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  • Multicenter, International ...
    Espinel-Ingroff, A; Abreu, D P B; Almeida-Paes, R; Brilhante, R S N; Chakrabarti, A; Chowdhary, A; Hagen, F; Córdoba, S; Gonzalez, G M; Govender, N P; Guarro, J; Johnson, E M; Kidd, S E; Pereira, S A; Rodrigues, A M; Rozental, S; Szeszs, M W; Ballesté Alaniz, R; Bonifaz, A; Bonfietti, L X; Borba-Santos, L P; Capilla, J; Colombo, A L; Dolande, M; Isla, M G; Melhem, M S C; Mesa-Arango, A C; Oliveira, M M E; Panizo, M M; Pires de Camargo, Z; Zancope-Oliveira, R M; Meis, J F; Turnidge, J

    Antimicrobial agents and chemotherapy, 10/2017, Letnik: 61, Številka: 10
    Journal Article

    Clinical and Laboratory Standards Institute (CLSI) conditions for testing the susceptibilities of pathogenic species to antifungal agents are based on a collaborative study that evaluated five clinically relevant isolates of and some antifungal agents. With the advent of molecular identification, there are two basic needs: to confirm the suitability of these testing conditions for all agents and species and to establish species-specific epidemiologic cutoff values (ECVs) or breakpoints (BPs) for the species. We collected available CLSI MICs/minimal effective concentrations (MECs) of amphotericin B, five triazoles, terbinafine, flucytosine, and caspofungin for 301 , 486 , 75 , and 13 molecularly identified isolates. Data were obtained in 17 independent laboratories (Australia, Europe, India, South Africa, and South and North America) using conidial inoculum suspensions and 48 to 72 h of incubation at 35°C. Sufficient and suitable data (modal MICs within 2-fold concentrations) allowed the proposal of the following ECVs for and , respectively: amphotericin B, 4 and 4 μg/ml; itraconazole, 2 and 2 μg/ml; posaconazole, 2 and 2 μg/ml; and voriconazole, 64 and 32 μg/ml. Ketoconazole and terbinafine ECVs for were 2 and 0.12 μg/ml, respectively. Insufficient or unsuitable data precluded the calculation of ketoconazole and terbinafine (or any other antifungal agent) ECVs for , as well as ECVs for and These ECVs could aid the clinician in identifying potentially resistant isolates (non-wild type) less likely to respond to therapy.