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 Cordob, S.
A1 Dannaoui, E.
A1 García Rodríguez, J.
A1 González, G.M.
A1 Govender, N.P.
A1 Martín Mazuelos, E.
A1 Lackner, M.
A1 Lass-Florl, C.
A1 Linares Sicilia, M.J.
A1 Rodríguez Iglesias, Manuel Antonio
A1 Peláez, T.
A1 Shields, R.K.
A1 García Effron, G.
A1 Guinea, J.
A1 Sanguinetti, M.
A1 Turnidger, J.
A2 BiomedicinaBiotecnología y Salud Pública
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
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 μg/ml for C. dubliniensis and 2, 8, 2, and 16 μg/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 American Society for Microbiology
SN 1098-6596
YR 2017
FD 2017
LK http://hdl.handle.net/10498/36673
UL http://hdl.handle.net/10498/36673
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 11-nov-2026