Affiliation:
1. Dermatology Department Hospital Vithas Vigo Vigo Spain
2. Fundación Vithas Grupo Hospitalario Vithas Madrid Spain
3. Department of Health Sciences University of Vigo Vigo Spain
4. Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón Ciudad de México Mexico
5. Department of Dermatology Zealand University Hospital Roskilde Denmark
6. Health Sciences Faculty University of Copenhagen Copenhagen Denmark
7. Department of Dermatology Kings College Hospital NHS Trust London UK
8. Department of Dermatology, Venereology and Allergology Wroclaw Medical University Wroclaw Poland
9. Servicio de Micología Hospital General "Dr. Manuel Gea González" Ciudad de México Mexico
10. Department of Dermatology and Venereology Zagreb University School of Medicine and Zagreb University Hospital Zagreb Croatia
11. Department of Dermatovenereology University Clinical Center of Sarajevo Sarajevo Bosnia and Herzegovina
Abstract
AbstractBackgroundNakaseomyces glabratus (N. glabratus) formerly known as Candida glabrata (C. glabrata), is an endogenous opportunistic pathogen, which is generally located in the gastrointestinal tract but can spread in immunocompromised patients. N. glabratus is the second most common pathogen that causes candidemia in several countries. N. glabratus virulence factors may increase antifungal resistance and reduce the number of available treatment options. High resistance to azoles and increasing resistance to echinocandins have been previously reported in N. glabratus.ObjectiveTo establish the distribution of N. glabratus isolates in Europe and its drug susceptibility/resistance in each country over the last 7 years.MethodsThe search was performed across three databases: PubMed, Scopus and Scielo, using the MeSH terms: “Candida glabrata”, “Nakaseomyces glabratus”, “Europe”, “resistance” and “Epidemiology” exclusively in English. All available information from January 2002 to December 2022 was included, excluding reviews, meta‐analyses and book chapters.ResultsFifty‐seven articles with information on antifungal susceptibility in Europe were retrieved and analysed with a total of 15,400 reported C. glabrata isolates. Remarkably, nations that presented the maximum number of cases during the study period included the United Kingdom (n = 7241, 47.02%), France (n = 3190, 20.71%), Spain (n = 900, 5.84%), Hungary (n = 745, 4.84%) and Italy (n = 486, 3.16%). C. glabrata isolates presented resistance to azoles [voriconazole (n = 2225, 14.45%), fluconazole (n = 1612, 10.47%), itraconazole (n = 337, 2.19%) and clotrimazole (n = 89, 0.58%)], increased resistance to echinocandins, especially to anidulafungin (n = 138, 0.89%), and high sensitivity to amphotericin B.ConclusionThe number of candidemia cases associated with triazole‐resistant N. glabratus isolates have been increasing in Europe. Therefore, echinocandins and amphotericin B can be considered optional empirical treatments; however, antifungal susceptibility testing is required to determine the best therapeutic options.