Paradoxical Effect of Echinocandins across <i>Candida</i> Species In Vitro: Evidence for Echinocandin-Specific and <i>Candida</i> Species-Related Differences

Abstract

Paradoxical growth of some Candida isolates occurs at concentrations above the MIC for echinocandins. In 60 Candida bloodstream isolates from cancer patients (20 C. albicans isolates and 10 isolates each of C. parapsilosis, C. tropicalis, C. krusei, and C. glabrata), paradoxical growth was more frequent with caspofungin than micafungin or anidulafungin, was unrelated to MIC, and was strikingly absent in C. glabrata isolates.