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Type: Journal article
Title: Multilaboratory study of epidemiological cutoff values for detection of resistance in eight Candida species to fluconazole, posaconazole, and voriconazole
Author: Espinel-Ingroff, A.
Pfaller, M.
Bustamante, B.
Canton, E.
Fothergill, A.
Fuller, J.
Gonzalez, G.
Lass-Flörl, C.
Lockhart, S.
Martin-Mazuelos, E.
Meis, J.
Melhem, M.
Ostrosky-Zeichner, L.
Pelaez, T.
Szeszs, M.
St-Germain, G.
Bonfietti, L.
Guarro, J.
Turnidge, J.
Citation: Antimicrobial Agents and Chemotherapy, 2014; 58(4):2006-2012
Publisher: American Society for Microbiology
Issue Date: 2014
ISSN: 0066-4804
Statement of
A. Espinel-Ingroff, M.A. Pfaller, B. Bustamante, E. Canton, A. Fothergill, J. Fuller, G.M. Gonzalez, C. Lass-Flörl, S.R. Lockhart, E. Martin-Mazuelos, J.F. Meis, M.S.C. Melhem, L. Ostrosky-Zeichner, T. Pelaez, M.W. Szeszs, G. St-Germain, L.X. Bonfietti, J. Guarro, J. Turnidge
Abstract: 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 μg/ml for C. albicans, 0.5, 0.25, and 0.03 μg/ml for C. dubliniensis, 8, 1, and 0.25 μg/ml for C. glabrata, 8, 0.5, and 0.12 μg/ml for C. guilliermondii, 32, 0.5, and 0.25 μg/ml for C. krusei, 1, 0.06, and 0.06 μg/ml for C. lusitaniae, 1, 0.25, and 0.03 μg/ml for C. parapsilosis, and 1, 0.12, and 0.06 μg/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.
Keywords: Candida; antifungal agents
Rights: Copyright © 2014, American Society for Microbiology. All Rights Reserved.
DOI: 10.1128/AAC.02615-13
Appears in Collections:Aurora harvest 7
Microbiology and Immunology publications

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