PMID- 34370582 OWN - NLM STAT- MEDLINE DCOM- 20211102 LR - 20220419 IS - 1098-6596 (Electronic) IS - 0066-4804 (Print) IS - 0066-4804 (Linking) VI - 65 IP - 11 DP - 2021 Oct 18 TI - Etest ECVs/ECOFFs for Detection of Resistance in Prevalent and Three Nonprevalent Candida spp. to Triazoles and Amphotericin B and Aspergillus spp. to Caspofungin: Further Assessment of Modal Variability. PG - e0109321 LID - 10.1128/AAC.01093-21 [doi] LID - e01093-21 AB - Susceptibility testing is an important tool in the clinical setting; its utility is based on the availability of categorical endpoints, breakpoints (BPs), or epidemiological cutoff values (ECVs/ECOFFs). CLSI and EUCAST have developed antifungal susceptibility testing, BPs, and ECVs for some fungal species. Although the concentration gradient strip bioMerieux Etest is useful for routine testing in the clinical laboratory, ECVs are not available for all agent/species; the lack of clinical data precludes development of BPs. We reevaluated and consolidated Etest data points from three previous studies and included new data. We defined ECOFFinder Etest ECVs for three sets of species-agent combinations: fluconazole, posaconazole, and voriconazole and 9 Candida spp.; amphotericin B and 3 nonprevalent Candida spp.; and caspofungin and 4 Aspergillus spp. The total of Etest MICs from 23 laboratories (Europe, the Americas, and South Africa) included (antifungal agent dependent): 17,242 Candida albicans, 244 C. dubliniensis, 5,129 C. glabrata species complex (SC), 275 C. guilliermondii (Meyerozyma guilliermondii), 1,133 C. krusei (Pichia kudriavzevii), 933 C. kefyr (Kluyveromyces marxianus), 519 C. lusitaniae (Clavispora lusitaniae), 2,947 C. parapsilosis SC, 2,214 C. tropicalis, 3,212 Aspergillus fumigatus, 232 A. flavus, 181 A. niger, and 267 A. terreus SC isolates. Triazole MICs for 66 confirmed non-wild-type (non-WT) Candida isolates were available (ERG11 point mutations). Distributions fulfilling CLSI ECV criteria were pooled, and ECOFFinder Etest ECVs were established for triazoles (9 Candida spp.), amphotericin B (3 less-prevalent Candida spp.), and caspofungin (4 Aspergillus spp.). Etest fluconazole ECVs could be good detectors of Candida non-WT isolates (59/61 non-WT, 4 of 6 species). FAU - Espinel-Ingroff, A AU - Espinel-Ingroff A AUID- ORCID: 0000-0002-9977-9741 AD - VCU Medical Center, Richmond, Virginia, USA. FAU - Sasso, M AU - Sasso M AUID- ORCID: 0000-0002-6539-8545 AD - MIVEGEC, Universite, Montpellier, CHU de Nimes, CNRS, IRD, Montpellier, France. FAU - Turnidge, J AU - Turnidge J AUID- ORCID: 0000-0003-4240-5578 AD - Adelaide Medical School and School of Biological Sciences, University of Adelaide, Adelaide, Australia. FAU - Arendrup, M AU - Arendrup M AUID- ORCID: 0000-0002-4747-0144 AD - Unit of Mycology, Department of Microbiological Surveillance and Research, Statens Serum Institutgrid.6203.7, Copenhagen, Denmark. FAU - Botterel, F AU - Botterel F AD - Unite de Parasitologie-Mycologie, CHU Henri Mondor, APHP, Paris, France. FAU - Bourgeois, N AU - Bourgeois N AD - MIVEGEC, Universite Montpellier, CHU de Montpellier, CNRS, IRD, Montpellier, France. FAU - Bouteille, B AU - Bouteille B AD - Service de Parasitologie-Mycologie, CHU Limoges, Limoges, France. FAU - Canton, E AU - Canton E AD - Grupo Infeccion Grave, Instituto Investigacion Sanitaria La Fe, Valencia, Spain. FAU - Cassaing, S AU - Cassaing S AD - Service de Parasitologie-Mycologie, CHU Toulouse, Universite Paul Sabatier, Toulouse, France. FAU - Dannaoui, E AU - Dannaoui E AUID- ORCID: 0000-0002-2817-3830 AD - Laboratoire de Parasitologie-Mycologie, Departement de Microbiologie, Universite de Paris, Faculte de Medecine, APHP, Hopital Europeen Georges Pompidou, Paris, France. FAU - Dehais, M AU - Dehais M AD - Laboratoire de Parasitologie