Caspofungin Etest susceptibility testing of Candida species: risk of misclassification of susceptible isolates of C. glabrata and C. krusei when adopting the revised CLSI caspofungin breakpoints.
Open accessAbstract
The purpose of this study was to evaluate the performance of caspofungin Etest and the recently revised CLSI breakpoints. A total of 497 blood isolates, of which 496 were wild-type isolates, were included. A total of 65/496 susceptible isolates (13.1%) were misclassified as intermediate (I) or resistant (R). Such misclassifications were most commonly observed for Candida krusei (73.1%) and Candida glabrata (33.1%). The revised breakpoints cannot be safely adopted for these two species.
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Caspofungin is unreliable for MIC determination due to high interlaboratory variability.
“Caspofungin has been found to be unreliable for MIC determination due to high interlaboratory variability [33,34,35,36].”
From Treatment of Invasive Candidiasis: A Narrative Review (2018) · cites this paper as [36]
Some laboratories have noted an unexpected high number of C. glabrata and C. krusei isolates being categorised as non-susceptible using the CLSI method for testing caspofungin susceptibility and by using the Etest and Sensititre Yeast One system.
“Despite this, some laboratories have noted an unexpected high number of C. glabrata and C. krusei isolates being categorised as non-susceptible using the CLSI method for testing caspofungin susceptibility and by using the Etest and Sensititre Yeast One system, which are standardised against the CLSI method (29;43–45).”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [44]
Antifungal susceptibility testing has been optimised over recent years.
“Antifungal susceptibility testing has been optimised over the recent years and should be available real time for centres managing high-risk patients.”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [40]
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References 22 · Cited by 67
- Authors
- Arendrup, M. C., Pfaller, M. A., & the Danish Fungaemia Study Group
- Affiliations
- Statens Serum Institut (DK)
- University of Iowa (US)
- Venue
- Antimicrobial Agents and Chemotherapy
- Publisher
- American Society for Microbiology
- Published
- 2012-07
- Volume
- 56
- Issue
- 7
- Pages
- 3965-3968
- ISSN
- 0066-4804 (ISSN-L)
- 1098-6596
- PMC
- PMC3393381
- OpenAlex
- W2104637915
- Cited by
- 67
- References
- 22
- Citations by year
- 2026: 1 · 2025: 3 · 2023: 2 · 2021: 1 · 2020: 2 · 2019: 6 · 2018: 8 · 2017: 5 · 2016: 10 · 2015: 9 · 2014: 13 · 2013: 6 · 2012: 1
- FWCI
- 6.40
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Antimicrobial Agents and Chemotherapy (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Funders
- Pfizer
- Gilead Sciences
- Astellas Pharma
- Merck Sharp and Dohme
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
- Keywords
- caspofungin, Candida glabrata, Candida krusei, antifungal susceptibility testing, E-test, CLSI breakpoints, blood culture isolates, wild-type isolates
- MeSH terms
- Caspofungin, Antifungal Agents, Candida, Candidiasis, Microbial Sensitivity Tests, Drug Resistance, Fungal, Candida glabrata, Echinocandins, Lipopeptides
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