RT Journal Article
T1 Multicenter Study of Method-Dependent Epidemiological Cutoff Values for Detection of Resistance in Candida spp. and Aspergillus spp. to Amphotericin B and Echinocandins for the Etest Agar Diffusion Method
A1 Espinel-Ingroff, A.
A1 Arendrup, M.
A1 Canton, E.
A1 Cordoba, S.
A1 Dannaoui, E.
A1 Garcia-Rodriguez, J.
A1 Gonzalez, G. M.
A1 Govender, N. P.
A1 Martin-Mazuelos, E.
A1 Lackner, M.
A1 Lass-Florl, C.
A1 Linares Sicilia, M. J.
A1 Rodriguez-Iglesias, M. A.
A1 Pelaez, T.
A1 Shields, R. K.
A1 Garcia-Effron, G.
A1 Guinea, J.
A1 Sanguinetti, M.
A1 Turnidger, J.
K1 ECVs
K1 Etest ECVs
K1 Etest MICs Candida
K1 Etest MICs Aspergillus
K1 WT isolates
K1 amphotericin B resistance
K1 antifungal resistance
K1 echinocandin resistance
K1 non-WT
K1 susceptibility marker
K1 Isolates causing fungemia
K1 Method m27-a3 document
K1 Eucast technical note
K1 Antifungal susceptibility
K1 Broth microdilution
K1 Mic distributions
K1 Sensititre yeastone
K1 Caspofungin mics
K1 Clsi
K1 Anidulafungin
AB Method-dependent Etest epidemiological cutoff values (ECVs) are not available for susceptibility testing of either Candida or Aspergillus species with amphotericin B or echinocandins. In addition, reference caspofungin MICs for Candida spp. are unreliable. Candida and Aspergillus species wild-type (WT) Etest MIC distributions (microorganisms in a species-drug combination with no detectable phenotypic resistance) were established for 4,341 Candida albicans, 113 C. dubliniensis, 1,683 C. glabrata species complex (SC), 709 C. krusei, 767 C. parapsilosis SC, 796 C. tropicalis, 1,637 Aspergillus fumigatus SC, 238 A. flavus SC, 321 A. niger SC, and 247 A. terreus SC isolates. Etest MICs from 15 laboratories (in Argentina, Europe, Mexico, South Africa, and the United States) were pooled to establish Etest ECVs. Anidulafungin, caspofungin, micafungin, and amphotericin B ECVs (in micrograms per milliliter) encompassing >= 97.5% of the statistically modeled population were 0.016, 0.5, 0.03, and 1 for C. albicans; 0.03, 1, 0.03, and 2 for C. glabrata SC; 0.06, 1, 0.25, and 4 for C. krusei; 8, 4, 2, and 2 for C. parapsilosis SC; and 0.03, 1, 0.12, and 2 for C. tropicalis. The amphotericin B ECV was 0.25 mu g/ml for C. dubliniensis and 2, 8, 2, and 16 mu g/ml for the complexes of A. fumigatus, A. flavus, A. niger, and A. terreus, respectively. While anidulafungin Etest ECVs classified 92% of the Candida fks mutants evaluated as non-WT, the performance was lower for caspofungin (75%) and micafungin (84%) cutoffs. Finally, although anidulafungin (as an echinocandin surrogate susceptibility marker) and amphotericin B ECVs should identify Candida and Aspergillus isolates with reduced susceptibility to these agents using the Etest, these ECVs will not categorize a fungal isolate as susceptible or resistant, as breakpoints do.
PB Amer soc microbiology
SN 0066-4804
YR 2017
FD 2017-01-01
LK http://hdl.handle.net/10668/19004
UL http://hdl.handle.net/10668/19004
LA en
DS RISalud
RD Apr 11, 2025