Journal
JOURNAL OF CLINICAL MICROBIOLOGY
Volume 50, Issue 6, Pages 2040-2046Publisher
AMER SOC MICROBIOLOGY
DOI: 10.1128/JCM.00248-12
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Funding
- Achaogen
- Aires
- American Proficiency Institute (API)
- Anacor
- Astellas
- AstraZeneca
- Bayer
- bioMerieux
- Cempra
- Cerexa
- Cosmo Technologies
- Contrafect
- Cubist
- Daiichi
- Dipexium
- Enanta
- Furiex
- GlaxoSmithKline
- Johnson Johnson (JJ)
- LegoChem Biosciences Inc.
- Meiji Seika Kaisha
- Merck
- Nabriva
- Novartis
- Paratek
- Pfizer (Wyeth)
- PPD Therapeutics
- Premier Research Group
- Rempex
- Rib-X Pharmaceuticals
- Seachaid
- Shionogi
- Shionogi USA
- Medicines Co.
- Theravance
- ThermoFisher
- TREK Diagnostics
- Vertex Pharmaceuticals
- Astellas Pharma
- Gilead Sciences
- Merck Sharp and Dohme
- Pfizer
- Schering Plough
- Soria Melguizo SA
- Ferrer International
- European Union
- ALBAN
- Spanish Agency for International Cooperation
- Spanish Ministry of Culture and Education
- Spanish Health Research Fund
- Instituto de Salud Carlos III
- Ramon Areces Foundation
- Mutua Madrile a Foundation
- Merck, Astellas
- Innovative Biosensors
- PurThread Technologies
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Clinical breakpoints (CBPs) and epidemiological cutoff values (ECVs) have been established for several Candida spp. and the newer triazoles and echinocandins but are not yet available for older antifungal agents, such as amphotericin B, flucytosine, or itraconazole. We determined species-specific ECVs for amphotericin B (AMB), flucytosine (FC) and itraconazole (ITR) for eight Candida spp. (30,221 strains) using isolates from 16 different laboratories in Brazil, Canada, Europe, and the United States, all tested by the CLSI reference microdilution method. The calculated 24- and 48-h ECVs expressed in mu g/ml (and the percentages of isolates that had MICs less than or equal to the ECV) for AMB, FC, and ITR, respectively, were 2 (99.8)/2 (99.2), 0.5 (94.2)/1 (91.4), and 0.12 (95.0)/0.12 (92.9) for C. albicans; 2 (99.6)/2 (98.7), 0.5 (98.0)/0.5 (97.5), and 2 (95.2)/4 (93.5) for C. glabrata; 2 (99.7)/2 (97.3), 0.5 (98.7)/0.5 (97.8), and 05. (99.7)/0.5 (98.5) for C. parapsilosis; 2 (99.8)/2 (99.2), 0.5 (93.0)/1 (90.5), and 0.5 (97.8)/0.5 (93.9) for C. tropicalis; 2 (99.3)/4 (100.0), 32 (99.4)/32 (99.3), and 1 (99.0)/2 (100.0) for C. krusei; 2 (100.0)/4 (100.0), 0.5 (95.3)/1 (92.9), and 0.5 (95.8)/0.5 (98.1) for C. lusitaniae; -/2 (100.0), 0.5 (98.8)/0.5 (97.7), and 0.25 (97.6)/0.25 (96.9) for C. dubliniensis; and 2 (100.0)/2 (100.0), 1 (92.7)/-, and 1 (100.0)/2 (100.0) for C. guilliermondii. In the absence of species-specific CBP values, these wild-type (WT) MIC distributions and ECVs will be useful for monitoring the emergence of reduced susceptibility to these well-established antifungal agents.
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