Previous antimicrobial use is linked to drug resistance in Candida glabrata bloodstream infections
Bloodstream infections caused by the fungus Candida glabrata have recently increased. Fluconazole is often used to treat these infections; however, some strains of C. glabrata are resistant to fuconazole. A patient's previous use of fluconazole is a risk factor for this drug resistance, finds a new study that was conducted at three hospitals in the University of Pennsylvania health system from 2003 to 2007.
The researchers studied 76 patients with fluconazole-resistant C. glabrata infections. These patients were more likely to have used fluconazole in the past compared with those who did not have C. glabrata infection. Further, use of linezolid, another antimicrobial used to treat bacterial infections, was also found to be a risk factor for fluconazole-resistant C. glabrata infections.
The authors suggest that use of these drugs may alter the body's natural flora and permit infection with and colonization of fluconazole-resistant C. glabrata. Additionally, the researchers found that previous use of either one of the antimicrobials cefepime and metronidazole was associated with fluconazole-susceptible C. glabrata. This study was funded in part by the Agency for Healthcare Research and Quality (HS16946 and HS10399).
See "Risk factors for fluconazole-resistant Candida glabrata bloodstream infections," by Ingi Lee, M.D., M.S.C.E., Neil O. Fishman, M.D., Theoklis E. Zaoutis, M.D., M.S.C.E., and others in the February 23, 2009, Archives of Internal Medicine, 169(4), pp. 379-383.
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