Activity of a Long-Acting Echinocandin, Rezafungin, and Comparator Antifungal Agents Tested against Contemporary Invasive Fungal Isolates (SENTRY Program, 2016 to 2018).

We evaluated the activity of rezafungin and comparators, using Clinical and Laboratory Standards Institute (CLSI) broth microdilution methods, against a worldwide collection of 2,205 invasive fungal isolates recovered from 2016 to 2018. ( = 1,904 isolates; 6 species), ( = 73), ( = 183), and ( = 45) isolates were tested for their susceptibility (S) to rezafungin as well as the comparators caspofungin, anidulafungin, micafungin, and azoles. Interpretive criteria were applied following CLSI published clinical breakpoints (CBPs) and epidemiological cutoff values (ECVs). Isolates displaying non-wild-type (non-WT) echinocandin MIC values were sequenced for hot spot (HS) mutations. Rezafungin inhibited 99.8% of isolates (MIC, 0.03/0.06 μg/ml), 95.7% of isolates (MIC, 0.06/0.12 μg/ml), 97.4% of isolates (MIC, 0.03/0.06 μg/ml), 100.0% of isolates (MIC, 0.03/0.06 μg/ml), and 100.0% of isolates (MIC, 0.06/0.12 μg/ml) at ≤0.12 μg/ml. All (329/329 [100.0%]) isolates (MIC,1/2 μg/ml) were inhibited by rezafungin at ≤4 μg/ml. Fluconazole resistance was detected among 8.6% of isolates, 12.5% of isolates, 3.2% of isolates, and 2.6% of isolates. The activity of rezafungin against these 6 spp. was similar to the activity of the other echinocandins. Detection of the HS mutation was performed by sequencing echinocandin-resistant or non-WT isolates. Good activity against was observed for fluconazole and the other azoles, whereas the echinocandins, including rezafungin, displayed limited activity. Rezafungin displayed activity similar to that of the other echinocandins against and These data contribute to accumulating research demonstrating the potential of rezafungin for preventing and treating invasive fungal infections.