期刊
CURRENT FUNGAL INFECTION REPORTS
卷 4, 期 3, 页码 168-174出版社
SPRINGER
DOI: 10.1007/s12281-010-0022-x
关键词
Antifungal susceptibility testing; Fluconazole; Epidemiologic cutoff values; Clinical breakpoints; Candida
资金
- Astellas
- Merck
- Pfizer
- Schering-Plough
Antifungal susceptibility testing of Candida against fluconazole has been standardized by both the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Both CLSI and EUCAST have developed clinical breakpoint (CBP) criteria for fluconazole, but these differ in both magnitude and target species. Studies using the EUCAST method have also defined wild-type minimum inhibitory concentration (MIC) distributions and epidemiologic cutoff values (ECVs or ECOFFs) for the common species of Candida. The ECVs serve as a sensitive means of discriminating wild-type strains from those with acquired resistance mechanisms and include MICs of 1 mu g/mL for C. albicans, 2 mu g/mL for C. tropicalis and C. parapsilosis, 32 mu g/mL for C. glabrata, and 128 mu g/mL for C. krusei. Because the CLSI CBPs may be too insensitive to detect emerging resistance among strains of C. albicans, C. tropicalis, and C. parapsilosis, and bisect the WT MIC distribution of C. glabrata, we sought to establish the wildtype MIC distribution and ECVs for fluconazole and Candida spp. The establishment of the wild-type MIC distributions and ECVs for fluconazole using CLSI methods will be useful in resistance surveillance and may prove to be an important step in the development of speciesspecific CBPs for this important antifungal agent.
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