Cited by 105Antifungal resistance and susceptibilityYeasts and Rust Fungi StudiesFungal Plant Pathogen Control

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Multilaboratory Study of Epidemiological Cutoff Values for Detection of Resistance in Eight Candida Species to Fluconazole, Posaconazole, and Voriconazole

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Espinel-Ingroff, A., Pfaller, M. A., Bustamante, B., Canton, E., Fothergill, A., Fuller, J., Gonzalez, G. M., Lass-Flörl, C., Lockhart, S. R., Martin-Mazuelos, E., Meis, J. F., Melhem, M. S. C., Ostrosky-Zeichner, L., Pelaez, T., Szeszs, M. W., St-Germain, G., Bonfietti, L. X., Guarro, J., Turnidge, J.·2014·Antimicrobial Agents and Chemotherapy

DOI 10.1128/aac.02615-13PMC PMC4023759

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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.

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Authors: Espinel-Ingroff, A., Pfaller, M. A., Bustamante, B., Canton, E., Fothergill, A., Fuller, J., Gonzalez, G. M., Lass-Flörl, C., Lockhart, S. R., Martin-Mazuelos, E., Meis, J. F., Melhem, M. S. C., Ostrosky-Zeichner, L., Pelaez, T., Szeszs, M. W., St-Germain, G., Bonfietti, L. X., Guarro, J., & Turnidge, J.
Affiliations: VCU Medical Center, Richmond, Virginia, USA
University of Iowa (US)
Universidad Peruana Cayetano Heredia (PE)
Unidad de Microbiologia Experimental, Centro de Investigacion, Hospital Universitario La Fe, Valencia, Spain
The University of Texas at San Antonio Health Science Center (US)
University of Alberta (CA)
Universidad Autonóma de Nuevo León, Monterrey, Nuevo León, Mexico
The Innsbruck Medical University, Division of Hygiene and Medical Microbiology, Innsbruck, Austria
Centers for Disease Control and Prevention (US)
Hospital Universitario de Valme, Seville, Spain
Radboud University Nijmegen (NL)
Fungal Taxonomy Laboratories, Adolfo Lutz Institute, São Paulo City, Brazil
University of Texas Health Science Center, Houston, Texas, USA
Hospital General Universitario Gregorio Maraňón, Facultad de Medicina, Universidad Complutense, Madrid, Spain
Instituto Adolfo Lutz (BR)
Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Quebec, Canada
Institut de Recerca Biomèdica Catalunya Sud (ES)
The University of Adelaide (AU)
ORCID: Pfaller, M. A.
Bustamante, B.
Lockhart, S. R.
Meis, J. F.
Bonfietti, L. X.
Guarro, J.
Turnidge, J.
Venue: Antimicrobial Agents and Chemotherapy
Publisher: American Society for Microbiology
Published: 2014-04
Volume: 58
Issue: 4
Pages: 2006-2012
ISSN: 0066-4804 (ISSN-L)
1098-6596
DOI: 10.1128/aac.02615-13
PMC: PMC4023759
OpenAlex: W2113614834
Cited by: 105
References: 40
Citations by year: 2026: 2 · 2025: 2 · 2024: 2 · 2023: 7 · 2022: 7 · 2021: 6 · 2020: 6 · 2019: 12 · 2018: 11 · 2017: 15 · 2016: 11 · 2015: 18 · 2014: 6
FWCI: 11.68
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: journals.asm.org/non-commercial-tdm-license (tdm)
Locations: Antimicrobial Agents and Chemotherapy (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Radboud Repository (Radboud University) (submittedVersion)
Rovira & Virgili repository (submittedVersion, cc-by)
Radboud Repository (Radboud University) (submittedVersion, other-oa)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Life Sciences › Immunology and Microbiology › Microbiology › Yeasts and Rust Fungi Studies
Life Sciences › Agricultural and Biological Sciences › Plant Science › Fungal Plant Pathogen Control
Keywords: epidemiological cut-off values, Candida, antifungal resistance, fluconazole, posaconazole, voriconazole, triazole antifungals, Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, Candida krusei, Candida lusitaniae, Candida guilliermondii, Candida dubliniensis
MeSH terms: Antifungal Agents, Candida, Microbial Sensitivity Tests, Pyrimidines, Triazoles, Fluconazole, Voriconazole

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Multilaboratory Study of Epidemiological Cutoff Values for Detection of Resistance in Eight Candida Species to Fluconazole, Posaconazole, and Voriconazole

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