Candidozyma auris susceptibility from Michigan hospitals to manogepix, rezafungin and nine other antifungal agents

Document Type

Article

Publication Date

6-1-2026

Publication Title

JAC Antimicrob Resist

Abstract

BACKGROUND: Candidozyma auris (C. auris) is a resistant fungal pathogen with high mortality. OBJECTIVES: To evaluate the in vitro activity of 11 antifungal agents against C. auris from multiple hospitals. METHODS: MIC was determined by microdilution testing for amphotericin B, anidulafungin, caspofungin, manogepix, micafungin, rezafungin and five triazoles. Sanger sequencing was performed on one echinocandin resistant isolate. RESULTS: There were 84 C. auris isolates from Michigan that were compared with 27 organisms from external sources. Manogepix had the lowest MIC(90) (0.03 mg/L). The next most active agent was micafungin. The echinocandins demonstrated a 98.8% susceptibility. A single isolate was found to have a S639F mutation. Amphotericin B demonstrated a 97.6% susceptibility. The MIC(90) demonstrated values of ≤0.5 mg/L for isavuconazole, itraconazole and posaconazole. When separating by colonization versus infection isolates, the MIC(90) values were identical for all agents, except micafungin, which showed 0.25 versus 0.12 mg/L, respectively. When comparing the reference isolates with Michigan isolates, the MIC(90) was identical for echinocandins and manogepix. Differences noted were with amphotericin B, for which 85.2% were susceptible for reference isolates compared to 97.6% from Michigan isolates, and fluconazole, where 25.9% were susceptible for the reference isolates compared with 4.8% from Michigan isolates. CONCLUSIONS: Manogepix and echinocandins demonstrated the greatest activity against C. auris irrespective of hospital and were like the reference isolates. Amphotericin B demonstrated greater activity compared with published studies. Fluconazole has poor activity; the activity of other triazoles remains unclear.

PubMed ID

42211724

Volume

8

Issue

3

First Page

089

Last Page

089

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