棘白菌素类药物和念珠菌属的野生型 MIC 分布和流行病学折点值
Wild-type MIC distributions and epidemiological cutoff values for the echinocandins and Candida spp.
机构信息
Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
出版信息
J Clin Microbiol. 2010 Jan;48(1):52-6. doi: 10.1128/JCM.01590-09. Epub 2009 Nov 18.
We tested a global collection of Candida sp. strains against anidulafungin, caspofungin, and micafungin, using CLSI M27-A3 broth microdilution (BMD) methods, in order to define wild-type (WT) populations and epidemiological cutoff values (ECVs). From 2003 to 2007, 8,271 isolates of Candida spp. (4,283 C. albicans, 1,236 C. glabrata, 1,238 C. parapsilosis, 996 C. tropicalis, 270 C. krusei, 99 C. lusitaniae, 88 C. guilliermondii, and 61 C. kefyr isolates) were obtained from over 100 centers worldwide. The modal MICs (in microg/ml) for anidulafungin, caspofungin, and micafungin, respectively, for each species were as follows: C. albicans, 0.03, 0.03, 0.015; C. glabrata, 0.06, 0.03, 0.015; C. tropicalis, 0.03, 0.03, 0.015; C. kefyr, 0.06, 0.015, 0.06; C. krusei, 0.03, 0.06, 0.06; C. lusitaniae, 0.05, 0.25, 0.12; C. parapsilosis, 2, 0.25, 1; and C. guilliermondii, 2, 0.5. 05. The ECVs, expressed in microg/ml (percentage of isolates that had MICs that were less than or equal to the ECV is shown in parentheses) for anidulafungin, caspofungin, and micafungin, respectively, were as follows: 0.12 (99.7%), 0.12 (99.8%), and 0.03 (97.7%) for C. albicans; 0.25 (99.4%), 0.12 (98.5%), and 0.03 (98.2%) for C. glabrata; 0.12 (98.9%), 0.12 (99.4%), and 0.12 (99.1%) for C. tropicalis; 0.25(100%), 0.03 (100%), and 0.12 (100%) for C. kefyr; 0.12 (99.3%), 0.25 (96.3%), and 0.12 (97.8%) for C. krusei; 2 (100%), 0.5 (98.0%), and 0.5 (99.0%) for C. lusitaniae; 4 (100%), 1 (98.6%), and 4 (100%) for C. parapsilosis; 16 (100%), 4 (95.5%), and 4 (98.9%) for C. guilliermondii. These WT MIC distributions and ECVs will be useful in surveillance for emerging reduced echinocandin susceptibility among Candida spp. and for determining the importance of various FKS1 or other mutations.
我们使用 CLSI M27-A3 肉汤微量稀释（BMD）方法对来自全球 100 多个中心的 8271 株念珠菌属菌株（4283 株白念珠菌、1236 株光滑念珠菌、1238 株近平滑念珠菌、996 株热带念珠菌、270 株克柔念珠菌、99 株葡萄牙念珠菌、88 株季也蒙念珠菌和 61 株假热带念珠菌）进行了安尼拉fungin、卡泊芬净和米卡芬净的测试，以确定野生型（WT）种群和流行病学截止值（ECV）。从 2003 年到 2007 年，8271 株念珠菌属菌株（4283 株白念珠菌、1236 株光滑念珠菌、1238 株近平滑念珠菌、996 株热带念珠菌、270 株克柔念珠菌、99 株葡萄牙念珠菌、88 株季也蒙念珠菌和 61 株假热带念珠菌）来自全球 100 多个中心。各物种分别为安尼拉fungin、卡泊芬净和米卡芬净的模式 MIC（μg/ml）如下：白念珠菌，0.03、0.03、0.015；光滑念珠菌，0.06、0.03、0.015；热带念珠菌，0.03、0.03、0.015；假热带念珠菌，0.06、0.015、0.06；克柔念珠菌，0.03、0.06、0.06；葡萄牙念珠菌，0.05、0.25、0.12；近平滑念珠菌，2、0.25、1；季也蒙念珠菌，2、0.5、0.05。安尼拉fungin、卡泊芬净和米卡芬净的 ECVs（以μg/ml 表示（MICs 等于或小于 ECV 的分离株百分比显示在括号中））分别为：白念珠菌，0.12（99.7%）、0.12（99.8%）和 0.03（97.7%）；光滑念珠菌，0.25（99.4%）、0.12（98.5%）和 0.03（98.2%）；热带念珠菌，0.12（98.9%）、0.12（99.4%）和 0.12（99.1%）；假热带念珠菌，0.25（100%）、0.03（100%）和 0.12（100%）；克柔念珠菌，0.12（99.3%）、0.25（96.3%）和 0.12（97.8%）；葡萄牙念珠菌，2（100%）、0.5（98.0%）和 0.5（99.0%）；近平滑念珠菌，4（100%）、1（98.6%）和 4（100%）；季也蒙念珠菌，16（100%）、4（95.5%）和 4（98.9%）。这些 WT MIC 分布和 ECVs 将有助于监测念珠菌属中新兴的棘白菌素敏感性降低，并确定 FKS1 或其他突变的重要性。
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