Barchiesi  F, Bille  J, Chryssanthou  E, Denning  DW, Multicenter evaluation of the reproducibility of the proposed antifungal susceptibility testing method for fermentative yeasts of the Antifungal Susceptibility Testing Subcommittee of the European Committee on Antimicrobial Susceptibility Testing (AFST-EUCAST). Clin Microbiol Infect. 2003;9:46774. DOIPubMedGoogle Scholar
  5. de Hoog  GS, van den Ende  GAH. Molecular diagnostics of clinical strains of filamentous Basidiomycetes. Mycoses. 1998;41:1839.PubMedGoogle Scholar
  6. Masclaux  F, Gueho  E, de Hoog  GS, Christen  R. Phylogenetic relationships of human-pathogenic Cladosporium (Xylohypha) species inferred from partial LS rRNA sequences. J Med Vet Mycol. 1995;33:32738. DOIPubMedGoogle Scholar
  7. O’Donnell  K. Fusarium and its near relatives. Wallingford (UK): CAB International; 1993.
  8. Foulet  F, Nicolas  N, Eloy  O, Botterel  F, Gantier  JC, Costa  JM, Microsatellite marker analysis as a typing system for Candida glabrata. J Clin Microbiol. 2005;43:45749. DOIPubMedGoogle Scholar
  9. Tavanti  A, Davidson  AD, Johnson  EM, Maiden  MC, Shaw  DJ, Gow  NA, Multilocus sequence typing for differentiation of strains of Candida tropicalis. J Clin Microbiol. 2005;43:5593600. DOIPubMedGoogle Scholar
  10. Armitage  P, Berry  G. Statistical methods in medical research. 3rd ed. Oxford (UK): Blackwell Publishing; 1994.
  11. Hosmer  DW, Lemeshow  S. Applied logistic regression. 2nd ed. Toronto; John Wiley & Sons Ltd.; 2000.
  12. Cuenca-Estrella  M, Diaz-Guerra  TM, Mellado  E, Rodriguez-Tudela  JL. Flucytosine primary resistance in Candida species and Cryptococcus neoformans. Eur J Clin Microbiol Infect Dis. 2001;20:2769.PubMedGoogle Scholar
  13. Moore  CB, Walls  CM, Denning  DW. Comparison of three methods for in vitro susceptibility testing of Candida species with flucytosine. J Antimicrob Chemother. 2003;51:297304. DOIPubMedGoogle Scholar
  14. Alexander  BD, Byrne  TC, Smith  KL, Hanson  KE, Anstrom  KJ, Perfect  JR, Comparative evaluation of Etest and sensititre yeastone panels against the Clinical and Laboratory Standards Institute M27–A2 reference broth microdilution method for testing Candida susceptibility to seven antifungal agents. J Clin Microbiol. 2006;45:698706. DOIPubMedGoogle Scholar
  15. Quindos  G, Ruesga  MT, Martin-Mazuelos  E, Salesa  R, Alonso-Vargas  R, Carrillo-Munoz  AJ, In-vitro activity of 5-fluorocytosine against 1,021 Spanish clinical isolates of Candida and other medically important yeasts. Rev Iberoam Micol. 2004;21:639.PubMedGoogle Scholar
  16. Takakura  S, Fujihara  N, Saito  T, Kudo  T, Iinuma  Y, Ichiyama  S. National surveillance of species distribution in blood isolates of Candida species in Japan and their susceptibility to six antifungal agents including voriconazole and micafungin. J Antimicrob Chemother. 2004;53:2839. DOIPubMedGoogle Scholar
  17. Nerson  D, De Closets  F, Dupouy-Camet  J, Kures  L, Marjollet  M, Poirot  JL, Antifungal susceptibility of yeasts (and a few filamentous fungi) by a standardized micromethod [in French]. Bulletin de la Société Francaise de Mycologie Médicale. 1987;16:3958.
  18. Fleck  R, Dietz  A, Hof  H. In vitro susceptibility of Candida species to five antifungal agents in a German university hospital assessed by the reference broth microdilution method and Etest. J Antimicrob Chemother. 2007;59:76771. DOIPubMedGoogle Scholar
  19. Almirante  B, Rodriguez  D, Park  BJ, Cuenca-Estrella  M, Planes  AM, Almela  M, Epidemiology and predictors of mortality in cases of Candida bloodstream infection: results from population-based surveillance, Barcelona, Spain, from 2002 to 2003. J Clin Microbiol. 2005;43:182935. DOIPubMedGoogle Scholar
  20. Tortorano  AM, Peman  J, Bernhardt  H, Klingspor  L, Kibbler  CC, Faure  O, Epidemiology of candidaemia in Europe: results of 28-month European Confederation of Medical Mycology (ECMM) hospital-based surveillance study. Eur J Clin Microbiol Infect Dis. 2004;23:31722. DOIPubMedGoogle Scholar
  21. Fasoli  MO, Kerridge  D, Ryley  JF. Pathogenicity of 5-fluorocytosine resistant strains of Candida albicans. J Med Vet Mycol. 1990;28:2734. DOIPubMedGoogle Scholar
  22. Waldorf  AR, Polak  A. Mechanisms of action of 5-fluorocytosine. Antimicrob Agents Chemother. 1983;23:7985.PubMedGoogle Scholar
  23. Hope  WW, Tabernero  L, Denning  DW, Anderson  MJ. Molecular mechanisms of primary resistance to flucytosine in Candida albicans. Antimicrob Agents Chemother. 2004;48:437786. DOIPubMedGoogle Scholar
  24. Coste  A, Turner  V, Ischer  F, Morschhauser  J, Forche  A, Selmecki  A, A mutation in Tac1p, a transcription factor regulating CDR1 and CDR2, is coupled with loss of heterozygosity at chromosome 5 to mediate antifungal resistance in Candida albicans. Genetics. 2005;172:213956. DOIPubMedGoogle Scholar
  25. Baixench  MT, Aoun  N, Desnos-Ollivier  M, Garcia-Hermoso  D, Bretagne  S, Ramires  S, Acquired resistance to echinocandins in Candida albicans: case report and review. J Antimicrob Chemother. 2007;59:107683. DOIPubMedGoogle Scholar
  26. Vermes  A, Guchelaar  HJ, Dankert  J. Flucytosine: a review of its pharmacology, clinical indications, pharmacokinetics, toxicity and drug interactions. J Antimicrob Chemother. 2000;46:1719. DOIPubMedGoogle Scholar
  27. Papon  N, Noël  T, Florent  M, Gibot-Leclerc  S, Jean  D, Chastin  C, Molecular mechanism of flucytosine resistance in Candida lusitaniae: contribution of the FCY2, FCY1, and FUR1 genes to 5-fluorouracil and fluconazole cross-resistance. Antimicrob Agents Chemother. 2006;51:36971. DOIPubMedGoogle Scholar

