International and multicenter comparison of EUCAST and CLSI M27-A2 broth microdilution methods for testing susceptibilities of Candida spp. to fluconazole, itraconazole, posaconazole, and voriconazole
International and multicenter comparison of EUCAST and CLSI M27-A2 broth microdilution methods for testing susceptibilities of Candida spp. to fluconazole, itraconazole, posaconazole, and voriconazole
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DOI：
10.1128/jcm.43.8.3884-3889.2005
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发表时间：
2005-08-01
影响因子：
9.4
通讯作者：
Verweij, PE
中科院分区：
文献类型：
--
作者：
Espinel-Ingroff, A;Barchiesi, F;Verweij, PE
本研究的目的是比较欧洲抗生素敏感性测试委员会 (EUCAST) 和 CLSI（以前称为 NCCLS）方法在 15 种白色念珠菌（5 种氟康唑耐药菌株和 4 种敏感剂量依赖性 [S-DD] 分离株）、10 种都柏林念珠菌、7 种念珠菌中的每一个中心获得的氟康唑、伊曲康唑、泊沙康唑和伏立康唑的 MIC。 glabrata（2 个氟康唑耐药分离株）、5 个 C. guilliermondii（2 个氟康唑耐药分离株）、10 个 C. krusei、9 个 C. lusitaniae、10 个 C. parapsilosis 和 5 个 C.tropicalis（1 个氟康唑耐药分离株）分离株。 CLSI MIC 在 24 小时和 48 小时时目视获得，分光光度法 EUCAST MIC 在 24 小时获得。方法之间的一致性（在 3 倍稀释范围内）取决于物种、药物和孵育时间，并且是由于 EUCAST 低于 CLSI MIC：总体而言，当将 EUCAST MIC 与 24 小时 CLSI 结果进行比较时，氟康唑和伏立康唑为 94% 至 95%，泊沙康唑和伊曲康唑为 90% 至 91%。与 48 小时 CLSI 终点相比，一致性较低（85% 至 94%）。每种方法的总体实验室间重现性≥ 92%。当基于 CLSI 断点分类进行比较时，包括氟康唑耐药菌株和 S-DD 菌株在内的四个物种中的三个物种的一致性为 68% 至 76%；在氟康唑耐药菌株中观察到 9% 的非常大的差异 (= 64 μ g/ml)，而在伏立康唑耐药菌株中观察到 50% (= 4 μ g/ml)。在评估的八个物种中，有七个使用伊曲康唑观察到了类似的结果（28％至77％的绝对一致性）。对于其中一些分离株，泊沙康唑 EUCAST MIC 也显着低于 CLSI MIC 模式（0.008 至 1 μg/ml 对比 1 至 >= 8 μg/ml）。因此，CLSI 断点不应用于解释 EUCAST MIC 数据。
The aim of this study was to compare MICs of fluconazole, itraconazole, posaconazole, and voriconazole obtained by the European Committee on Antibiotic Susceptibility Testing (EUCAST) and CLSI (formerly NCCLS) methods in each of six centers for 15 Candida albicans (5 fluconazole-resistant and 4 susceptibledose-dependent [S-DD] isolates), 10 C. dubliniensis, 7 C. glabrata (2 fluconazole-resistant isolates), 5 C. guilliermondii (2 fluconazole-resistant isolates), 10 C. krusei, 9 C. lusitaniae, 10 C. parapsilosis, and 5 C. tropicalis (1 fluconazole-resistant isolate) isolates. CLSI MICs were obtained visually at 24 and 48 h and spectrophotometric EUCAST MICs at 24 h. The agreement (within a 3-dilution range) between the methods was species, drug, and incubation time dependent and due to lower EUCAST than CLSI MICs: overall, 94 to 95% with fluconazole and voriconazole and 90 to 91% with posaconazole and itraconazole when EUCAST MICs were compared against 24-h CLSI results. The agreement was lower (85 to 94%) against 48-h CLSI endpoints. The overall interlaboratory reproducibility by each method was >= 92%. When the comparison was based on CLSI breakpoint categorization, the agreement was 68 to 76% for three of the four species that included fluconazole-resistant and S-DD isolates; 9% very major discrepancies (= 64 mu g/ml) were observed among fluconazole-resistant isolates and 50% with voriconazole (= 4 mu g/ml). Similar results were observed with itraconazole for seven of the eight species evaluated (28 to 77% categorical agreement). Posaconazole EUCAST MICs were also substantially lower than CLSI MIC modes (0.008 to 1 mu g/ml versus 1 to >= 8 mu g/ml) for some of these isolates. Therefore, the CLSI breakpoints should not be used to interpret EUCAST MIC data.