Progress in antifungal susceptibility testing of Candida spp. by use of Clinical and Laboratory Standards Institute broth microdilution methods, 2010 to 2012

Journal of Clinical Microbiology

Volumn 50, Issue 9, 2012, Pages 2846-2856

  Pfaller, M A ^a,b   Diekema, D J ^b  

^a JMI LABORATORIES   (United States)

^b UNIVERSITY OF IOWA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AMPHOTERICIN B; ANIDULAFUNGIN; CASPOFUNGIN; FLUCONAZOLE; FLUCYTOSINE; ITRACONAZOLE; MICAFUNGIN; POSACONAZOLE; STEROL 14ALPHA DEMETHYLASE; VORICONAZOLE;

ANTIFUNGAL RESISTANCE; ANTIFUNGAL SUSCEPTIBILITY; BROTH DILUTION; CANDIDA; CANDIDA ALBICANS; CANDIDA DUBLINIENSIS; CANDIDA GLABRATA; CANDIDA KRUSEI; CANDIDA ORTHOPSILOSIS; CANDIDA PARAPSILOSIS; CANDIDA TROPICALIS; CANDIDIASIS; CLAVISPORA LUSITANIAE; DRUG BLOOD LEVEL; FUNGAL STRAIN; HUMAN; KLUYVEROMYCES MARXIANUS; MOLECULAR EPIDEMIOLOGY; NONHUMAN; OROPHARYNX CANDIDIASIS; OUTCOME ASSESSMENT; PICHIA ANOMALA; PICHIA GUILLIERMONDII; PRIORITY JOURNAL; PROPHYLAXIS; SHORT SURVEY; SPECIES DIFFERENTIATION; VALIDATION PROCESS;

ANTIFUNGAL AGENTS; CANDIDA; CANDIDIASIS; HUMANS; MICROBIAL SENSITIVITY TESTS;

EID: 84865165327     PISSN: 00951137     EISSN: 1098660X     Source Type: Journal    
DOI: 10.1128/JCM.00937-12     Document Type: Short Survey

References (99)

1. Alexander BD, et al. 2005. Candida glabrata fungemia in transplant patients receiving voriconazole after fluconazole. Transplantation 80: 868-871. doi:10.1097/01.tp.0000173771.47698.7b. (Pubitemid 41443773)
2. Arendrup MC, Denning DW. 2007. Does one voriconazole breakpoint suit all Candida species? J. Clin. Microbiol. 45:2093-2094.
3. Arendrup MC, Kahlmeter G, Rodriguez-Tudela JL, Donnelly JP. 2009. Breakpoints for susceptibility testing should not divide wild-type distribution of important target species. Antimirob. Agents Chemother. 53: 1628-1629. doi:10.1128/AAC.01624-08.
4. Arendrup MC, et al. 2010. Echinocandin susceptibility testing of Candida spp.: comparison of EUCAST EDef 7.1, CLSI M27-A3, Etest, disk diffusion, and agar dilution methods with RPMI and isosensitest media. Antimicrob. Agents Chemother. 54:426-439. doi:10.1128/AAC.01256-09.
5. Arendrup MC, et al. 2011. Diagnostic issues, clinical characteristics, and outcomes for patients with fungemia. J. Clin. Microbiol. 49:3300-3308.
6. Armstrong-James D. 2007. Invasive Candida species infection: the importence of adequate empirical antifungal therapy. J. Antimicrob. Chemother. 60:459-460. (Pubitemid 47299857)
7. Arthington-Skaggs BA, et al. 2002. Comparison of visual and spectrophotometric methods of broth microdilution MIC endpoint determination and evaluation of a sterol quantitative method for in vitro susceptibility testing of fluconazole and itraconazole against trailing and nontrailing Candida isolates. Antimicrob. Agents Chemother. 46:2477-2481. doi:10.1128/AAC.46.8.2477- 2481.2002. (Pubitemid 34793452)
8. Baddley JW, et al. 2004. Utility of real-time antifungal susceptibility testing for fluconazole in the treatment of candidemia. Diagn. Microbiol. Infect. Dis. 50:119-124. (Pubitemid 39335847)
9. Baddley JW, et al. 2008. Association of fluconazole pharmacodynamics with mortality in patients with candidemia. Antimicrob. Agents Chemother. 52:3022-3028. doi:10.1128/AAC.00116-08.