Mycologie, Rouen, France. FAU - Delhaes, L AU - Delhaes L AD - Service de Parasitologie-Mycologie, CHU Bordeaux, France. FAU - Dupont, D AU - Dupont D AD - Hospices Civils de Lyongrid.413852.9, Institut des Agents Infectieux, Parasitologie-Mycologie Medicale, Universite Lyon 1, Lyon, France. FAU - Fekkar, A AU - Fekkar A AUID- ORCID: 0000-0001-9954-075X AD - AP-HP, Groupe Hospitalier Pitie-Salpetriere, Service de Parasitologie-Mycologie, Paris, France. FAU - Fuller, J AU - Fuller J AD - Western University, Ontario, Canada. FAU - Garcia-Effron, G AU - Garcia-Effron G AD - Laboratorio de Micologia y Diagnostico Molecular-CONICET, Catedra de Parasitologia y Micologia, Fac. Bioquimica y Ciencias Biologicas, Universidad Nacional del Litoral, Santa Fe, Argentina. FAU - Garcia, J AU - Garcia J AD - Hospital Universitario La Pazgrid.81821.32, Madrid, Spain. FAU - Gonzalez, G M AU - Gonzalez GM AD - Universidad Autonoma de Nuevo Leon, Monterrey, Mexico. FAU - Govender, N P AU - Govender NP AUID- ORCID: 0000-0001-7869-9462 AD - National Institute for Communicable Diseases, a Division of the National Health Laboratory Service and Faculty of Health Sciences University of Witwatersrand, Johannesburg, South Africa. FAU - Guegan, H AU - Guegan H AD - Univ Rennes, CHU, Inserm, Irset (Institut de Recherche en Sante, Environnement et Travail)-UMR_S 1085, Rennes, France. FAU - Guinea, J AU - Guinea J AUID- ORCID: 0000-0002-7901-8355 AD - Servicio de Microbiologia Clinica y Enfermedades Infecciosas-VIH, Hospital General Universitario Gregorio Maranon and Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain. FAU - Houze, S AU - Houze S AD - Universite de Paris, UMR 261 MERIT, IRD, Service de Parasitologie, AP-HP, Hopital Bichat, Paris, France. FAU - Lass-Florl, C AU - Lass-Florl C AUID- ORCID: 0000-0002-2946-7785 AD - Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria. FAU - Pelaez, T AU - Pelaez T AD - Hospital Universitario Central de Asturias, Fundacion para la Investigacion Biosanitaria del Principado de Asturias, Oviedo, Spain. FAU - Forastiero, A AU - Forastiero A AD - Servicio de Micologia, Laboratorio de Microbiologia, Hospital Britanico, Buenos Aires, Argentina. FAU - Lackner, M AU - Lackner M AD - Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria. FAU - Magobo, R AU - Magobo R AD - National Institute for Communicable Diseases, a Division of the National Health Laboratory Service and Faculty of Health Sciences University of Witwatersrand, Johannesburg, South Africa. LA - eng PT - Journal Article DEP - 20210809 PL - United States TA - Antimicrob Agents Chemother JT - Antimicrobial agents and chemotherapy JID - 0315061 RN - 0 (Antifungal Agents) RN - 0 (Triazoles) RN - 7XU7A7DROE (Amphotericin B) RN - F0XDI6ZL63 (Caspofungin) RN - Clavispora lusitaniae RN - Kluyveromyces marxianus RN - Meyerozyma guilliermondii RN - Pichia kudriavzevii SB - IM MH - *Amphotericin B/pharmacology MH - Antifungal Agents/pharmacology MH - Aspergillus MH - *Candida MH - Caspofungin MH - Disk Diffusion Antimicrobial Tests MH - Drug Resistance, Fungal MH - Kluyveromyces MH - Microbial Sensitivity Tests MH - Pichia MH - Saccharomycetales MH - Triazoles/pharmacology PMC - PMC8522771 OTO - NOTNLM OT - Aspergillus spp. OT - Candida OT - ECOFFS OT - ECVs OT - ERG11 mutants OT - amphotericin B OT - antifungal resistance OT - caspofungin OT - nonprevalent Candida OT - triazoles EDAT- 2021/08/10 06:00 MHDA- 2021/11/03 06:00 PMCR- 2022/04/18 CRDT- 2021/08/09 17:15 PHST- 2021/08/10 06:00 [pubmed] PHST- 2021/11/03 06:00 [medline] PHST- 2021/08/09 17:15 [entrez] PHST- 2022/04/18 00:00 [pmc-release] AID - 01093-21 [pii] AID - aac.01093-21 [pii] AID - 10.1128/AAC.01093-21 [doi] PST - ppublish SO - Antimicrob Agents Chemother. 2021 Oct 18;65(11):e0109321. doi: 10.1128/AAC.01093-21. Epub 2021 Aug 9.