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Comparison of Three Statistical Methods for Establishing Tentative Wild-Type Population and Epidemiological Cutoff Values for Echinocandins, Amphotericin B, Flucytosine, and Six Ca...
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| Zeitschriftentitel: | Journal of Clinical Microbiology |
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| Personen und Körperschaften: | , , , , , , , , , , , , , , |
| In: | Journal of Clinical Microbiology, 50, 2012, 12, S. 3921-3926 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
American Society for Microbiology
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| Schlagwörter: |
| Zusammenfassung: | <jats:title>ABSTRACT</jats:title> <jats:p> The Sensititre YeastOne (SYO) method is a widely used method to determine the susceptibility of <jats:named-content content-type="genus-species">Candida</jats:named-content> spp. to antifungal agents. CLSI clinical breakpoints (CBP) have been reported for antifungals, but not using this method. In the absence of CBP, epidemiological cutoff values (ECVs) are useful to separate wild-type (WT) isolates (those without mechanisms of resistance) from non-WT isolates (those that can harbor some resistance mechanisms), which is the goal of any susceptibility test. The ECVs for five agents, obtained using the MIC distributions determined by the SYO test, were calculated and contrasted with those for three statistical methods and the MIC <jats:sub>50</jats:sub> and modal MIC, both plus 2-fold dilutions. The median ECVs (in mg/liter) (% of isolates inhibited by MICs equal to or less than the ECV; number of isolates tested) of the five methods for anidulafungin, micafungin, caspofungin, amphotericin B, and flucytosine, respectively, were as follows: 0.25 (98.5%; 656), 0.06 (95.1%; 659), 0.25 (98.7%; 747), 2 (100%; 923), and 1 (98.5%; 915) for <jats:named-content content-type="genus-species">Candida albicans</jats:named-content> ; 8 (100%; 352), 4 (99.2%; 392), 2 (99.2%; 480), 1 (99.8%; 603), and 0.5 (97.9%; 635) for <jats:named-content content-type="genus-species">C. parapsilosis</jats:named-content> ; 1 (99.2%; 123), 0.12 (99.2%; 121), 0.25 (99.2%; 138), 2 (100%; 171), and 0.5 (97.2%; 175) for <jats:named-content content-type="genus-species">C. tropicalis</jats:named-content> ; 0.12 (96.6%; 174), 0.06 (96%; 176), 0.25 (98.4%; 188), 2 (100%; 209), and 0.25 (97.6%; 208) for <jats:named-content content-type="genus-species">C. glabrata</jats:named-content> ; 0.25 (97%; 33), 0.5 (93.9%; 33), 1 (91.9%; 37), 4 (100%; 51), and 32 (100%; 53) for <jats:named-content content-type="genus-species">C. krusei</jats:named-content> ; and 4 (100%; 33), 2 (100%; 33), 2 (100%; 54), 1 (100%; 90), and 0.25 (93.4%; 91) for <jats:named-content content-type="genus-species">C. orthopsilosis</jats:named-content> . The three statistical methods gave similar ECVs (within one dilution) and included ≥95% of isolates. These tentative ECVs would be useful for monitoring the emergence of isolates with reduced susceptibility by use of the SYO method. </jats:p> |
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| Umfang: | 3921-3926 |
| ISSN: |
0095-1137
1098-660X |
| DOI: | 10.1128/jcm.01730-12 |