10. British Society for Mycopathology. 1984. Laboratory methods for flucytosine (5-fluorocytosine). Report of a Working Group of the British Society for Mycopathology. J. Antimicrob. Chemother. 14:1-8.
11. Chau AG, et al. 2004. Application of real-time quantitative PCR to molecular analysis of Candida albicans strains exhibiting reduced susceptibility to azoles. Antimicrob. Agents Chemother. 48:2124-2131. doi:10.1128/AAC.48.6. 2124-2131.2004.
12. Chen SCA, et al. 2010. Antifungal therapy in invasive fungal infections. Curr. Opin. Pharmacol. 10:522-530.
13. CLSI. 2008. Reference method for broth dilution antifungal susceptibility testing of yeasts, 3rd ed. M27-A3. Clinical and Laboratory Standards Institute, Wayne, PA.
14. CLSI. 2008. Reference method for broth dilution antifungal susceptibility testing of yeasts, 3rd informational supplement. M27-S3. Clinical and Laboratory Standards Institute, Wayne, PA.
15. Collins CD, et al. 2007. To test or not to test: a cost minimization analysis of susceptibility testing for patients with documented Candida glabrata fungemias. J. Clin. Microbiol. 45:1884-1888. (Pubitemid 46933921)
16. Cuenca-Estrella M, Rodriguez-Tudela JL. 2010. The current role of the reference procedures by CLSI and EUCAST in the detection of resistance to antifungal agents in vitro Expert Rev. Anti Infect. Ther. 8:267-276.
17. Diekema DJ, Pfaller MA. 2012. Utility of antifungal susceptibility testing and clinical correlations, p 131. In Hall GS (ed), Interactions of yeasts, moulds, and antifungal agents: how to detect resistance. Springer, New York, NY.
18. Dodgson AR, et al. 2004. Clade-specific flucytosine resistance is due to a single nucleotide change in the FUR1 gene of Candida albicans Antimicrob. Agents Chemother. 48:2223-2227. doi:10.1128/AAC.48.6.2223-2227.2004. (Pubitemid 38691622)
19. Edlind TD, Katiyar SK. 2010. Mutational analysis of flucytosine resistance in Candida glabrata Antimicrob. Agents Chemother. 54:4733-4738. doi:10.1128/AAC.00605-10.
20. Espinel-Ingroff A, et al. 2005. International and multicenter comparison of EUCAST and CLSI M27-A2 broth microdilution methods for testing susceptibilities of Candida spp. to fluconazole, itraconazole, posaconazole, and voriconazole. J. Clin. Microbiol. 43:3884-3889. (Pubitemid 41129676)
21. Espinel-Ingroff A, et al. 2005. Comparison of visual 24-hour and spectrophotometric 48-hour MICs to CLSI reference microdilution MICs of fluconazole, itraconazole, posaconazole, and voriconazole for Candida spp.: a collaborative study. J. Clin. Microbiol. 43:4535-4540. (Pubitemid 41298239)
22. Espinel-Ingroff A, et al. 2009. Comparison of 24-hour and 48-hour voriconazole MICs as determined by the Clinical and Laboratory Standards Institute broth microdilution method (M27-A3 document) in three laboratories: results obtained with 2,162 clinical isolates of Candida spp. and other yeasts. J. Clin. Microbiol. 47:2766-2771.
23. European Committee on Antimicrobial Susceptibility Testing Subcommittee on Antifungal Susceptibility Testing (EUCAST-AFST). 2008. EUCAST technical note on fluconazole. Clin. Microbiol. Infect. 14:193-195.
24. European Committee on Antimicrobial Susceptibility Testing Subcommittee on Antifungal Susceptibility Testing (EUCAST-AFST). 2008. EUCAST technical note on voriconazole. Clin. Microbiol. Infect. 14:985-987.
25. Florent M, et al. 2009. Nonsense and missense mutations in FCY2 and FCY1 genes are responsible for flucytosine resistance and flucytosinefluconazole cross-resistance in clinical isolates of Candida lusitaniae Antimicrob. Agents Chemother. 53:2982-2990. doi:10.1128/AAC.00880-08.