Main Article

1The YEASTS group is composed of (in alphabetical order by city): Claire Bouges-Michel (Hôpital Avicenne, Bobigny), Isabelle Poilane (Hôpital Jean Verdier, Bondy), Marie-Elisabeth Bougnoux, Jean Dunand (Hôpital Ambroise Paré, Boulogne), Guy Galeazzi (Hôpital Louis Mourier, Colombes), Stéphane Bretagne, Françoise Botterel (Hôpital Henri Mondor, Créteil), Nathalie Fauchet (Centre Hospitalier Intercommunal de Créteil, Créteil), Elisabeth Forget (Hôpital Beaujon, Clichy), Françoise Botterel, Christine Bonnal (Hôpital du Kremlin Bicêtre), Odile Eloy (Hôpital Mignot, Le Chesnay), Christine Lawrence (Hôpital Raymond Poincaré, Garches), Marie-Françoise David, Liliana Mihaila (Hôpital Paul Brousse, Villejuif), Elisabeth Chachaty, Olivier Adam (Institut Gustave Roussy, Villejuif), and in Paris: Christian Chochillon (Hôpital Bichat), André Paugam, Marie-Thérèse Baixench (Hôpital Cochin), Muriel Cornet (Hôpital de l’Hôtel Dieu), Marie-Christine Escande (Institut Curie), Svetlana Challier, Marie-Elisabeth Bougnoux (Hôpital Necker), Eric Dannaoui (Hôpital Européen Georges Pompidou), Annick Datry, Houria Laklache, Bader Lmimouni, Sophie Brun (Hôpital de la Pitié-Salpétrière), Jean-Louis Poirot (Hôpital Saint Antoine), Claire Lacroix (Hôpital Saint Louis), Didier Moissenet (Hôpital Trousseau), Michel Develoux (Hôpital Tenon), and Stéphane Bonacorsi (Hôpital Robert Debré).

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