Wild-Type MIC Distributions and Epidemiological Cutoff Values for Amphotericin B, Flucytosine, and Itraconazole and Candida spp. as Determined by CLSI Broth Microdilution
Wild-Type MIC Distributions and Epidemiological Cutoff Values for Amphotericin B, Flucytosine, and Itraconazole and Candida spp. as Determined by CLSI Broth Microdilution
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DOI：
10.1128/jcm.00248-12
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发表时间：
2012-06-01
影响因子：
9.4
通讯作者：
Szeszs, M. W.
中科院分区：
文献类型：
--
作者：
Pfaller, M. A.;Espinel-Ingroff, A.;Szeszs, M. W.
临床断点（CBPs）和流行病学临界值（ECVs）已被确定用于几种念珠菌属和较新的三唑类和棘白菌素，但尚未用于较老的抗真菌药物，如两性霉素B、氟胞嘧啶或伊曲康唑。我们使用来自巴西、加拿大、欧洲和美国16个不同实验室的分离株，采用CLSI参考微量稀释法测定了8种念珠菌（30,221株）的两性霉素B （AMB）、氟胞嘧啶（FC）和伊曲康唑（ITR）的种特异性ecv。计算得到的AMB、FC和ITR的24和48 h ECV表达量（以及mic小于或等于ECV的分离株百分比）分别为2(99.8)/2（99.2）、0.5(94.2)/1（91.4）和0.12 (95.0)/0.12 (92.9)；2(99.6) / 2(98.7), 0.5(98.0) / 0.5(97.5),和2 (95.2)/ 4 c . glabrata (93.5);2(99.7) / 2(97.3), 0.5(98.7) / 0.5(97.8),和05。（99.7）/0.5 (98.5)；2(99.8) / 2(99.2), 0.5(93.0) / 1(90.5),和0.5 (97.8)/ 0.5 (93.9)c . tropicalis;2(99.3) / 4(100.0), 32(99.4) / 32(99.3),和1 (99.0)/ 2 c . krusei (100.0);2(100.0) / 4(100.0), 0.5(95.3) / 1(92.9),和0.5 (95.8)/ 0.5 (98.1)c . lusitaniae;- 0.5 / 2(100.0),(98.8) / 0.5(97.7),和0.25 (97.6)/ 0.25 (96.9)c . dubliniensis;为2(100.0)/2（100.0）、1(92.7)/-和1(100.0)/2（100.0）。在缺乏物种特异性CBP值的情况下，这些野生型（WT） MIC分布和ecv将有助于监测对这些已建立的抗真菌药物敏感性降低的情况。
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.