26. Forrest G. 2006. Role of antifungal susceptibility testing in patient management. Curr. Opin. Infect. Dis. 19:538-543. (Pubitemid 44665459)
27. Garcia-Effron G, et al. 2008. A naturally occurring Fks1p proline to alanine amino acid change in Candida parapsilosis, Candida orthopsilosis, and Candida metapsilosis accounts for reduced echinocandin susceptibility. Antimicrob. Agents Chemother. 52:2305-2312. doi:10.1128/AAC.00262-08. (Pubitemid 351915657)
28. Garcia-Effron G, et al. 2009. Correlating echinocandin MIC and kinetic inhibition of fks 1 mutant glucan synthase for Candida albicans: implications for interpretive breakpoints. Antimicrob. Agents Chemother. 53:112-122. doi:10.1128/AAC.01162-08.
29. Garcia-Effron G, et al. 2009. Effect of Candida glabrata FKS1 and FKS2 mutations on echinocandin sensitivity and kinetics of 1,3-β-D-glucan synthase: implication for existing susceptibility breakpoint. Antimicrob. Agents Chemother. 53:3690-3699. doi:10.1128/AAC.00443-09.
30. Garey KW, et al. 2006. Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin. Infect. Dis. 43:25-31. (Pubitemid 43939072)
31. Ghannoum MA, Rice LB. 1999. Antifungal agents: mode of action, mechanisms of resistance, and correlation of these mechanisms with bacterial resistance. Clin. Microbiol. Rev. 12:501-517. (Pubitemid 29484744)
32. Grim SA, et al. 2012. Timing of susceptibility-based antifungal drug administration in patients with Candida bloodstream infection: correlation with outcomes. J. Antimicrob. Chemother. 67:707-714.
33. Hadley S, et al. 2002. Real-time antifungal susceptibility screening aids management of invasive yeast infections in immunocompromised patients. J. Antimicrob. Chemother. 49:415-419. (Pubitemid 34162641)
34. Hope WW, et al. 2004. Molecular mechanisms of primary resistance to flucytosine in Candida albicans Antimicrob. Agents Chemother. 48:4377-4386. (Pubitemid 39434901)
35. Johnson EM. 2008. Issues in antifungal susceptibility testing. J. Antimicrob. Chemother. 61(Suppl. 1):i13-i18.
36. Kahlmeter G, et al. 2003. European harmonization of MIC breakpoints for antimicrobial susceptibility testing of bacteria. J. Antimicrob. Chemother. 52:145-148. (Pubitemid 36986868)
37. Karthaus M, et al. 2011. Current issues in the clinical management of invasive candida infections-the AGIHO, DMykG, ÖGMM and PEG web-based survey and expert consensus conference 2009. Mycoses 54:e546-e556. doi:10.1111/j.1439-0507.2010.01988.x.
38. Law D, et al. 1997. Amphotericin B resistance testing of Candida spp.: a comparison of methods. J. Antimicrob. Chemother. 40:109-112. (Pubitemid 27341641)
39. Lockhart SR, et al. 2011. Validation of 24-hour flucytosine MIC determination by comparison with 48-hour determination by the Clinical and Laboratory Standards Institute M27-A3 broth microdilution reference method. J. Clin. Microbiol. 49:4322-4325.
40. Lopez-Ribot JL, et al. 1998. Distinct patterns of gene expression associated with development of fluconazole resistance in serial Candida albicans isolates from human immunodeficiency virus-infected patients with oropharyngeal candidiasis. Antimicrob. Agents Chemother. 42:2932-2937. (Pubitemid 28501228)
41. MacCallum DM, et al. 2010. Genetic dissection of azole resistance mechanisms in Candida albicans and their validation in a mouse model of disseminated infection. Antimicrob. Agents Chemother. 54:1476-1483. doi:10.1128/AAC.01645-09.
42. Magill SS, et al. 2006. Triazole cross-resistance among Candida spp.: case report, occurrence among bloodstream isolates, and implications for antifungal therapy. J. Clin. Microbiol. 44:529-535. (Pubitemid 43222248)
43. Marr KA, et al. 1997. Development of fluconazole resistance in Candida albicans causing disseminated infection in a patient undergoing marrow transplantation. Clin. Infect. Dis. 25:908-910. (Pubitemid 27443861)
44. Marr KA, et al. 1998. Rapid transient fluconazole resistance in Candida albicans is associated with increased mRNA level of CDR. Antimicrob. Agents Chemother. 42:2584-2589. (Pubitemid 28462897)
45. McManus BA, et al. 2009. A Sec 29 Leu substitution in the cytosine deaminase Fca 1p is responsible for clade-specific flucytosine resistance in Candida dubliniensis Antimicrob. Agents Chemother. 53:4678-4685. doi:10.1128/AAC.00607-09.
