Multilaboratory study of epidemiological cutoff values for detection of resistance in eight Candida species to fluconazole, posaconazole, and voriconazole
Publication year
2014Source
Antimicrobial Agents and Chemotherapy, 58, 4, (2014), pp. 2006-2012ISSN
Publication type
Article / Letter to editor

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Organization
Medical Microbiology
Journal title
Antimicrobial Agents and Chemotherapy
Volume
vol. 58
Issue
iss. 4
Page start
p. 2006
Page end
p. 2012
Subject
Radboudumc 4: lnfectious Diseases and Global Health RIHS: Radboud Institute for Health SciencesAbstract
Although epidemiological cutoff values (ECVs) have been established for Candida spp. and the triazoles, they are based on MIC data from a single laboratory. We have established ECVs for eight Candida species and fluconazole, posaconazole, and voriconazole based on wild-type (WT) MIC distributions for isolates of C. albicans (n=11,241 isolates), C. glabrata (7,538), C. parapsilosis (6,023), C. tropicalis (3,748), C. krusei (1,073), C. lusitaniae (574), C. guilliermondii (373), and C. dubliniensis (162). The 24-h CLSI broth microdilution MICs were collated from multiple laboratories (in Canada, Brazil, Europe, Mexico, Peru, and the United States). The ECVs for distributions originating from >/=6 laboratories, which included >/=95% of the modeled WT population, for fluconazole, posaconazole, and voriconazole were, respectively, 0.5, 0.06 and 0.03 mug/ml for C. albicans, 0.5, 0.25, and 0.03 mug/ml for C. dubliniensis, 8, 1, and 0.25 mug/ml for C. glabrata, 8, 0.5, and 0.12 mug/ml for C. guilliermondii, 32, 0.5, and 0.25 mug/ml for C. krusei, 1, 0.06, and 0.06 mug/ml for C. lusitaniae, 1, 0.25, and 0.03 mug/ml for C. parapsilosis, and 1, 0.12, and 0.06 mug/ml for C. tropicalis. The low number of MICs (<100) for other less prevalent species (C. famata, C. kefyr, C. orthopsilosis, C. rugosa) precluded ECV definition, but their MIC distributions are documented. Evaluation of our ECVs for some species/agent combinations using published individual MICs for 136 isolates (harboring mutations in or upregulation of ERG11, MDR1, CDR1, or CDR2) and 64 WT isolates indicated that our ECVs may be useful in distinguishing WT from non-WT isolates.
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- Academic publications [202863]
- Electronic publications [101052]
- Faculty of Medical Sciences [80039]
- Open Access publications [69734]
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