Echinocandin Susceptibility Testing of Candida spp. Using EUCAST EDef 7.1 and CLSI M27-A3 Standard Procedures: Analysis of the Influence of Bovine Serum Albumin Supplementation, Storage Time, and Drug Lots
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The MICs of echinocandins against Candida isolates with fks mutations are higher than those for wild-type (WT) isolates. However, the MIC ranges for susceptible and mutant populations overlap or are poorly separated. It was recently reported that a greater separation could be achieved in the presence of serum. To more fully explore this possibility, we compared the performances of the reference microdilution methods by using standard and bovine serum albumin (BSA)-supplemented growth medium. Anidulafungin, caspofungin, and micafungin MICs were determined according to EUCAST and CLSI methods and with 50% BSA in the medium for 93 clinical isolates, including Candida albicans (20/10 [number of isolates/number of mutants]), C. glabrata (19/10), C. dubliniensis (2/1), C. krusei (16/3), C. parapsilosis (19), and C. tropicalis (19/4) isolates. Stability of the plates was tested after storage at −80°C for 2 and 6 months, and the performance of two different lots of caspofungin was investigated. The addition of BSA to the medium resulted in higher MICs (1 to 9 2-fold dilution steps) for all isolates and compounds. The increases were greatest for anidulafungin and micafungin and, among WT isolates, for C. parapsilosis . The number of very major errors (VMEs) was reduced (24% [20/84 isolates] versus ≤7% [6/84 isolates]) using BSA-supplemented EUCAST medium but not using BSA-supplemented CLSI medium (6% versus 9%). MIC results were unchanged after 6 months of storage of test plates. The two lots of caspofungin yielded identical results. Addition of BSA to the EUCAST medium increases the ability to differentiate between WT isolates and isolates harboring resistance mutations.
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The high number of caspofungin non-susceptible isolates may in part be associated with variability in the caspofungin used for in vitro testing.
“This may in part be associated with variability in the caspofungin used for in vitro testing (46).”
From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [46]
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- Authors
- Arendrup, M. C., Rodriguez-Tudela, J.-L., Park, S., Garcia-Effron, G., Delmas, G., Cuenca-Estrella, M., Gomez-Lopez, A., & Perlin, D. S.
- Affiliations
- Statens Serum Institut (DK)
- Instituto de Salud Carlos III (ES)
- Rutgers New Jersey Medical School (US)
- Public Health Research Institute, UMDNJ-New Jersey Medical School, Newark, New Jersey
- Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain
- Corresponding author
- Arendrup, Maiken Cavling
- Venue
- Antimicrobial Agents and Chemotherapy
- Publisher
- American Society for Microbiology
- Published
- 2011-04
- Volume
- 55
- Issue
- 4
- Pages
- 1580-1587
- ISSN
- 0066-4804 (ISSN-L)
- 1098-6596
- PMC
- PMC3067145
- OpenAlex
- W2152007862
- Cited by
- 57
- References
- 7
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 4 · 2020: 3 · 2018: 3 · 2017: 2 · 2016: 6 · 2015: 2 · 2014: 6 · 2013: 9 · 2012: 8
- FWCI
- 6.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Antimicrobial Agents and Chemotherapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- CONICET Digital (CONICET) (submittedVersion, cc-by-nc-sa)
- Funders
- National Institute of Allergy and Infectious Diseases (AI069397, R01AI069397)
- 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 › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
- Keywords
- Candida, caspofungin, anidulafungin, micafungin, Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata, Candida dubliniensis, Candida krusei, very major errors, antifungal resistance
- MeSH terms
- Caspofungin, Micafungin, Anidulafungin, Animals, Antifungal Agents, Candida, Cattle, Microbial Sensitivity Tests, Serum Albumin, Bovine, Echinocandins, Lipopeptides
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