46. Mora-Duarte J, et al. 2002. Comparison of caspofungin and amphotericin B for invasive candidiasis. N. Engl. J. Med. 347:2020-2029. (Pubitemid 35461658)
47. Mori T, et al. 1997. Myelofibrosis complicated by infection due to Candida albicans: emergence of resistance to antifungal agents during therapy. Clin. Infect. Dis. 25:1470-1471. (Pubitemid 28022691)
48. Morrell M, et al. 2005. Delaying empiric treatment of Candida blood-stream infection until positive blood culture results are obtained: a potential risk factor for mortality. Antimicrob. Agents Chemother. 49:3640-3645. doi:10.1128/AAC.49.9.3640-3645.2005. (Pubitemid 41233011)
49. Nolte FS, et al. 1997. Isolation and characterization of fluconazole- and amphotericin B-resistant Candida albicans from blood of two patients with leukemia. Antimicrob. Agents Chemother. 41:196-199. (Pubitemid 26428157)
50. Ostrosky-Zeichner L, et al. 2008. Rationale for reading fluconazole MICs at 24 hours rather than 48 hours when testing Candida spp. by the CLSI M27-A2 standard method. Antimicrob. Agents Chemother. 52:4175-4177. doi:10.1128/AAC.00420-08.
51. Pakyz AL, et al. 2011. Antifungal use in hospitalized adults in U.S. academic health centers. Am. J. Health-Syst. Pharm. 68:415-418.
52. Pappas PG, et al. 2009. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin. Infect. Dis. 48:503-535.
53. Park BJ, et al. 2006. Evaluation of amphotericin B interpretive break-points for Candida bloodstream isolates by correlation with therapeutic outcome. Antimicrob. Agents Chemother. 50:1287-1292. doi:10.1128/AAC.50.4.1287- 1292.2006.
54. Parkins MD, et al. 2007. Adequacy of empirical antifungal therapy and effect on outcome among patients with invasive Candida species infections. J. Antimicrob. Chemother. 60:613-618. (Pubitemid 47299877)
55. Perkhofer S, et al. 2010. In vitro susceptibility testing in fungi: what is its role in clinical practice? Curr. Infect. Dis. Rep. 12:401-408.
56. Perlin DS. 2011. Echinocandin-resistant Candida: molecular methods and phenotypes. Curr. Fungal Infect. Rep. 5:113-119.
57. Pfaller MA. 2012. Antifungal drug resistance: mechanisms, epidemiology, and consequences for treatment. Am. J. Med. 125:S3-S13. doi:10.1016/j.amjmed. 2011.11.001.
58. Pfaller MA, et al. 2006. Interpretive breakpoints for fluconazole and Candida revisited: a blueprint for the future of antifungal susceptibility testing. Clin. Microbiol. Rev. 19:435-447.
59. Pfaller MA, et al. 2006. Correlation of MIC with outcome for Candida species tested against voriconazole: analysis and proposal for interpretive breakpoints. J. Clin. Microbiol. 44:819-826.
60. Pfaller MA, Diekema DJ. 2007. Azole antifungal drug cross-resistance: mechanisms, epidemiology, and clinical significance. J. Invasive Fungal Infect. 1:74-92.
61. Pfaller MA, et al. 2008. Validation of 24-hour fluconazole MIC readings versus the CLSI 48-hour broth microdilution reference method: results from a global Candida antifungal surveillance program. J. Clin. Microbiol. 46:3585-3590.
62. Pfaller MA, et al. 2008. Correlation of MIC with outcome for Candida species tested against caspofungin, anidulafungin, and micafungin: analysis and proposal for interpretive MIC breakpoints. J. Clin. Microbiol. 46:2620-2629.
63. Pfaller MA, Diekema DJ. 2010. Wild-type MIC distributions and epidemiologic cutoff values for fluconazole and Candida: time for new clinical breakpoints? Curr. Fungal Infect. Rep. 4:168-174.
