Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/90025
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Type: Journal article
Title: Multicenter evaluation of MIC distributions for epidemiologic cutoff value definition to detect amphotericin B, posaconazole, and itraconazole resistance among the most clinically relevant species of Mucorales
Author: Espinel-Ingroff, A.
Chakrabarti, A.
Chowdhary, A.
Cordoba, S.
Dannaoui, E.
Dufresne, P.
Fothergill, A.
Ghannoum, M.
Gonzalez, G.
Guarro, J.
Kidd, S.
Lass-Flörl, C.
Meis, J.
Pelaez, T.
Tortorano, A.
Turnidge, J.
Citation: Antimicrobial Agents and Chemotherapy, 2015; 59(3):1745-1750
Publisher: American Society for Microbiology
Issue Date: 2015
ISSN: 0066-4804
1098-6596
Statement of
Responsibility: 
A. Espinel-Ingroff, A. Chakrabarti, A. Chowdhary, S. Cordoba, E. Dannaoui, P. Dufresne, A. Fothergill, M. Ghannoum, G. M. Gonzalez, J. Guarro, S. Kidd, C. Lass-Flörl, J. F. Meis, T. Pelaez, A. M. Tortorano and J. Turnidge
Abstract: Clinical breakpoints (CBPs) have not been established for the Mucorales and any antifungal agent. In lieu of CBPs, epidemiologic cutoff values (ECVs) are proposed for amphotericin B, posaconazole, and itraconazole and four Mucorales species. Wild-type (WT) MIC distributions (organisms in a species-drug combination with no detectable acquired resistance mechanisms) were defined with available pooled CLSI MICs from 14 laboratories (Argentina, Australia, Canada, Europe, India, Mexico, and the United States) as follows: 10 Apophysomyces variabilis, 32 Cunninghamella bertholletiae, 136 Lichtheimia corymbifera, 10 Mucor indicus, 123 M. circinelloides, 19 M. ramosissimus, 349 Rhizopus arrhizus, 146 R. microsporus, 33 Rhizomucor pusillus, and 36 Syncephalastrum racemosum isolates. CLSI broth microdilution MICs were aggregated for the analyses. ECVs comprising ≥95% and ≥97.5% of the modeled populations were as follows: amphotericin B ECVs for L. corymbifera were 1 and 2 μg/ml, those for M. circinelloides were 1 and 2 μg/ml, those for R. arrhizus were 2 and 4 μg/ml, and those for R. microsporus were 2 and 2 μg/ml, respectively; posaconazole ECVs for L. corymbifera were 1 and 2, those for M. circinelloides were 4 and 4, those for R. arrhizus were 1 and 2, and those for R. microsporus were 1 and 2, respectively; both itraconazole ECVs for R. arrhizus were 2 μg/ml. ECVs may aid in detecting emerging resistance or isolates with reduced susceptibility (non-WT MICs) to the agents evaluated.
Keywords: Humans
Mucorales
Mucormycosis
Amphotericin B
Triazoles
Itraconazole
Antifungal Agents
Microbial Sensitivity Tests
Drug Resistance, Multiple, Fungal
Rights: © 2015 by the American Society for Microbiology.
DOI: 10.1128/AAC.04435-14
Published version: http://dx.doi.org/10.1128/aac.04435-14
Appears in Collections:Aurora harvest 2
Microbiology and Immunology publications

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