64. Pfaller MA, Diekema DJ. 2010. Epidemiology of invasive mycoses in North America. Crit. Rev. Microbiol. 36:1-53.
65. Pfaller MA, et al. 2010. Wild-type MIC distributions, epidemiological cutoff values and species-specific clinical breakpoints for fluconazole and Candida: time for harmonization of CLSI and EUCAST broth microdilution methods. Drug Resist. Updat. 13:180-195.
66. Pfaller MA, et al. 2010. Comparison of EUCAST and Etest methods with the CLSI broth microdilution method for echinocandin susceptibility testing of Candida species. J. Clin. Microbiol. 48:1592-1599.
67. Pfaller MA, et al. 2010. Wild-type MIC distributions and epidemiological cutoff values for the echinocandins and Candida spp. J. Clin. Microbiol. 48:52-58.
68. Pfaller MA, et al. 2010. Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-year analysis of susceptibilities of Candida species to fluconazole and voriconazole determined by CLSI standardized disk diffusion. J. Clin. Microbiol. 48:1366-1377.
69. Pfaller MA, et al. 2011. Clinical breakpoints for voriconazole and Candida spp. revisited: review of microbiologic, molecular, pharmacodynamic, and clinical data as they pertain to the development of species-specific interpretive criteria. Diagn. Microbiol. Infect. Dis. 70:330-343.
70. Pfaller MA, et al. 2011. Clinical breakpoints for the echinocandins and Candida revisited: integration of molecular, clinical, and microbiological data to arrive at species-specific interpretive criteria. Drug Resist. Updat. 14:164-176.
71. Pfaller MA, et al. 2011. Comparison of the broth microdilution (BMD) method of the European Committee on Antimicrobial Susceptibility Testing with the 24-hour CLSI BMD method for testing susceptibility of Candida species to fluconazole, posaconazole, and voriconazole by use of epidemiological cutoff values. J. Clin. Microbiol. 49:845-850.
72. Pfaller MA, et al. 2011. Validation of 24-hour posaconazole and voriconazole MIC readings versus the CLSI 48-hour broth microdilution reference method: application of epidemiological cutoff values to results from a global Candida antifungal surveillance program. J. Clin. Microbiol. 49:1274-1279.
73. Pfaller MA, et al. 2011. Wild-type MIC distributions and epidemiological cutoff values for posaconazole and voriconazole and Candida spp. as determined by 24-hour CLSI broth microdilution. J. Clin. Microbiol. 49:630-637.
74. Pfaller MA, et al. 2011. Triazole and echinocandin MIC distributions with epidemiological cutoff values for differentiation of wild-type strains from non-wild-type strains of six uncommon species of Candida J. Clin. Microbiol. 49:3800-3804.
75. Pfaller MA, Diekema DJ. 2012. The epidemiology of invasive candidiasis, p 449-480. In Calderone RA, Clancy CJ (ed), Candida and candidiasis, 2nd ed. ASM Press, Washington, DC.
76. Pfaller MA, et al. 2012. Wild-type MIC distributions and epidemiological cutoff values for amphotericin B, flucytosine, and itraconazole and Candida spp. as determined by CLSI broth microdilution. J. Clin. Microbiol. 50:2040-2046.
77. Pfeiffer CD, et al. 2010. Breakthrough invasive candidiasis in patients on micafungin. J. Clin. Microbiol. 48:2373-2380.
78. Pujol C, et al. 2004. Flucytosine resistance is restricted to a single genetic clade of Candida albicans Antimicrob. Agents Chemother. 48:262-266. doi:10.1128/AAC.48.1.262-266.2004. (Pubitemid 38040206)
79. Redding S, et al. 1994. Resistance of Candida albicans to fluconazole during treatment of oropharyngeal candidiasis in a patient with AIDS: documentation by in vitro susceptibility testing and DNA subtype analysis. Clin. Infect. Dis. 18:240-242. (Pubitemid 24055265)
80. Revankar SG, et al. 1998. Interpretation of trailing endpoints in antifungal susceptibility testing by the National Committee for Clinical Laboratory Standards method. J. Clin. Microbiol. 36:153-156. (Pubitemid 28047451)
81. Rex JH, et al. 1994. A randomized trail comparing fluconazole and amphotericin B for the treatment of candidemia in patients without neutropenia. N. Engl. J. Med. 331:1325-1330. (Pubitemid 24347001)
82. Rex JH, et al. 1995. Antifungal susceptibility testing of isolates from a randomized, multicenter trail of fluconazole versus amphotericin B as treatment of nonneutropenic patients with candidemia. Antimicrob. Agents Chemother. 39:40-44. doi:10.1128/AAC.39.1.40.
83. Rex JH, et al. 1997. Development of interpretive breakpoints for antifungal susceptibility testing: conceptual framework and analysis of in vitro-in vivo correlation data for fluconazole, itraconazole, and Candida infections. Clin. Infect. Dis. 24:235-247. (Pubitemid 127774263)
84. Rex JH, et al. 1998. Optimizing the correlation between results of testing in vitro and therapeutic outcome in vivo for fluconazole by testing critical isolates in a murine model of invasive candidiasis. Antimicrob. Agents Chemother. 42:129-134. (Pubitemid 28053338)
85. Rex JH, et al. 2001. Antifungal susceptibility testing: practical aspects and current challenges. Clin. Microbiol. Rev. 14:643-658. (Pubitemid 32979625)
86. Rex JH, Pfaller MA. 2002. Has antifungal susceptibility testing come of age? Clin. Infect. Dis. 35:982-989. (Pubitemid 35178316)
87. Rodriguez-Tudela JL, et al. 2008. EUCAST definitive document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts. Clin. Microbiol. Infect. 14:398-405. (Pubitemid 351356536)
88. Rogers TR. 2006. Antifungal drug resistance: limited data, dramatic impact? Int. J. Antimicrob. Agents 275(Suppl. 1):S7-S11.
89. Sanglard D, Odds FC. 2002. Resistance of Candida species to antifungal agents: molecular mechanisms and clinical consequences. Lancet Infect. Dis. 2:73-85. (Pubitemid 36114141)
90. Simjee S, et al. 2008. Potential confusion regarding the term "resistance"in epidemiological surveys. J. Antimicrob. Chemother. 61:228-229.
91. Sun HY, Singh N. 2010. Characterization of breakthrough invasive mycoses in echinocandin recipients: an evidence-based review. Int. J. Antimicrob. Agents 35:211-218.
92. Turnidge J, et al. 2006. Statistical characterization of bacterial wild-type MIC value distributions and determination of epidemiological cutoff values. Clin. Microbiol. Infect. 12:418-425.
93. Turnidge J, Paterson DL. 2007. Setting and revising antimicrobial susceptibility break-points. Clin. Microbiol. Rev. 20:391-408. (Pubitemid 47175010)
94. Vandeputte P, et al. 2011. Molecular mechanisms of resistance to 5-fluorocytosine in laboratory mutants of Candida glabrata Mycopathologia 171:11-21. doi:10.1007/s11046-010-9342-1.
95. White TC. 1997. Increased mRNA levels of ERG16 CDR, and MDR1 correlate with increase in azole resistance in Candida albicans isolates from a patient infected with human immunodeficiency virus. Antimicrob. Agents Chemother. 41:1482-1487. (Pubitemid 27289672)
96. White TC. 1997. The presence of an R467K amino acid substitution and loss of allelic variation correlate with an azole-resistant lanosterol 14-alpha demethylase in Candida albicans Antimicrob. Agents Chemother. 41:1488-1494. (Pubitemid 27289673)
97. White TC, et al. 1998. Clinical cellular, and molecular factors that contribute to antifungal drug resistance. Clin. Microbiol. Rev. 11:382-402. (Pubitemid 28197359)
98. Xiao L, et al. 2004. Three-dimensional models of wild-type and mutated forms of cytochrome P450 14 alpha-sterol demethylase from Aspergillus fumigatus and Candida albicans provide insights into posaconazole binding. Antimicrob. Agents Chemother. 48:568-574. doi:10.1128/AAC.48.2.568-574.2004. (Pubitemid 38141718)
99. Zimbeck AJ, et al. 2010. FKS mutations and elevated echinocandin MIC values among Candida glabrata isolates from U.S. population-based surveillance. Antimicrob. Agents Chemother. 54:5042-5047. doi:10.1128/AAC.00836-10.